AAPM Medical Physics Practice Guideline 18.a: Superficial radiation therapy using low-energy kilovoltage x-rays.
9 affiliations
- 1Department of Radiation Oncology, Herbert Wertheim Cancer Institute, Baptist Health South Florida, Miami, Florida, USA.
- 2Department of Oncological Sciences, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
- 3Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
- 4PMM Inc., Atlanta, Georgia, USA.
- 5Department of Radiation Oncology, Miami VA Medical Center, Miami, Florida, USA.
- 6Radiation Oncology, SunState Medical Specialists, Miami, Florida, USA.
- 7Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York, USA.
- 8Colorado Associates in Medical Physics, Colorado Springs, Colorado, USA.
- 9Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Abstract
Superficial radiation therapy (SRT), utilizing low-energy kilovoltage (kV) x-rays typically in the 50-100 kVp range, is a well-established modality in dermatology and radiation oncology clinics for the management of non-melanoma skin cancer and various benign dermatological conditions. The comprehensive medical physics practice guidelines presented in this report are designed to facilitate adherence to minimum standards for SRT delivery. A technical overview of commercially available SRT systems in the United States is provided. Detailed guidelines for commissioning and routine quality assurance are presented, specifying daily, monthly, and annual tests, alongside established action limits. The SRT clinical workflow is delineated, encompassing patient simulation, treatment time or monitor unit calculations, data entry, independent treatment plan review, and radiation delivery. A summary of typical state regulatory requirements for x-ray machines is included. Adherence to relevant state regulations is emphasized and radiation safety considerations, comprising structural shielding, radiation surveys, personnel monitoring, signage, periodic spot checks, and machine operation, are discussed to ensure a safe and effective clinical environment. References to relevant societal practice guidance are provided to support standardized clinical implementation.
Related
- Surface-guided Radiation Therapy in Clinical Practice: A Review with Perspectives on Implementation in Resource-constrained Settings
- Retrospective intrafraction motion verification using triggered kilovoltage images during bone metastases stereotactic body radiotherapy
- Evaluation of Concordance between Radiation Therapists and Medical Physicists in MR-Guided Online Adaptive Planning.
- The Development of The Cartoon-Assisted Practicum Guideline To Enhance Students’ Science Process Skills in Physics Learning
- Compact laser power measurement at tens of watts via amplified radiation pressure
BibTeX
@article{lee2026aapm,
title = {{AAPM Medical Physics Practice Guideline 18.a: Superficial radiation therapy using low-energy kilovoltage x-rays.}},
author = {Yongsook C Lee and Seng Boh Lim and Peter M Mondalek and Sergio O Reilly and David G Saez and Ren-Dih Sheu and Gerald A White and Strahinja Stojadinovic},
journal = {Journal of applied clinical medical physics},
year = {2026},
month = oct,
doi = {10.1002/acm2.70857},
url = {https://europepmc.org/article/MED/42963823},
note = {CC BY},
}
RIS
TY - JOUR
TI - AAPM Medical Physics Practice Guideline 18.a: Superficial radiation therapy using low-energy kilovoltage x-rays.
AU - Yongsook C Lee
AU - Seng Boh Lim
AU - Peter M Mondalek
AU - Sergio O Reilly
AU - David G Saez
AU - Ren-Dih Sheu
AU - Gerald A White
AU - Strahinja Stojadinovic
PY - 2026
DA - 2026/10/30
JO - Journal of applied clinical medical physics
DO - 10.1002/acm2.70857
UR - https://europepmc.org/article/MED/42963823
AB - Superficial radiation therapy (SRT), utilizing low-energy kilovoltage (kV) x-rays typically in the 50-100 kVp range, is a well-established modality in dermatology and radiation oncology clinics for the management of non-melanoma skin cancer and various benign dermatological conditions. The comprehensive medical physics practice guidelines presented in this report are designed to facilitate adherence to minimum standards for SRT delivery. A technical overview of commercially available SRT systems in the United States is provided. Detailed guidelines for commissioning and routine quality assurance are presented, specifying daily, monthly, and annual tests, alongside established action limits. The SRT clinical workflow is delineated, encompassing patient simulation, treatment time or monitor unit calculations, data entry, independent treatment plan review, and radiation delivery. A summary of typical state regulatory requirements for x-ray machines is included. Adherence to relevant state regulations is emphasized and radiation safety considerations, comprising structural shielding, radiation surveys, personnel monitoring, signage, periodic spot checks, and machine operation, are discussed to ensure a safe and effective clinical environment. References to relevant societal practice guidance are provided to support standardized clinical implementation.
SN - 1526-9914
ER -