PurposeThe purpose of this study is to characterize the positional accuracy of the multileaf collimator (MLC) using an ionization chamber array and develop an MLC quality assurance (QA) method. MethodsHalf of the volume for each ionization chamber located at the lower layer of the device was occluded by a specific leaf using the half-beam block (HBB) method, and the corresponding ionization chamber response was used as a baseline for the subsequent MLC QA study. The sensitivity of the method was assessed by introducing known leaf positional errors, varying from 0.5 to 2.5 mm in 0.5 mm increments in the positive and negative directions, into the baseline. The relative outputs of the detectors were linearly corrected according to the leaf position error recorded. The relationship between detector response variation relative to the baseline and the introduced leaf error was determined by function. The usefulness of the MLC QA technique developed in this study was verified weekly over 5 months. ResultsDuring the development of the algorithm, the maximum leaf absolute random position error was 0.3 mm. A strong linear relationship was observed between the relative output of the detector and the MLC positional error introduced, and the slope and coefficient of determination were −0.05159 and 0.99928, respectively. The mean MLC positional accuracy across all leaves for the error field and HBB baseline field over the 5-month assessment was 0.0649 ± 0.1340 mm and 0.0002± 0.0835 mm, respectively. ConclusionsThe automated MLC QA procedure we proposed has proven to be effective and robust, and satisfies the American Association of Physicists in Medicine (AAPM) Task Group Report 198 guideline criteria of ± 1 mm.