Feasibility and evaluation of an automated software module for routine image-guided radiotherapy quality assurance: a clinical implementation and comparative study

Background: Image-guided radiotherapy (IGRT) has revolutionized precision in radiotherapy treatments by ensuring accurate patient positioning and real-time anatomical localization. This study explores the clinical feasibility and utility of implementation of a web-based automated quality assurance (QA) software, for routine IGRT QA procedures. Methods: Periodic IGRT QA procedures were conducted on a Varian TrueBeam linear accelerator (v2.5) with a web-based automated QA software platform. The kilovoltage (kV), megavoltage (MV), and cone beam computed tomography (CBCT) imaging systems were evaluated using appropriate phantoms namely, automated software company provided kV and MV phantom, Varian 6 Dot Marker, Varian MPC, TOR 18FG, Las Vegas, and Catphan® 604. Parameters such as geometric accuracy, spatial resolution, uniformity, low-contrast detectability, noise, slice thickness, and HU constancy were evaluated. Results: The QA metrics met predefined baselines or AAPM TG-142 tolerances. The full QA process, including setup and analysis, was completed in 40–45 minutes. The software ensured consistent results with minimal manual intervention. Conclusions: AQMS significantly improves the efficiency and consistency of routine IGRT QA. Its integration into clinical practice streamlines workflows and ensures compliance with QA standards, making it highly suitable for busy radiotherapy centers.