**11. Dosimetry in clinical trials**

Clinical trials including the NCTN and industry are the primary vehicles used to validate process improvements in patient care. Quality assurance in clinical trials is important as the process ensures consistency in trial execution and we can trust the outcome of the trial. Physics and dosimetry teams play an important role in the development and execution of clinical trials. Members of the Imaging and Radiation Oncology Core (IROC) will write guidelines and data management strategies into each clinical trial for imaging and radiation oncology. IROC will review clinical trial objects in real time to ensure completeness of the data acquisition process and re-compute patient analytics for target and normal tissue dose in a single platform to harmonize dose to volume for each patient on study. It is only through processes such as this that data can be powered to understand toxicity relative to dose/volume and ensure protocol coverage of tumor targets. Moving forward, large databases housed in a uniform format with planning and outcome imaging will be required to optimize our understanding of tumor contouring and normal tissue metrics. Annotation of these cases can be used for the development of AI programs. Clinical trials remain our primary resource to confirm standards of care and the quality assurance physics and dosimetry teams of IROC serve an important role in the development and standardization of standards. The Cancer Imaging Archive (TCIA) will be an important resource to further enhance our knowledge by associating radiation therapy data with pathomics and radiomics [1–11].
