All-Ireland evaluation of ultrasound systems for prostate brachytherapy: Application specific quality control protocol and quality assurance phantoms

Abstract

Context: The goal of quality assurance (QA) for transrectal ultrasound (TRUS) prostate brachytherapy is to ensure optimum patient outcomes by providing a high-quality service using equipment that is operating at optimum performance levels. There are specific recommendations from professional organisations that outline the QA parameters that need to be considered specifically for ultrasound guided prostate brachytherapy. However, these recommendations are heavily based on the guidance made for the general application of ultrasound to all relevant clinical applications. Additionally, there is a lack of consensus on the optimum QA test device to conduct the schedule of testing for this specific application of TRUS image guided interventional procedures.

Procedures: In this study, we describe a task-specific testing schedule for TRUS QA, detailing the QA test protocol, and the recommended equipment set-up, and scan parameters to evaluate these systems. Also described are the commercially available test devices, as well as custom made devices including the design and acoustic characteristics of the materials used to design the custom devices. This QA test protocol was used to evaluate nine TRUS systems used on the island of Ireland in prostate brachytherapy treatment.

Main findings: The evaluation revealed significant differences among the nine TRUS scanners, highlighting variations in manufacturer pre-sets and their potential limitations in effectively guiding prostate brachytherapy.

Conclusion: This study highlights the urgent need for application specific QA test devices for TRUS systems used to guide prostate brachytherapy, and the need for the optimization of scanning parameters during these procedures.

Keywords: Image Quality; Prostate Brachytherapy; Quality Assurance; Test Phantoms; Transrectal ultrasound (TRUS).