REF 91250 - Standard Imaging
Contents
1. Measurement of high activity radioactive sources is potentially hazardous and should be performed by qualified personnel A CAUTION As desired by IAEA English is the default language for labeling and manuals If translated versions are available resolve any differences in favor of the English versions WARNING Proper use of this device depends on careful reading of all instructions and labels WARNING Where applicable Standard Imaging products are designed to be used with the versions of common radiation delivery devices treatment planning systems and other products or systems used in the delivery of ionizing radiation available at the time the Standard Imaging product is released Standard Imaging does not assume responsibility liability and or warrant against problems with the use reliability safety or effectiveness that arise due to the evolution updates or changes to these products or systems in the future Itis the responsibility of the customer or user to determine if the Standard Imaging product can be properly used with these products or systems gt P Should repair or replacement of this product become necessary after the warranty period the customer should seek advice from Standard Imaging Inc prior to such repair or replacement If this product is in need of repair it should not be used until all repairs have been made and the product is functioning properly and ready for use After repair t2. required because the measured film isodoses can be physically placed on the expected TPS isodoses for a quick qualitative check of the Rx isodose line as well as the 90 50 and 10 percent lines TPS Commissioning Test Examples The CT studies of the SRS Dosimetric QA Slab Configuration can be used to confirm geometric and CT density number accuracy on the imported studies Contour volume size of the complex shapes embedded in the SRS Dosimetric QA Slab can be used to test the volumetric accuracy of the TPS software Single beam dosim etry can be validated using the provided air cavity General Test Flow CT images are acquired of each phantom configuration in one of two orientations depending upon the test to be conducted Refer to Table 1 Dosimetry Test Descrip tion Summary The general test work flow includes CT study acquisition Import CT image sets as patient studies Treatment plans generation Import as patient treatments on the Cy berKnife SGI Treatment Delivery System Generate the DRRs and confirm the scription Setup and treat the phantom Compare measured results with the ex pected values 8 CyberKnife Sample Dosimetry Tests Continued CT Setup Phantom Configuration lon Chamber Configuration Page 10 Test Description Absolute Dose Calibration Traceability Collimator Dose Delivery Confirmation Using a Micro Chamber Model A19 Exradin Clas sic Farmer t
3. 0 mm cylinder as a trigeminal object using the C Shape as the avoidance structure When testing conformality use the appropriate range of SADs and collimator sizes TPS Commissioning and Dose Conformality Testing Cont Once a plan similar to Image 6 is gen erated import it into the SGI treatment delivery system generate the DRRs for patient phantom setup confirm the prescription and deliver the plan to the phantom in the Film Configuration The resulting film can be scanned at the prescription isodose line and the 90 50 and 20 lines relative to the point of maximum dose Conformality of the dose delivered relative to the expected isodose lines can be evalu ated The film dose plot can be directly placed on the phantom for a qualitative relative dose analysis If dose analysis software is available the DTA between planned and measured doses can be determined as well as the isodose level agreement Image 6 Software image showing a conformal plan to the C Shape Film Dosimetry Film Dosimetry The Film Configuration is comprised of two slabs of 5 mm thickness plus five slabs of 2 mm thickness that have a recessed pocket to contain GAF film in a precise geometry relative to the phantom and the embedded gold fiducials Either conformality test plans generated using the SRS Dosimetric QA Slab Configured Phantom or patient overlay treatments are delivered to this phantom The film insert and th
