TABLE 10.
Annual QA summary.
| Report/Section | Item | Tolerance |
|---|---|---|
| TG 135/ II.A.2 | EPO button | Functional |
|
TG 135/ II.B.3 TG 135.B/7.3 |
TG‐51 or IAEA TRS‐398, including secondary independent check | Adjust calibration if >1% difference is found |
| Beam data checks on at least three field sizes per collimator assembly, including largest and smallest clinically relevant field size, and compared to commissioning data. | ||
|
TPR or PDD constancy Profile constancy |
<2% for FS ≤20 mm, <1% for FS > 20 mm < 2% |
|
| Iris field size (FWHM) |
Preferred: ±0.2 mm Acceptable: ±0.5 mm |
|
| Relative OF |
Preferred: <1% for FS ≥ 10 mm, <2% for FS < 10 mm (< 5% for Iris and when FS < 5 mm) Acceptable: <2% for FS ≥10 mm, <3% for FS < 10 mm (< 5% for Iris and when FS < 5 mm) |
|
| Dose output linearity to the lowest MU used and highest clinical MU | <1% | |
| TG 135.B/3.5.2 | MLC leakage | Max transmission < 0.5% |
| TG 135/ II.C.2 | Imager kVp accuracy, mA station exposure linearity, exposure reproducibility, focal spot size | See Table 1 in AAPM TG 135 for references |
| TG 135/ II.C.3 | Signal to noise ratio, contrast to noise ratio, relative modulation transfer function, imager sensitivity stability, bad pixel count and pattern, uniformity corrected images, detector centering, and imager gain statistics | Compare to baseline |
|
TG 135/ II.D TG 135.B/7.3 |
AAPM TG 53 and MPPG 5.a/5.b as applicable | AAPM TG 53 6 , MPPG 5.a/5.b 7 , 8 |
| CT QA (in addition to monthly tests) | AAPM TG 66 89 | |
| Data security and verification | Functional | |
| TG 135/ III.B.2 | 2nd Order Path Verification (including paths for all available collimators); currently only possible with the help of a service engineer. Beam laser vs. CAX must be checked to be unchanged before path verification |
Preferred: Each node < 0.5 mm, RMS < 0.3 mm Acceptable: RMS < 0.5 mm |
| TG 135/ III.D | Check noise level of optical markers | <0.2 mm |
| TG 135/ IV.C | Run Synchrony E2E test with at least 20° phase shift; analyze penumbra spread | Compare to baseline |
| TG 135/ IV.C | Monthly QA | In addition to tolerances listed above, update all parameters and checklists |
| TG 135/IV.B | Daily QA | Update parameters |
| TG 135.B | Review all Policies & Procedures related to robotic radiosurgery | Update to current clinical practice; all team members read and sign |