Quality assurance for image‐guided radiation therapy utilizing CT‐based technologies: A report of the AAPM TG‐179

TLDR

The report aims to provide consensus quality‑assurance recommendations for CT‑based image‑guided radiotherapy systems to ensure patient safety and treatment fidelity. The authors review clinical implementation and QA of kilovolt and megavolt cone‑beam CT, fan‑beam MVCT, and CT‑on‑rails systems, summarizing literature and long‑term QC data to propose test frequencies and tolerances. The report presents a vendor‑independent QA program for CT‑based IGRT systems, emphasizing geometry, image quality, dose, operation, and safety, and aligns with AAPM TG‑101, TG‑104, TG‑142, and TG‑148.

Abstract

Purpose: Commercial CT‐based image‐guided radiotherapy (IGRT) systems allow widespread management of geometric variations in patient setup and internal organ motion. This document provides consensus recommendations for quality assurance protocols that ensure patient safety and patient treatment fidelity for such systems. Methods: The AAPM TG‐179 reviews clinical implementation and quality assurance aspects for commercially available CT‐based IGRT, each with their unique capabilities and underlying physics. The systems described are kilovolt and megavolt cone‐beam CT, fan‐beam MVCT, and CT‐on‐rails. A summary of the literature describing current clinical usage is also provided. Results: This report proposes a generic quality assurance program for CT‐based IGRT systems in an effort to provide a vendor‐independent program for clinical users. Published data from long‐term, repeated quality control tests form the basis of the proposed test frequencies and tolerances. Conclusion: A program for quality control of CT‐based image‐guidance systems has been produced, with focus on geometry, image quality, image dose, system operation, and safety. Agreement and clarification with respect to reports from the AAPM TG‐101, TG‐104, TG‐142, and TG‐148 has been addressed.