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Version 4.4 User Manual

1. 7 Complete dak AOT ORAE TE EA EE sate To kal tampe and sample code fier nonr Epress editions of SOL Server J003 AZ see the CodePlex Web abe ot H kids 71 Teor ashe erat Fre Geer carne lethal Eee ee PIPSPRO SOFTWARE Installing PIPSpro continued 18 Open the SQL Server Management Studio New Installation EZ seven 1 From the PIPSpro Installer Dashboard select Step 4 Install SQL Fies and Settings Trill i eee tet cease he R Database Setup Scripts Wizard I Windows PowerShell 1 0 gt All Programs Microsoft SQL Server 2008 gt I Microsoft SQL Server 2005 gt E IssueView gt Configuration Tools gt I Integration Services 2 From the browser dialog select a directory to copy the script files to This can be any place on your system that you have access to 3 Run SQL Management Studio Start Menu gt All Programs gt Microsoft SQL Server 2008 R2 gt SQL Server Management Studio Express 4 Select the appropriate SQL Server if you have more than one Accept the default settings and select the Connect button 19 If you installed SQL Server 2005 previously you will be prompted to import settings Choose Yes Microsoft SQL Server Management Studio 5 Select File gt Open gt File Browse to the directory where the scripts You can import customized user settings From SQL
2. PIPSPRO SOFTWARE Installing PIPSpro continued It is highly recommended that you create a Username and Password for the licensing system although it is not required Having an account set up will make it easier in the future if licensing issues need to be resolved To create an account Fill in the requested information NOTE First Name Last Name Email Address and Company Name are required to be filled in Click the Register button to complete the registration process Authorization of a computer without internet access If your computer is not connected to the internet or firewall issues prevent you from utilizing the web based registration click on the manual registration button You will be shown the following screen Registration Product Activation Manual Activation Installation ID 201132701 4266211 4 Unlock Code Please Manually Activate Your Software One of Three Ways 1 Activate from another computer through the Internet https Awww internetactivation com ECOSYSTEM ActivationServertiactivate default aspx 2 Activate by phone toll free 800 261 4446 U S or 608 631 0025 3 Activate by e mail support standardimaging com ls Copy the Installation ID number shown on your screen and follow the directions to either 1 Activate from another computer that is connected to the internet Call Standard Imaging for an unlock code E mail y
3. If left blank lt No Linac ID supplied gt will appear on report OK Cancel L Se eel History View Tab not available in off line mode As data is collected in the database viewing historical data to determine if the results are trending in a negative way can be a valuable exercise Clicking on the History View Tab will bring up the Linac Select dialog NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically Linac Select Manufacturer Varian Medical Systems Model 21 EX Select Cancel Choose the linear accelerator that the history would like to be viewed for and then click Select in the dialog In the left hand panel the Linac Info is shown along with the Settings area Settings e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually Clicking Apply will apply your settings and the results will be shown in the right hand panel e Table View all of the data that matches the chosen settings will be shown Values that are outside of the acceptable range will be color coded yellow background for warning and red background for failure 5 Don t Chart clicking the Don t Chart check box will prevent the data from
4. 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 Measurement of high activity radioactive sources is potentially hazardous and should be performed by qualified personnel 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 It is the responsibility of the customer or user to determine if the Standard Imaging product can be properly used with these products or systems 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
5. Export Parameters 21 EX Date Range Select Show AIl v Start Date 10 6 2010 End Date 12 19 2011 Test Type C Leaf Position C Leaf Width Multi Port Leaf Transmission Generate Repo Cancel a e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Test Type Choose which type of test you would like to export data for Click the Export button to export the data A standard Windows Save As dialog will be shown Name the file and choose a location for saving and click on the Save button to create the file PIPSPRO SOFTWARE Leaf Transmission Trend Analysis After clicking the Apply button each Leaf Transmission test will be shown in the results window for the chosen date range Trending is automatic and all data will be shown in the chart view at the bottom of the results screen Separate charts are included for the inter leaf and inter bank leakage W PIPSero Compretensive M V Gie Application MICQA Wircow Don t Chart Sometimes there are data points saved to the database that can skew the graphical results in a negative way If you would not like to see the results from a particular test on the chart view click the Don t Chart box at the left of the listing The results will no longer be visualized in the chart when viewed on s
6. Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save a button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file 28 Section 2 Using PIPSpro Starshot Module Image Analysis Open the Starshot Module by choosing Application StarShot from the menu 6 PIPSpro Comprehensive BETA Not for clinical use File Edit View Macro Window Help Qc Radiation Light Field StarShot CBCT Module Stereotactic MLCQA IGRT Dewarp b Image Enhancement gt Image Analysis Tools b The module will load in the window with the Image Analysis tab chosen by default F VE a Comprehensive BETA Not for clinical use Starshot as The module features two window areas The area on left displays information pertinent to the operation that is being performed and the area on the right is for the display of the image and the results of the analysis The area of the left can be collapsed by clicking on the bar in between the two areas to allow for more viewing area of the image or the results if needed To load an image choose StarShot Load Image from th
7. Registration Pin detect There is a routine in the Image Analysis Tools menu which will detect pins or other small dark objects A special tool in the EditTool Fiducial turns the mouse cursor into a pin detector and clicking on the image near a pin will display it as a fiducial point In the Configuration Settings dialog box you can adjust the controlling parameters Sensi tivity is used to reduce the sensitivity until false readings from noise are reduced or eliminated 1 is high sensitivity 10 is low Detect Size is the size of the search region in pixels around the cursor See Pin Detect in the Feature menu section Image View Percent This is the default value for View when images are opened or imported You may still change the value of View Zoom for individual images DICOM Tab The standard extension for DICOM images is dcm but some equipment vendors also use other extensions such as s c img ima etc Enter additional extensions here separated by a semi colon so that File Open will recognise these files as DICOM format JPEG Tab Opening an 8 bit jpeg image is quite straightforward and the image is uncompressed automatically and displayed on the screen Some vendors are now using a 16 bit lossless compressed jpeg file format e g Elekta VViewGT OREX File Open will normally work well with these images but if necessary you can select Show Import dialog to set the format parameters when a jpeg image is
8. To archive data in the Table View highlight the row for the data that is to be archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the row for the data that is to be un archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status Choosing another Linac for History View not available in off line mode Clicking on the Select Linac tab will open the Linac Select dialog Choose the linear accelerator you would like to see a history for and click Select Choose the settings and click Apply 43 In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header lt Enter Department Nameand Linac 1D S Enter information that will appear on the report Department Name o o If left blank lt No department name supplied gt will appear on report Linac ID
9. 49 7 49 7 PIPSPRO SOFTVVA r E oom Section 2 Using PIPSpro Application Menu gt MLCQA continued Leaf Transmission Test TG 142 recommends testing the leaf transmission values on a yearly basis The MLC Leaf Transmission Test accomplishes this important QA Aquiring Images It is recommended that a QA Patient be set up in the record and verify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time The MLC is set up so the leaves are closed at the isocenter plane with leaves open slightly only at the 0 position and at a position 8 cm from center 4 cm if using a collimator that will not show the spherical marker at 8 cm The MLC should be opened just enough to let the radio opaque markers of the phantom show in the image The backup jaws need to closed to 4 cm from isocenter on either side for an 8 cm opening where the MLC s will be able to be seen The MLC phantom is set up and the EPID is raised to the highest position possible without a collision with either the couch or the phantom to ensure that as many of the MLC as is possible can be acquired on the imager For machines Varian in which the maximum imaging size is across the imager it is advisable to turn the collimator 90 degrees so that the MLC
