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Automated Patient Safety Management and Quality Control in Radiation Therapy
Automated Patient Safety Management and Quality Control in Radiation Therapy
Automated Patient Safety Management and Quality Control in Radiation Therapy

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자료유형  
 학위논문 서양
최종처리일시  
20250211151319
ISBN  
9798382331805
DDC  
574.191
저자명  
Charters, John Austin.
서명/저자  
Automated Patient Safety Management and Quality Control in Radiation Therapy
발행사항  
[Sl] : University of California, Los Angeles, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
128 p
주기사항  
Source: Dissertations Abstracts International, Volume: 85-11, Section: B.
주기사항  
Advisor: Lamb, James Michael.
학위논문주기  
Thesis (Ph.D.)--University of California, Los Angeles, 2024.
초록/해제  
요약The research aims presented in this dissertation are centered on broad themes of improving automation and error detection in radiation oncology. The first aim was to create a stereoscopic radiographic generator for the ExacTrac image-guidance system. Our methodology enables medical physicists to compute geometric parameters for ray tracing based on values contained in ExacTrac configuration logs. Rigid registrations to ground-truth radiographs were performed using medical imaging software, and the results demonstrated sub-millimeter accuracy.The second aim was to create deep-learning models to automatically detect off-by-one vertebral body misalignments with on-board planar imaging. Thoracic and abdominal radiotherapy plans were retrieved from our clinical servers using the DICOM networking protocol. Pairs of digital and treatment radiographs were organized according to beam energy and orientation. Realistic off-by-one misalignments were systematically produced. Convolutional neural networks were trained to classify whether such radiographic pairs are aligned or misaligned. Given a desired 95% model specificity, the orthogonal kilovoltage model achieved a sensitivity of 99%. The models established an independent review process for setup error incidents over large retrospective datasets, which are nearly impossible to review by hand. Of particular emphasis, an instance of a previously unnoticed off-by-one setup error at our institution was found.The third aim was to create automated algorithms to evaluate the quality of prostate radiotherapy treatment plans. Quality metrics included number of days to plan approval, target margins, presence of fiducial markers, and prescribed radiation dose. The automated measurements were compared with values determined manually in clinical software, and high accuracy was obtained. Furthermore, deep-learning models for auto-contouring prostate bed target volumes were created. Refined models were developed using a novel data-driven approach to separate contours based on anterior and posterior convexity. Quality outliers were flagged for retrospective human review. Among the cases reviewed, a previously unnoticed mistake was identified, where a prostate patient treated at our institution was overexposed by 2 Gy. The automated algorithms were applied on treatment plans from our institution and from hospitals in the greater community, which allowed us to assess the existing range of standards of care in clinical practice.
일반주제명  
Biophysics
일반주제명  
Medical imaging
일반주제명  
Oncology
키워드  
Automated error detection
키워드  
Automated quality control
키워드  
Image-guided radiation therapy
키워드  
Off-by-one vertebral body misalignments
키워드  
Prostate cancer treatment
키워드  
Radiation oncology
기타저자  
University of California, Los Angeles Physics and Biology in Medicine 009Y
기본자료저록  
Dissertations Abstracts International. 85-11B.
전자적 위치 및 접속  
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MARC

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■040    ▼aMiAaPQ▼cMiAaPQ
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■1001  ▼aCharters,  John  Austin.
■24510▼aAutomated  Patient  Safety  Management  and  Quality  Control  in  Radiation  Therapy
■260    ▼a[Sl]▼bUniversity  of  California,  Los  Angeles▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a128  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  85-11,  Section:  B.
■500    ▼aAdvisor:  Lamb,  James  Michael.
■5021  ▼aThesis  (Ph.D.)--University  of  California,  Los  Angeles,  2024.
■520    ▼aThe  research  aims  presented  in  this  dissertation  are  centered  on  broad  themes  of  improving  automation  and  error  detection  in  radiation  oncology.  The  first  aim  was  to  create  a  stereoscopic  radiographic  generator  for  the  ExacTrac  image-guidance  system.  Our  methodology  enables  medical  physicists  to  compute  geometric  parameters  for  ray  tracing  based  on  values  contained  in  ExacTrac  configuration  logs.  Rigid  registrations  to  ground-truth  radiographs  were  performed  using  medical  imaging  software,  and  the  results  demonstrated  sub-millimeter  accuracy.The  second  aim  was  to  create  deep-learning  models  to  automatically  detect  off-by-one  vertebral  body  misalignments  with  on-board  planar  imaging.  Thoracic  and  abdominal  radiotherapy  plans  were  retrieved  from  our  clinical  servers  using  the  DICOM  networking  protocol.  Pairs  of  digital  and  treatment  radiographs  were  organized  according  to  beam  energy  and  orientation.  Realistic  off-by-one  misalignments  were  systematically  produced.  Convolutional  neural  networks  were  trained  to  classify  whether  such  radiographic  pairs  are  aligned  or  misaligned.  Given  a  desired  95%  model  specificity,  the  orthogonal  kilovoltage  model  achieved  a  sensitivity  of  99%.  The  models  established  an  independent  review  process  for  setup  error  incidents  over  large  retrospective  datasets,  which  are  nearly  impossible  to  review  by  hand.  Of  particular  emphasis,  an  instance  of  a  previously  unnoticed  off-by-one  setup  error  at  our  institution  was  found.The  third  aim  was  to  create  automated  algorithms  to  evaluate  the  quality  of  prostate  radiotherapy  treatment  plans.  Quality  metrics  included  number  of  days  to  plan  approval,  target  margins,  presence  of  fiducial  markers,  and  prescribed  radiation  dose.  The  automated  measurements  were  compared  with  values  determined  manually  in  clinical  software,  and  high  accuracy  was  obtained.  Furthermore,  deep-learning  models  for  auto-contouring  prostate  bed  target  volumes  were  created.  Refined  models  were  developed  using  a  novel  data-driven  approach  to  separate  contours  based  on  anterior  and  posterior  convexity.  Quality  outliers  were  flagged  for  retrospective  human  review.  Among  the  cases  reviewed,  a  previously  unnoticed  mistake  was  identified,  where  a  prostate  patient  treated  at  our  institution  was  overexposed  by  2  Gy.  The  automated  algorithms  were  applied  on  treatment  plans  from  our  institution  and  from  hospitals  in  the  greater  community,  which  allowed  us  to  assess  the  existing  range  of  standards  of  care  in  clinical  practice.
■590    ▼aSchool  code:  0031.
■650  4▼aBiophysics
■650  4▼aMedical  imaging
■650  4▼aOncology
■653    ▼aAutomated  error  detection
■653    ▼aAutomated  quality  control
■653    ▼aImage-guided  radiation  therapy
■653    ▼aOff-by-one  vertebral  body  misalignments
■653    ▼aProstate  cancer  treatment
■653    ▼aRadiation  oncology
■690    ▼a0786
■690    ▼a0574
■690    ▼a0800
■690    ▼a0992
■71020▼aUniversity  of  California,  Los  Angeles▼bPhysics  and  Biology  in  Medicine  009Y.
■7730  ▼tDissertations  Abstracts  International▼g85-11B.
■790    ▼a0031
■791    ▼aPh.D.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17161171▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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