Guideline on Acceptance Test and Commissioning of High-Precision External Radiation Therapy Equipment

Abstract

The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.

Initial experience with an electron FLASH research extension (FLEX) for the Clinac system

“…Immediately after the FLEX conversion of the linac to operate with 16 MeV eFLASH, a radiation survey was conducted to ensure safety. Next, acceptance tests and additional dosimetric characterization of the 16 MeV eFLASH beam were conducted based on the guiding principles for conventional radiotherapy 18–20 …”

“…Next, acceptance tests and additional dosimetric characterization of the 16 MeV eFLASH beam were conducted based on the guiding principles for conventional radiotherapy. 18 , 19 , 20 …”

Método de dosimetria de aceleradores lineares com medidas ponto a ponto e sistema automatizado 3D

“…De acordo com o ICRU (1), para radioterapia com uso de alta tecnologia, como a de intensidade modulada (IMRT -Intensity-modulated Radiation Therapy), a utilização de dosimetria computacional e imagens 3D é essencial. A distribuição de dose complexa e as características da liberação de dose na IMRT aumentaram a importância de medições precisas dos feixes de aceleradores lineares (2). O processo de aquisição desses dados e inserção deles no Sistema de Planejamento de Tratamento (TPS -Treatment Planning System) chama-se comissionamento, e o mais conveniente equipamento para obtenção de tais dados é um sistema automatizado de varredura de campo de radiação 3 .…”