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Independent verification of the dose per monitor unit (MU) to deliver the prescribed dose to a patient has been a mainstay of radiation oncology quality assurance (QA). We discuss the role of secondary dose/MU calculation programs as part of a comprehensive QA program. This report provides guidelines on calculation-based dose/MU verification for intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) provided by various modalities. We provide a review of various algorithms for “independent/second check” of monitor unit calculations for IMRT/VMAT. The report makes recommendations on the clinical implementation of secondary dose/MU calculation programs; on commissioning and acceptance of various commercially available secondary dose/MU calculation programs; on benchmark QA and periodic QA; and on clinically reasonable action levels for agreement of secondary dose/MU calculation programs.
Zhu, T. C., Stathakis, S., Clark, J. R., Feng, W., Georg, D., Holmes, S. M., … Xiao, Y. (2021). Report of AAPM Task Group 219 on independent calculation-based dose/MU verification for IMRT. Medical Physics, 48(10), e808–e829. https://doi.org/10.1002/mp.15069