Machine Performance Check

Reference Guide

P1067213-001-A APRIL 2024

Legal Information
Publication ID
P1067213-001-A

Publication Title
Machine Performance Check Reference Guide

Abstract
This document provides information about Machine Performance Check (MPC), V2.7, applied prior to treatment to verify
® ®
that critical functions of the TrueBeam and VitalBeam V2.7 system are operating within specification.
This publication is the English-language original.

Notice
Information in this publication is subject to change without notice and does not represent a commitment on the part of
Varian.

Copyright
© 2015—2024 Varian Medical Systems, Inc. All rights reserved. Published in Switzerland.
No part of this publication may be reproduced, translated, or transmitted without the express written permission of Varian
Medical Systems, Inc.

Trademarks
Varian Medical Systems, Inc. or its affiliates own the names of our products and services referenced herein. These names
® ™
are either registered trademarks ( ) or trademarks ( ) in the United States and/or other countries. All other trademarks are
the property of their respective owners. Any rights not expressly granted herein are reserved.

Contact Varian Customer Support / Report Incidents

For customer support, go to www.MyVarian.com and select Contact Us. Use MyVarian to report incidents. If you do not
have access to MyVarian, contact your local representative or call +41-41-749-8844.
Any serious incident that has occurred while using the device should be reported to the manufacturer and the competent
authority of the Member State in which the user or patient is established.

Electronic Labeling
This symbol on the label indicates that the Instructions for Use for the corresponding product are available at
www.MyVarian.com. Access the Instructions for Use in electronic form by logging in with your assigned MyVarian user
credentials.

In compliance with Anvisa regulations, Varian will send Brazil customers a free printed
copy of the Instructions for Use within 7 days. Use the “Paper Publication Request” form
provided on the Varian webpage to order your copy.

WHO
ICD-O codes and terms used by permission of WHO, from:
● International Classification of Diseases for Oncology, Third Edition.
ICD-10 codes and terms used by permission of WHO, from:
● International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).

2 Machine Performance Check Reference Guide

 Medical Device

CAUTION: US Federal law restricts this device to sale by or on the order of a physician.

FDA 21 CFR 820 Quality System Regulations (cGMPs)

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within this federal regulation.

International Organization for Standardization ISO 13485

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within the ISO 13485 quality standard.

Legal Manufacturer

Varian Medical Systems, Inc.

3100 Hansen Way
Palo Alto, CA 94304
United States of America

Legal Information 3
Table of Contents
MPC Overview ............................................................................................................... 7
What is MPC? ................................................................................................................................... 7
Who Should Read This Guide .................................................................................................. 8
About This Document ............................................................................................................... 8
Related Publications ................................................................................................................. 8
Visual Cues .............................................................................................................................. 8

Safety ........................................................................................................................... 10
Safety Overview .............................................................................................................................. 10
Maintaining System Integrity ........................................................................................................... 10
Unauthorized or Modified Software ................................................................................................. 10
Unauthorized Hardware .................................................................................................................. 11

MPC Operation Modes ............................................................................................... 12

About MPC Operation Modes ......................................................................................................... 12
User Rights ...................................................................................................................................... 12
Console Mode ................................................................................................................................. 13
Acquisition Workspace ........................................................................................................... 14
Review Workspace ................................................................................................................. 15
Offline Mode .................................................................................................................................... 17

Setting Up MPC ........................................................................................................... 19

About MPC Setup ............................................................................................................................ 19
Console Setup ................................................................................................................................. 19
Schedule ................................................................................................................................ 19
Baseline .................................................................................................................................. 20
Acquire Couch Reference ...................................................................................................... 21
MLC Leaf Gap Configuration ........................................................................................................... 21
Default Options for Beam & Geometry Check ................................................................................. 22
Offline Setup .................................................................................................................................... 22
Define Machines ..................................................................................................................... 22

Using MPC ................................................................................................................... 24

About Using MPC ............................................................................................................................ 24
Performing MPC and Quick Evaluation ........................................................................................... 24
Positioning the Phantom ........................................................................................................ 24
Perform Check ....................................................................................................................... 26
Quick Evaluation .................................................................................................................... 26
MPC Reporting ....................................................................................................................... 27

4 Machine Performance Check Reference Guide

 Add / Remove Checks ............................................................................................................ 28
Change Mode ......................................................................................................................... 28
Reviewing and Analyzing MPC Data ............................................................................................... 28
History View Usage ................................................................................................................ 28
Details View Usage ................................................................................................................ 29
Trends View Usage ................................................................................................................ 30

Checks ......................................................................................................................... 31
Overview of Check Options ............................................................................................................. 31
Beam Constancy Check ......................................................................................................... 31
Beam and Geometry Check ................................................................................................... 31
Enhanced Couch Option ........................................................................................................ 31
Enhanced MLC Check ........................................................................................................... 32
ICVI Check ............................................................................................................................. 32
ICVI Axis Alignment Check .................................................................................................... 32
Scheduled and Ad-hoc Checks .............................................................................................. 32
Overview of Performance Values .................................................................................................... 32
Beam Constancy ............................................................................................................................. 34
Output Change ....................................................................................................................... 35
Uniformity Change .................................................................................................................. 35
Center Shift ............................................................................................................................ 35
Geometry ......................................................................................................................................... 35
Isocenter ................................................................................................................................. 35
Collimation .............................................................................................................................. 36
Gantry ..................................................................................................................................... 37
Couch ..................................................................................................................................... 37
Enhanced Couch .................................................................................................................... 38
Conical Collimator .................................................................................................................. 40
Session ............................................................................................................................................ 41
History ............................................................................................................................................. 41

Appendix: Data Management .................................................................................... 42

Retention ......................................................................................................................................... 42
Synchronization ............................................................................................................................... 42
Data Export ..................................................................................................................................... 42
Per-Check Results in CSV Format ......................................................................................... 43
Full MPC history in CSV format .............................................................................................. 43
Export a single check to a Zip file ........................................................................................... 43

Table of Contents 5
Appendix: Reports ...................................................................................................... 45
Reporting ......................................................................................................................................... 45
Session Report ................................................................................................................................ 45
Check Report .................................................................................................................................. 45

Index .......................................................................................................................... 48

6 Machine Performance Check Reference Guide

MPC Overview

What is MPC?
Machine Performance Check (MPC) is an integrated self-check tool used to verify if the critical
functions of the system are operating within specifications. The application is designed for reliable
and fast system testing on a daily basis before routine treatment starts.

Figure 1 Components required for running Machine Performance Check

1. User Interface of Machine Performance Check

2. IsoCal Phantom with MPC Phantom Holder
3. kV and MV Imaging Systems

Performing MPC Beam and Geometry Check requires the Isocenter Calibration (IsoCal) phantom
to be firmly mounted to the couch top using a dedicated MPC phantom holder (figure above).
MPC then automatically acquires a series of MV and kV images, capturing beam properties as
well as mechanical characteristics for different collimator and gantry rotations, couch settings and
collimating devices. The acquired series of images is immediately processed and the results
displayed to the user for quick evaluation. The results indicate whether the values are within
system specifications.

Note: On systems without kV imaging capabilities, MPC omits the KV Imager Projection
Offset test and performs all other tests using MV images.

In addition, the MPC application features a review workspace for detailed analysis of current as
well as past MPC checks. The review workspace provides access to all previous checks and
includes an export function for further processing of MPC data with non-Varian applications.
Notification as well as trending capabilities enable long term investigation of specific parameters
and can be used as predictive measures for potential system failures.
The offline mode can be installed on a separate workstation for an in-depth analysis of MPC data
acquired on different systems.

MPC Overview 7
 Who Should Read This Guide
Machine Performance Check (MPC) is an application running on the console workstation,
intended to be operated by therapists on a daily basis to check key machine performance values.
MPC should only be used by qualified medical professionals.
This guide is written mainly for medical physicists, radiation oncologists, dosimetrists, and
radiation therapists, who may have specific tasks regarding Machine Performance Checks.

