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A Novel, Highly Efficient and Automated Quality Assurance Tool for Modern Linear Accelerators

S Goddu

S Goddu1*, B Sun1 , S Yaddanapudi1 , G Kamal1 , C Baltes2 , S Rose2 , K Stinson3 , S Mutic1 , (1) Washington University, St. Louis, MO, (2) Varian Medical Systems iLab GmbH, Baden, Dattwil, (3) Varian Medical Systems, Palo Alto, CA


TU-C-BRE-2 Tuesday 10:15AM - 12:15PM Room: Ballroom E

Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. Varian’s Machine Performance Check (MPC) uses IsoCal phantom to test geometric and dosimetric aspects of the TrueBeam systems in <5min. In this study we independently tested the accuracy and robustness of the MPC tools.

Methods: MPC is automated for simultaneous image-acquisition, using kV-and-MV onboard-imagers (EPIDs), while delivering kV-and-MV beams in a set routine of varying gantry, collimator and couch angles. MPC software-tools analyze the images to test: i) beam-output and uniformity, ii) positional accuracy of isocenter, EPIDs, collimating jaws (CJs), MLC leaves and couch and iii) rotational accuracy of gantry, collimator and couch. 6MV-beam dose-output and uniformity were tested using ionization-chamber (IC) and IC-array. Winston-Lutz-Tests (WLT) were performed to measure isocenter-offsets caused by gantry, collimator and couch rotations. Positional accuracy of EPIDs was evaluated using radio-opaque markers of the IsoCal phantom. Furthermore, to test the robustness of the MPC tools we purposefully miscalibrated a non-clinical TrueBeam by introducing errors in beam-output, energy, symmetry, gantry angle, couch translations, CJs and MLC leaves positions.

Results: 6MV-output and uniformity were within ±0.6% for most measurements with a maximum deviation of ±1.0%. Average isocenter-offset caused by gantry and collimator rotations was 0.316±0.011mm agreeing with IsoLock (0.274mm) and WLT (0.41mm). Average rotation-induced couch-shift from MPC was 0.378±0.032mm agreeing with WLT (0.35mm). MV-and-kV imager-offsets measured by MPC were within ±0.15mm. MPC predicted all machine miscalibrations within acceptable clinical tolerance. MPC detected the output miscalibrations within ±0.61% while the MLC and couch positions were within ±0.06mm and ±0.14mm, respectively. Gantry angle miscalibrations were detected within ±0.1°.

Conclusions: MPC is a useful tool for QA of TrueBeam systems and its automation makes it highly efficient for testing both geometric and dosimetric aspects of the machine. This is very important for hypo-fractionated SBRT treatments.

Funding Support, Disclosures, and Conflict of Interest: Received support from Varian Medical Systems, Palo Alto, CA 94304-1038.

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