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Australian Clinical Dosimetry Service

About ACDS || Clinical Advisory Group || ACDS Staff || ACDS Audits || References

Scientists undertaking an audit using Linac

About the ACDS

The Australian Clinical Dosimetry Service was officially launched on Friday 4 February 2011.

In 2010, the Australian Health Ministers’ Advisory Council accepted the Commonwealth’s offer to fund the establishment of the Australian Clinical Dosimetry Service to be located within the Australian Radiation Protection and Nuclear Safety Agency, with the service commencing operation at the beginning of 2011. The pilot program operated for three years, with funding extended until the end of 2016. The service operates under a Memorandum of Understanding with the Department of Health.

The ACDS will provide an integrated national approach to promoting safety and quality in radiotherapy, which is expected to lead to further improvements in radiotherapy treatment outcomes. Around 50,000 Australians require radiotherapy for cancer treatment every year. Australia has approximately 80 radiotherapy facilities at which these treatments are delivered, mostly by use of linear accelerators, of which there are approximately 180.

Radiation doses delivered to patients in Australia are checked by teams of medical physicists and radiation therapists employed in the radiotherapy clinics. The Australian Clinical Dosimetry Service will provide these specialists with a source of independent checks for equipment and patient doses.

The result of the new service will mean that recipients of radiotherapy and their families can have even greater confidence that they are receiving the highest standard of treatment.

The Australian Clinical Dosimetry Service will also help to maintain the quality of radiotherapy in Australia, and provide a national approach to radiation measurements, making radiotherapy more consistent across the country and safer for patients.

Getting the dose right

Radiotherapy uses high levels of ionising radiation in order to kill tumour cells. The radiation dose required is high enough to affect normal tissue and in some cases there is a very narrow range of doses that will treat the tumour without causing significant side effects. For this reason, getting the dose right, and making sure it is delivered to the right place, is extremely important for radiotherapy patients. Too little radiation and there is no curative effect; too much radiation, and the risk of serious complications increases rapidly.

Radiation doses delivered to patients in Australia are checked by teams of medical physicists and radiation therapists employed in the radiotherapy clinics. Part of their work is to perform ‘quality assurance’ measurements – output checks and measurements of dose which confirm the radiation delivered to the patient. The treatments prescribed by radiation oncologists and the treatment plans generated by therapists require review and cross-checking.

The Australian Clinical Dosimetry Service will provide these specialists with a source of independent checks for equipment and patient doses. Although independent checks are already being performed, the service will make them readily available and enable a national approach to ensure the quality of all radiotherapy treatments. The service will work with the radiotherapy facilities to prioritise the treatments most in need of independent checks, and to carry these out when required.

The simplest of these measurements is an ‘output check’. This confirms that the linear accelerator is delivering the dose that the control system thinks it is. More complicated checks include measuring the beam profile and the energy of the radiation. The most important and complicated check, however, involves using a ‘dummy’ patient, called a phantom. This phantom is treated in exactly the same way as a real patient. It is imaged, the radiation dose is prescribed, and a computer-generated treatment plan is developed. The phantom is then placed on a treatment table and treated. Inside the phantom, radiation sensitive equipment is used to determine where the radiation was delivered and the dose. In this way, the entire treatment process can be checked.

The Australian Clinical Dosimetry Service is a joint initiative between the Department of Health and the Australian Radiation Protection and Nuclear Safety Agency.

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