4. Delivery Accuracy Patient Dose Overlay Test Example using Radiologi cal Physics Center Dose Phantom Place the Film Insert onto the bottom 4 cm slab alignment pins Scan in both the coronal and transverse plane i e the film in parallel to the CT table coronal and also parallel with the CT slice transverse Scan the Radiological Physics Center CyberKnife SRS phan tom as instructed Table 1 Dosimetry Test Description Summary Plans generated to the Dosimetric QA phantom are delivered to the Film Phantom The film is scanned to the Rx isodose line IDL and over lain directly onto the conformal shape that was planned Using the MultiPlan overlay function to copy the desired treatment plan onto the Dose Film Phantom lon Chamber Configuration Configuration for CT Scanning The Stereotactic Dose Verification Phantom is comprised of rectangular slabs of water equivalent material which are precisely stacked together with two guideposts and either flat topped or thumb screws It is de signed to accommodate many types of ion chambers or diodes Four embedded gold fiducial markers provide positioning accuracy similar to the implanted fiducials used for patient alignment All phantom configurations are scanned according to the Accuray treat ment planning system requirements Use a Field of View that fully encompasses the phantom slice thicknesses of less than 1 tilt mm and 120 kVp The mA can be adjusted so tha
5. assembly as well as ensuring the embedded gold markers are in their correct orientation at all times An alignment mark similar to a dimple is located in the corner of each slab for use as a quick visual guide Orient each slab with this mark facing upward and directly over the mark on the previous slab Once assembled thread the desired screws into the alignment posts until firm do not over tighten nylon screws 2 gt Scanning the phantom with imager Arrange the assembled Stereotactic Dose Verification Phantom on the CT table and align appropriately Use the same scan parameters as for a typical patient to scan the phantom Position the phantom on the treatment couch Position the Stereotactic Dose Verification Phantom on the treatment table and properly align to the alignment lasers Image the phantom to confirm that the phantom position matches the planning CT position Treat the phantom Treat the phantom as required to test the dosimetry and imaging functions of the specific TPS to be evaluated thumb screws SRS Dosimetric QA Slab SDVP Heterogeneity Insert Configuration Optional Configuration Film lon Chamber Configuration Configuration Four methods of Stereotactic Dose Verification Phantom assembly SRS Dosimetric QA Slab The SRS Stereotactic Radiosurgery Dosimetric QA Slab consists of three main components air pocket core target shapes and CT densit
6. to properly package insure and ship the product with the RMA number clearly identified on the outside of the package The customer must immediately file a claim with their carrier for any shipping damage or lost shipments Return shipping and insurance is to be pre paid or billed to the customer and the customer may request a specific shipper Items found to be out of warranty are subject to a minimum service fee of 1 hour labor excluding recalibrations for diagnostic efforts and require a purchase order PO before service is performed With concurrence from customer the product may be replaced if it is unserviceable or if the required service is cost prohibitive Products incurring service charges may be held for payment Standard Imaging does not provide loaner products See the Standard Imaging Warranty and Customer Responsibility for additional information Serialization Information Standard Imaging products that are serial ized contain coded logic in the serial number which indicates the product day and year of manufacture and a sequential unit number for identification AYY DDD X A Unique product ID if applicable YY Last two digits of the year e g 1999 99 2000 00 DDD Day of the year 1 lt DDD lt 365 Unique unit ID Number 1 lt X lt 9 Return Policy No merchandise will be accepted for credit without prior approval of return Please contact Standard Imaging s Customer Service Departme
