{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:24:15Z","timestamp":1787963055441,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Single\u2010isocenter multiple\u2010target stereotactic radiosurgery (SIMT SRS) has emerged as an efficient treatment for multiple brain metastases. However, this technique demands exceptional geometric accuracy, particularly off\u2010axis, to ensure optimal dose delivery while sparing healthy tissue. Traditional quality assurance (QA) methods require adaptation for SIMT SRS, highlighting the need for robust testing protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the long\u2010term off\u2010axis targeting accuracy of three Varian TrueBeam linear accelerators using a dedicated off\u2010axis Winston\u2013Lutz test (OAWLT) and to investigate correlations with routine varian machine performance check (MPC) results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials &amp; Methods<\/jats:title>\n                    <jats:p>Weekly OAWLT measurements were performed over a 6\u2010month period on three TrueBeam linacs using the Sun Nuclear StereoPHAN phantom and MultiMet\u2010WL cube. The test delivered 6 MV flattening filter\u2010free beams to multiple off\u2010axis targets via eight beam orientations, simulating clinical SIMT SRS workflows. Concurrently, daily MPC assessments evaluated geometric parameters including isocenter size, kV isocenter offset, beam center, and couch radiation\u2010induced offset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median OAWLT errors were 0.38, 0.44, and 0.59 mm for the three linacs included in this study, with maximum errors of 1.12, 1.08, and 1.54 mm. Notably, off\u2010axis errors increased with target off\u2010axis distance, with the worst performance observed at 7 cm off\u2010axis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine OAWLT is an effective and sensitive QA tool for monitoring off\u2010axis targeting accuracy in SIMT SRS. Despite the convenience of daily MPC, it cannot substitute for a dedicated OAWLT. The study supports implementing weekly OAWLT in clinical practice to ensure high\u2010quality, consistent treatment delivery for SIMT SRS treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70275","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T02:49:44Z","timestamp":1759286984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quality assurance of single isocentre multiple target stereotactic radiosurgery: Findings from long\u2010term off\u2010axis Winston\u2010Lutz testing and machine performance checks"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-2618","authenticated-orcid":false,"given":"Joel","family":"Poder","sequence":"first","affiliation":[{"name":"St George Hospital Cancer Care Centre  Kogarah NSW Australia"},{"name":"Centre for Medical Radiation Physics University of Wollongong  Wollongong NSW 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