10. Contrast Enhancement of Portal Images by Selective Histogram Equalization Crooks and B G Fal lone Medical Physics 20 199 204 1993 It is particularly useful for highlighting edges in portal images Try it with scale factor 0 9 for example PIPSpro Histogram Shift Operation UpperBound 254 Cancel LowerBound 1 3 The image can now be saved using the File Save As menu item for further analysis Smooth This provides two different approaches for smoothing images Linear is selected from the pop up menu the grey level value of every pixel will be replaced with the average value of the pixels from its nxn neighborhood The weight factors are equal to 1 if the Aver age Smooth option is selected or they will be normally distributed if the Gaussian Smooth is selected The neighborhood size n and the standard deviation o are selected from a dialog window The default value for o is 1 65 PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Dewarp continued Three standard high pass filters are provided and the kernel values are shown For a frame of 3x3 these values will define the kernel For larger frames the intervening pixels are set to zero PIPSpro Sharpen Image Ez Frame 7 7 OK Scale fi Cancel Shift m Method High Pass Degree 1 6 High Pass Degree 2 High Pass Degree 3 CES C Custom Filter Mask Edit Mask M
11. Data that has been saved to the database can be exported out as a common comma delimited csv format allowing for analysis in the user s choice of software programs To export data click on the Export tab The Linac Select dialog will be shown Choose the linear accelerator you would like to export data for and click Select 34 Application Menu gt CBCT Cone Beam Computed Tomography Section 2 Using PIPSpro EEE CBCT Cone Beam Computed Tomography DICOM 3 0 Directory Scan _ Facility Edward Hospital PIPSpro 4 2 Demo Files CECT of data fy DEMO_1 fy DEMO_2 fs DEMO_4 DEMO_ Serial OBI CBCT In the left window click on the image set you would like to analyze to highlight it The image slices will then be shown in the right hand window gt Edward Hospital 05 07 2006 CATPHAN CBCT 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 2 500000 Click on the first image in the image set in this example at table 147 5 and a small thumbnail of the image will be shown 2500000 145 2500000 5 2000000 140 2500000 5 2 500000 135 2500000 132 5 2500000 130 2500000 127 5 2 500000 125 2500000 122 5 2 500000 120 2500000 1175 gt gt SelectALL SkipALL _ Auto Select Field of View 241 mm kY ma Pulse msec 35 The CBCT Module is designed to automatically analyze image sets a
12. The Reports Tab If you would like to create a report without going into the History View clicking on the Reports Tab will bring up the Linac Select dialog Choose the linear accelerator you would like to create a report for and click Select The Generate Report dialog will appear Report Parameters Date Range Select Show All Start Date 4 13 2011 End Date e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Imager Choose whether the data to be trended in the report was collected on the MV imager or the kV imager e Comparison Type Choose whether the data to be trended in the report were 2D orthogonal planar images or 3D 3D image set such as a Cone beam CT Click the Generate button to create the report The report will be shown in the Preview Window The report can be printed to paper or saved as a PDF file Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file PIPSPRO SOFTWARE Application Menu gt Dewarp S
13. tab Select Add Port In the Name field type PipsDSvr without quotation marks In the Port field type the port number from step 3 Select OK and close the Control Panel 0 Inthe PIPSpro directory find and double click RegDSvr bat This will re register your PIPSpro DICOM Server 11 Restart Computer N T O P D aS PIPSPRO SOFTWARE Section 7 Other Information DICOM Conformance Statement Functional Definitions of Application Entities All communications and image transfer with the remote application is accomplished utilizing the DICOM protocol over a network using the TCP IP protocol stack PIPSpro DICOM Server Module supports the following functions SCP Verification e Storage Application Entity Specifications The PIPSpro DICOM Server Module services provide support for the following DICOM 3 0 SOP Classes as an SCP SOP Class Name 1 2 840 10008 5 1 CR Image Storage CT Image Storage MR Image Storage US Image Storage SC Image Storage NM Image Storage PET Image Storage Verification 1 2 840 10008 5 1 4 1 1 128 Number of Associations The PIPSpro DICOM Server Module can support multiple associations simultaneously as an SCP The PIPSpro DICOM Server Module will listen for incoming associations and spawn a new process to manage each request This ability means it is possible for the PIPSpro DICOM Server Module to receive both images and query retrieve requests from multiple
