Fish-tank meetings for quality control

The design of a high-quality proton therapy treatment plan involves many steps, including quality assurance checks. These checks are performed by a multidisciplinary team before, midway during and at the end of treatment planning. They include the critical evaluation of beam characteristics (angle, range, absolute dose), target coverage and the dose delivered to critical organs. Special attention may be directed towards the presence of a tracheal stoma, bone flaps or a drain, at how these may affect the delivered dose distribution and at how their impact can be minimized. Prior to these quality control meetings, a medical physicist has used a checklist to validate overall technical feasibility of the treatment plan.

The multidisciplinary team consists of the attending physician and one or more colleagues with the same tumor specialization, two or more medical physicists and at least two radiotherapy technologists specialized in treatment planning. The meetings are called 'fish-tank meetings' as they take place within a glass enclosure.