ATC Credentialing Requirments

Credentialing Requirements for ATC-Supported Protocols

3DCRT Protocols

A Facility Questionnaire describing institutional personnel, equipment, and treatment techniques must be downloaded from the ATC web site and submitted to the Image-guided Therapy QA Center (ITC).

Image-guided Therapy Center
Attn: Roxana Haynes
4511 Forest Park Ave., Suite 200
St. Louis, MO 63108
E-mail: itc@wustl.edu
Phone: 314-747-5415
FAX: 314-747-5423

Dry Run (Benchmark) Test: The Dry Run test is simply a test of digital data submission capabilities. The treatment planning system to be used to plan patients on the study should be used for this digital data submission test. The test may use data for a patient or phantom that has received the same modality (3DCRT) for which you are attempting to become credentialed. Please contact the ITC (itc@castor.wustl.edu) to request an SFTP account for digital data submission, if you do not have one already. For further information, see Dry Run Guidelines per protocol at http://atc.wustl.edu/protocols/.

IMRT Protocols

Image-guided Therapy Center
Attn: Roxana Haynes
4511 Forest Park Ave., Suite 200
St. Louis, MO 63108
E-mail: itc@castor.wustl.edu
Phone: 314-747-5415
FAX: 314-747-5423

Dry Run (Benchmark) Test: The Dry Run test for IMRT protocols is simply a test of digital data submission capabilities. The treatment planning system to be used to plan patients on the study should be used for this digital data submission test. The test may use data for a patient or phantom that has received the same modality (IMRT) for which you are attempting to become credentialed. If you have performed a phantom experiment, the submission of the phantom treatment planning data to the ITC may suffice as your dry run test. Please contact Bill Straube at the ITC to determine if your phantom submission is sufficient for a test of digital data submission. The first protocol case you submit will be reviewed by the study chair(s) in a timely fashion and feedback concerning the review will be communicated to your institution. (Study chair approval may be requresd prior to treatment, see protocol.) We ask that no subsequent patients be registered on the study by your institution until you have received this feedback. If there are major problems with the first case, the second case may be subject to a timely review as well. Please contact the ITC (itc@castor.wustl.edu) to request an SFTP account for digital data submission, if you do not have one already. For further information, see Dry Run Guidelines per protocol at http://atc.wustl.edu/protocols/.

Phantom Dosimetry Test: A TLD/Film dosimetry - treatment plan verification phantom experiment must be conducted. Contact the Radiological Physics Center (http://rpc.mdanderson.org/rpc/) to arrange to receive a phantom. The phantom is to be scanned and treated according to RPC instructions. Phantoms (including TLDs and films) are to be returned to the RPC. The corresponding treatment planning data set is to be submitted to the ITC.

Permanent-Seed Brachytherapy Protocols (TIPPB)

1.	Credentialing for this protocol is through the RPC. Facility questionnaires and knowledge assessment forms as well as other credentialing instructions can be found on the RPC website (http://rpc.mdanderson.org/rpc/).
2.	Dry Run (Benchmark) Test: Contact the Image-guided Therapy Center (itc@castor.wustl.edu) to request an SFTP account for digital data submission. A complete patient data set as specified by the treatment protocol must be submitted to the ITC to demonstrate compliance with 3D technical requirements. This dry run will be reviewed by the RPC.

Stereotactic Body Radiation Therapy Protocols (SBRT)

Image-guided Therapy Center
Attn: Roxana Haynes
4511 Forest Park Ave., Suite 200
St. Louis, MO 63108
E-mail: itc@castor.wustl.edu
Phone: 314-747-5415
FAX: 314-747-5423

Dry Run (Benchmark) Test: Contact the ITC (itc@castor.wustl.edu) and request an SFTP account for digital data submission. A complete patient data set as specified by the treatment protocol must be submitted to the ITC to demonstrate compliance with 3D technical requirements (see Dry Run Guidelines at http://atc.wustl.edu/protocols/).

Immobilization/Localization and Respiration Control Systems Test: A patient imaging study must be carried out to document the setup reproducibility for their choice of immobilization and/or localization equipment. Respiration control is another important part of this study, and all measurements carried out for this portion of the credentialing process must be gathered in such a way that the institution's method of respiration control is evaluated at the same time. That is, the images used for determining setup reproducibility must be obtained under the conditions that will be used for actual patient treatment for this protocol. (See procedure for this test at http://atc.wustl.edu/protocols/ .)

Highly-Conformal Radiation Therapy Protocols

Image-guided Therapy Center
Attn: Roxana Haynes
4511 Forest Park Ave., Suite 200
St. Louis, MO 63108
E-mail: itc@castor.wustl.edu
Phone: 314-747-5415
FAX: 314-747-5423

The Facility Questionnaire requires institutional and/or peer-reviewed documentation of accountability for internal organ motion, including compensation for respiratory movement by one of the following methods:

Inhibition of diaphragmatic movement by abdominal compression or equivalent;
Active breath holding techniques synchronized to radiation delivery;
Respiratory gating monitoring consistent breathing patterns synchronized to radiation delivery;
Dynamic tumor tracking with collimator or machine movement synchronized to radiation delivery.