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1 R m {!y ` }r Y:845 GLB142 HCL> American Association of Physicists in Medicine Task Group 142 report: Quality assurance of medical accelerators W /9J:L y ` aS q r } r 9J:L U} / 9J:L / 23-A-13 e . , [k , W XR } / 9J:LQ Preface'to'the'Japanese'translation'of'A APM'TG5142'Report'!In!2007!the!Radiation !Therapy!Committee!of!the!American!Assoc iation!of!Physicists!in!Medicine!improve d!the!formulation!and!initiation!of!a!ta sk!group!]

2 On!the!quality!assurance!of!medical!acce lerators,!later!known!as!TGD142.!!The!ch arges!of!this!task!group!were!to!update, !as!needed,!recommendations!from!Table!I I!of!the!AAPM!TGD40!Report!on!quality!as surance,!and!in!addition!recommendations !for!asymmetric!jaws,!multiDcollimation! and!Dynamic/Virtual!Wedges.!!The!composi tion!of!the!task!group!membership!includ ed:!!Eric!Klein,!as!the!chair;!Chihray!L iu;!Chris!Serago;!Joseph!Hanley;!Lijun!M a;!Bijan!Arjomandy;!Sean!Dresser;!Franci sco!Aguirre;!John!Bayouth;!FangDFang!Yin ;!William!Simon,!with!consultants!from!E lekta,!and!

3 Varian.!!This!composition!was!important, !as!all!accelerator!manufacturers!users! were!included,!along!with!both!academic! and!community!hospital!physicists.!!The! task!group!had!a!deadline!of!2009!to!com plete!the!report,!which!was!met!and!subs equent!publication!was!September,!2009!i n!the!Journal!of!Medical!Physics.!!The!t ask!group!(TG)!for!quality!assurance!of! medical!accelerators!was!constituted!by! the!American!Association!of!Physicists!i n!Medicine s!Science!Council,!under!the!direction!o f!the!Radiation!Therapy!Committee!and!th e!Quality!Assurance!and!Outcome!Improvem ent!

4 Subcommittee.!!The!task!group!(TG!#142)! had!two!main!charges.!!First!to!update,! as!needed,!recommendation!of!Table!II!of !the!AAPM!TGD40!Report!on!Quality!Assura nce,!and!second,!to!add!recommendations! for!Asymmetric!Jaws,!Multileaf!Collimati on!(MLC),!and!Dynamic/Virtual!Wedges.!!T he!TG!accomplished!the!update!to!TGD40,! specifying!new!test!and!tolerances,!and! has!added!recommendations!for!not!only!t he!new!ancillary!delivery!technologies,! but!also!for!imaging!devices!that!are!pa rt!of!the!linear!accelerator.!!The!imagi ng!devices!include!xDray!imaging,!photon !portal!imaging,!

5 And!coneDbeam!CT.!!The!TG!report!was!des igned!to!account!for!the!types!of!treatm ents!delivered!with!the!particular!machi ne.!!For!example,!machines!that!are!used !for!radiosurgery!treatments,!or!intensi ty!modulated!radiotherapy!(IMRT)!require !different!tests!and/or!tolerances.!!The re!are!specific!recommendations!for!MLC! quality!assurance!for!machines!performin g!IMRT.!!The!report!also!gives!recommend ations!as!to!action!levels!for!the!physi cists!to!implement!particular!actions,!w hether!they!are!inspection,!scheduled!ac tion,!or!immediate!and!correction!action .!!The!report!

6 Is!geared!to!be!flexible!for!the!physici st!to!customize!the!QA!program!depending !on!clinical!utility.!!There!are!specifi c!tables!according!to!daily,!monthly,!an d!annual!reviews,!along!with!unique!tabl es!for!wedge!systems,!MLC,!and!image!che cks.!!The!report!also!gives!specific!rec ommendations!regarding!setup!of!a!QA!pro gram!by!the!physicist!in!regards!to!buil ding!a!QA!team,!establishing!procedures, !training!of!personnel,!documentation,!a nd!endDtoDend!system!checks.!!The!tabula ted!items!of!this!report!have!been!consi derably!expanded!as!compared!with!the!or iginal!TG!

7 40!report!and!the!recommended!tolerances !accommodate!differences!in!the!intended !use!of!the!machine!functionality!(nonDI MRT,!IMRT,!and!Stereotactic!Delivery).!! The!task!group,!and!effectively!the!AAPM ,!promotes!implementation!of!the!Task!Gr oup!142!recommendations.!!The!Radiologic al!Physics!Center,!which!was!responsible !for!the!beam!parameters!and!delivery!sy stems!that!are!used!to!treat!patients!on !clinical!trials,!quickly!adopted!TG!142 !as!the!standard!for!quality!assurance!f or!radiation!oncology!facilities!partici pating!in!clinical!trials.!!As!accelerat or!technology!

8 Including!imaging!has!accelerated!over!r ecent!years!the!need!to!modernize!qualit y!assurance!programs!is!vital.!!This!alo ng!with!the!fact!that!many!of!the!radiat ion!therapy!accidents!that!have!occurred !could!have!been!avoided!with!a!programm atic,!robust!quality!assurance!program!s uch!as!outlined!TG!142.!!It!is!therefore ,!strongly!encouraged!that!all!societies !internationally!adopt!programs!similar! to!TG!142.!!Though!the!workload!seems!ex cessive,!the!task!group!report!does!poin t!out!that!physicists,!who!should!be!the !charge!person!for!the!technical!quality !assurance!

9 Program!of!the!radiation!oncology!depart ment,!has!the!leeway!to!decide!on!the!fr equency!of!such!testing!depending!on!the !prioritization!of!the!most!important!as pects!of!the!program!where!a!patient!is! going!to!be!harmed!the!most,!along!with! the!dependability!of!the!particular!aspe ct!of!the!accelerator.!!Thank!you,!!!!!! !!Eric!E.!Klein,! !!Professor!of!Medical!Physics!Departmen t!of!Radiation!Oncology!Washington!Unive rsity!School!of!Medicine!in!St.!Louis,!U SA! }r Y :845 GLB142 HCL> r m {!y ` h / !k ( / ! )+IJ ! / *# .u+ p % ij% !

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