SU-F-T-495: Method for Simultaneous Commissioning of Multiple Truebeam (TB) Linacs: Small Field Data and the Choice of Dosimetric Lead Gap (DLG).

PURPOSE: Many times a set of multiple Varian-Truebeam (TB) linacs are acquired by an institution. Since "beam matching" is an important requirement for many facilities, we developed a strategy to perform a "simultaneous" commissioning between multiple linacs.

METHODS AND MATERIALS: We first commissioned the required photon beam data for eclipse on the 1st TB for all the energy modalities with a beam scanning system, while integrated measurements for output factors, of all field sizes (from 1×1 to 40×40cm(2) ) were conducted on the 2nd TB. Care was exercised during small field dosimetry so the appropriate detectors were used with data taken between two detectors be "linked" to a larger field size (4×4cm(2) ) with the "daisy-chaining" technique via: OF=[M-PTW(fs)×(M-PTW(4×4))-1]×[MA12s(4×4)×(M-A12S(10×10))-1]. For all energy modalities, data that span the entire range of field size, was repeated on the next TB linac, for verification. The primarily energy-dependent dosimetric leaf gap (DLG) which was measured separately on each TB. The modeled data was validated with special measurements conducted on both linacs during commissioning.

RESULTS: Our data agreed with the "TB representative beam data" to within 0.5% for all energy modalities and field sizes ≥3×3cm2. Sample depth-doses and cross-profiles of a 3×3cm2 between the linacs agreeing to within 1% between linacs. The measured DLGs were quite different with a uniform difference of 1.3% between the two linacs. The measured DLG values are independent of the average dose rate and medium used for the measurements.

CONCLUSION: A comprehensive method of commissioning identical Varian-TB linacs, outlining the critical issues, especially small field dosimetry and DLG. The dosimetric effect of different DLG values, when it comes to, dynamic delivery and data comparisons will be presented. The dependence of DLG value on the measurement medium (in-air vs. water) or dose rate used will also be discussed. This work was supported by CAMC Cancer Center and Alliance Oncology.