AAPM Medical Physics Practice Guideline 2.a: Commissioning and quality assurance of X‐ray‐based image‐guided radiotherapy systems

Fontenot, Jonas D.; Alkhatib, H; Garrett, Jeffrey A.; Jensen, Andrew R.; McCullough, Steven; Olch, Arthur J.; Parker, Barry; Yang, Chuan; Fairobent, Lynne

doi:10.1120/jacmp.v15i1.4528

Cited by 34 publications

(36 citation statements)

References 12 publications

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“…AAPM TG‐142 and TG‐179 aid in addressing these concerns by recommending a rigid structure of annual, monthly, and daily QA assessments of specific image‐quality parameters for universal imaging systems. More recently, AAPM has published IGRT Medical Physics Practice Guidelines (MPPGs) which are focused on the commissioning and quality assurance of X‐ray based IGRT radiotherapy systems (16) . In this, a concise, but comprehensive review of key minimal practices for QA of an IGRT system is outlined.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the stability of image‐quality parameters of Varian on‐board imaging (OBI) and EPID imaging systems

Stanley

Papanikolaou

Gutiérrez

2015

J Applied Clin Med Phys

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Quality assurance (QA) of the image quality for image‐guided localization systems is crucial to ensure accurate visualization and localization of regions of interest within the patient. In this study, the temporal stability of selected image parameters was assessed and evaluated for kV CBCT mode, planar radiographic k V, and MV modes. The motivation of the study was to better characterize the temporal variability in specific image‐quality parameters. The CATPHAN, QckV‐1, and QC‐3 phantoms were used to evaluate the image‐quality parameters of the imaging systems on a Varian Novalis Tx linear accelerator. The planar radiographic images were analyzed in PIPSpro with high‐contrast spatial resolution false(normalf30,normalf40,normalf50lp/mmfalse) being recorded. For OBI kV CBCT, high‐quality head full‐fan acquisition and pelvis half‐fan acquisition modes were evaluated for uniformity, noise, spatial resolution, HU constancy, and geometric distortion. Dose and X‐ray energy for the OBI were recorded using the Unfors RaySafe Xi system with the R/F High Detector for kV planar radiographic and the CT detector for kV CBCT. Dose for the MV EPID was recorded using a PTW975 Semiflex ion chamber, PTW UNIDOS electrometer, and CNMC Plastic Water. For each image‐quality parameter, values were normalized to the mean, and the normalized standard deviations were recorded to evaluate the parameter's temporal variability. For planar radiographic modes, the normalized standard deviations of the spatial resolution false(normalf30,normalf40,& normalf50false) were 0.015, 0.008, 0.004 lp/mm and 0.006, 0.009, 0.018 lp/mm for the kV and MV, respectively. The normalized standard deviation of dose for kV and MV were 0.010 mGy and 0.005 mGy, respectively. The standard deviations for full‐and half‐fan kV CBCT modes were averaged together. The following normalized standard deviations for each kV CBCT parameter were: 0.075 HU (uniformity), 0.071 HU (noise), 0.006 mm (AP‐geometric distortion), 0.005 mm (LAT‐geometric distortion), 0.058 mm (slice thickness), 0.124 (f50), 0.031 (HU constancy – Lung), 0.063 (HU constancy – Water), 0.020 (HU constancy – Bone), 0.006 mGy (Dose – Center), 0.004 mGy (Dose –Periphery). Using control chart analysis, institutional QA tolerances were reported as warning and action thresholds based on 1σ and 2σ thresholds. A study was performed to characterize the stability of image‐quality parameters recommended by AAPM Task Group‐142 for the Varian OBI and EPID imaging systems. Both imaging systems show consistent imaging and dosimetric properties over the evaluated time frame.PACS number: 87.10.‐e

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Section: Discussionmentioning

confidence: 99%

An evaluation of the stability of image‐quality parameters of Varian on‐board imaging (OBI) and EPID imaging systems

Stanley

Papanikolaou

Gutiérrez

2015

J Applied Clin Med Phys

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“…Evaluation of the imaging performance of the Halcyon closely followed standard practice (as defined in MPPG2a) to establish baseline values, as expected for any medical linear accelerator. However, the imaging dose evaluation revealed some interesting features for Halcyon and its testing is described below.…”

Section: Methodsmentioning

confidence: 99%

“…This study describes the pre-clinical testing of the Halcyon 1.0 (two units, one at each institution), and the subsequent testing of a clinical version of the device at UPENN. The testing is exhaustive and largely based on relevant American Association of Physicists in Medicine (AAPM) and IAEA documents [2][3][4][5][6][7][8][9][10][11] . A large portion of the test results (common to both Halcyon and other linacs) are available via an electronic supplement.…”

Section: Introductionmentioning

confidence: 99%

Experience in commissioning the halcyon linac

Netherton

Gao

et al. 2019

Medical Physics

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Purpose This manuscript describes the experience of two institutions in commissioning the new HalcyonTM platform. Its purpose is to: (a) validate the pre‐defined beam data, (b) compare relevant commissioning data acquired independently by two separate institutions, and (c) report on any significant differences in commissioning between the Halcyon linear accelerator and other medical linear accelerators. Methods Extensive beam measurements, testing of mechanical and imaging systems, including the multi‐leaf collimator (MLC), were performed at the two institutions independently. The results were compared with published recommendations as well. When changes in standard practice were necessitated by the design of the new system, the efficacy of such changes was evaluated as compared to published approaches (guidelines or vendor documentation). Results Given the proper choice of detectors, good agreement was found between the respective experimental data and the treatment planning system calculations, and between independent measurements by the two institutions. MLC testing, MV imaging, and mechanical system showed unique characteristics that are different from the traditional C‐arm linacs. Although the same methodologies and physics equipment can generally be used for commissioning the Halcyon, some adaptation of previous practices and development of new methods were also necessary. Conclusions We have shown that the vendor pre‐loaded data agree well with the independent measured ones during the commission process. This verifies that a data validation instead of a full‐data commissioning process may be a more efficient approach for the Halcyon. Measurement results could be used as a reference for future Halcyon users.

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“…The scope of this guideline does not include tests for on‐board imaging equipment. Imaging tests are essential in a linac QA program and they are addressed in previous reports …”

Section: Goals and Rationalementioning

confidence: 99%

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

Smith

Balter

Duhon³

et al. 2017

J Applied Clin Med Phys

Self Cite

129

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PurposeThe purpose of this guideline is to provide a list of critical performance tests in order 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.MethodsA risk assessment was performed on tests from current task group reports on linac QA to highlight those tests that are most effective at maintaining safety and quality for the patient. Recommendations are made on the acquisition of reference or baseline data, the establishment of machine isocenter on a routine basis, basing performance tests on clinical use of the linac, working with vendors to establish QA tests and performing tests after maintenance.ResultsThe recommended tests proposed in this guideline were chosen based on the results from the risk analysis and the consensus of the guideline's committee. 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.ConclusionThis 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.

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AAPM Medical Physics Practice Guideline 2.a: Commissioning and quality assurance of X‐ray‐based image‐guided radiotherapy systems

Cited by 34 publications

References 12 publications

An evaluation of the stability of image‐quality parameters of Varian on‐board imaging (OBI) and EPID imaging systems

An evaluation of the stability of image‐quality parameters of Varian on‐board imaging (OBI) and EPID imaging systems

Experience in commissioning the halcyon linac

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

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