7. Shape 2 38 Avoidance Structure Shape 0 56 cm Included Components Bottom slab with imbedded gold markers lead BBs and integral alignment posts Top slab with imbedded gold markers and lead BBs 1 2 0 chamber slab with generic cavity hole lon chamber plugs drilled for Model A19 Exradin Classic Farmer type Chamber and Model A16 Exradin Micro Chamber 1 Blank chamber plug 2 5 0 slabs 5 2 0 mm slabs with recessed pockets to accept 63 5 mm 63 5 2 500 2 500 film 2 Flathead nylon 6 6 screws 1 Flathead screwdriver 1 User Manual See www standardimaging com for applicable tech notes Specifications are subject to change without notice 19 Features and Specifications Continued Material Densities Main Phantom Physical Density Nominal CT Components g cc value HU Black delrin alignment 143 355 posts thumbscrews screws SRS Dosimetric Physical Density Nominal CT Electron Density Relative Electron QA Slab g cc value HU cc x 10 Density to Water Blue Water plastic 3 524 1 055 shapes Cortical bone plug 1500 5 952 1 782 Trabecular bone plug 3 863 1 157 S D V P Physical Density Nominal CT Electron Density Relative Electron Heterogeneity Insert g cc value HU per x 1023 Density to Water Blue Water plastic 3 524 1 055 HU Values may differ from those shown here since these values are dependent the CT s
8. ation treatment plan Refer to Image 2 below with the Model A19 Exradin Classic Farmer type ion chamber showing the precision placement of the four gold fiducials Many types of chambers or diodes can be used with this insert using custom made plugs per request Contact Standard Imaging regarding availability Use an expansion of the FB volume to ensure that the active volume 97 dose cloud covers the active volume Select 80 cm SAD and the 60 mm collimator used for the absolute dose calibration of the CyberKnife CYRIS muttiPian ceiter Contimed Image 2 Software image showing the Model 19 Exradin Classic Farmer type Chamber and gold fiducial placement Software screenshots used with permission of Accuray Incorporated 11 lon Chamber Configuration Continued Collimator Dose Delivery Confirma tion Using a Micro Chamber For the collimator dose delivery confir mation test the smallest micro chamber is used Image 3 Model A16 Exradin Micro Chamber in the lon Chamber Configuration Collimator Dose Delivery Test Generate a conformal plan to the micro chamber using the trigeminal path set at 80 cm SAD nCl new conformality index of less than 1 5 should be achievable Image 4 Collimator Dose Delivery Accuracy Inverse Conformal Plan to a Model A16 Exradin Micro Chamber with 5 mm collimator 80 cm SAD is recommended if trigeminal cases are to be done 12 TPS C
9. canner scanner calibration imaging protocol and image reconstruction technique See www standardimaging com for applicable tech notes Specifications are subject to change without notice 20 Features and Specifications Continued Ss 10 0 mm 180 0 mm 200 0 mm Dimensioned locations of the gold markers and BBs embedded within the phantom See www standardimaging com for applicable tech notes Specifications are subject to change without notice 21 Features and Specifications Continued 45 5 18 8 45 5 k 200 Dimensioned locations of the gold markers and BBs embedded within the SDVP Heterogeneity Insert See www standardimaging com for applicable tech notes Specifications are subject to change without notice 22 Notes 23 Notes 24 Service Policy If service including recalibration is required please contact Standard Imaging s Customer Service department by phone or email prior to shipping the product Standard Imaging s Customer Service and Technical Service staff will attempt to address the product issue via phone or email If unable to address the issue a return material authorization RMA number will be issued With the RMA number the product can be returned to Standard Imaging It is the responsibility of the customer
10. e fiducials allow preci sion placement of the phantom so that the expected plan relative and absolute dose is automatically aligned within the phantom A Conformal Relative Dose Delivery Accuracy A plan is generated to one of the complex shapes contained in the SRS Dosimetric QA Slab The treatment is delivered to the Film Configured Phantom which is substituted for the SRS Dosimetric QA Slab Configured Phantom The resulting film may then be scanned and the prescription iso dose plotted If the prescription isodose line is scaled to true dimension and then plotted the plot can be physically overlain on the actual object for which the plan was generated The plot of the prescription isodose and the complex shape should match within 1 mm of the approved isodose cloud encompassing the object for which the plan was gener ated and treated See Image 9 B Patient Dose Overlay Test Uses either the Film or lon Chamber Configuration for dose measure ments Image 7 Stereotactic Dose Verification Phan tom shown in the Film Configuration Image 8 2 mm thick slab with recessed pocket to hold GAF film 15 Film Dosimetry Continued Any treatment plan generated using the SRS Dosimetric QA Slab Configured Phantom can be delivered to the Film Configured Phantom without using the overlay function If patient specific QA is to be done 1 Select the phantom overlay function 2 Select the film phantom 3 Select the
