Investigation of the sag in linac secondary collimator and MLC carriage during arc deliveries

In modern radiotherapy, it is vitally important to monitor the performance of all linac components including the collimation system. In this study, a simple measurement method and accurate algorithm are introduced for investigation of the secondary and tertiary collimator sag during radiotherapy arc treatments. The method is based on cine EPID images of a ball bearing marker fixed to the gantry head and determines the jaw and MLC sag in all directions relative to the reference at zero gantry angle. Analysis was performed using different field sizes and collimator angles, different linacs and different gantry rotation directions. The accuracy of the method was tested and was less than 0.02mm. The repeatability and reproducibility of the method was 0.005 and 0.09mm, respectively. The setup is easy and quick and the algorithm is fast and fully automatic with sub-pixel accuracy. This method is suitable to be included in the routine quality assurance of linacs to monitor the collimator system performance.