Note: For daily Machine Performance Check tasks done as part of the clinical workflow,
see the TrueBeam or VitalBeam Instructions for Use.

About This Document

This document describes features and functionality of the Machine Performance Check. Some of
the features and functionality may not be available to you, but may be available for purchase;
some of the graphics may look slightly different.

Related Publications
®
The following Varian Medical Systems publications provide information on the TrueBeam or
®
VitalBeam medical linear accelerators and related equipment:
● TrueBeam/VitalBeam Instructions for Use
● TrueBeam/VitalBeam Administrators Guide
● TrueBeam/VitalBeam Safety Guide
● TrueBeam/VitalBeam Quick Reference Guide
● TrueBeam/VitalBeam Technical Reference Guide Volume 1
● TrueBeam/VitalBeam Technical Reference Guide Volume 2: Imaging
● Machine Performance Check Reference Guide

Visual Cues
This publication uses the following visual cues to help you find information:

WARNING: A warning describes actions or conditions that can result in serious

injury or death.

CAUTION: A caution describes hazardous actions or conditions that can result in

minor or moderate injury.

NOTICE: A notice describes actions or conditions that can result in damage to

equipment or loss of data.

Note: A note describes information that may pertain to only some conditions, readers, or
sites.

8 Machine Performance Check Reference Guide

 Tip: A tip describes useful but optional information such as a shortcut, reminder, or
suggestion, to help get optimal performance from the equipment or software.

MPC Overview 9
Safety

Safety Overview
This chapter provides overall comments on safety for the general operation of Machine
Performance Check and all associated equipment. Specific warnings and cautions describing a
particular hazard are given in the associated TrueBeam or VitalBeam documentation. For details
on cautions and warnings, see the Safety Guide and Instructions for Use corresponding to your
TrueBeam or VitalBeam system.
MPC executes automatic gantry and couch movements. To avoid any collisions, you must follow
the safety guidelines in the Safety Guide corresponding to your TrueBeam or VitalBeam system.
The hospital is responsible for establishing emergency and safety procedures to ensure safe
operation and maintenance conditions.
Where applicable, hardware and software are designed to meet current international
technological and safety standards, for example, IEC for the protection of users and patients.
Since hazards can be encountered, and risks cannot be ruled out completely, instructions and
procedures in the manuals must be followed to guarantee safety of the patients.
The system must only be run with its original and unmodified fittings and replacement parts.
Modifications or adjustments to the system or its parts are not permitted, unless with prior
approval and check by Varian.
Varian is not responsible for any use of the system and/or software which does not comply with
the agreed use described in this manual or other related Varian manuals.
No modifications may be made to any system parts or to the software.

Note: MPC may stop if a non-Varian gating device is connected and configured to the
Varian medical linear accelerator system. Ensure that such a device is properly
configured for non-treatment beams.

Maintaining System Integrity

Modifying or altering the products, or the software in the products, in any way constitutes willful
infringement of Varian's intellectual property and may endanger patient safety. Any such
modification or alteration will render the system adulterated under the United States Federal
Food, Drug, and Cosmetic Act (or applicable law in the territory) and could subject the customer
or the authorized users to action by the United States Food and Drug Administration, resulting in
seizure, injunction, civil penalties, or criminal prosecution.

Unauthorized or Modified Software

Modifying any of the software provided with the system, or installation and use of any software
other than that provided or validated by Varian, can seriously compromise the integrity of stored
data and the performance of operational applications and can result in uncertain, unreliable, and
potentially hazardous system operation.

10 Machine Performance Check Reference Guide

 By accepting Varian's Terms and Conditions of Sale, you authorize Varian to remove any
unauthorized software that has been added to, or altered, the system computer, its operating
systems, or the control applications. To minimize system corruption that may result in serious
damage to your system or in patient harm:
● Do not modify the system software, including the operating system, control applications, and
data files.
● Do not install software on the system.
● Do not alter the configuration of the system installed by Varian personnel, including printed
circuit boards, control devices, and all settings.

Unauthorized Hardware
The installation of an unapproved supplemental device:
● May modify or damage the calibration, performance, treatment, or safety measures installed.
● Will void the Varian warranty.
● Can result in the termination of applicable software licenses.
● Could lead to severe patient injury or death.
Such unapproved supplemental devices include:
● Any device interfaced to the system using an unauthorized interface.
● Any unapproved device interfaced to the system using authorized interfaces.

Safety 11
MPC Operation Modes

About MPC Operation Modes

The MPC application features two operation modes.

Console The console mode runs on the treatment workstation and is used for the quick
Mode evaluation of an acquired and processed kV/MV image series as well as for an in-
depth analysis of the assessed machine characteristics.

Offline The offline mode is used for detailed analysis of the MPC history of treatment
Mode units. The offline mode can be installed on any personal computer, laptop, or
workstation connected to the network drive to which the MPC histories of the
treatment units are synchronized. For details, see Synchronization on page 42.

User Rights
User actions are controlled by assigning specific roles to predefined users. These users are
implemented in both MPC operation modes, but the associated user actions differ between
operation modes.
There are three main users:
● Therapist
● Physicist
● Service
Each user role has specific access rights assigned to it.

Note: Service access requires activation from a Varian representative. It provides

access to additional MPC values as well as import/export functions with which detailed
reviews of the machine status can be conducted.

Console Mode
Console mode users are defined through the Varian Service Portal server. MPC assumes the
different user roles to have the following Varian Service Portal privileges:

Therapist Access Daily QA Mode

Turn ON Treatment Machine

Physicist Access Daily QA Mode

Turn ON Treatment Machine
Administer QA Application

The following table summarizes the assignment of user actions to users:

12 Machine Performance Check Reference Guide

 Table 1 User Actions in Console Mode

User Action Therapist Physicist

Acquire checks X X
View checks X X
Add ad-hoc check X X
Remove individual ad-hoc checks X X
Remove scheduled checks X
Delete acquisitions X (sign off)
Change MPC configuration X
Appoint baseline X (sign off)

Therapists can acquire MPC checks, scheduled as well as ad-hoc, for the purpose of quickly
evaluating the results. Also, they may perform a detailed analysis of MPC parameters that are out
of thresholds. In addition, therapists can add or remove ad-hoc checks, but cannot remove
scheduled MPC checks.
In addition to all Therapist tasks, Physicists can also configure the MPC application by defining
scheduled checks and set up a baseline for beam constancy checks. The physicist can delete
existing MPC checks. However, in this case a specific electronic sign-off is required.

Offline Mode
In offline mode authentication is not required. All users have access. The offline mode is intended
for review and trend analysis. The offline mode supports reviewing MPC data of different
treatment units. However, no tools for inter-machine comparison are provided. MPC data is
accessible in read-only mode.

Console Mode
On the treatment workstation, the console mode is started from the Major Mode menu using the
MPC button. Once launched MPC occupies both monitors (see figure below) displaying the MPC
acquisition screen on the left hand side and the MPC review screen on the right hand side.

Figure 2 Acquisition screen (left) and review screen (right) in console mode

MPC Operation Modes 13

 Acquisition Workspace
The layout and features of the Acquisition workspace are similar to the Treatment application,
employing a gray-scale color scheme. The color scheme has been adjusted to be distinctly
different from the treatment mode. The color scheme together with the application labeling is
used to alert the user of the non-clinical nature of the MPC mode. The workspace can be divided
into six areas (see figure below).

Figure 3 Layout of the MPC Acquisition Workspace

1. Major Mode Indicator 4. Instructions

2. Session Area 5. Beam State Indicator
3. Live View and Interlocks 6. Parameter Area

Major Mode Shows the current major mode (in the figure above, Machine Performance
Indicator Check). To exit the current mode the user can select the Change Mode
button that will exit to the mode selection screen.

