Peter Greer, PhD

Preventing Errors

Peter Greer, PhD, and his team at Calvary Mater Newcastle Hospital and the University of Newcastle, Australia have developed the WatchDog system that monitors dose delivery in real-time for radiation therapy patients and can prevent errors. The system uses imaging equipment that is present on all linear accelerators and could have a major impact on radiation oncology safety and accuracy.

With the grant from ROI, Dr. Greer and his team:

• Implemented and tested the WatchDog system, which uses images captured by EPID to determine treatment delivery accuracy in real-time. 
• Performed real-time patient treatment verification.
• Acquired real-time patient verification data at multiple institutions. Optimized the system for error detection.

Additional Research

Since the completion of the ROI grant:

• The National Health and Medical Research Council (Australian Government) awarded Dr. Greer $593,742 (AUD, approximately $450,000 USD) over three years for continued testing of the WatchDog system. 
• Testing of the WatchDog system has continued and expanded to Memorial Sloan Kettering Cancer Center, NY, USA, University of Manitoba, Winnipeg, Canada, Royal North Shore Hospital, Sydney, Australia and Calvary Mater Newcastle, Newcastle, Australia.
• Development of a new version that will be able to be used clinically is underway.

Publications and Presentations

• WatchDog: A Feasibility Study to Monitor Respiratory Motion for Liver/Lung Cancer Patients presented at the 2018 American Association of Physicists in Medicine (AAPM) meeting. 
• Investigation of a real-time EPID-based patient dose monitoring safety system using site-specific control limits was published in Radiation Oncology on August 12, 2016. 
• TH-CD-207A-11: Sensitivity Analysis of Action Limits for Real-Time EPID-Based Delivery Verification System Using Artificial Clinical Relevant Error Simulations presented at the 2016 American Association of Physicists in Medicine (AAPM) meeting.
• TU-D-BRC-02: Free Information-EPID-Based In Vivo Dosimetry invited presentation at the 2016 AAPM meeting.
• OC-0361: Simulation of clinical relevance errors detected by real-time EPID-based patient verification system presented at ESTRO 35. 
• EPID Dosimetry: pre-treatment verification, clinical trial credentialling and real-time patient dose monitoring presented at the 2015 Engineering and Physical Sciences in Medicine meeting in Wellington, New Zealand.
• First experience with real-time EPID based delivery verification during IMRT and VMAT treatments was published in the November 1, 2015 issue of the Red Journal.
• A cine-EPID based method for jaw detection and quality assurance for tracking jaw in IMRT/VMAT treatments was published in the February 2015 issue of Physica Medica.