11. ed nC delivered to the phantom versus expected nC from the treatment plan should be within 5 Treatment Planning and Dose De livery Conformality and Dosimetric Accuracy Highly conformal plans are generated using the optional SRS Dosi metric QA Slab Configuration see page 4 which contains the complex shape used for planning After import of the plan into the Cy berKnife delivery system the plan is delivered to the Film Configuration see page 4 A fiducial plan guarantees sub millimeter positioning accuracy of the film since the fiducials are embed ded in the top and bottom portion of the phantom The resulting film can be placed directly on the conformality shape of the SRS Dosimetric QA Slab for a qualitative check of the actual delivered dose shape relative to the actual complex shape that was planned If film dosim etry such as a calibrated RIT system is available prescribed versus measured actual dose can also be verified from the film as well as the Distance to Agreement DTA values If desired the highly conformal plan can also be treated to the lon Chamber Configura CyberKnife is a registered trademark of Accuray Incorporated tion for an absolute dose delivered verification Patient Specific Dosimetry is done using the MultiPlan patient overlay func tion to generate a copy of the patient plan onto either the 1 lon Chamber Configuration or the 2 Film Configu ration Complex film dosimetry is not
12. een two standard Blue Water SDVP end slabs The chamber plug with gold markers for the SDVP Hetero geneity Insert is made of Blue Water and is designed to simulate a small tumor within the lung equivalent material The SDVP Hetero geneity Insert is used with an ion chamber or other small detector to perform small field tests in a highly heterogeneous environment SRS QA Slab Configuration Optional REF 70650 The SRS Dosimetric QA Slab is available as an accessory which provides a third option for the center slab It contains targets which test treatment planning and CT number accuracy Used in conjunction with the ion chamber and film configurations the SRS Dosimetric QA Slab tests the accuracy of the TPS planned dose delivery More information is available in the Optional SRS Dosimetric QA Slab section on page 6 of this manual Heterogeneity Insert Configuration for small field tests in a highly heterogenous environment Optional SRS Dosimetric QA Slab REF 70650 General Operation The Stereotactic Dose Verification Phantom is easily set up for single beam dose output tests as well as treatment plan delivery dose verification tests for a number of tracking methods 1 General Phantom Setup and Assembly The alignment posts of the phantom do not allow accidental incorrect assembly of the phantom slabs Rotated or inverted slabs are visually apparent This is critical for the repeatability of
13. etric QA Slab provide ad ditional options lon Chamber Configuration The lon Chamber Configuration consists of a 2 slab with interchangable 5 8 diameter plugs drilled to accept an ion chamber of choice The centroid of the chamber s collect ing volume coincides with the center of the slab and can be identified radiographically with the center of mass of the embedded gold markers Additional plugs for other thimble ion chambers or diodes are available Film Configuration The Film Configuration consists of two 5mm slabs and five 2 mm slabs The 2 mm slabs are machined to precisely position film cut to dimensions of 63 5 mm x 63 5 mm 2 500 x 2 500 0 007 this stack of five 2 mm slabs is positioned between the 5 mm slabs The recessed pocket in each slab accomo dates the thickness of the GAF film NOTE It is advised to mark each individual film for identification and orientation pur poses to avoid mistakes during assembly and disassembly of the phantom lon Chamber Configuration for dose measurements Film Configuration for patient specific or treatment plan dose verification Overview Continued SDVP Heterogeneity Insert Configuration Optional REF 72313 The SDVP Heterogeneity Insert consists of two 5 cm slabs of lung equivalent material and one 2 cm chamber slab The chamber slab is placed between the two thicker lung slabs and the entire lung equivalent as sembly is then placed betw