Session Area Lists the scheduled checks in the upper part of the window. At the bottom
of this display the Tools and Create Report buttons are located. (see
About Using MPC on page 24 for more information).

Live View and Shows the current user, machine information and date/time in the upper
Interlocks left corner. The rest of the area is occupied by the Live View and interlock
indicators. The area layout changes to show acquired images during the
beam on (see About Using MPC on page 24 for more information).

Instructions Gives the user a brief description of the next step to perform. The content
changes based on the beam state.

Beam State Shows the current beam state. It functions the same as in the Treatment
Indicator mode.

Parameter Area Displays the planned and actual machine positions. Its function is the same
as in the Treatment mode.

14 Machine Performance Check Reference Guide

 Review Workspace
The MPC Review workspace supports three major views.
● History View
● Details View
● Trends View

History View

The History view gives an overview of all performed MPC checks and their status. It can be used
to select checks and investigate them in greater detail. This view is divided in two areas.

Figure 4 Layout of the MPC Review workspace in History view

1. Title and menu area

2. Timeline area

Title and Menu Displays two check boxes for adapting the Timeline visualization and the
Area Option menu (see About MPC Setup on page 19 and About Using MPC on
page 24 for more information).

Timeline Area Lists the history of all MPC checks over time. Each colored box represents an
individual MPC check for which the high level result is indicated by color. The
meaning of the different icons and colors is described in the legend:

Green Within thresholds

Orange Within thresholds, but close to outside of thresholds,
(defined as approaching 10% of the threshold's limit).
Red Outside of thresholds

MPC Operation Modes 15

 Gray Baseline
Icon paper sheet Notes attached

Checks for the same beam energy are displayed per row, while checks performed on the same
day or in the same session are listed per column. Multiple checks on the same day appear side-
by-side.
Notes can be attached to a check in order to write down free text information on any observation
or changes to the system such as re-calibration of the Multileaf Collimator (MLC).

Details View

The Details view lists the specific values of the MPC check selected from the History view. All
evaluated parameters are listed in addition to the kV/MV image series on which the evaluation is
based.

Figure 5 Review workspace in Details view

1. Title and menu area

2. Check results
3. Image review area

Title and Lists the specific values of the MPC check selected in the History view. All
Menu Area evaluated parameters are listed in addition to the kV/MV image series on which
the evaluation is based.

Check Can be divided into three sections:

Results
● At the top, the status of the actual check for Beam Delivery (MPC data
Area
acquisition) and Processing is indicated.
● The middle section contains a table in which the evaluated MPC parameters
are listed with name, actual value and applicable threshold.

16 Machine Performance Check Reference Guide

 ● The bottom section provides a free-text box for entering specific comments
for the current MPC check.

Image Displays the kV/MV image series on which the MPC check is based. On the left
Review Area hand side a navigation pane can be used to select individual images from the
series. The selected image is displayed in the large viewport on the right hand
side.

See section About Using MPC on page 24 for more information.

Trends View

Figure 6 Review workspace in Trends view

1. Legend area
2. Plot area

Legend Lists the labels of all data curves which are displayed in the Plot area. The
Area visibility of the different data curves can be controlled by check boxes next to its
label. In addition, results can be added to the graph for comparison.

Plot Area Displays the selected data curves over time. While the vertical axis indicates the
scale for the selected MPC value including the data unit, the horizontal axis
indicates the date/time when the corresponding data were acquired.

See section Trends View Usage on page 30 for more information.

Offline Mode
The basic layout and functionality of the Offline mode is similar to the Review workspace of the
MPC Console mode.

MPC Operation Modes 17

 Figure 7 MPC Offline Mode

1. Select Machine

No authentication is required to log into Offline Mode.

In contrast to the Review workspace, the user can administer MPC histories of different treatment
units. An additional menu item (see figure above) is available for importing additional units and for
selecting the unit to be reviewed (see section Reviewing and Analyzing MPC Data on page 28
for more information).

18 Machine Performance Check Reference Guide

Setting Up MPC

About MPC Setup

Setting up MPC differs in console and offline mode. Setting up in console mode requires the user
privilege Physicist, the offline mode can be configured by any user.

Table 2 Access Rights in Console and Offline Mode

Mode Access Right

Console Physicist
Offline All users

Console Setup
After starting up the MPC console mode for the first time only a limited number of steps are
required for set up and configuration. The user Physicist defines the schedule for mandatory
Beam Checks. The baseline checks, for all beam constancy checks, have to be assigned and the
couch reference needs to be verified or acquired.

Schedule
The user Physicist schedules mandatory MPC Beam Checks by selecting Options >
Configuration in the review workspace.

Table 3 The Options menu in the review workspace of the MPC console mode

Options Menu
Show Repeated Checks
Hide Empty Days
Limit view to last 90 days
Export MPC History to Comma Separated Values (CSV) Files
Configuration
About

Setting Up MPC 19
 Check Schedule

To schedule beam constancy checks:

1. Open the Configuration tab.

Figure 8 Scheduling beam constancy checks

Note: The table above does not list the beam energy used for the geometry check.
The geometry check is done along with the corresponding beam constancy check.
MPC uses the 6 MV flattened beam for its geometric verifications. If a 6 MV flattened
beam is not available, the lowest photon treatment energy is used. The combined
beam constancy and geometry check will automatically be scheduled every day.

2. Select the weekdays in which specific beam constancy checks are performed.
3. Save the Check Schedule.
Note that scheduled checks which have not been performed on that day are automatically due on
the next day.

Baseline
Each beam constancy check requires a corresponding baseline check.
Follow these rules for defining baseline checks:
● Only successfully acquired and processed beam constancy checks can be appointed as
baseline.
● Only the most recent beam constancy check can be appointed as baseline, and only in the
same MPC session in which the check was acquired.
In addition, special rules apply for retaining baseline checks and the processing of beam
constancy checks:
● Baseline checks are retained indefinitely.

20 Machine Performance Check Reference Guide

 ● After appointing a new baseline check, previous beam constancy checks do not get
reprocessed. A new baseline is only applicable for future beam constancy checks.

Define Baseline Check

Do the following to define a baseline check:

1. Login as Physicist.
2. Verify the appropriate beam steering and tuning for each beam energy with the aid of a
separate measurement device such as an ion chamber.
3. Acquire beam constancy checks for all required energies.
4. Open the Details view in the review workspace of the corresponding beam checks.
a. Select Appoint as Baseline in the Options menu.
b. Confirm in the confirmation dialog.
c. Repeat for each additional energy for which a new beam constancy baseline
measurement was acquired.

Acquire Couch Reference

As mentioned previously, the MPC geometry check requires a couch reference position that
locates the IsoCal phantom approximately at the isocenter.
Before using MPC for the first time a reference couch position matching the local configuration
must be set. The setup procedure requires entering the treatment room to position the phantom
on to the couch top. The phantom must be manually positioned to the isocenter using the
available laser system.
On the treatment workstation MPC is started. From the Tools menu the user can select the
option Acquire Couch Reference. A confirmation dialog displays the new settings.

Note: Setting the wrong reference can prevent the acquisition of evaluation of some or
all performance values.

When setting a new couch reference, take precautions to ensure that no parts of the accelerator
collide with the phantom.

MLC Leaf Gap Configuration

Some sites have multiple machines configured to be dosimetrically equivalent. This is usually
done by configuring the offset of an MLC gap on one or more of the respective machines in
Service Mode. The configuration widens the static gap of the MLC system. It is measured by
MPC with the offset of the MLC leaves.
To consider the MLC gap offset within MPC, the user enters the absolute gap increase in
centimeters. If multiple incremental changes have been applied in Service Mode, please enter the
accumulated value in MPC.

Setting Up MPC 21
 Figure 9 MLC Leaf Gap Offset

Note: The adjustment only changes the evaluation of the MLC measurement results. No
harm to the machine is caused by not synchronizing the MPC settings with the Service
Mode adjustment.

