ABSTRACT
The linear accelerators use by radiation therapy (RT) centers are accompanied by advanced technology and can deliver complex treatment beam arrangements such as those required for intensity-modulated radiotherapy or stereotactic radiosurgery. The advanced technologies typically consist of many interdependent processes that make them difficult to verify properly, therefore, the entire treatment process must be evaluated using what is known as an end-to-end quality assurance (E2E QA) test. The test is an audit methodology that tests whether all of the components in the treatment process function in a manner such that the desired radiation dose is delivered accurately only to the intended spatial location. One of the most essential and complex components of the RT treatment chain of events are the treatment planning process, more specifically, the treatment planning computer. A multi-institutional clinical trial may incorporate a credentialing program in an effort to minimize the number of protocol violations and improve the overall quality of the trial.
