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      Evaluation of the TrueBeam machine performance check (MPC) beam constancy checks for flattened and flattening filter‐free (FFF) photon beams

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          Abstract

          Machine Performance Check ( MPC) is an automated and integrated image‐based tool for verification of beam and geometric performance of the TrueBeam linac. The aims of the study were to evaluate the MPC beam performance tests against current daily quality assurance ( QA) methods, to compare MPC performance against more accurate monthly QA tests and to test the sensitivity of MPC to changes in beam performance. The MPC beam constancy checks test the beam output, uniformity, and beam center against the user defined baseline. MPC was run daily over a period of 5 months (n = 115) in parallel with the Daily QA3 device. Additionally, IC Profiler, in‐house EPID tests, and ion chamber measurements were performed biweekly and results presented in a form directly comparable to MPC. The sensitivity of MPC was investigated using controlled adjustments of output, beam angle, and beam position steering. Over the period, MPC output agreed with ion chamber to within 0.6%. For an output adjustment of 1.2%, MPC was found to agree with ion chamber to within 0.17%. MPC beam center was found to agree with the in‐house EPID method within 0.1 mm. A focal spot position adjustment of 0.4 mm (at isocenter) was measured with MPC beam center to within 0.01 mm. An average systematic offset of 0.5% was measured in the MPC uniformity and agreement of MPC uniformity with symmetry measurements was found to be within 0.9% for all beams. MPC uniformity detected a change in beam symmetry of 1.5% to within 0.3% and 0.9% of IC Profiler for flattened and FFF beams, respectively.

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          Task Group 142 report: quality assurance of medical accelerators.

          The task group (TG) for quality assurance of medical accelerators was constituted by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance and Outcome Improvement Subcommittee. The task group (TG-142) had two main charges. First to update, as needed, recommendations of Table II of the AAPM TG-40 report on quality assurance and second, to add recommendations for asymmetric jaws, multileaf collimation (MLC), and dynamic/virtual wedges. The TG accomplished the update to TG-40, specifying new test and tolerances, and has added recommendations for not only the new ancillary delivery technologies but also for imaging devices that are part of the linear accelerator. The imaging devices include x-ray imaging, photon portal imaging, and cone-beam CT. The TG report was designed to account for the types of treatments delivered with the particular machine. For example, machines that are used for radiosurgery treatments or intensity-modulated radiotherapy (IMRT) require different tests and/or tolerances. There are specific recommendations for MLC quality assurance for machines performing IMRT. The report also gives recommendations as to action levels for the physicists to implement particular actions, whether they are inspection, scheduled action, or immediate and corrective action. The report is geared to be flexible for the physicist to customize the QA program depending on clinical utility. There are specific tables according to daily, monthly, and annual reviews, along with unique tables for wedge systems, MLC, and imaging checks. The report also gives specific recommendations regarding setup of a QA program by the physicist in regards to building a QA team, establishing procedures, training of personnel, documentation, and end-to-end system checks. The tabulated items of this report have been considerably expanded as compared with the original TG-40 report and the recommended tolerances accommodate differences in the intended use of the machine functionality (non-IMRT, IMRT, and stereotactic delivery).
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            The use of an aSi-based EPID for routine absolute dosimetric pre-treatment verification of dynamic IMRT fields.

            In parallel with the increased use of intensity modulated radiation treatment (IMRT) fields in radiation therapy, flat panel amorphous silicon (aSi) detectors are becoming the standard for online portal imaging at the linear accelerator. In order to minimise the workload related to the quality assurance of the IMRT fields, we have explored the possibility of using a commercially available aSi portal imager for absolute dosimetric verification of the delivery of dynamic IMRT fields. We investigated the basic dosimetric characteristics of an aSi portal imager (aS500, Varian Medical Systems), using an acquisition mode especially developed for portal dose (PD) integration during delivery of a-static or dynamic-radiation field. Secondly, the dose calculation algorithm of a commercially available treatment planning system (Cadplan, Varian Medical Systems) was modified to allow prediction of the PD image, i.e. to compare the intended fluence distribution with the fluence distribution as actually delivered by the dynamic multileaf collimator. Absolute rather than relative dose prediction was applied. The PD image prediction was compared to the corresponding acquisition for several clinical IMRT fields by means of the gamma evaluation method. The acquisition mode is accurate in integrating all PD over a wide range of monitor units, provided detector saturation is avoided. Although the dose deposition behaviour in the portal image detector is not equivalent to the dose to water measurements, it is reproducible and self-consistent, lending itself to quality assurance measurements. Gamma evaluations of the predicted versus measured PD distribution were within the pre-defined acceptance criteria for all clinical IMRT fields, i.e. allowing a dose difference of 3% of the local field dose in combination with a distance to agreement of 3 mm.
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              Dosimetric properties of an amorphous silicon electronic portal imaging device for verification of dynamic intensity modulated radiation therapy.

              Dosimetric properties of an amorphous silicon electronic portal imaging device (EPID) for verification of dynamic intensity modulated radiation therapy (IMRT) delivery were investigated. The EPID was utilized with continuous frame-averaging during the beam delivery. Properties studied included effect of buildup, dose linearity, field size response, sampling of rapid multileaf collimator (MLC) leaf speeds, response to dose-rate fluctuations, memory effect, and reproducibility. The dependence of response on EPID calibration and a dead time in image frame acquisition occurring every 64 frames were measured. EPID measurements were also compared to ion chamber and film for open and wedged static fields and IMRT fields. The EPID was linear with dose and dose rate, and response to MLC leaf speeds up to 2.5 cm s(-1) was found to be linear. A field size dependent response of up to 5% relative to dmax ion-chamber measurement was found. Reproducibility was within 0.8% (1 standard deviation) for an IMRT delivery recorded at intervals over a period of one month. The dead time in frame acquisition resulted in errors in the EPID that increased with leaf speed and were over 20% for a 1 cm leaf gap moving at 1.0 cm s(-1). The EPID measurements were also found to depend on the input beam profile utilized for EPID flood-field calibration. The EPID shows promise as a device for verification of IMRT, the major limitation currently being due to dead-time in frame acquisition.
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                Author and article information

                Contributors
                Michael.barnes@calvarymater.org.au
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                30 November 2016
                January 2017
                : 18
                : 1 ( doiID: 10.1002/acm2.2017.18.issue-1 )
                : 139-150
                Affiliations
                [ 1 ] Department of Radiation Oncology Calvary Mater Hospital Newcastle NSW Australia
                [ 2 ] School of Medical Radiation Sciences University of Newcastle Newcastle NSW Australia
                [ 3 ] School of Mathematical and Physical Sciences University of Newcastle Newcastle NSW Australia
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Michael P Barnes

                E‐mail: Michael.barnes@ 123456calvarymater.org.au ;

                Telephone: (+612) 401 43636;

                Fax: (+612) 401 43 169.

                Article
                ACM212016
                10.1002/acm2.12016
                5689878
                28291921
                a167e2b7-a999-4511-b4ed-72c20794543e
                © 2016 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 August 2016
                : 27 October 2016
                Page count
                Figures: 8, Tables: 6, Pages: 12, Words: 9121
                Categories
                87.55.Qr
                Radiation Oncology Physics
                Radiation Oncology Physics
                Custom metadata
                2.0
                acm212016
                January 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.5 mode:remove_FC converted:16.11.2017

                linac quality assurance,machine performance check (mpc)

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