Default Options for Beam & Geometry Check

The Beam & Geometry check is due each day and automatically added to the session list. If the
Enhanced Couch Option has been selected, the Beam & Geometry check automatically
performs the couch check using the Enhanced Couch Option to test the full rotation range of the
couch. See Enhanced Couch on page 38.

Figure 10 Beam & Geometry Check

Offline Setup
The MPC offline mode is intended as a review tool. There are no special access rights for uses
with different privileges. Setting up the offline mode requires only the definition of the treatment
unit to be reviewed.

Define Machines
The MPC offline mode provides a menu item to add new treatment units or to choose between
already imported treatment units (see History View Usage on page 28). The user can monitor
several treatment units with this functionality.
Treatment units can be removed by hovering the mouse over the area next to the treatment unit
label and clicking on the minus sign.

Note: By removing a treatment unit only the reference in the MPC application will be
removed, the corresponding MPC data remains on the hard drive.

22 Machine Performance Check Reference Guide

 Adding a Machine in Offline Mode

To add a machine do the following in MPC Offline Mode:

1. Select Add a Machine … in the machine selection menu.
2. Navigate to the shared network drive containing the copied MPC data.
3. Select the folder Checks of the desired machine.
4. Enter a unique machine name in the text field Machine Name.
Note that MPC displays a serial number as the default machine name.
5. Go to the machine selection menu to access the MPC data of the newly added machine.
6. Enter the user-defined name for the machine.

Setting Up MPC 23
Using MPC

About Using MPC

Two MPC operation modes were designed to support the major use cases of the MPC
application. While the MPC console mode features both the acquisition and review of MPC data
for a single treatment unit, the offline mode is dedicated to a detailed review of MPC histories
from multiple treatment units.
The following sections describe the two major MPC use cases:
● Performing MPC and quick evaluation.
● Reviewing and analyzing MPC data.

Performing MPC and Quick Evaluation

The MPC application is intended to be used on a daily basis. Running the scheduled MPC tests
should be the first task in the morning, and might also be repeated before critical treatment
sessions. The therapist launches the MPC application from the Major Mode.
After startup the MPC acquisition workspace is displayed on the left screen, the MPC review
workspace on the right screen (Figure 2 Acquisition screen (left) and review screen (right) in
console mode on page 13). The application automatically lists all scheduled MPC checks to be
performed for the day in the Session Area and displays an instruction to place the phantom on
the couch. Before entering the treatment room the system can be turned on by selecting Power
Saver (Standby) in the Tools menu.

Positioning the Phantom

Position the phantom as required for the MPC test.
There are two phantoms available for MPC:
● IsoCal phantom: The IsoCal phantom is used for the Beam and Geometry check.
● Integrated Conical Collimator Verification and Interlock system (ICVI) phantom: The ICVI
phantom is used only for the ICVI Check.

Note: Use of the wrong phantom will result in failure of MPC to perform the test.

IsoCal Phantom

MPC assumes that the IsoCal phantom does not change its position relative to the couch top
during the geometry check. For this reason, the phantom is fixed firmly to the couch top using the
MPC bracket. The exact couch position is specified on the phantom bracket.

24 Machine Performance Check Reference Guide

 Figure 11 Mounting Bracket and Phantom
The MPC bracket is used to firmly mount the IsoCal phantom to the couch top. The bracket is
positioned at the notches (blue arrows) indicated on the bracket label. Accurate positioning of the
phantom is ensured by three defined points touching the couch top (red arrows).

Note: Mounting instructions are labeled on the bracket. In some cases it may be
necessary to firmly press the phantom down to ensure that it is positioned correctly.
Otherwise, discrepancies or false data can result.

The MPC bracket is designed to support the Varian IGRT couch top and QFIX Calypso kVue
standard insert. Positioning on other couch tops might require custom-made fixations to ensure
that the IsoCal phantom is not shifting relative to the couch top during the MPC data collection.
To achieve reproducible positioning of the IsoCal phantom between subsequent MPC sessions,
the user may want to mark the correct couch location. The couch reference position can be
defined during the first MPC session as described in the section “Acquire Couch Reference” (see
section Acquire Couch Reference on page 21 for more information).

Note: Phantom fixation devices should not interfere with the images of the IsoCal
phantom. Interference with these images may result in failure of MPC to perform its test
sequence or in incorrect results.

ICVI Phantom

The ICVI Phantom consists of a metal bearing ball and rod, mounted to the Head End Interface
(HEI) couch clamp extension. The metal bearing ball has to be manually aligned to the room
lasers or the center of the field light. Only a rough alignment is needed. The projection of the
bearing ball must never intersect the field edge of the conical collimator. This can be verified by
rotating the gantry, with the conical collimator mounted and the light field enabled. The phantom
can be ordered separately as the ICVI QA Tool Kit, part number P1002593.

Using MPC 25
 Figure 12 ICVI Phantom

Perform Check
At the treatment console the user first selects Prepare and then Motion Enable to drive the
machine to the initial position. After selecting Beam-on, MPC automatically performs the checks
in the list of checks. After completion, the acquired images are instantaneously processed.

Note: Selecting Beam-on is required for each beam energy.

Quick Evaluation
Check results can be viewed in the acquisition workspace. Simple icons are used to indicate
whether the test results are within or outside of the specifications. A green check mark indicates a
passing result; a red X indicates a result outside of tolerance; an orange check mark indicates a
marginal pass, where the result is close to out-of-tolerance. While the overall test result is always
displayed for each MPC check, further details of a specific check are indicated using a drop down
menu.

26 Machine Performance Check Reference Guide

 Figure 13 Detailed view of the MPC check results in the acquisition workspace of the MPC
console mode
Beam Delivery and Processing indicate whether MPC data acquisition and processing were
successfully performed. Other entries exist for the major parameter groups of the corresponding
check such as Beam, Isocenter, Collimation, Gantry and Couch and indicate the machine specific
results. In addition, a specific check can be performed again using the Repeat button. The overall
result indicates the worst result of the individual checks, for example if one test fails then the
overall result indicates failure.
The MPC console mode also provides a review workspace for a detailed analysis of recently
acquired as well as previous MPC checks performed on the treatment unit. The features of the
review workspace are identical to the features of the MPC offline mode (see Reviewing and
Analyzing MPC Data on page 28 for a detailed description of the features). For the evaluation
procedure of the machine parameters, see Checks on page 31.

MPC Reporting
A test report in PDF format can be created for the current MPC checks by applying the Create
Report button (see Check Report on page 45). The report is displayed in a new window.
Upon creation, the test report PDF will be automatically stored on the hard drive in the directory:
<VMSOS_Data_Root>\AppData\TDS\Output\MPC\Reports\. The default setting for
<VMSOS_Data_Root> is D:\VMSOS\ on the console workstation and C:\VMSOS\ on the
customer workstation.

Using MPC 27
 Add / Remove Checks
Additional checks can be selected using the menu item Tools > Add Check. This menu lists all
available checks and allows their selection for the photon and electron beam energies available
on the system. The geometry checks such as the Beam & Geometry Check or the Enhanced
MLC Check use the 6X photon beam energy (if available) or, otherwise, the lowest treatment
photon energy available. After selection the MPC check will be added to the list of checks to be
executed. Ad-hoc checks can be used for additional investigations and must not interfere with the
scheduled checks. For this reason ad-hoc checks are always added to the end of the check list.

Note: Therapists cannot remove scheduled checks. They can add any MPC check listed
in the menu Tools > Add Check and remove the checks they added. Physicists have the
right to add and remove any check.
In Physics mode the physicist may choose to perform the 6X (or Low X) beam check
without performing the geometry checks. To do this, first remove the 6x beam and
geometry check from the list, then add the 6x beam check.

