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Volume 18, Number 5, 2013

Commissioning and Acceptance Testing of the existing linear accelerator upgraded to volumetric modulated arc therapy

Ekambaram Varadharajan, Velayudham Ramasubramanian


Aim: The RapidArc commissioning and Acceptance Testing program will test and ensure
accuracy in DMLC position, precise dose-rate control during gantry rotation and accurate
control of gantry speed.
Background: Recently, we have upgraded our linear accelerator capable of performing IMRT
which was functional from 2007 with image guided RapidArc facility. The installation of
VMAT in the existing linear accelerator is a tedious process which requires many quality
assurance procedures before the proper commissioning of the facility and these procedures
are discussed in this study.
Materials and methods: Output of the machine at different dose rates was measured to verify
its consistency at different dose rates. Monitor and chamber linearity at different dose rates were checked. DMLC QA comprising of MLC transmission factor measurement and dosimetric leaf gap measurements were performed using 0.13 cm3 and 0.65 cm3 Farmer type ionization chamber, dose 1 dosimeter, and IAEA 30 cm × 30 cm × 30 cm water phantom.
Picket fence test, garden fence test, tests to check leaf positioning accuracy due to carriage movement, calibration of the leaves, leaf speed stability effects due to the acceleration
and deceleration of leaves, accuracy and calibration of leaves in producing complex fields, effects of interleaf friction, etc. were verified using EDR2 therapy films, Vidar scanner, Omnipro accept software, amorphous silicon based electronic portal imaging device and EPIQA software.1–8
Results: All the DMLC related quality assurance tests were performed and evaluated by film
dosimetry, portal dosimetry and EPIQA.7
Conclusion: Results confirmed that the linear accelerator is capable of performing accurate

Signature: Rep Pract Oncol Radiother, 2013; 18(5) : 286-297

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