Therapeutic radiation beam output and energy variation across clinics, technologies, and time

Mehran Miron Zaini,¹ Jessica M. Fagerstrom,¹ Edward I. Marshall,¹ Kathryn M. Hedrick,¹ Daniel Zaks,¹ Hung Tran,¹ Trevor M. Fitzgerald^1
1Northwest Medical Physics Center, Lynnwood, WA 

Journal of Applied Clinical Medical Physics (2023).

Over the past several decades, a medical physics service group covering 35 clinical sites has provided routine monthly output and energy quality assurance for over 75 linear accelerators. Based on the geographical spread of these clinics and the large number of physicists involved in data acquisition, a systematic calibration procedure was established to ensure uniformity. A consistent measurement geometry and data collection technique is used across all machines for every calendar month, using a standardized set of acrylic slabs. Charge readings in acrylic phantoms are linked to AAPM’s TG-51 formalism via a parameter denoted k_acrylic, used to convert raw charge readings to machine output values. Statistical analyses of energy ratios and k_acrylic values are presented. Employing the k_acrylic concept with a uniform measurement geometry of similar acrylic blocks was found to be a reproducible and simple way of referencing a calibration completed in water under reference conditions and comparing to other machines, with the ability to alert physicists of outliers.