Change Mode
After completion of the daily MPC tests the application can be shut down by selecting Change
Mode. The system will then return to the Major Mode menu.

Reviewing and Analyzing MPC Data

The review workspace of the MPC console mode and the MPC offline mode provide identical
functionalities for reviewing and analyzing MPC data. The review workspace is intended for in
depth analysis of individual machine parameters and their trends. When accessing the review
workspace in MPC console mode or starting the MPC offline application the performed MPC
checks are displayed in the MPC History view (see History View on page 15).

History View Usage

All MPC checks performed for a specific treatment system are summarized in the MPC history
view. Each colored blip represents an individual MPC check. The combined beam constancy and
geometry check is indicated as a single colored blip.
The user can review the results of an individual check by clicking on the respective blip to open
the Details view (Details View Usage on page 29).
The user can access additional functionalities via the menu Options (Table 3 The Options menu
in the review workspace of the MPC console mode on page 19). The entire MPC history including
all evaluated MPC parameters can be exported to a file with comma-separated values (CSV)
using the item Export MPC History to CSV File. (Export directory:
<VMSOS_Data_Root>\AppData\TDS\Output\MPC\Results\. The default setting for
'VMSOS_Data_Root is D:\VMSOS\ on console workstation and C:\VMSOS\ on customer
workstation). The About item provides information on vendor and software versions.

28 Machine Performance Check Reference Guide

 In contrast to the review workspace of the MPC console application, the MPC offline mode
supports reviewing and analyzing MPC data from different treatment systems. The menu Select
Machine (Figure 7 MPC Offline Mode on page 18) enables switching between different MPC
histories (one menu item per machine) or importing a new MPC history (menu item Add a
Machine … Setting Up MPC on page 22).

Details View Usage

The user can investigate the evaluated parameters of the selected MPC check as listed in tabular
form in the Check Results Area (Figure 5 Review workspace in Details view on page 16). The
two parameters Beam Delivery and Processing indicate whether MPC data collection and the
subsequent processing were successful. Even in the case of faults during data acquisition MPC
continues to evaluate all MPC parameters as far as possible using the remaining images, thus
results of partially completed MPC checks are provided.
Listed in the table columns are the name of the MPC parameter, its actual value and the
threshold against which it is compared. Color-coded check marks and X-marks are used for a
clear indication of whether the parameter is within, close within or outside of thresholds as
reflected in the system specification. MPC parameters for beam constancy and geometry check
are grouped under the major groups such as Isocenter, Beam, Collimation, Gantry and Couch, to
provide a better overview. A combined evaluation is provided for each parameter group. The
group evaluation reflects the worst result of any individual check, for example, the group
evaluation indicates outside of thresholds if any individual item is outside of thresholds. Clicking
the adjacent arrows opens the next parameter level. A detailed description of how the individual
parameters were derived is given in Checks on page 31.
A free text field on the bottom of the Check Results area allows for entering notes for this specific
MPC check such as re-calibration of the MLC. The individual images acquired in the MPC
acquisition workspace can be investigated in the Image Review area. The navigation pane on the
left hand side of the Image Review area allows scrolling through the images and selecting the
image of interest. The selected image including the detected features is displayed in the viewport
on the right.
The user can create a report or export the results of this specific MPC check using the items
Create Report or Export Check of the menu Options.
In the review workspace of the MPC console mode the user with privileges Physicist can, in
addition to the above functions in the Options menu, appoint baselines (see Console Setup on
page 19) as well as delete MPC checks.

Figure 14 Entering the Trends view.

The user can access the Trends view by hovering with the mouse over the area next to an MPC
parameter until the Trends view icon appears and click on it.

Using MPC 29
 Trends View Usage
In the Trends View the selected parameter value is plotted over time. In addition to the parameter
values, the different acceptance areas are indicated using background color: green / orange / red
corresponding to within / close / outside thresholds.
Optional notes stored with a specific data point are indicated by vertical gray bars. The content of
the note can be read after hovering over the gray bar.
Different parameter values can be compared in the trends plot. The user hovers with the mouse
over the area next to any curve label in the legend area. Clicking on the plus sign opens a list of
parameter values to be added to the graph. Existing curves can be removed by clicking on the
minus sign. The user can hide without removing parameter curves by deselecting the check box
next to the curve label. The plot area will be updated accordingly.

Note: The acceptance areas are only indicated for parameters with identical thresholds
such as Isocenter – kV / MV Imager Projection Offset (Figure 6 Review workspace in
Trends view on page 17). Acceptance areas are omitted in the case of different
thresholds when comparing, for example, Isocenter – Size (threshold: 0.5 mm) and Jaws
– Offset X1 (threshold: 1 mm). When comparing parameter values with different units,
separate y-scales are plotted for each parameter unit such as Isocenter – Size (Unit:
mm) and Beam Uniformity (Unit: %).

After reviewing a single MPC check and the corresponding parameter trends the user has to
close the Trends View and the Details View first to return to the History View.

30 Machine Performance Check Reference Guide

Checks

Overview of Check Options

The MPC application supports the following checks:
● Beam constancy check
● Beam and geometry check
● Beam and geometry check (enhanced couch)
● Enhanced MLC check
● ICVI check
● ICVI axis alignment check

Beam Constancy Check

The beam constancy check evaluates changes in beam characteristics by comparing a current
MV test image to a customer defined baseline image. MPC always performs a beam constancy
and geometry check using the 6 MV flattened beam. If a 6 MV flattened beam is not available, the
lowest photon treatment energy is used. The combined beam constancy and geometry check will
automatically be scheduled each day MPC is started.
The following beam characteristics are evaluated:
● Beam output change
● Beam uniformity change
● Beam center shift

Beam and Geometry Check

The geometry check monitors the mechanical characteristics of the treatment system by
evaluating the following values:
● Treatment isocenter size
● Coincidence of treatment and imaging isocenter
● Positioning accuracy of kV and MV imaging systems
● Accuracy of collimator and gantry rotation angle
● Positioning accuracy of jaws and inner MLC leaves
● Positioning reproducibility of inner MLC leaves
● Couch positioning accuracy

Enhanced Couch Option

When selecting the Enhanced Couch Option for the Beam & Geometry Check, additional couch
measurements are performed.
● Couch positioning accuracy on an extended set of positions of up to 180° rotational range.

Checks 31
 Enhanced MLC Check
The enhanced MLC check monitors the mechanical characteristics of the MLC. It provides
additional coverage on MLC parameters compared to the geometry check. The following values
are evaluated:
● Positioning accuracy of all MLC leaves
● Positioning reproducibility of all MLC leaves
● MLC leaf side offset (for HD120 MLC only)

ICVI Check
The ICVI check verifies the accurate geometric alignment of the accessory system and the
mounted conical collimators and the resulting mechanical characteristics of the treatment system.
For this purpose MV images of a radiopaque ball positioned at the isocenter are automatically
acquired and analyzed.
The ICVI check is applicable for conical collimator sizes equal and larger than 10mm and
evaluates the following performance parameters for the mounted conical collimator:
● Alignment to collimator rotation axis
● Gantry-collimator isocenter size
● Gantry-collimator-couch isocenter size
● Ball-isocenter offset (for information only; not considered for pass/fail decision)

ICVI Axis Alignment Check

The ICVI axis alignment check verifies the accurate geometric alignment of the accessory system
and the mounted conical collimators with the collimator rotation axis. For this purpose MV images
for different collimator rotation angles are automatically acquired and analyzed. No phantom is
required. The ICVI axis alignment check is applicable for all sizes of conical collimators and
evaluates the following performance values for the mounted conical collimator:
● Alignment to collimator rotation axis

Scheduled and Ad-hoc Checks

MPC distinguishes between scheduled and non-scheduled (ad-hoc) checks. The MPC
administrator schedules beam checks to be performed for each day of the week. These checks
cannot be skipped by the therapist.
Ad-hoc checks can be added or removed as needed via the Tools > Add Check menu.
Checks other than the Beam check cannot be scheduled and have to be added and performed
ad-hoc. Under normal operating conditions, scheduling MPC checks ensures frequent control of
the beam energies (see Setting Up MPC on page 19 for further details).

