{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:48:51Z","timestamp":1790891331839,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to compare the sensitivity of log file\u2010based quality assurance (LF\u2010QA) and measurement\u2010based quality assurance (MB\u2010QA) for detecting multileaf collimator (MLC) positional errors and to evaluate the dosimetric impacts of MLC mechanical drive train defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mechanical degradation of the MLC was simulated on a TrueBeam STx system by inducing three defect types: T\u2010nut surface wear (0.5\u20131.2\u00a0mm), drive screw thread wear, and motor degradation. MLC positioning accuracy was assessed using a rotational Picket Fence (PF) test, and the dosimetric impacts were evaluated on clinical breast intensity\u2011modulated radiation therapy (IMRT) and prostate volumetric\u2011modulated arc therapy (VMAT) plans. LF\u2010QA and MB\u2010QA were performed concurrently under identical delivery conditions. Gamma passing rates (GPRs) and dose\u2010volume histogram (DVH) analyses were compared between baseline and defective deliveries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LF\u2010QA detected positional deviations between baseline and defective conditions\u00a0(&lt;0.14\u00a0mm;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) but consistently underestimated the extent of the induced defects. Correspondingly, LF\u2010QA gamma analysis (GPRs \u2248 100%) and DVH metrics (\u2206\n                      <jats:italic>D<\/jats:italic>\n                      \u00a0&lt;\u00a00.2%) showed no detectable dosimetric differences. MB\u2010QA exhibited higher sensitivity to specific MLC defects, identifying localized fluence variations for T\u2010nut surface wear, whereas no discernible differences were observed for drive screw thread wear or motor degradation. MB\u2010QA gamma analysis revealed localized dose differences of up to 15% in breast IMRT and 7.4% in prostate VMAT. DVH analysis further demonstrated clinically relevant dose variations in organs at risk (OARs), including the contralateral breast (\u0394\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>mean<\/jats:sub>\n                      : 5.52%) and right lung (\u0394\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      : 4.50%) in breast IMRT, and the penile bulb (\u0394\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>99<\/jats:sub>\n                      : 1.55%) in prostate VMAT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LF\u2010QA showed limited sensitivity to sub\u2010millimeter MLC errors and did not capture clinically meaningful dosimetric deviations under mechanically degraded conditions. MB\u2010QA enabled superior error detection and clinically relevant dosimetric verification. These findings indicate that LF\u2010QA alone may be insufficient for patient\u2010specific QA and that incorporating MB\u2010QA is essential for ensuring reliable dosimetric verification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70389","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T03:22:16Z","timestamp":1763522536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of log file\u2010based and measurement\u2010based QA for detecting MLC positional errors and evaluating dosimetric impacts of MLC defects"],"prefix":"10.1002","volume":"26","author":[{"given":"Chul Hang","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"},{"name":"Department of Biomedical Engineering Pusan National University  Pusan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Mun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"},{"name":"Institute of Health Science Gyeongsang National University  Jinju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0998-0685","authenticated-orcid":false,"given":"Hoon Sik","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"},{"name":"Institute of Health Science Gyeongsang National University  Jinju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(00)00419\u20103"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/22373346"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v16i5.5515"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00411\u2010024\u201001097\u2010w"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v12i3.3409"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4749965"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/53\/1\/005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjr\/tqaf053"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13061"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2010.06.013"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13708"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14992"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14160"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15069"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v8i3.2443"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v15i2.4665"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13246\u2010023\u201001219\u20106"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13053"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v3i2.2578"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1751011"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13202"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/59\/9\/N49"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4949002"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13660"},{"key":"e_1_2_10_26_1","unstructured":"Varian Medical Systems.Rapid Arc QA Test Procedures and Files (T1.1_PicketFenceRA_HD120.dcm and T0.2_PicketFenceStatic_HD120.dcm). 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