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Commissioning followed MPPG 5.b tests. The reference-dose agreement, magnetic-field modelling, directional dependence, output factors, off-axis points, heterogeneous slab geometries and calculation properties were assessed. Nine step-and-shoot IMRT plans (courtesy of Elekta) and 226 retrospectively analysed adapted fractions (prostate and pelvic nodes; planning target volumes 1.9\u2013170.0\u00a0cm\n                    <jats:sup>3<\/jats:sup>\n                    ) were compared between TQA and Monaco by gamma analysis (global 10.0% threshold; 2.0%\/2.0\u00a0mm, 3.0%\/2.0\u00a0mm). At 10.0\u00a0cm depth under TQA reference conditions, the mean absolute point-dose difference versus Monaco was 0.4%. TQA reproduced models the magnetic-field\u2013induced cross-plane asymmetry with close agreement to Monaco. Directional dependence differences were \u2264\u2009\u2009\u00b1\u20091.2% except when traversing the couch (\u00b1\u20091.8%). Output factors agreed within \u2264\u20091.0% (SSD 133.5\u00a0cm) and \u2264\u20092.0% (SSD 138.5\u00a0cm). In 226 clinical fractions, 3.0%\/2.0\u00a0mm (global) yielded 93.0% passes in the high-dose region and 100.0% in other regions; 2.0%\/2.0\u00a0mm yielded 25% high-dose passes. TQA results were available within about 1\u00a0min post Monaco export. TQA provides accurate, rapid, volumetric secondary dose verification for Unity, improves agreement with Monaco, and reduces console time by eliminating dose point re-selection. A 3.0%\/2.0\u00a0mm global gamma criterion is a clinical acceptance level, with tighter criteria reserved for targeted investigations.\n                  <\/jats:p>","DOI":"10.1007\/s13246-025-01693-0","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T13:42:00Z","timestamp":1768830120000},"page":"639-654","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of ThinkQA (v2.0.1.11) as an online secondary dose check for MR guided radiation therapy with the Elekta Unity MR-Linac"],"prefix":"10.1007","volume":"49","author":[{"given":"Ariadne S.","family":"Brodmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Baines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"issue":"3","key":"1693_CR1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.semradonc.2014.02.009","volume":"24","author":"JJW Lagendijk","year":"2014","unstructured":"Lagendijk JJW, Raaymakers BW, van Vulpen M (2014) The magnetic resonance imaging-linac system. 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Therefore, no ethics approval was required (THHSAudit 202512-899).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}