Overview of Performance Values

In Check Values mode, the user has an easy-to-use overview of the main functions.

32 Machine Performance Check Reference Guide

 Table 4 Check Panel

Isocenter
Size
MV Imager Projection Offset
kV Imager Projection Offset
Beam
Output Change
Uniformity Change
Center Shift
Collimation
Jaws
Offset X1
Offset X2
Offset Y1
Offset Y2
MLC
Maximal Offset Leaves A
Maximal Offset Leaves B
Mean Offset Leaves A
Mean Offset Leaves B
Leaves A
Leaves B
MLC Reproducibility
Maximal Reproducibility Leaves A
Maximal Reproducibility Leaves B
Mean Reproducibility Leaves A
Mean Reproducibility Leaves B
Leaves A
Leaves B
Rotation Offset
Gantry
Absolute
Relative

Checks 33
 Couch
Lateral
Longitudinal
Vertical (for Enhanced
Couch)—5 cm couch move-
ment
Vertical (Large)—20 cm
couch movement
Rotation (Fine) (for En-
hanced Couch)
Rotation-(Large)
Rotation-Induced couch shift
Pitch
Roll
Conical Colli-
mator
Alignment to Collimator Ro-
tation Axis
Gantry-Collimator Isocenter
Size
Gantry-Collimator-Couch
Isocenter Size
Ball-Isocenter Size

Beam Constancy
MPC uses the Electronic Portal Imaging Device (EPID) to evaluate beam constancy. Beam
measurements in MPC are strictly relative measurements. Hence, this category is only available
if, for a given energy, a baseline has been previously defined. This category is evaluated for both
the beam and the geometry check.
The beam check is performed using an uncorrected, jaw-collimated, symmetric (18x18cm) beam
image (gantry 0° IEC61217). A ratio image is calculated between the baselines and the
respective beam image of the check. The two values that follow are evaluated on the basis of this
ratio image.
To reduce the impact of jaw positioning, the beam characteristics output and uniformity change
are evaluated on an inner area of the field (13.3 x 13.3 cm at the isocenter) .

Note: The beam evaluation relies on an up-to-date pixel defects map.

34 Machine Performance Check Reference Guide

 Output Change
Output Change represents the average percentage of change in detector response in the central
area of the imager. As the EPID produces a stable output even over an extended period of time,
this value is influenced primarily by changes in the beam. This evaluation does not represent a
dosimetric measurement on the beam.

Uniformity Change
Uniformity Change represents the total percentage of change in detector response in the central
area of the imager. It captures the worst-case, the variation between the two imager pixels with
the lowest and the highest ratio. For this evaluation, high frequency noise is filtered.
This value can indicate changes in the target and filter system as well as in the steering of the
beam. Please note that this is not an evaluation of the symmetry of the beam. The uniformity can
be changed without affecting symmetry. This evaluation does not represent a dosimetric
measurement on the beam.

Center Shift
The beam center shift describes the relative shift of the field center, defined by a jaw-collimated
field, with respect to the baseline. The field center is established through detection of the jaw
edges in the beam image. This shift represents a summary value on the precision of the beam
steering system, the collimation and MV imaging system.

Geometry
The geometry check evaluates the positioning accuracy of the various mechanical axes of the
TrueBeam or VitalBeam system.

Isocenter
An important characteristic of the radiotherapy machine is the position and size of the treatment
isocenter. The isocenter is determined in MPC using the IsoCal geometric phantom, which is
located in the beam during the check. The isocenter is defined as the ideal intersection point of
the beam's central axis over a full gantry rotation. The central beam axis in MPC is defined by the
center of rotation of the highest priority collimating device, the MLC.
The treatment isocenter is determined using acquisitions on eight representative gantry angles (0,
45, 90, 135, 180, 225, 270, 315)° IEC61217.

Size
The size of the treatment isocenter is defined as the maximum distance of a beam's central axis
under gantry rotation from the idealized isocenter.

Checks 35
 MV and kV Imager Offset
An important characteristic of the MV and kV imager systems is the offset of the treatment
isocenter projection with the imager center. The imager projection offset represents the maximum
distance of the imager center from the projection of the treatment isocenter. It is a measure of the
correctness of the IsoCal calibration. A low value is important for matching as well as essential for
Cone Beam Computer Tomography (CBCT) image quality.

Collimation
The positioning accuracy of the collimation system is determined using static field evaluations at
gantry position 0° IEC61217. The position of the collimating devices is defined as the point
perpendicular to the edge which shows the steepest gradient.

MLC (maximal offset, mean offset, individual offset, leaves A/B, reproducibility)
The positioning accuracy of each MLC leaf is determined using a static comb pattern with
alternating leaves. It is measured as the distance of the MLC leaf tip from the MLCs center line.
This center line is defined as the line through the center of rotation of the MLC that is
perpendicular to the edges of the leaves.
Reproducibility values are determined by the same pattern, but with the MLC leaves approaching
the same nominal position from opposing sides. The absolute difference between both measured
positions is reported as the reproducibility.
The leaves that are measured, arranged by MLC type, are in the following table (for each bank).
The availability of the MLC Type depends upon your configuration.

MLC Type Measured Leaves Measured Leaves

(Geometry Check) (Enhanced MLC Check)
80 MLC leaf 11-30 (of 40) all
120 MLC leaf 11-50 (of 60) all
™
HD120 leaf 2-59 (of 60) all
High-Definition MLC

The average and maximum offset is evaluated per bank.

Note: Due to the imager position of SID=150 used for the Beam & Geometry check, not
all leaves are visible in the field and therefore cannot be evaluated.

For details on MLC technology, see the Technical Reference Guide—Volume 1 corresponding to
your TrueBeam or VitalBeam system.

Enhanced MLC
Compared to the geometry check, the enhanced MLC check acquires images at the imager
position of SID=100 cm and with a collimator angle that ensures that all leaf positions can be
evaluated, regardless of MLC and imager type.
The positioning accuracy is determined using a static comb pattern, similar to the geometry
check.

36 Machine Performance Check Reference Guide

 The mean leaf side offset is determined using a static, symmetric comb pattern. The offsets of all
extended leaf sides are averaged to obtain the mean leaf side offset. The reference is given by
the center of rotation of the MLC. This value is only available for the enhanced MLC check and on
a machine equipped with the HD120 MLC.

Jaws (Offset X1 / X2 / Y1 / Y2)

Jaw edges are detected on a symmetric 18 cm field. The result is measured as the distance of
the jaw edges from the center of rotation of the MLC.

Rotation Offset
A MLC comb pattern is acquired for five collimator rotation angles at gantry position 0° IEC61217.
The rotation offset is determined as the maximum deviation of the nominal versus the actual
collimator rotation angle observable through the edges of the MLC leaves.

Gantry
The MPC geometry check evaluates two characteristics of the machines gantry positioning
system.

Absolute
The absolute positioning accuracy is defined as the coincidence of the couches vertical axis with
the central beam axis at gantry 0° IEC61217. For a movement along the vertical couch axis MPC
evaluates any lateral or longitudinal shift of the phantom with respect to the beam and the
treatment isocenter as the absolute gantry angle positioning error.

Relative
The angle of the gantry is evaluated as defined by the MV imaging system using the geometric
phantom. The relative positioning accuracy of the gantry is the maximum offset between the
angle determined by the MV imaging system, and the nominal gantry angle. The values are
compared for eight representative gantry angles (0, 45, 90, 135, 180, 225, 270, 315)° IEC61217.

