PMID- 33410254
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 22
IP  - 1
DP  - 2021 Jan
TI  - An electronic portal image device (EPID)-based multiplatform rapid daily LINAC QA 
      tool.
PG  - 45-58
LID - 10.1002/acm2.13055 [doi]
AB  - PURPOSE: To develop an efficient and economic daily quality research tool (DQRT) 
      for daily check of multiplatform linear accelerators (LINACs) with flattening 
      filter (FF) and flattening filter-free (FFF) photon beams by using an Electronic 
      Portal Image Device (EPID). MATERIALS AND METHODS: After EPID calibration, the 
      monitored parameters were analyzed from a 10 cm x 10 cm open and 60 degrees  wedge portal 
      images measured by the EPID with 100 MU exposure. Next, the repeatability of the 
      EPID position accuracy, long-term stability, and linearity between image gray 
      value and exposure were verified. Output and beam quality stability of the 6-MV 
      FF and FFF beams measured by DQRT with the introduced setup errors of EPID were 
      also surveyed. Besides, some test results obtained by DQRT were compared with 
      those measured by FC65-G and Matrixx. At last, the tool was evaluated on three 
      LINACs (Synergy, VersaHD, TrueBeam) for 2 months with two popular commercial QA 
      tools as references. RESULTS: There are no differences between repeatability 
      tests for all monitored parameters. Image grayscale values obtained by EPID and 
      exposure show good linearity. Either 6 MV FF or FFF photon beam shows minimal 
      impact to the results. The differences between FC65-G, Matrixx and DQRT results 
      are negligible. Monitor results of the two commercial tools are consistent with 
      the DQRT results collected during the 2-month period. CONCLUSION: With a shorter 
      time and procedure, the DQRT is useful to daily QA works of LINACs, producing a 
      QA result quality similarly to or more better than the traditional tools and 
      giving richer contents to the QA results. For hospitals with limited QA time 
      window available or lack of funding to purchase commercial QA tools, the proposed 
      DQRT can provide an alternative and economic approach to accomplish the task of 
      daily QA for LINACs.
CI  - (c) 2021 The Authors. Journal of Applied Clinical Medical Physics published by 
      Wiley Periodicals, Inc. on behalf of American Association of Physicists in 
      Medicine.
FAU - Ma, Yangguang
AU  - Ma Y
AD  - Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Wang, Xuemin
AU  - Wang X
AD  - Department of Radiotherapy Hospital Unit Radiation Therapy, Shaanxi Provincial 
      Tumor Hospital, Xi'an, China.
FAU - Mai, Rizhen
AU  - Mai R
AD  - Department of Medical Equipment, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Wang, Tao
AU  - Wang T
AD  - Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Pei, Yuntong
AU  - Pei Y
AD  - Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Liu, Shuaipeng
AU  - Liu S
AD  - Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
FAU - Guo, Yuexin
AU  - Guo Y
AD  - Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, China.
LA  - eng
GR  - 182102310369/HeNan Provincial Science and Technology Department Research Project/
GR  - 2018A007/Shaanxi Provincial Health Funding Project/
GR  - 201602035/Henan Provincial Medical Science and Technology Research Project/
GR  - HDRS20200101110/China International Medical Foundation/
PT  - Journal Article
DEP - 20210107
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
SB  - IM
MH  - Calibration
MH  - *Electronics
MH  - Humans
MH  - *Particle Accelerators
MH  - Radiometry
PMC - PMC7856503
OTO - NOTNLM
OT  - electronic portal image device
OT  - quality assurance
OT  - quick daily check
COIS- The authors report no conflict of interest. The authors alone are responsible for 
      the content and writing of the paper.
EDAT- 2021/01/08 06:00
MHDA- 2021/06/22 06:00
PMCR- 2021/01/07
CRDT- 2021/01/07 06:17
PHST- 2020/10/07 00:00 [received]
PHST- 2020/08/07 00:00 [revised]
PHST- 2020/09/11 00:00 [accepted]
PHST- 2021/01/08 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2021/01/07 06:17 [entrez]
PHST- 2021/01/07 00:00 [pmc-release]
AID - ACM213055 [pii]
AID - 10.1002/acm2.13055 [doi]
PST - ppublish
SO  - J Appl Clin Med Phys. 2021 Jan;22(1):45-58. doi: 10.1002/acm2.13055. Epub 2021 
      Jan 7.