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Evaluation of Elekta Agility multi-leaf collimator performance using statistical process control tools.

Sandra M Meyers1,2, Michael J Balderson1, Daniel Létourneau1,3

  • 1Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Ontario, Canada.

Journal of Applied Clinical Medical Physics
|June 15, 2019
PubMed
Summary
This summary is machine-generated.

Elekta Agility multi-leaf collimator (MLC) leaf positioning demonstrates high stability with an automated quality control (QC) test. This daily QC supports monthly MLC testing with a 1 mm tolerance, identifying servicing and beam spot motion as causes of variation.

Keywords:
SBRT treatment deliverycontrol chartsmulti-leaf collimatorquality controlstatistical process control

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Quality Assurance

Background:

  • Accurate positioning of the multi-leaf collimator (MLC) is critical for precise radiation delivery in cancer therapy.
  • Routine quality control (QC) is essential to ensure the consistent performance of MLC systems.
  • The Elekta Agility MLC is a widely used component in modern linear accelerators.

Purpose of the Study:

  • To assess the performance and stability of Elekta Agility MLC leaf positioning.
  • To implement and evaluate a daily, automated QC test using megavoltage (MV) images and statistical process control (SPC).
  • To identify specific causes of variations in MLC leaf positioning.

Main Methods:

  • Collected daily leaf position data from 13 Elekta linear accelerators over 11-37 months.
  • Utilized an automated QC test analyzing 23 MV images to determine leaf positions relative to the radiation isocenter.
  • Assessed stability using individual and moving range control charts with specification levels of ±0.5, ±1, and ±1.5 mm.

Main Results:

  • The Elekta Agility MLC exhibited high stability, with mean leaf position error of -0.01 mm.
  • Data consistently remained within ±1 mm specification for an average of 457 days and within ±1.5 mm for the entire period.
  • Sporadic out-of-control events, linked to servicing, beam spot motion, and image artifacts, resulted in a mean in-control duration of 2.8 days.

Conclusions:

  • The Elekta Agility MLC demonstrates robust performance and high stability, supporting current QC recommendations.
  • The study validates the efficacy of daily automated QC testing with a ±1 mm tolerance for MLC leaf positioning.
  • Future research will explore optimizing recalibration frequency based on high-frequency QC test results.