14. f assistance is desired in the proper disposal or recycling of this product including accessories and components after its useful life please return to Standard Imaging Parts and Accessories REF Description 70650 SRS Dosimetric QA Slab 71202 SDVP 91250 Plug with cavity drilled for ion chamber of choice 72313 Stereotactic Dose Verification Phantom Heterogeneity Insert 72771 Heterogeneity Insert 72313 Plug with gold markers and cavity drilled for ion chamber of choice 92726 Exradin A16 lon Chamber MicroPoint 0 007 cc 92746 Exradin A26 lon Chamber MicroPoint 0 015 cc 92739 Exradin W1 Scintillator 92722 Exradin A1SL lon Chamber Slimline Miniature Shonka 0 053 cc 92723 Exradin A14SL lon Chamber Slimline MicroChamber 0 015 cc 92749 Exradin A28 lon Chamber Scanning 0 125 cc 92700 Exradin A12 lon Chamber Farmer type Chamber 0 64 cc 92734 Exradin A19 lon Chamber Classic Farmer type 0 62 cc 90015 MAX 4000 Electrometer 90018 SuperMAX Electrometer 70004 Extension Cable available lengths 1 3 6 10 15 20 25 30 m or custom length 18 Features and Specifications E Assembled Phantom Dimensions Height 10 00 cm 3 94 in Width 20 00 cm 7 87 in Length 20 00 cm 7 87 in Weight Complete Stereotactic Dose Verification 4 4 kg 9 7 Ibs Phantom ion chamber or film configuration SRS Dosimetric QA Slab only 0 9 kg 2 0 Ibs Core Target Shape Volume Tentacle Shape gt 9 86
15. he product may need to be calibrated The owner of this product has sole responsibility for any malfunction resulting from abuse improper use or maintenance or repair by anyone other than Standard Imaging Inc The information in this manual is subject to change without notice No part of this manual may be copied or reproduced in any form or by any means without prior written consent of Standard Imaging Inc 26 Warranty Standard Imaging Inc sells this product under the warranty herein set forth The warranty is extended only to the buyer purchasing the product directly from Standard Imaging Inc or as a new product from an authorized dealer or distributor of Standard Imaging Inc For a period provided in the table below from the date of original delivery to the purchaser or a distributor this Standard Imaging Inc product provided in the table is warranted against functional defects in design materials and workmanship provided it is properly operated under conditions of normal use and that repairs and replacements are made in accordance herewith The foregoing warranty shall not apply to normal wear and tear or if the product has been altered disassembled or repaired other than by Standard Imaging Inc or if the product has been subject to abuse misuse negligence or accident Product Warranty Period Standard Imaging lonization Chambers 2 years Standard Imaging Well Chambers 2 year
16. igned with the corresponding mark on the chamber slab 2 Create treatment plan Use the CT images to create a treatment plan and establish expected results 3 Align on treatment couch Place the phantom on the treatment couch and align with room coordinates Insert the ion chamber into the plug and the plug into the middle chamber slab Ensure that the chamber plug is aligned as in step 1 Align the phantom initially us ing lasers or beam crosshairs Adjust alignment of the phantom using image guidance if desired For gated treat ments the phantom may be placed on a motion platform 4 Acquire measurement with ion chamber or other small detector Deliver the treatment plan to the phan tom and acquire measurements with the ionization chamber 5 Compare the measurement data with expected results Image 10 Heterogeneity Insert Configuration Image 11 Location of markers within Heterogeneity Insert Configuration NOTE Handle lung slabs with care Lung material is soft and can be easily scratched or deformed with misuse 17 Maintenance Exterior cleaning of the device can be done with a soft brush and a cloth Gently brush all surfaces to remove dirt and dust Remove any remaining dirt with a cloth slightly dampened with a solution of mild detergent and water or a liquid disinfecting agent Calibration is not required There are no serviceable parts on the Stereotactic Dose Verification Phantom I
