AAPM Task Group 66U1 report 83.B: Quality assurance for computed‐tomography simulators in radiation oncology

This Task Group (TG) report provides updated guidance from American Association of Physicists in Medicine TG 66, published in 2003, on quality assurance (QA) of computed tomography (CT) simulators used for radiation therapy (RT) treatment planning. In addition to updates and expansions of the original recommendations, this report provides recommendations for QA on various techniques that are now commonly used in radiation oncology but were not covered by TG 66, including respiratory‐correlated four‐dimensional CT (4D‐CT), extended Hounsfield Unit scales, metal‐artifact reduction, extended field‐of‐view, and multi‐energy CT. The report provides recommendations for the scanning of material‐density calibration phantoms and for the maintenance and management of CT scan protocols. A risk‐based analysis of the CT simulation process is presented, using an example of the 4D‐CT process for lung stereotactic body RT simulation. A comprehensive summary of recommendations from both the original and the updated report is included for reference in the appendix.