A beam-matching concept for medical linear accelerators

Acta Oncol 48(2):192-200 (2009) PMID 18752079

The flexibility in radiotherapy can be improved if a patient can be moved between any one of the department's medical linear accelerators without the need to change anything in the patient's treatment plan. For this to be possible, the dosimetric characteristics of the various accelerators must be the same, or nearly the same i.e. the accelerators must be beam-matched. During a period of nine months, eight Varian iX accelerators with 6 and 15 MV photon beams and 6-18 MeV electron beams (only four of the eight) were installed at our clinic. All accelerators fulfilled the vendor-defined "fine beam-match" criteria, and a more extensive set of measurements was carried out during commissioning. The measured absorbed dose data for each accelerator were compared with the first accelerator, chosen as reference, and the TPS calculations. Two of the eight accelerators showed a larger discrepancy for the 15 MV beam not revealed by the vendor-defined acceptance criteria, whereas the other six accelerators were satisfactorily matched. The beam-matching acceptance criteria defined by the vendor are not strict enough to guarantee optimal beam-match. Deviations related to dose calculations and to beam-matched accelerators may add up. The safest and most practical way to ensure that all accelerators are within clinical acceptable accuracy is to include TPS calculations in the evaluation. Further, comparisons between measurements and calculations should be done in absolute dose terms.