Facilities should select the radiotherapy unit based on the range of energies required and ease of patient setup.
Due to the high price of radiotherapy equipment, facilities need to carefully assess their needs and choose a versatile radiotherapy unit that can meet their needs.
Many different cobalt linear accelerator designs are available from various manufacturers who offer a slightly different approach to device design. There is no sufficient data to show the clinical superiority of a particular design.
Different cobalt linear accelerator models offer various numbers and sizes of collimator leaves.
The main differences between low, mid, and high-energy cobalt linear accelerators are the photon and electron energy ranges. Buyers should choose the appropriate type based on the main uses of the radiographic unit.
The cobalt linear accelerator units, much like the low energy LINACs, are mainly used for treating bone cancer and head, neck, and breast tumors.
For treating deep-seated neoplasms and tumors of the pelvis and thorax, higher energy cobalt linear accelerators are used. These can also produce low-energy beams, and therefore are capable of more applications than lower-energy LINACs. However, they are significantly more expensive.
The cobalt linear accelerator can be either a travel or standing wave accelerator for all types of LINACs. The microwave power source can be either magnetron or klystron, and the gantry rotation range should be 360°.
LINACs should have multileaf collimators with at least 40 leaves.
For x-rays, the collimators should define fields of 40 × 40 cm. For electrons, they should be 25 × 25 cm.
Radiation treatment requires a wide range of photon and electron energy and treatment field sizes due to the fact that cancerous tumors occur at different depths and locations within the body.
Approximately 60% of patients require low-energy therapy, 25% of patients require medium to high-energy therapy, and 15% require a high-energy electron beam.
Before installation of a radiotherapy unit, the shielding requirements should be determined by a medical physicist. Due to the higher doses, IMRT may require additional shielding.
For calibrating equipment and identifying operating irregularities, buyers should establish a comprehensive quality assurance program.

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