- Title
- Technology assessment and quality improvement in a clinical HDR brachytherapy setting
- Creator
- Dempsey, Claire Louise
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2014
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- High dose rate (HDR) brachytherapy is a form of radiation therapy in which the source of radiation is placed into, or as close as possible to, a cancerous tumour. Brachytherapy was first applied over 100 years ago and has been evolving and refining ever since. Often problems with introduction of new HDR brachytherapy technology and techniques into clinical departments are the lack of published guidelines regarding effective and safe implementation. Instigating change should involve systematic analysis of individual processes to improve patient care; however this can be time and work intensive. It has been shown that quality improvements can be made in a realistic time-frame if quality improvement models are adopted. This research aimed to enhance brachytherapy treatment accuracy and improve patient treatment outcomes by investigating quality improvements made across specific components of HDR brachytherapy in a single radiation oncology department. This was achieved by following the Focus-Analyse-Develop-Execute (FADE) quality improvement model to complete six separate studies covering the spectrum of stages of HDR brachytherapy treatments. These stages were classified as insertion, imaging, planning, equipment, treatment and follow up. Each stage was covered by at least one study that was peer-reviewed and presented as published or submitted works. Study one (planning and equipment) generated a commissioning methodology for brachytherapy treatment planning systems. Study two (planning, equipment and treatment) examined cause and effect of a well ionisation chamber calibration error. Study three (insertion and planning) created a treatment planning optimisation technique for a new treatment applicator. Study four (equipment and treatment) reviewed current international equipment quality assurance guidelines to produce a brachytherapy quality assurance recommendation document for Australasia. Study five (imaging and planning) created a new imaging protocol for magnetic resonance (MR) imaging in brachytherapy treatment planning, and study six (treatment and follow up) analysed changes and trends in dosimetry of patient treatments. Beginning with study one, and finishing with study six, this project successfully introduced improvements to treatment options, patient imaging, treatment planning, quality assurance measures and patient radiation dose distributions, each ultimately improving treatment quality. Breaking a large system into small components, and methodically addressing each, provided a pathway to commence building quality improvements to a treatment modality.
- Subject
- brachytherapy; radiation oncology; cancer; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1055829
- Identifier
- uon:15944
- Rights
- Copyright 2014 Claire Louise Dempsey
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 594 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 7 MB | Adobe Acrobat PDF | View Details Download |