17. nt to receive a return authorization number before returning any merchandise for exchange or credit Products manufactured by Standard Imaging must be returned within thirty days of receipt of order in like new condition No credit will be given for products returned after thirty days from receipt of order A minimum twenty percent restocking fee will be charged on all returned merchandise All materials returned must be shipped pre paid Credit for returned goods will be issued to customer s account for use against future purchases of merchandise only Special orders custom products re sale not manufactured by Standard Imaging products and ADCL calibrations will not be accepted for return credit or exchange 25 Customer Responsibility This product and its components will perform properly and reliably only when operated and maintained in accordance with the instructions contained in this manual and accompanying labels A defective device should not be used Parts which may be broken or missing or are clearly worn distorted or contaminated should be replaced immediately with genuine replacement parts manufactured by or made available from Standard Imaging Inc CAUTION Federal law in the U S A and Canadian law restrict the sale distribution or use of this product to by or on the order of a licensed medical practitioner The use of this product should be restricted to the supervision of a qualified medical physicist
18. ommissioning and Dose Conformality Testing e A TPS Geometric Accuracy The left right and superior inferior distance is 180 mm while the anterior posterior distance is 80 mm The diagonal distance can be calculated as well to verify that the CT studies are imported without geometric distortion Use the graphical ruler from the global tools on the right side of the CyberKnife software interface See page 21 for dimension information B CT Density Model Left mouse click on the CT plugs to compare with the CT numbers mea sured on your local CT scanner where the SRS Dosimetric QA Slab Config ured Phantom was scanned Image 5 SRS Dosimetric QA Slab shown within its Stereotactic Dose Verification Phantom configuration and independently C Single Beam Dose Calculation Tests Use the AQA path to place a single beam on the SRS Dosimetric QA Slab Configured Phantom The Physics Es sentials manual supplied by Accuray contains detailed steps for single beam dosimetry analysis 13 Dose Conformality with Complex Shapes Several complex shapes are included in the SRS Dosimetric QA Slab See page 7 for shape dimensioning and material information 1 C Shape 2 Avoidance 6 0 mm Cylinders or Trigeminal Target 3 Tentacle For example a conformal plan is displayed to the C Shape in Image 6 where the 6 0 mm cylinder was treated as an avoidance object The opposite can also be easily done using the 6
19. patient plan that you wish to treat to the film DV phantom An example phantom is depicted in Image 9 below The plan can be delivered to the CYRI S muian f load Fuse Align 127222 Film Configured Phantom to evaluate the relative isodose distribution of the plan for the example phantom depicted below in comparison with the distribution delivered to the Film Configured Phantom NOTE The BODY treatment delivery selection must be made to deliver a fidu cial treatment The phantom needs to be placed AWAY from the head end of the table and placed in a CHEST position to avoid collisions Image 9 An example phantom adapted for Fiducial Treatment Delivery 16 SDVP Heterogeneity Insert SDVP Heterogeneity Insert The SDVP Heterogeneity Insert is used with an ion chamber or other small detector to perform small field tests in a highly hetero geneous environment Extended guideposts are provided to as semble and align this configuration and radio opaque alignment markers are present in both the chamber slab and the chamber plug Lung treatment planning and delivery may be tested using the following steps 1 Acquire CT Images Assemble the SDVP Heterogeneity Insert Configura tion and acquire CT images Note the fiducial markers located in both the lung and standard SDVP slabs as well as the chamber plug Ensure that the chamber plug rotational orientation mark is al
