Dynamic and omni wedge implementation on an Elekta SL linac

Photon beam commissioning of an Elekta Synergy linear accelerator

The aim of this study is to present the results of commissioning of Elekta Synergy linear accelerator (linac). The acceptance test and commissioning were performed for three photon beams energies 4 MV, 6 MV and 15 MV and for the multileaf collimator (MLC). The percent depth doses (PDDs), in-plane and cross-plane beam profiles, head scatter factors (Sc), relative photon output factors (Scp), universal wedge transmission factor and MLC transmission factors were measured. The size of gantry, collimator, and couch isocenter were also measured.

Commissioning an Elekta Versa HD linear accelerator

The purpose of this study is to report the dosimetric aspects of commissioning performed on an Elekta Versa HD linear accelerator (linac) with high-dose-rate flattening filter-free (FFF) photon modes and electron modes. Acceptance and commissioning was performed on the Elekta Versa HD linac with five photon energies (6 MV, 10 MV, 18 MV, 6 MV FFF, 10 MV FFF), four electron energies (6 MeV, 9MeV, 12 MeV, 15 MeV) and 160-leaf (5 mm wide) multileaf collimators (MLCs). Mechanical and dosimetric data were measured and evaluated. The measurements include percent depth doses (PDDs), in-plane and cross-plane profiles, head scatter factor (Sc), relative photon output factors (Scp), universal wedge transmission factor, MLC transmission factors, and electron cone factors. Gantry, collimator, and couch isocentricity measurements were within 1 mm, 0.7 mm, and 0.7 mm diameter, respectively. The PDDs of 6 MV FFF and 10 MV FFF beams show deeper dmax and steeper falloff with depth than the corresponding flattened beams. While flatness values of 6 MV FFF and 10 MV FFF normalized profiles were expectedly higher than the corresponding flattened beams, the symmetry values were almost identical. The cross-plane penumbra values were higher than the in-plane penumbra values for all the energies. The MLC transmission values were 0.5%, 0.6%, and 0.6% for 6 MV, 10 MV, and 18 MV photon beams, respectively. The electron PDDs, profiles, and cone factors agree well with the literature. The outcome of radiation treatment is directly related to the accuracy in the dose modeled in the treatment planning system, which is based on the commissioned data. Commissioning data provided us a valuable insight into the dosimetric characteristics of the beam. This set of commissioning data can provide comparison data to others performing Versa HD commissioning, thereby improving patient safety.

Task Group 142 report: quality assurance of medical accelerators

The task group (TG) for quality assurance of medical accelerators was constituted by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance and Outcome Improvement Subcommittee. The task group (TG-142) had two main charges. First to update, as needed, recommendations of Table II of the AAPM TG-40 report on quality assurance and second, to add recommendations for asymmetric jaws, multileaf collimation (MLC), and dynamic/virtual wedges. The TG accomplished the update to TG-40, specifying new test and tolerances, and has added recommendations for not only the new ancillary delivery technologies but also for imaging devices that are part of the linear accelerator. The imaging devices include x-ray imaging, photon portal imaging, and cone-beam CT. The TG report was designed to account for the types of treatments delivered with the particular machine. For example, machines that are used for radiosurgery treatments or intensity-modulated radiotherapy (IMRT) require different tests and/or tolerances. There are specific recommendations for MLC quality assurance for machines performing IMRT. The report also gives recommendations as to action levels for the physicists to implement particular actions, whether they are inspection, scheduled action, or immediate and corrective action. The report is geared to be flexible for the physicist to customize the QA program depending on clinical utility. There are specific tables according to daily, monthly, and annual reviews, along with unique tables for wedge systems, MLC, and imaging checks. The report also gives specific recommendations regarding setup of a QA program by the physicist in regards to building a QA team, establishing procedures, training of personnel, documentation, and end-to-end system checks. The tabulated items of this report have been considerably expanded as compared with the original TG-40 report and the recommended tolerances accommodate differences in the intended use of the machine functionality (non-IMRT, IMRT, and stereotactic delivery).

Commissioning of motorized wedge for the first equinox-80 telecobalt unit and implementation in the Eclipse 3D treatment planning system

A new model of the telecobalt unit (TCU), Theratron Equinox-80, (MDS Nordion, Canada) equipped with a single 60 degree motorized wedge (MW), four universal wedges (UW) for 15 degrees, 30 degrees, 45 degrees and 60 degrees have been evaluated. MW was commissioned in Eclipse (Varian, Palo Alto, USA) 3D treatment planning system (TPS). The profiles and central axis depth doses (CADD) were measured with Wellhofer blue water phantom for MW and the measured data was commissioned in Eclipse. These profiles and CADD for MW were compared with UW in a homogeneous phantom generated in Eclipse for various field sizes. The dose was also calculated in the same phantom at 10 cm depth. For the particular MW angle and the respective open and MW beam weights, the dose was measured for a field size of 10 cm x 10 cm in a MEDTEC water phantom at 10 cm depth with a 0.13 cc thimble ion chamber (Scanditronix Wellhofer, Uppsala, Sweden) and a NE electrometer (Nuclear Enterprises, UK). Measured dose with ion chamber was compared with the TPS calculated dose. MW angle verification was also done on the Equinox for four angles (15 degrees, 30 degrees, 45 degrees and 60 degrees). The variation in measured and calculated dose at 10 cm depth was within 2%. The measured and the calculated wedge angles were in good agreement within 2 degrees. The motorized wedges were successfully commissioned in Eclipse for four wedge angles.