As IMRT treatment processes advance and mature, so must the quality assurance processes being used to validate their delivery. In some respects, treatment delivery advancements (e.g. VMAT) have out-paced QA advancements. The purpose of this session is to describe new processes that are being implemented to bring IMRT QA up-to-date with the treatment delivery advances. It would explore emerging IMRT QA paradigms, including requirements-based IMRT QA which necessitates definition of delivery errors (e.g. patient dose error, leaf positioning error) and development of processes to ensure reliable error detection. Engineeringbased QA approaches, including use of IMRT treatment delivery process trees, fault tree analysis and failure modes effects analysis would be described. Approaches to detect errors such as (1) during treatment delivery validation using exit fluence detectors (e.g. EPIDs); (2) analysis of treatment delivery via use of machine parameter log files; (3) dose recalculation using (3a) treatment planning system; (3b) record-and-verify; or (3c) entrance and exit fluence measurement parameters would be explained. The relative advantages and disadvantages of each method would be discussed. Schemes for error classification and root cause analysis would be described – steps which are essential for future error prevention. For each QA method, testing procedures and results would be presented indicating the types of errors that can be detected, those that cannot be detected, and the reliability of the error detection method (for example determined via ROC analysis). For speakers, we are seeking to engage non-commercially biased experts. Those listed below are a sub-sample of possible qualified individuals.