Key Features

Mechanical

• Jaw Position & Light Field Coincidence
• Light Field vs Radiation Field Coincidence
• ODI Verification
• Table / Couch Angles
• MLC Leaf Position Accuracy
• Picket Fence

Output

• Photons & Electrons
• Typical Dose Rate Output Constancy
• Dynamic Wedge Constancy
• Energy Constancy
• Flatness & Symmetry (Profile Constancy)
  
  

MV EPID, kV Planar Imaging

• Scaling
• Spatial Resolution 
• Contrast
• Noise
• Uniformity

CBCT Imaging

• HU Constancy & Contrast Visibility
• Geometric Distortion
• Spatial Resolution
• Low Contrast Resolution
• Noise
• Uniformity

Full Description

Purpose

Audience

• Clinical Physicists responsible for multiple machines at one site, or many sites
• RO Networks seeking data-driven hardware and process monitoring to achieve standardization
• LINAC manufacturers seeking a standardized and efficient solution for TG-142 implementation
• Research  & Education organizations

Constancy Verification vs. Calibration

• Has my system deviated since last baseline calibration? To what extent?
• Where are deviations occurring for hardware, software, processes?
• Are these deviations acceptable within the scope of AAPM TG-142 as well as our internal clinical procedures?
• How is the system at Site A performing in comparison to the system at Site B, C, D, etc?

Implementation

1. CALIBRATE. You perform full commissioning, end-to-end, and routine calibrations for your entire delivery system in accordance with your existing clinical procedures and manufacturer's recommendations. Ideally, your system is functioning at optimal performance.
2. DEFINE. Use the TG-142 phantom and demo workflow provided by IMT to create your first site-specific workflow, taking pictures of your hardware, setup, and phantom. Establish the Visual Verification Protocol  (Section 1 of the Demo Workflow below). Acquire CBCT, kV, MV images needed for IMT to configure your iQA TG-142 Installation Package, image capture and DICOM transfer workflow. This is performed in accordance with IMT 2-20-20-029 iQA Pre-Installation Instructions.
3. BASELINE REVIEW. IMT will provide a live demo link and PDF report of your first baseline results. IMT will review the workflow and baseline iQA results with you to establish your workflow as iQA Protocols, in preparation for installation at your clinic.
4. INSTALL. IMT will work with you and your IT department to perform the iQA installation at your clinic.

FAQ

• Q - What's included with the IMT TG-142 Check Phantom Package?
• A - Our standard package includes: TG-142 Check Phantom, Electron Insert, Precision Bubble Level, Ion Chamber Adapter, & iQA. Additional inserts, adapters, and software licenses are available.

• Q - Can the TG-142 Check Phantom be used without iQA? Can we use our own in-house image analysis solution?
• A - Yes. The TG-142 Check Phantom provides a comprehensive range of features which physicists can utilize for manual analysis or with their own software.

• Q - I already have many tools to perform TG-142 QA. Why is this solution beneficial to my organization?
• A - This is a comprehensive solution requiring one phantom and ion chamber. Entry into and out of the vault is minimized. Additional Phantoms and software licenses can be added to expand with your organization's goals and requirements. 

• Q - I have a Developer/API license from my LINAC manufacturer. Can this be utilized to further automate routines and analysis?
• A - Yes. We would be happy to assist you and your LINAC manufacturer in achieving this solution. This solution is ideal for clinics with multiple similar machines, and networks with multiple sites. In this regard, most - if not all - Key Process Indicators could integrated into Daily QA routines to provide daily monitoring against your TG-142 Baseline data in minutes instead of hours.
  
  
• Q - Can the iQA Protocols be utilized in different languages?
• A - Yes. A sample workflow can be found here.

Demo Workflow

1. Perform visual verifications. A sample workflow of these items can be found in steps 1-25 of IMT's TG-142 Demo Protocol. 
   • CAX, SSD
   • Laser & Alignment Systems Verification
   • Gantry & Collimator Indicators and Shifts
   • Table / Couch Angles
   • Light Field Sizes
   • ODI Indication
2.  Capture CBCT, kV, MV Images (where applicable). A sample workflow of these items can be found in steps 26-35 of IMT's TG-142 Demo Protocol.
   • Scaling
   • Spatial Resolution
   • Low Contrast Resolution
   • Contrast
   • Noise
   • Uniformity
3. Acquire dosimetry readings for photons and electrons with your chamber or detector. A sample workflow of these items can be found in steps 36-43 of IMT's TG-142 Demo Protocol.
   • Typical Dose Rate Output Constancy
   • Energy Constancy
   • Profile Constancy
4. Send images to iQA. Input visual verification and manual data collection items to iQA.