Stambaugh Cassandra, Yancey Jessica, Shukla Utkarsh, Melhus Christopher, Stambaugh Nathaniel
Radiation Oncology, Tufts Medical Center, Boston, USA.
Mathematics, Dexter Southfield School, Brookline, USA.
Cureus. 2023 Mar 2;15(3):e35695. doi: 10.7759/cureus.35695. eCollection 2023 Mar.
Purpose To investigate time efficiency, applicability, and accuracy of using a web-based, independent quality assurance (QA) platform and vendor-dependent based system check for daily linear accelerator (LINAC) QA. Methods Time needed to perform daily QA on a single (n=1) LINAC was collected for three months. Task Group report 142 (TG-142) compliant daily QA included dosimetry checks (four photon, four electron beams); imaging checks (planar kilovolt (kV) & megavolt (MV), kV cone-beam computed tomography (CBCT)); and mechanical and safety checks using SunCHECK Machine (SCM) (Sun Nuclear Inc., Melbourne, FL, USA). Additionally, Machine Performance Check (MPC) (Varian Medical Systems, Inc., Palo Alto, CA, USA) was performed for all energies. Four trained radiation therapists performed daily QA on both platforms. Data were collected to identify the time required to complete both SCM and MPC. Additionally, the two platforms were evaluated on usability and features. Output results were compared to our monthly standard to assess accuracy. Results On average, SCM took 22 minutes with a standard deviation of six minutes and MPC took 15 minutes with a standard deviation of three minutes. MPC output results were impacted due to the beam output being coupled to the beam profile changes. As a result, the two systems on average disagreed by -1.41% after three months despite being baselined at the same time point and output agreeing well initially (average difference of -0.1% across all energies). While there was overlap in the tests performed, SCM tests were more relevant to TG-142 while MPC tests were beneficial to machine service and, with a clear understanding of the limitations of the system, found suitable as a secondary backup to SCM for daily output verification. Conclusions This work demonstrates that a comprehensive TG-142 daily QA can be designed using SCM and MPC can be added as a beneficial tool and backup for output verification while still maintaining an efficient daily QA process.
目的 研究使用基于网络的独立质量保证（QA）平台以及依赖供应商的系统检查进行每日直线加速器（LINAC）QA的时间效率、适用性和准确性。方法 收集三个月内对一台（n = 1）直线加速器进行每日QA所需的时间。符合任务组报告142（TG - 142）的每日QA包括剂量学检查（四个光子束、四个电子束）；成像检查（平面千伏（kV）和兆伏（MV）、kV锥形束计算机断层扫描（CBCT））；以及使用SunCHECK Machine（SCM，美国佛罗里达州墨尔本的Sun Nuclear公司）进行的机械和安全检查。此外，对所有能量均进行了机器性能检查（MPC，美国加利福尼亚州帕洛阿尔托的Varian Medical Systems公司）。四名经过培训的放射治疗师在两个平台上进行每日QA。收集数据以确定完成SCM和MPC所需的时间。此外，对两个平台的可用性和功能进行了评估。将输出结果与我们的月度标准进行比较以评估准确性。结果 平均而言，SCM耗时22分钟，标准差为6分钟，MPC耗时15分钟，标准差为3分钟。由于束输出与束轮廓变化相关联，MPC的输出结果受到影响。因此，尽管两个系统在同一时间点进行了基线校准且最初输出吻合良好（所有能量的平均差异为 - 0.1%），但三个月后两者平均差异为 - 1.41%。虽然所执行的测试存在重叠，但SCM测试与TG - 142更相关，而MPC测试对机器维护有益，并且在清楚了解系统局限性的情况下，可作为SCM的二级备份用于每日输出验证。结论 这项工作表明，可以使用SCM设计全面的TG - 142每日QA，并且可以添加MPC作为输出验证的有益工具和备份，同时仍能保持高效的每日QA流程。