Note: Note that the value shown is signed, displaying the direction of the maximum
offset for any gantry angle for this check. It can thus vary between the negative and the
positive maximum of the positioning accuracy for the gantry angles, showing an
oscillating behavior.

Couch
MPC measures the positioning accuracy of the different couch axes with respect to a reference
position (see Acquire Couch Reference on page 21 for more information). All available couch
axes are moved to various positions and the actual travel range of the couch axes is determined.
The standard couch measurement procedure uses the following couch shifts.

Checks 37
 Linear axes
1. Vertically + 15 cm
2. Laterally + 5 cm, Longitudinally − 5 cm

Rotational
axes:
3. Patient Support Angle − 10°
if available:
● Patient Pitch + 3°
● Patient Roll − 3°

The following evaluations are each made on a single position and reported as signed offsets.

Lateral Describes the positioning accuracy of the lateral couch axis on a 5 cm travel
range (IEC61217 positive direction, to the right).

Longitudinal Describes the positioning accuracy of the longitudinal couch axis on a 5 cm

travel range (IEC61217 negative direction, away from gantry).

Vertical (Large) Describes the positioning accuracy of the vertical couch axis on a 15 cm
travel range (IEC61217 positive direction, upward).

Rotation Describes the positioning accuracy of the patient support angle on a 10°
travel range (IEC61217 positive direction, view source to couch: CCW).

Pitch and Roll These values are only evaluated when using a Varian PerfectPitch couch
top.
The pitch and roll axes of the couch are measured in isocentric coordinates.
This means that the mechanical travel ranges of the other axes will be
different from the above values.
The pitch axis is rotated by the mechanical maximum of 3° (IEC61217
positive direction, rear end of couch lowering).
The roll axis is rotated by the mechanical maximum of 3° (IEC61217
negative direction, view towards gantry: CCW)

Rotation- The center of rotation of the couch is determined through a motion on all
Induced Couch available rotational axes and differs from the location of the treatment
Shift isocenter. The rotation-induced couch shift is the offset of this center of
rotation from the treatment isocenter.

Enhanced Couch
The Enhanced Couch Option can be performed at any time by selecting its Ad Hoc test (Tools >
Add Check > Beam & Geometry Check (Enhanced Couch) (see Scheduled and Ad-hoc
Checks on page 32). The Enhanced Couch Option can also be enabled for all Beam & Geometry
checks by selecting the option in Configuration (see Default Options for Beam & Geometry Check
on page 22).

38 Machine Performance Check Reference Guide

 When choosing the Enhanced Couch Option, an extended set of positions gets tested. As
opposed to the standard couch measurements, the offset of every axis is evaluated on multiple
couch positions (as reported in below list). As a consequence, the offsets for each axis are
reported as maximum absolute offsets.

Linear Axes:
1. Vertically + 5 cm
2. Laterally + 5 cm
3. Longitudinally + 5 cm
4. Vertically + 5 cm, Laterally − 5cm, Longitudinally + 5 cm
5. Vertically − 5 cm, Laterally + 5cm, Longitudinally − 5 cm

Rotational
Axes:
6. Patient Support Angle + 6 °
if available:
● Patient Pitch + 3°
● Patient Roll − 3°
7. Patient Support Angle − 6°
if available:
● Patient Pitch − 3°
● Patient Roll + 3°
8. Patient Support Angle − 45°
9. Patient Support Angle − 90° (or the outermost position as defined by the machine
configuration)
10. Patient Support Angle + 45°
11. Patient Support Angle + 90° (or the outermost position as defined by the machine
configuration)

Lateral Describes the positioning accuracy of the lateral couch axis on any of the
measured positions 1 to 5.

Longitudinal Describes the positioning accuracy of the longitudinal couch axis on any of
the measured positions 1 to 5.

Vertical Describes the positioning accuracy of the vertical couch on any of the
measured positions 1 to 5.

Maximum Describes the positioning accuracy considering all linear axes on any of
Positioning Error the measured positions 1 to 5.

Checks 39
 Rotation (Fine) Describes the positioning accuracy of the patient support angle for fine
patient positioning, evaluated on positions 6 and 7.

Rotation (Large) Describes the positioning accuracy of the patient support angle over the
full range, evaluated on positions 6 to 11.

Pitch and Roll These values are only evaluated when using a Varian PerfectPitch couch
top.
Describes the positioning accuracy of the patient support pitch and roll
angles on positions 6 and 7.
The pitch and roll axes of the couch are measured in isocentric
coordinates. This means that the mechanical travel ranges of the other
axes will be different from the above values.
The pitch and roll axes are rotated to their mechanical maximum of ± 3°.

Rotation- Induced The center of rotation of the couch is determined through a motion on all
Couch Shift (Full available rotational axes and differs from the location of the treatment
Range) isocenter. The rotation-induced couch shift is the offset of this center of
rotation from the treatment isocenter. This is evaluated on positions 6 to
11.

Conical Collimator
Radiotherapy treatments using conical collimators place high demands on the positional accuracy
of the radiation beam.
MPC evaluates three important characteristics for the ICVI system and the mounted conical
collimators. A fourth parameter, ball-isocenter offset, is displayed for informational purposes only.
The alignment of the conical collimator with the collimator rotation axis is evaluated by acquiring
MV images for five collimator rotation angles evenly distributed (0, 72, 144, 216, 288)° IEC61217
over the full range. Subsequently, the circular collimated fields are detected with (ICVI check) or
without (ICVI axis alignment check) the phantom ball in the field. The MPC ICVI axis alignment
check evaluates the conical collimator alignment for one gantry angle only.

Alignment to Collimator Rotation Axis

The alignment to the collimator rotation axis is defined as the maximum distance of all field
centers from the collimator rotation center.

Gantry-Collimator Isocenter Size

The gantry-collimator isocenter size is defined as the maximum distance of all collimator rotation
axes from the idealized treatment isocenter under gantry and collimator rotation.
In the MPC ICVI check, the isocenter is determined using the phantom ball which is located in the
collimated beam. The collimator rotation axis is determined for five different gantry angles (0, 90,
180, 270, 360)° IEC61217 according to above procedure. The isocenter is defined as the ideal
point minimizing the distance to all collimator rotation axes for the five gantry angles.

40 Machine Performance Check Reference Guide

 Gantry-Collimator-Couch Isocenter Size

The gantry-collimator-couch isocenter size is defined as the sum of the rotation induced couch
shift and the gantry-collimator isocenter size.
The couch rotation center is evaluated from the different phantom ball positions under couch
rotation. For this purpose MV images are acquired at five different couch rotation angles (90, 45,
0, 315, 270)° IEC61217 with fixed gantry (180° IEC61217) and collimator position (288° IEC
61217). It is important to note that this estimation does not depend on the exact positioning of the
phantom ball to the treatment isocenter. The evaluated phantom ball positions are corrected for
the initial misalignment between treatment isocenter and ball position. The maximum distance
between the corrected ball positions and the ideal treatment isocenter is defined as the rotation
induced couch shift.

Ball-Isocenter Offset

The ball-isocenter offset is defined as the distance between the phantom ball position and the
treatment isocenter under collimator and couch rotation.

Session
An MPC session is defined as the sum of all checks acquired after launching the MPC
application. Both scheduled as well as ad-hoc MPC checks are combined within one MPC
session (for more information see Schedule on page 19).

History
Results of all MPC checks performed on a treatment unit constitute the MPC history of that
system. The history can be viewed for trend analysis and for researching failures. In the MPC
offline mode the MPC history of multiple systems can be reviewed.

Checks 41
Appendix: Data Management

Retention
MPC manages the data from acquired checks automatically.
Checks of the last three days, including all images, are kept. Data results are retained for two
years. Baselines are never deleted.

Note: The local MPC history has a disk space quota of 5 GB. However, if the available
actual disk space drops below 5.5 GB on the disk drive, no new checks can be acquired.

