title: A Novel Method for Quality Assurance of the Cyberknife Iris Variable Aperture Collimator.
abstract: OBJECTIVE
  To characterize a novel method for field-size quality assurance of a variable approximately circular aperture collimator by means of dose-area product measurements and to validate its practical use over two years of clinical application.
  
  
  METHODS
  To assess methodical limitations, we analyze measurement errors due to change in linac output, beam tuning, uncertainty in MU delivery, daily factors, inherent uncertainty of the large-area parallel-plate ionisation chamber, and misalignment of the large-area parallel-plate ionisation chamber relative to the primary beam axis. To establish a baseline for quality assurance, the dose-area product is measured with the large-area parallel-plate ionisation chamber for all 12 clinical iris apertures in relation to the 60 mm fixed reference aperture. To evaluate the long-term stability of the Iris collimation system, deviation from baseline data is assessed monthly and compared to a priori derived tolerance levels.
  
  
  RESULTS
  Only chamber misalignment, variation in output, and uncertainty in MU delivery contribute to a combined error that is estimated at 0.2 % of the nominal field size. This is equivalent to a resolution of 0.005 mm for the 5 mm, and 0.012 mm for the 60 mm field. The method offers ease of use, small measurement time commitment, and is independent of most error sources. Over the observed period, the Iris accuray is within the tolerance levels.
  
  
  CONCLUSIONS
  The method is an advantageous alternative to film quality assurance with a high reliability, short measurement time, and superior accuracy in field-size determination.
authors.affiliation: Medical Physicist, European Cyberknife Center Munich.
authors.forename: Sarah-Charlotta
authors.initials: SC
authors.lastname: Heidorn
authors.affiliation: Medical Physicist, European Cyberknife Center Munich.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kremer
authors.affiliation: Chief Medical Physicist, European Cyberknife Center Munich.
authors.forename: Christoph
authors.initials: C
authors.lastname: Fürweger
keywords: cyberknife; field-size determination; iris; large-area parallel-plate ionisation chamber; quality assurance; variable circular aperture collimator