Purpose: The recent AAPM all-member survey listed 157 physics initial chart checks for photon/electron external beam radiation therapy. It is time-consuming to practice this as initial chart check mostly relies on physicistâ€™s manual inspection. This work shares a review on the initial chart checklist by the physicists in our institution and investigates our current status and future expectation of initial chart check automation.
Methods: Six board-certified physicists with 2-to-20-year clinical experience reviewed the 157 checks. The manual inspection time of each check for a general treatment site was estimated for 3 types of plans (IMRT/VMAT, 3D, and simple-calculation). The manual inspection time was calculated for 3 levels of chart check automation---I)our current practice (using an in-house program to check plan parameters and Mobius3D software for plan quality/delivery), II)advanced (=our practice plus the automation of all potential fully automated targets in the AAPM survey) and III)maximum (which only excludes those checks that were regarded as impossible to be automated in the AAPM survey). The manual check time was also calculated for 131 checks after eliminating some low-user-frequency checks based on our practice.
Results: To complete the 157 physics checks by pure manual inspection, our physicistsâ€™ review shows an average of 153, 130, 102min manual time for IMRT/VMAT, 3D and simple calculation plans, respectively. Relative to the pure manual inspection, our current practice saves 19-40min (19-26%) of manual check time, which can be shortened to 32-47min (157 checks) and 24-35min (131 checks) using advanced automation, and further shortened to 15-23min (157 checks) and 10-14min (131 checks) using maximum automation. Up to 10 tests that were marked as â€œnot manually applicableâ€? by some physicists can be practiced as more automated checks are involved.
Conclusion: The automated initial chart check should be pursued for the potential significant efficiency improvement and more error detection.
Not Applicable / None Entered.