The MPC data retention module is designed to retain as much data as possible with respect to
the above criteria. This is accomplished by gradually removing acquisitions from the checks
folders. MPC acquires a variety of images during a checks run. After extracting the essential
geometric features, the corresponding images are only available for review within MPC. They will
be deleted as soon as the available disk space drops below 5.5 GB or more than 5 GB of disk
space is used. MPC will remove all geometry acquisitions beginning with the oldest checks. Once
there are no more geometry acquisitions to be deleted, beam data is removed, beginning with the
oldest check. Baselines always retain at least the beam image as a historic reference.

Note: This process only starts after the quota is filled. During the initial phase of using
MPC, all acquired images will be available also after the three days full retention period.

Synchronization
The treatment workstation is configured by Varian service to synchronize the local MPC history to
the following directory on the local file server:
\\<yourserver>\va_transfer\TDS\<machineID>\MPCChecks
MPC Offline mode can be used to review these files on another computer over the network.

Note: When accessed for offline review the shared network folder should be configured
as read-only.

The synchronization solution (PeerSync) performs an instant replication of the data. PeerSync
copies all new and changed MPC data from the MPC console directory to the network share
drive, but it will not delete any data on the network share drive. Therefore, the rules for data
retention (see Retention on page 42) do not apply. MPC's Offline mode does not monitor the file
system for changes. The user must restart MPC to refresh the history view.

Data Export
There are three ways provided to export data for use in a non-Varian environment:
● Per-Check Results in CSV format
● Full MPC History in CSV format
● Export a single check to a Zip file

42 Machine Performance Check Reference Guide

 Per-Check Results in CSV Format
Each check folder has a Results.csv file that contains all display values of the check in a machine
readable format (text file, comma separated values).
The format row-based, where each row has the following, comma-separated format:
Name [Unit], Value, Threshold, Evaluation Result
An exemplary value will read:
IsoCenterGroup/IsoCenterSize [mm], 0.3, 0.5, Pass
The first column represents a unique identifier of the evaluated value. Values are sorted in the
same hierarchy of groups like in the detail view of the review mode. The unit of the value is also
contained in this column.
The next two columns contain the actual value and the value used as threshold. The last column
contains the evaluation state of the value. It can be Pass, MarginalPass or Fail.
This file can be directly used in Excel.
While check folders cannot be directly accessed on the console workstation, the check folders
are accessible on the network drive to which the MPC data are synchronized or on the customer
workstation. Use export option 3 to access the Results.csv file on the console workstation.

Full MPC history in CSV format

For statistical evaluation on the performance values, the results of all checks of an MPC history
can be exported to a cumulative text file in CSV format. One file per energy is created. Exported
text files are stored in the directory:
<VMSOS_Data_Root>\AppData\TDS\Output\MPC\Results (the default setting for
VMSOS_Data_Root: is D:\VMSOS\ on the Console workstation and C:\VMSOS\ on the
Customer workstation).
It uses a column-based, comma separated format:
● The first column contains the checks date and time.
● The following columns contain a list of all performance values.
The first row in the file represents the header and contains the identifiers of the single
performance values contained in the columns.

Note: Empty values are possible in cases where the respective values could not be
evaluated.

Export a single check to a Zip file

For external evaluation, manual archiving or support of Varian Service, single checks can be
exported into Zip format. The exported file can be extracted and reviewed in the MPC Offline
mode.
Exported Zip files are stored in the directory:

Data Management 43
 <VMSOS_Data_Root>\AppData\TDS\Output\MPC\Checks\ (the default setting for
VMSOS_Data_Root: is D:\VMSOS\ on the console workstation and C:\VMSOS\ on the
customer workstation).

44 Machine Performance Check Reference Guide

Appendix: Reports

Reporting
A check report in PDF format can be created for MPC checks by clicking Create Session Report
in the MPC Test window, or by selecting the Create Check Report option in the MPC review
workspace or MPC Offline. The report displays in a new window.
Upon creation, click Accept to store an electronic version of the check report on the hard drive
(Directory: <VMSOS_Data_Root>\AppData\TDS\Output\MPC\Reports\. The default setting
for <VMSOS_Data_Root:>D:\VMSOS\ on the console workstation and C:\VMSOS\ on the
customer workstation.) Alternatively, click Discard to not store the check report.

Session Report
The MPC application allows for creating test session reports in the MPC console. The session
report contains details of all the checks that have been performed in the current MPC session.
Like the check report, it is stored in PDF format.
To create a session report, complete all checks in the MPC console, and then click Create
Session Report.

Check Report
The MPC application allows for creating check reports both in MPC console as well as in MPC
offline mode. The check report can be stored in PDF format.
To create a report while reviewing data in the MPC review workspace or MPC Offline, open the
Details View for any test session and choose Options > Create report.

Reports 45
 Figure 15 MPC check report for 6X Beam & Geometry Check
Check reports provide information in the Overview sections on the treatment unit and on the
origin of the report. The results section contains a summary of the MPC check as well as a table
with the detailed results. The summary contains the following information:
● Name of the MPC check
● Overall test result
● Date and time in which the check was performed

46 Machine Performance Check Reference Guide

 ● Date and time in which the baseline used to process the current MPC check was acquired
● Status of MPC beam delivery and processing
The table contains the identical information listed in the Details View. Only MPC results for the
individual MLC leaf positioning accuracy are omitted to avoid clustering.

Reports 47
Index
A couch option
enhanced 31
about this document 8 couch reference
acquire couch reference 21 acquire 21
acquisition workspace 14 CSV files 19
ad-hoc check 32 CSV format 43
add a machine per-check results 43
to the offline mode 23

D
B
data export 42
ball-isocenter define machines 22
offset 41 details 29
baseline check details view 16
define 21 disk space
prerequisites 20 actual 42
beam quota 42
constancy 34 disk space quota 42
beam and geometry checks
options 22
beam checks 19 E
beam constancy check 31
enhanced couch 38
enhanced couch option 31
C enhanced MLC check 32
EPID 34
CBCT 35 evaluation 26
center shift 35 export 43
change mode 28
check
ad-hoc 32 G
beam constancy 31
gantry 37
geometry 31
gantry-collimator
scheduled 32
isocenter size 40
check schedule 20
gantry-collimator-couch
checks 31
isocenter size 41
add/remove 28
geometry 24
beam 19
geometry check 31, 35
collimator 36
conical 40
collimator rotation axis H
alignment 40
conical collimator 40 HEI 25
console mode 13 history 28, 41
baseline check 20 in CSV format 43
couch 37 History view 15
enhanced 38

48 Machine Performance Check Reference Guide

I performance values 32
phantom
ICVI Drum 24
axis alignment check 32 ICVI 25
check 32 IsoCal 24
ICVI phantom 24 positioning 24
positioning 25 publication
intended audience intended audience 8
publication 8 publications
intended use of product 8 related 8
IsoCal phantom 7, 24
isocenter 35
Q

L quick evaluation 24, 26

leaf gap 21
R

M reporting 27
retention 42
Machine Performance Check review 28
check report 45 details view 29
reporting 45 history view 28
session report 45 trends 30
maintaining system integrity 10 review workspace 15
MLC 15, 36 details view 16
MLC check trends 17
enhanced 32
MLC leaf gap 21
modifying software S
hazardous 10 safety 10
MPC unauthorized hardware 11
overview 7 SBRT 24
schedule 19
O scheduled check 32
session 41
offline mode 17 setting up MPC
adding a machine 23 about 19
offline setup 22 setup
online setup 19 offline 22
acquire couch reference 21 online 19
beam checks 19 single check
schedule 19 export 43
operation modes SRS 24
about 12 synchronization 42
output change 35

T
P
trends 17
perform check 26 trends view 30

Index 49
U
uniformity change 35
user rights 12
using MPC
about 24

V
visual cues 8

Z
zip file 43

50 Machine Performance Check Reference Guide