Quality Assurance

My brother in law works in the field of radiation oncology, so I talked to him to understand things from his point of view. Basically quality assurance techniques are advancing at a slower rate than treatment technologies. For example, one company's new software allows for delivery of higher doses of radiation in less time, but that company does not offer compatible software to verify that the actual dose matches the expected dose. There is compatible software from another company, but it is extremely expensive. So, what many hospitals and doctors do is resort to older, less accurate quality assurance techniques. A hospital may advertise that they use 'Software X', but that doesn't mean they use "Software X Quality Assurance.' It is very complicated, but this partly explains why some people receive doses higher (and more dangerous) than prescribed.



Also, the radiation dangers reported in the NY Times happened years ago. The machines that failed have these moving leaves that act as shields to prevent the radiation from entering unwanted areas of the body. Often, the people who administered the radiation assumed the machines were working as intended since it was all computer programmed. Because they relied on technology and didn't bother to double check (quality assurance), they failed to see that the leaves were NOT working properly. The excess radiation led to massive damage and death.



http://www.nytimes.com/2010/01/24/health/24radiation.html?pagewanted=2



The solution, the advertisement said, was a linear accelerator with 120 computer-controlled metal leaves, called a multileaf collimator, which could more precisely shape and modulate the radiation beam. (View an interactive graphic demonstrating how multileaf collimators work, and how problems at St. Vincent's caused a fatal overdose.) This treatment is called Intensity Modulated Radiation Therapy, or I.M.R.T. The unit St. Vincent’s had was made by Varian Medical Systems, a leading supplier of radiation equipment.



Check out the interactive graphic!