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 performance of the MPC geometric tests relevant to OBI/CBCT IGRT geometric accuracy. This included evaluation of the MPC isocenter and couch tests. Evaluation was performed by comparing MPC to QA tests performed routinely in the department over a 4‐month period. The MPC isocenter tests were compared against an in‐house developed Winston–Lutz test and the couch compared against routine mechanical QA type procedures. In all cases the results from the routine QA procedure was presented in a form directly comparable to MPC to allow a like‐to‐like comparison. The sensitivity of MPC was also tested by deliberately miscalibrating the appropriate linac parameter. The MPC isocenter size and MPC kV imager offset were found to agree with Winston–Lutz to within 0.2 mm and 0.22 mm, respectively. The MPC couch tests agreed with routine QA to within 0.12 mm and 0.15°. The MPC isocenter size and kV imager offset parameters were found to be affected by a change in beam focal spot position with the kV imager offset more sensitive. The MPC couch tests were all unaffected by an offset in the couch calibration but the three axes that utilized two point calibrations were sensitive to a miscalibration of the size in the span of the calibration. All MPC tests were unaffected by a deliberate misalignment of the MPC phantom and roll of the order of one degree.

Highlights

  • In external beam radiotherapy the aim is to accurately deliver a prescribed radiation dose to a predefined target volume, while minimizing dose outside the target

  • The most common form of this imageguided radiotherapy (IGRT) is with kiloVoltage imaging systems aligned to the linac isocenter

  • All measurements in this study were performed on a single Varian TrueBeam STx linac fitted with an aS1200 EPID and six degree of freedom couch

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Summary

Introduction

In external beam radiotherapy the aim is to accurately deliver a prescribed radiation dose to a predefined target volume, while minimizing dose outside the target. It is common practice to align and shift patients based upon images of the patient taken from imaging systems. The most common form of this imageguided radiotherapy (IGRT) is with kiloVoltage (kV) imaging systems aligned to the linac isocenter. Such systems can be used as either planar x rays [On-Board-Imager (OBI)] or as Cone-Beam Computed Tomography (CBCT).[1] The correct functioning and accuracy of these systems are paramount for the geometrically accurate delivery of the treatment 2–6 and the required accuracy is increasing as treatment margins are reduced to spare healthy tissue

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