A review of radiotherapy linear accelerator quality control techniques.

This study provides a review of recent publications on different quality control (QC) techniques for radiotherapy linear accelerators (linacs). QC in radiotherapy is essential to ensure patient safety, deliver optimal quality treatments, monitor equipment performance over time and to satisfy statutory or recommended testing. Whilst conventional QC methods are still widely used and valuable, there have been advances in QC methods and approaches which aim to improve efficiency and keep pace with the rapidly advancing complexity of clinical equipment and treatment delivery methods. Existing reviews of QC concepts mainly focus on single QC techniques. There are limited reviews that explore and compare the variety of techniques to QC, which is the aim of this report. QC techniques were separated into seven domains: conventional QC, automated & manufacturer integrated QC, risk, statistical, artificial intelligence (AI), end-to-end & patient-specific QC (PSQC), external dosimetry audits & clinical trial credentialing audits. An overview of each technique with example studies from literature is presented.