Guide for Quality Control and Quality Assurance Tests in Image-guided Radiotherapy Systems

This report systematically addresses quality control and assurance tests aimed at enhancing the safety and
efficacy of Image-Guided Radiation Therapy (IGRT). IGRT utilizes advanced imaging systems to accurately
delineate tumor volumes, minimizing uncertainties caused by anatomical changes during treatment. The study
encompasses quality control tests for 2D, 3D, and 4D imaging systems integrated with linear accelerators, as
well as surface and respiratory tracking systems. The tests are categorized into three main groups: radiographic imaging systems, surface tracking systems, and respiratory tracking systems. The report details procedures and
tolerance values for critical parameters such as geometric accuracy, image quality, and safety tests. Additionally,
quality control methods for respiratory-gated radiation therapy systems and 4D-CBCT modules are presented.
The report emphasizes the importance of standardizing quality control protocols to ensure the accurate
and reliable implementation of IGRT and aims to serve as a guide for newly established clinics and medical
physicists, providing a reference for developing and implementing their own quality control procedures.

Keywords: 4D-CBCT; geometric accuracy; IGRT; quality control; respiratory tracking