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Integral Quality Monitoring

What is IQM?

Integral Quality Monitoring (IQM) is an automated “final check” of the intensity and localization of radiation therapy beams. It consists of a dose and location monitor that sits between the radiation source and the patient, verifying delivery independently.

How is treatment verified?

Approximately half of all cancer patients will receive radiation therapy. Advances in radiation delivery have improved cancer therapy, allowing radiation oncology teams to more precisely target radiation to tumours and minimize the damage to neighbouring healthy tissue. But the increased complexity of techniques like intensity modulated radiation therapy come with additional quality assurance needs. The total dose and the targeting, amongst other parameters, have to be carefully controlled to ensure safe and successful cancer treatment.

Radiation clinics perform exhaustive pre-treatment verification procedures to ensure that the correct dose is delivered to the correct part of the correct patient. The International Commission on Radiation Units and Measurements recommends that the dose delivered in treatment be within 5% of the dose prescribed in planning. Because there are many steps involved in the planning and treatment process, each step must be performed with an accuracy of much better than 95% in order for the overall process to have less than a 5% difference from plan. That level of accuracy and accountability necessitates a lengthy quality assurance process. IQM systems can reduce much of the quality assurance load by assessing the accuracy of the “final product” rather than at intermediate steps. In addition, this assessment is performed each time a treatment is delivered, and so patient safety is increased.

How is IQM different?

Many pre-treatment dosimetric verification procedures can be eliminated with IQM. IQM uses a novel radiation dose and location monitor to provide real-time monitoring of treatment beams. Further, the IQM system will detect and help prevent radiation mishaps, including malfunctions of software, equipment controller malfunctions, inaccurate equipment calibration, and human errors (selection of wrong patient or plan). Real-time monitoring will allow immediate notification of therapists if an error is detected.

By increasing quality assurance efficiencies and freeing treatment units from performing QA measurements, more patients can be treated with advanced radiation therapy techniques. The safety factor provided by the IQM system will enable efficient confirmation of hardware and software improvements in support of advanced radiotherapy techniques, and so allow faster implementation of these techniques. This Canadian innovation will contribute to decreasing overall healthcare costs while enhancing patient safety and positive outcomes.