title: A comprehensive study of the mechanical performance of gantry, EPID and the MLC assembly in Elekta linacs during gantry rotation.
abstract: OBJECTIVE
  In radiotherapy treatments, it is crucial to monitor the performance of linear accelerator (linac) components, including gantry, collimation system and electronic portal imaging device (EPID) during arc deliveries. In this study, a simple EPID-based measurement method is suggested in conjunction with an algorithm to investigate the stability of these systems at various gantry angles with the aim of evaluating machine-related errors in treatments.
  
  
  METHODS
  The EPID sag, gantry sag, changes in source-to-detector distance (SDD), EPID and collimator skewness, EPID tilt and the sag in leaf bank assembly owing to linac rotation were separately investigated by acquisition of 37 EPID images of a simple phantom with 5 ball bearings at various gantry angles. A fast and robust software package was developed for automated analysis of the image data. Nine Elekta AB (Stockholm, Sweden) linacs of different models and number of years in service were investigated.
  
  
  RESULTS
  The average EPID sag was within 2 mm for all tested linacs. Some machines showed >1-mm gantry sag. Changes in the SDD values were within 1.3 cm. EPID skewness and tilt values were <1° in all machines. The maximum sag in multileaf collimator leaf bank assemblies was around 1 mm. A meaningful correlation was found between the age of the linacs and their mechanical performance. Conclusions and Advances in knowledge: The method and software developed in this study provide a simple tool for effective investigation of the behaviour of Elekta linac components with gantry rotation. Such a comprehensive study has been performed for the first time on Elekta machines.
authors.affiliation: 1 School of Physics, University of Western Australia, Crawley, WA, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Rowshanfarzad
authors.affiliation: 2 Radiofysisk Laboratorium, Odense University Hospital, Odense, Denmark.
authors.forename: H L
authors.initials: HL
authors.lastname: Riis
authors.affiliation: 2 Radiofysisk Laboratorium, Odense University Hospital, Odense, Denmark.
authors.forename: S J
authors.initials: SJ
authors.lastname: Zimmermann
authors.affiliation: 1 School of Physics, University of Western Australia, Crawley, WA, Australia.|3 Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Ebert
mesh_terms: D000367:Age Factors; D000465:Algorithms; D006801:Humans; D010315:Particle Accelerators; D019047:Phantoms, Imaging; D011874:Radiometry / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D061106:Radiotherapy Setup Errors / Q000517:prevention & control; D015203:Reproducibility of Results; D012399:Rotation