Commissioning a linear accelerator is among the most consequential activities in any radiotherapy department. It is the process through which we verify that a complex, high-energy system is safe, accurate, and ready for clinical use. Yet commissioning scope varies significantly between vendors, and many facilities lack the in-house medical physics capacity to verify results independently. This gap is where problems begin — and where a structured, evidence-based approach makes the difference.
We begin every linac commissioning engagement by defining protocols aligned with international standards such as IAEA TRS-430, AAPM Task Group reports, and the manufacturer's own acceptance criteria. We do not simply witness vendor testing; we perform independent measurements using calibrated ionisation chambers, water phantoms, and electronic portal imaging devices. This dual-track approach ensures that beam data, mechanical isocentre, MLC positioning, and safety interlocks are verified from two independent perspectives before clinical release.
One of the most common issues we encounter is incomplete documentation. Commissioning generates enormous volumes of data — beam profiles, output factors, wedge factors, imaging chain QA, and mechanical tolerances. Without a structured documentation framework, critical results are scattered across vendor reports, email threads, and handwritten notes. We compile a commissioning dossier designed for regulatory submission and clinical governance review, with clear traceability from raw measurements to acceptance decisions.
For facilities commissioning their first linac or upgrading to a new platform, we recommend engaging independent consultancy support before the vendor arrives on site. Early involvement allows us to review bunker readiness, confirm dosimetry equipment calibration, and align your physics team on roles and responsibilities. The result is a smoother commissioning timeline, fewer surprises at acceptance, and a QA baseline that supports your department for years to come.