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Access Type

WSU Access

Date of Award

January 2020

Degree Type


Degree Name



Medical Physics

First Advisor

Brian Loughery


The purpose of this study was to utilize advanced delivery techniques to simulate a cone-based Winston-Lutz Test using an MLC-equipped linac, and to evaluate the applicability of this test as a replacement to the Winston-Lutz type testing protocols currently in practice. Two plans, a Single Target at Isocenter plan and an Off-Axis Multiple Target Single Isocenter plan, were constructed and delivered as XML Beams via TrueBeam Developer Mode. Three target alignment methods were used for evaluation: room lasers, CBCT registration and CBCT registration with an intentional offset. The target offset was measured and compared to the known value by analyzing deviations between the MLC field and target centroids. The Single Target at Isocenter plan was successful in predicting the amount of target offset. The Off-Axis Multiple Target Single Isocenter plan was not successful in offset prediction, possibly due to the phantom configuration and evaluation tools.

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