The capability of the TrueBeam treatment system to deliver step and shoot IMRT plans at low dose rates was evaluated. Beam characteristics during low dose rates (5 to 100 MU/min) were evaluated for consistency using a planar ion chamber array. MU constancy, linearity, and beam profile symmetry were all found to be equivalent within 0.5%. The response of the Scandi Dos Delta 4 system was also evaluated at low dose rates of using static open beams compared to ion chamber measurements, and step and shoot IMRT plans comparing 5 - 20 MU/min and 100 MU/min dose rates, with a maximum observed absolute dose difference of 0.8% and equivalence margin of 0.2%. The Gamma Index and measurement reproducibility were also found to be equivalent.
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