Modules / Annual QA

Annual QA

Annual linac QA checklist combining TG-142, TG-179, MPPG 2.b, MPPG 8.b and MPPG 9.b -- including TG-51 photon & electron reference dosimetry -- with tolerance grading and a printable report.

Record each test result below. For measured tests, enter the deviation from the expected value — a result passes when its absolute deviation is within the tolerance shown. Tolerances are pre-filled with the selected machine class default and may be edited per test.

Annual QA — header

Machine / linac name

QA date

Performed by

Machine class — sets default tolerances

Energies / notes (optional)

Dosimetry

TG-51 reference dosimetry. Run the absolute output calibration in the dedicated TG-51 calculator for each photon and electron energy, then record the result below on “X-ray / electron output calibration, TG-51” as the deviation from your expected output. Each calculator opens in a new tab, so this checklist is preserved.

Open TG-51 Photon calculator ↗ Open TG-51 Electron calculator ↗

Test	Tolerance	Result
X-ray / electron output calibration, TG-51 (absolute) — TG-142 Table III	± %	%
Photon flatness change from baseline — TG-142 Table III	± %	%
Photon symmetry change from baseline — TG-142 Table III	± %	%
Electron flatness change from baseline — TG-142 Table III	± %	%
Electron symmetry change from baseline — TG-142 Table III	± %	%
Photon beam quality (PDD10 or TMR20/10) from baseline — TG-142 Table III	± %	%
Electron beam quality (R50) from baseline — TG-142 Table III	± mm	mm
Field-size dependent output factors, x-ray (2% for FS <4x4 cm2, 1% for >=4x4 cm2) — TG-142 Table III	± %	%
Output factors for electron applicators (spot check) from baseline — TG-142 Table III	± %	%
Photon MU linearity / output constancy (2% for >=5 MU; 5% for 2-4 MU) — TG-142 Table III	± %	%
Electron MU linearity / output constancy (>=5 MU) — TG-142 Table III	± %	%
X-ray output constancy vs dose rate, from baseline — TG-142 Table III	± %	%
X-ray output constancy vs gantry angle, from baseline — TG-142 Table III	± %	%
Electron output constancy vs gantry angle, from baseline — TG-142 Table III	± %	%
X-ray / electron off-axis factor constancy vs gantry angle — TG-142 Table III	± %	%
Physical wedge transmission factor constancy — TG-142 Table III	± %	%
Arc mode (expected MU, degrees) from baseline — TG-142 Table III	± %	%
SRS arc rotation -- MU set vs delivered (1 MU or 2%; SRS/SBRT machines) — TG-142 Table III; MPPG 9.b	± MU	MU
SRS arc rotation -- gantry arc set vs delivered (1 deg or 2%; SRS/SBRT machines) — TG-142 Table III; MPPG 9.b	± deg	deg
Small-field / cone relative output factors, from baseline (2% for >1 cm, 5% for <=1 cm apertures; SRS/SBRT) — MPPG 9.b	± %	%
TPS dose-calculation end-to-end verification (measured vs planned, reference geometry) — MPPG 8.b annual	± %	%

Mechanical

Test	Tolerance	Result
Collimator rotation isocenter, from baseline — TG-142 Table III	± mm	mm
Gantry rotation isocenter, from baseline — TG-142 Table III	± mm	mm
Couch rotation isocenter, from baseline — TG-142 Table III	± mm	mm
Coincidence of radiation and mechanical isocenter — TG-142 Table III	± mm	mm
Table-top sag under clinical load, from baseline — TG-142 Table III	± mm	mm
Table angle accuracy — TG-142 Table III	± deg	deg
Table travel -- maximum range of movement, all directions — TG-142 Table III	± mm	mm
6-DoF couch translation / rotation accuracy (if installed; SRS/SBRT) — MPPG 9.b; TG-198	± mm	mm
Electron applicator interlocks — TG-142 Table III	Pass / Action / Fail
Stereotactic accessories / lockouts (SRS/SBRT machines) — TG-142 Table III; MPPG 9.b	Pass / Action / Fail
End-to-end hidden-target localization test (SRS/SBRT machines) — MPPG 9.b	± mm	mm
End-to-end dosimetric verification (film / ion-chamber phantom vs plan) — MPPG 9.b; MPPG 8.b	± %	%

MLC

Test	Tolerance	Result
MLC transmission (avg leaf & interleaf), from baseline — TG-142 Table V	± %	%
MLC leaf-position repeatability — TG-142 Table V	± mm	mm
MLC spoke-shot radius — TG-142 Table V	± mm	mm
MLC light field vs x-ray field coincidence (all energies) — TG-142 Table V	± mm	mm
Segmental (step-and-shoot) IMRT test -- max error RMS — TG-142 Table V	± mm	mm
Moving-window IMRT test, four cardinal angles -- max error RMS — TG-142 Table V	± mm	mm
Picket-fence test -- leaf-position deviation (MPPG 8.b 0.5 mm) — MPPG 8.b	± mm	mm

Safety

Test	Tolerance	Result
Manufacturer safety / interlock test procedures — TG-142 Table III	Pass / Action / Fail
Door closing safety (full annual procedure) — MPPG 8.b	Pass / Action / Fail
Emergency-off switches and emergency procedures (all locations) — MPPG 8.b	Pass / Action / Fail
Radiation survey of room and adjacent areas (state-regulatory compliance) — TG-198 implementation	Pass / Action / Fail

Imaging

Test	Tolerance	Result
Planar MV imaging -- full range of travel SDD — TG-142 Table VI	± mm	mm
Planar MV imaging dose vs baseline — TG-142 Table VI	Pass / Action / Fail
Planar kV imaging beam quality / energy vs baseline — TG-142 Table VI	Pass / Action / Fail
Planar kV imaging dose vs baseline — TG-142 Table VI	Pass / Action / Fail
Cone-beam CT imaging dose vs baseline (CTDI / phantom) — TG-142 Table VI; TG-179	Pass / Action / Fail
CBCT HU linearity / electron-density curve vs baseline (Catphan CTP404) — TG-179; MPPG 2.b	± HU	HU
CBCT uniformity full sweep (center vs periphery) — TG-179	± HU	HU
CBCT slice thickness / sensitivity profile vs baseline — TG-179	± mm	mm
CBCT spatial / scale integrity (known-distance phantom) — TG-179; MPPG 2.b	± mm	mm
IGRT registration accuracy across translations & rotations (end-to-end phantom) — MPPG 2.b	± mm	mm
Surface-guidance (SGRT) dynamic / motion-tracking accuracy (if installed) — MPPG 2.b	± mm	mm
Full IGRT image-quality scorecard review (action levels vs baseline) — MPPG 2.b	Pass / Action / Fail

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Clinical disclaimer. The default tolerances shown are TG-142, TG-198, TG-179, MPPG 2.b, MPPG 8.b and MPPG 9.b starting points only. They must be reviewed, set, and approved by a Qualified Medical Physicist for your institution before clinical use. Radiant QuikQA is a QA aid, not a vendor-validated QA product. All results must be independently verified.