Intensity-Modulated Radiation therapy(IMRT) is more advanced than normal radiation therapy.It utilizes computer controlled radiation beam delivery to improve the conformity of dose distribution to the shape of the tumor.The quality assurance of IMRT is the key for a successful treatment.

Objective:To analyze and compare the results and precision of three different methods to measure the surface dose of Intra-operative radiotherapy,and conclude some experience of clinical application in Intra- operative radiotherapy.Methods:The study compared the results of measurement surface dose in phantom through three ways:cylindrical ionization chamber with 3D water scanner,plane-parallel ionization chamber,and MOSFET detector.Results:the measurement results of plane-parallel-chamber and MOSFET detector have a better consistency,and the maximum deviation is -1.13%.The method with cylindrical ionization chamber and 3D water scanner has larger deviation compare to the other two methods,the deviation range from-5.55%to 4.55%.Conclusion:The methods of plane-parallel chamber and MOSFET detector to measure the surface dose of Intra-operative radiotherapy can obtain accurate results.

The similarity and difference between stationary and mobile electronic linear accelerators in intra-operative radiation therapy are introduced. The contents and methods of quality assurance for stationary and mobile electronic linear accelerators and the key points to deliver intra-operative radiation therapy are described.

The application of KV, MV real-time digital images and 3D reconstructed radiography in quality assurance of radiotherapy, provides effective means to verify the beam center and therapeutic range, calibrate the positioning accuracy and inspect the characteristics of radiotherapy equipment and radiation physics, greatly improves the quality and accuracy of radiotherapy.
Quality Assurance, Health Care ; methods ; Radiographic Image Enhancement ; Radiotherapy ; methods

OBJECTIVETo investigate the impact of metal implants with different materials on radiation dose distribution based on film measurement method.

METHODSTitanium plate, titanium intramedullary pin and stainless steel plate were set into phantom and irradiated separately by 6 MV and 15 MV X ray from linear accelerator. Dose distributions derived from different materials metal implants were measured and analyzed by film dosimeter.

RESULTSFor 6 MV X ray, the maximum interface dose increments of titanium plate, titanium intramedullary pin and stainless steel plate were 12.3%, 15.4% and 20.3%. As the radiation energy was increased from 6 MV to 15MV, the maximum interface dose increment of the titanium plate rose from 12.3% to 15.1%, the maximum interface dose increment of the steel plate rose from 20.3% to 30.8%.

CONCLUSIONSMetal implants with different materials have obvious impact on radiation dose distribution. With the increase of the metal atomic number and energy of radiation, the degree of elevated dose also increases. These results suggest that correction of dose distribution is required for radiotherapy of patients with metal implants.

The strategies and methods of the total quality management (TQM) need to applied in quality management of radiation therapy. We should improve the level of quality control and quality assurance in radiation therapy. By establishing quality control system in radiation therapy, standardization of radiation therapy workflow, strengthening quality control of devices and physical technique and paying attention to safety protection and staff training.
Quality Assurance, Health Care ; organization & administration ; Quality Control ; Radiotherapy ; Total Quality Management

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".
Engineering ; Equipment Safety ; Equipment and Supplies, Hospital ; Humans ; Maintenance and Engineering, Hospital ; Safety Management ; organization & administration

Objective To investigate the impact of metal implants with different materials on radiation dose distribution based on film measurement method. Methods Titanium plate, titanium intramedul ary pin and stainless steel plate were set into phantom and irradiated separately by 6 MV and 15 MV X ray from linear accelerator. Dose distributions derived from different materials metal implants were measured and analyzed by film dosimeter. Results For 6 MV X ray, the maximum interface dose increments of titanium plate, titanium intramedul ary pin and stainless steel plate were 12.3%, 15.4%and 20.3%. As the radiation energy was increased from 6 MV to 15MV, the maximum interface dose increment of the titanium plate rose from 12.3% to 15.1%, the maximum interface dose increment of the steel plate rose from 20.3% to 30.8%. Conclusions Metal implants with different materials have obvious impact on radiation dose distribution. With the increase of the metal atomic number and energy of radiation, the degree of elevated dose also increases. These results suggest that correction of dose distribution is required for radiotherapy of patients with metal implants.

Taking Endoscopy in hospitals as the research object, study on the safety risk characteristics in digital integration environment. On the basis of risk analysis, risk prevention and control measures are proposed from personnel, equipment, water and electricity, disinfection and the surrounding environment. Establish the endoscope safety risk management safeguard system to improve the safety risk management level of endoscopy.

In terms of service management in the medical equipment field, Medical Equipment after-sale Service Satisfaction Evaluation System is established through expert consultation and sample experiment. Meanwhile, questionnaire survey has been applied to local service satisfaction survey work among equipment managements and clinical departments in seventy second and third grade hospitals in Shanghai in ten consecutive years. The result indicates that the satisfaction index has been growing slightly and stably, which clearly demonstrates that the evaluation has continually boosted the service work of various mainstream suppliers. And overall, the evaluation has played an active role in safeguarding and motivating the safety and effectiveness of medical equipment.