1. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Quality Assurance of the Radiation Therapy Process Restoring the Missing Link Jan Pursley, MS Sicel Technologies

2. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Radiation therapy process is like a chain Success depends on the weakest link ! Immobilization Treatment Quality Assurance and Verification Treatment Planning Tumor Localization Patient Positioning Imaging Adapted from Webb S, “Physics of Three Dimensional radiation therapy”, IOP, 1993

3. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Radiation therapy process is like a chain Success depends on the weakest link ! Adapted from Webb S, “Physics of Three Dimensional radiation therapy”, IOP, 1993 Immobilization Treatment Quality Assurance and Verification Treatment Planning Tumor Localization Patient Positioning Imaging x

4. Sicel Technologies ® French Lessons…

5. Sicel Technologies ® French Lessons…

6. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc.

7. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. DVS Reader Implantable Dosimeter DVS ® (Dose Verification System)

8. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Individual Patient QA with Direct Patient Dose Measurement 2 What does ‘good’ look like? 1

9. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. 1 2 What does ‘good’ look like? What does ‘good’ look like? Individual Patient QA with Direct Dose Measurement 7-field IMRT plan designed to avoid prostheses Daily dose variations in patient with bilateral hip prostheses What does ‘not so good’ look like? DVS #2 DVS #1

10. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Individual Patient QA with Direct Dose Measurement What can be done to turn ‘bad’ into ‘good’? DVS #1 DVS #2

11. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Individual Patient QA with Direct Dose Measurement DVS #1 DVS #2 out of slice plane

12. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Individual Patient QA with Direct Dose Measurement

13. Sicel Technologies ® DVS is a product and trademark of Sicel Technologies ®, Inc. Summary As a complement to a radiation therapy QA process, in vivo dosimetry can identify gross errors that occur along the chain Internal dose verification (in situ dosimetry) alerts the physician to subtle errors that can improve therapeutic outcome and decrease morbidity