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. 2023 Nov;24(11):e14160.
doi: 10.1002/acm2.14160. Epub 2023 Oct 4.

AAPM Medical Physics Practice Guideline 8.b: Linear accelerator performance tests

Robert F Krauss  1 , Salim Balik  2 , Eileen T Cirino  3 , Austin Hadley  4 , Navneeth Hariharan  3 , Shannon M Holmes  5 , Kayla Kielar  6 , Hossein Lavvafi  7 , Kiernan McCullough  8 , Steven Palefsky  9 , J Phillip Sawyer  10 , Koren Smith  11 , Jason Tracy  12 , Jeff D Winter  13 , Nicholai E Wingreen  14
Affiliations

AAPM Medical Physics Practice Guideline 8.b: Linear accelerator performance tests

Robert F Krauss et al. J Appl Clin Med Phys. 2023 Nov.

Abstract

The purpose of this guideline is to provide a list of critical performance tests to assist the Qualified Medical Physicist (QMP) in establishing and maintaining a safe and effective quality assurance (QA) program. The performance tests on a linear accelerator (linac) should be selected to fit the clinical patterns of use of the accelerator and care should be given to perform tests which are relevant to detecting errors related to the specific use of the accelerator. Current recommendations for linac QA were reviewed to determine any changes required to those tests highlighted by the original report as well as considering new components of the treatment process that have become common since its publication. Recommendations are made on the acquisition of reference data, routine establishment of machine isocenter, basing performance tests on clinical use of the linac, working with vendors to establish QA tests and performing tests after maintenance and upgrades. The recommended tests proposed in this guideline were chosen based on consensus of the guideline's committee after assessing necessary changes from the previous report. The tests are grouped together by class of test (e.g., dosimetry, mechanical, etc.) and clinical parameter tested. Implementation notes are included for each test so that the QMP can understand the overall goal of each test. This guideline will assist the QMP in developing a comprehensive QA program for linacs in the external beam radiation therapy setting. The committee sought to prioritize tests by their implication on quality and patient safety. The QMP is ultimately responsible for implementing appropriate tests. In the spirit of the report from American Association of Physicists in Medicine Task Group 100, individual institutions are encouraged to analyze the risks involved in their own clinical practice and determine which performance tests are relevant in their own radiotherapy clinics.

Keywords: IMRT; MPPG; TG-142; TG-198; VMAT; baseline; commissioning; external beam; guideline; linac; percentage depth dose; primary reference data; profiles; quality assurance.

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Conflict of interest statement

The Chair of Medical Physics Practice Guideline 8.b: Linear accelerator performance tests (TG364) has reviewed the required Conflict of Interest statement on file for each member of TG364 and determined that disclosure of potential Conflicts of Interest is an adequate management plan. Disclosures of potential Conflicts of Interest for each member of TG364 are found at the close of this document.

Members of TG364 listed below attest that they have no potential Conflicts of Interest related to the subject matter or materials presented in this document: Salim Balik, Eileen Cirino, Austin Hadley, Navneeth Hariharan, Chaitanya Kalavagunta, Robert F Krauss, Hossein Lavvafi, Kiernan T McCullough, John P Sawyer, Koren Smith, Jeff D Winter, Binbin Wu, Nicholai Wingreen

Members of TG364 listed below disclose the following potential Conflict(s) of Interest related to subject matter or materials presented in this document: Shannon M Holmes is employed by Standard Imaging, Kayla N. Kielar is employed by Varian Medical Systems, Steven Palefsky is employed by Elekta, Daniel M. Ritt is employed by Radiological Imaging Technology, Jason B. Tracy is employed by Sun Nuclear.

Figures

FIGURE 1
FIGURE 1
Each secondary reference dataset and/or unique device baseline that measures dosimetric parameters must refer back to the Primary Reference Dataset, the treatment planning system (TPS).
See this image and copyright information in PMC

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