20. s Standard Imaging Electrometers 5 years Standard Imaging BeamChecker Products 2 years Standard Imaging Software Products 1 year All Other Standard Imaging Products 1 year Standard Imaging Custom Products 1 year Standard Imaging Remanufactured Products 180 days Standard Imaging Custom Select Products 90 days Consumables 90 days Serviced Product 90 days Resale Products As defined by the Original Equipment Manufacturer 0 90 days 100 of ADCL Calibration Costs ADOL Product Calibration 91 182 days 75 of ADCL Calibration Costs W ADCL fi g EA ti ired und 183 365 days 50 of ADCL Calibration Costs 366 639 days 25 of ADCL Calibration Costs warranty unless otherwise requested days from date of shipment to customer Standard Imaging s sole and exclusive obligation and the purchaser s sole and exclusive remedy under the above warranties are at Standard Imaging s option limited to repairing replacing free of charge or revising labeling and manual content on a product 1 which contains a defect covered by the above warranties 2 which are reported to Standard Imaging Inc not later than seven 7 days after the expiration date of the warranty period in the table 3 which are returned to Standard Imaging Inc promptly after discovery of the defect and 4 which are found to be defective upon examination by Standard Imaging Inc Tran
21. sportation related charges including but not limited to shipping customs tariffs taxes and brokerage fees to Standard Imaging are the buyer s responsibility This warranty extends to every part of the product excluding consumables fuses batteries or glass breakage or material reactions Standard Imaging Inc shall not be otherwise liable for any damages including but not limited to incidental damages consequential damages or special damages Repaired or replaced products are warranted for the balance of the original warranty period or at least 90 days This warranty is in lieu of all other warranties express or implied whether statutory or otherwise including any implied warranty of fitness for a particular purpose In no event shall Standard Imaging Inc be liable for any incidental or consequential damages resulting from the use misuse or abuse of the product or caused by any defect failure malfunction or material reactions of the product whether a claim of such damages is based upon the warranty contract negligence or otherwise This warranty represents the current standard warranty of Standard Imaging Inc Please refer to the labeling or instruction manual of your Standard Imaging Inc product or the Standard Imaging Inc web page for any warranty conditions unique to the product 27
22. t a reasonable grey scale range is ob tained If helical acquisition is used choose the lowest pitch value possible lon Chamber Configuration A Absolute Dose Calibration Trace ability The absolute dose insert houses plugs that are machined to accommodate most types and sizes of ionization chambers or diodes Typically the Farmer type Chamber used to calibrate the linear accelera tor is also used for the absolute dose traceability test The chamber insert depicted in Image 1 shows how the dose chambers and diodes are volu metrically centered to the geometric center of the phantom NOTE The chamber location geometry is for convenience only and allows use of the phantom with many treatment planning systems and linear accelera tors By rearranging the 4 cm slabs monthly output checks can be done with this phantom Image 1 Coronal View of the Model A19 Exradin Classic Farmer type Chamber in the lon Cham ber Configuration of the Stereotactic Dose Verification Phantom Dots at the outer corners indicate the 1 mm BB positions to confirm the geometric ac curacy of the imported CT study Positions numbered 1 through 4 indicate the gold fiducial positions for image alignment during treatment delivery to the phantom The Model 19 Exradin Classic Farmer type Chamber volume is positioned at the geomet ric center of the phantom lon Chamber Configuration Continued a Absolute dose calibration verific
23. utput checks and treatment planning system TPS commissioning and quality assurance QA tests as recommended by TG 53 and IEC 430 Treatment Planning System Commis sioning and QA Standards Patient specific dosimetry tests can be performed easily as well The fixed portion of the phantom consists of the top and bottom 4 cm slabs that contain Gold fiducials for positioning setup ac curacy e Lead BBs diameter 1 mm at known preci sion manufactured locations on three cor ners so that superior inferior left right anterior posterior and diagonal geometric distances can be confirmed in the imported patient CT studies thus demonstrating that no distortion is evident The bottom slab has two rigid alignment posts that ensure all phantom configurations are precisely and reproducibly aligned for every insert used with the phantom Addi tional large Blue Water blocks are available so that the 20 x 20 x 10 cm dimension can be increased to a 30 x 20 x 20 cm 2 BBs shown overlapped gold fiducials leadBB gold fiducials lead BB Front View lead BB gold fiducials 1 2 BBs shown overlapped lead BB Top View larger marks indicate marker located in top slab 3 Overview Continued Center Slab Configuration Details Two standard configurations of the 2 0 cm thick center slab accommodate an ion chamber or film The Heterogeneity Insert and SRS Dosim
