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Related Concept Videos

Quality Control01:05

Quality Control

Quality control is one of the three cyclical quality assurance activities that help keep a system under statistical control. Typical quality control activities include creating quality control charts, conducting proficiency testing, and documenting and archiving results.
Quality control helps track data, visualize trends, and identify variations, making it easier to detect deviations that may affect the accuracy of an analysis. One way to do this is by generating a quality control chart, which...
Quality Assurance01:19

Quality Assurance

Quality assurance is the overarching term used to describe the activities employed to ensure the proper performance of a system. These activities can be classified into three categories: quality control, quality assessment, and internal corrective measures. Typically, these activities work cyclically: quality control is performed before and during the analysis, while quality assessment occurs during and after the investigation. Internal corrective measures are implemented based on the findings...

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Routine kV-CBCT quality assurance in IGRT: Workflow-based comparison of QUART/MaximQA vs Catphan/ARTISCAN.

Karolina Sanocka1, Bartosz Pawałowski1, Ewelina Nowak1

  • 1Department of Medical Physics, Greater Poland Cancer Centre, Poznan, Poland.

Journal of Applied Clinical Medical Physics
|July 16, 2026
PubMed
Summary

The QUART/MaximQA system showed lower noise and higher SNR than Catphan/ARTISCAN for kV-CBCT QA, though both met standards. Absolute values differ due to phantom design, so use institution-specific baselines.

Keywords:
ARTISCANCatphanMaximQAQA phantomQUARTimage qualitykV‐CBCT

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Area of Science:

  • Medical Physics
  • Radiological Imaging
  • Quality Assurance

Background:

  • Image quality in kV-CBCT (kilovoltage cone-beam computed tomography) is crucial for image-guided radiation therapy (IGRT).
  • Standardized QA protocols, such as those recommended by AAPM TG-142 and TG-179, are essential for ensuring consistent performance of IGRT systems.
  • Comparing different QA phantoms and software is necessary to understand their impact on measured metrics.

Purpose of the Study:

  • To compare image-quality metrics obtained from two kV-CBCT QA systems: the QUART phantom with MaximQA software and the Catphan phantom with ARTISCAN software.
  • To evaluate these systems under standard clinical kV-CBCT imaging protocols within a Varian TrueBeam IGRT environment.
  • To assess compliance with AAPM TG-142 and TG-179 QA recommendations.

Main Methods:

  • Acquired QA scans using both QUART and Catphan phantoms across various imaging protocols (image gently, head, thorax, pelvis, pelvis large).
  • Measured key image quality metrics including noise, SNR, uniformity, geometric distortion, HU constancy, and CNR using MaximQA and ARTISCAN.
  • Analyzed data using descriptive statistics and paired t-tests (α=0.01), referencing TG-142/TG-179 tolerances.

Main Results:

  • The QUART/MaximQA system consistently demonstrated significantly lower image noise and higher SNR compared to Catphan/ARTISCAN across most protocols.
  • Both systems exhibited excellent geometric accuracy (distances ~99.6%-100% of nominal).
  • QUART phantom yielded HU values closer to nominal, while Catphan's Solid Water insert showed material-related HU behavior; uniformity differences were minor.

Conclusions:

  • Both QUART/MaximQA and Catphan/ARTISCAN provide reliable kV-CBCT QA metrics, but absolute values are not directly interchangeable due to differences in phantom design, ROI definition, software, and setup.
  • The selection of phantom and software can influence absolute QA measurements.
  • It is recommended to establish institution-specific baselines aligned with TG-142/TG-179 and consider emerging automated kV-CBCT QA solutions.