24. www STANDARD IMACE STEREOTACTIC DOSE VERIFICATION PHANTOM REF 91250 STANDARD IMAGING INC 3120 Deming Way Middleton WI 53562 1461 TEL 800 261 4446 TEL 608 831 0025 FAX 608 831 2202 Wa Oct 2014 2014 Standard Imaging Inc STANDARD IMAGING 4 DOC 80527 04 General Precautions WARNING Warnings and Cautions alert users to Follow manufacturer s rec dangerous conditions that can occur if ommended safety procedures instructions in the manual are not obeyed Warnings are conditions that can cause injury to the operator while Cautions can cause damage to the equipment for radioactive sources CAUTION Do not drop or mishandle the slabs CAUTION Refer all servicing to qualified individuals CAUTION Proper use of this device de pends on careful reading of all instructions and labels Table of Contents 2 General Precautions 3 Overview General Operation Optional SRS Dosimetric QA Slab lon Chamber Configuration TPS Commissioning and Dose Conformality Testing 15 Film Dosimetry 17 SDVP Heterogeneity Insert 18 Maintenance 18 Parts and Accessories 19 Features and Specifications Overview 6 7 8 CyberKnife Sample Dosimetry Tests 1 1 Wa STANDARDIMAGING 4 3120 DEMING WAY MIDDLETON WI 53562 1461 USA WWW STANDARDIMAGING COM The Stereotactic Dose Verification Phan tom can be used for a wide variety of tests including routine absolute dosimetry o
25. y plugs See material specifications section on page 18 Air Pocket The air pocket is used to test the dose calculation accuracy Core Target Shapes The core target shapes with their corresponding avoidance structures are used to test complex dose delivery plans and a relative dose shape against objects of known dimension The 6 x 6 cm core insert containing the shapes can be removed to be re orientated in the slab for additional positioning See dimensions below Thickness of all shapes is 20 0 mm CT Density Plugs 3 total From left to right Adipose Cortical Bone and Trabecular Bone Thickness of all plugs is 20 0 mm Alignment Mark SRS Dosimetric QA Slab R 3 18 7 11 mm mm oer 2 20 0 mm 31 75 mm 6 0 10 0 mm 20 0 mm Core Target Shape Dimensions not drawn to scale CyberKnife Sample Dosimetry Tests a The following section describes the steps required to perform Absolute Dose Traceability where a simple multibeam isocentric forward plan is generated to the Stereotactic Dose Verification Phantom lon Cham ber Configuration see page 4 Collimator Output Dose Delivery Verification is done using the smallest micro chamber in the ion chamber configuration For example using the 5 mm collimator with the output factor of 0 7 an inversely planned conformal plan is generated to an Exradin Micro Chamber with an expected dose of 10 Gy The measur
26. ype or other Farmer type Chamber in the coronal plane Micro Chamber or other micro thimble in the coronal plane TPS Plan Method Forward isocentric plan with the 60 mm collimator to 10 Gy Select a fiducial plan delivery From the nC measured for 10Gy to a single beam deliver multi beam plan to the chamber Results should be within 2 of expected Inverse conformal plan to the selected micro chamber using the 5 mm collimator and 80 cm SAD TPS Commissioning and Dose Conformality Testing Page 13 TPS Geometric Accuracy CT Density Model Single Beam Dose Calculation Tests Dose Conformality with Complex Shapes 1 C shape Avoidance 6 mm Cylinders or Trigeminal Target Tentacle Place SRS Dosimetric QA Slab onto the alignment 4 cm slabs Scan in both the transverse and coronal orientation C Add additional solid water blocks to achieve depth required for single beam dosimetry QA Inverse planning A When imported into the TPS use the graphical user interface ruler to confirm the distances between the lead BBs Measure CT numbers on the CT unit then measure on the imported study to confirm that the CT den sity model that you have entered into the MultiPlan TPS are in agreement Select the AQA path set to perform single beam do simetry tests from either the AP or LAT beam position Generate highly conformal plans at each SAD Film Dosimetry Page 15 A Conformal Relative Dose
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