14. 0 Imager Type Elekta 3 3 Siemens 3 All 5 Enter a description for your imager 6 Click OK to exit Add Edit a QC Phantom Enter a unique name for the phantom Enter the serial number found on the phantom Enter a description of the phantom a a E Enter the line pairs per millimeter Ip mm found on the phantoms calibration report 5 Click OK to exit PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt QC Quality Control contiuned A message may be shown in baselines have not been setup for the imager yet gt There is no baseline information for the specified imager phantom and energy combination Do you still want to do the QC Pips32 Click continue to perform the QC k An error message may be displayed if the program fails to find the boundaries of the phantom Use the EditTool see the Edit Menu section of the manual for instructions on using the EditTool and select the pen to place contour points in a clockwise direction on the four corners of the phantom You need to do this to only one of the images The results screen will be displayed QC Results Resolution Detected 50 Level 0 393 0 388 Acceptable Range 1 0 411 Caution Range 1 0 411 Detected 40 Level 0 486 0 479 Acceptable Range 9 459 0 507 Caution Range 0 459 0 507 Detected 30 Level 0 607 0 602 Accept
15. 98 100 DICOM Conformance Statement 103 Customer Responsibility 103 Warranty 104 Software License Agreement PIPSPRO SOFTWARE PIPSPRO SOFTWARE PIPSPRO SOFTWARE Section 1 Introduction PIPSpro Purpose PIPSpro Architecture PIPSpro Versions and Modules Installing PIPSpro 3 Working in Off line Mode versus Connected to a Database 3 Installation Procedure 8 Transferring a license 10 Opening PIPSpro Software version 4 4 10 Running PIPSpro the first time 10 Using PIPSpro with a SQL database 10 Changing From Off Line Mode or Changing Databases 10 Creating a Division 11 Adding Departments 11 Adding Users oO NNN PIPSPRO SOFTWARE PIPSpro Purpose PIPSpro Software features separate modules that enable the user to perform different QA tasks PIPSpro version 4 4 features eight modules for performing QA e QC Module QC and Comprehensive for performing planar imaging QA including MV and kV flat panel imagers This module analyzes images of the QC 3 and QCkV phantoms and provides quantitative information about resolution contrast and noise e Radiation Light Field QC and Comprehensive for performing the radiation field vs light field test and jaw position testing This module analyzes images of the FC 2 and center marker phantoms and provides quantitative information about the radiation field vs the light field position and the position of each of the jaws e StarShot QC and
16. NT AUTHORITY SYSTEM Automate Server Configuration SQL Server Browser NT AUTHORTTY Network Automate Database Engine Configuration Error Reporting instalation Configuration Rules Installation Progress Complete Use the same account for all SQL Server 2000 R2 services 1 4 Specify a user name and password for all SQL Server service accounts a ee 17 Once the installation completes Choose Close ke SQL Server 7008 AY Soup 13 Click OK Then Next Complete Tour SQL Server 0G RZ etalon comlehed succes 14 Account Provisioning is next Choose Windows authentication mode Surrey log fhe has been sarved to the felling location then next Ieor ra Infonnahion shout the Setup operation o possible newt steps 3 your 50k Server 2006 82 instalation completed success uly SOL Server 2008 R Setup Database Engine Configuration Specly Database Engine authentication mode adeerestrators and data directores Setup Support Rules Account Froveioning Data Directories FILESTREAM Feature Selection Rules Specty the authentcaton mode and administrators for the Database Enge Instance Configuration Authentication Mods Server Configuration O Mode Server Database Engine gt Hieed A Error Reporting Specify the password for the SQL Server system administrator sa sccourt Inst ation Configur shor Rias Installation Progress ae Nala wy a
17. Notwithstanding the foregoing in the event of any breach by Licensee of the terms and conditions of this agreement Standard Imaging may upon reasonable advance written notice to Licensee which in no event shall be less than thirty days terminate this license Upon such termination by Standard Imaging Licensee shall furnish Standard Imaging with a sworn affidavit stating that all of the product including without limitation its soft ware program s documentation and other related material and any copies thereof have been returned by certified mail return receipt requested to Standard Imaging or destroyed by Licensee This agreement shall be deemed executed in the State of Wisconsin and shall be interpreted and construed in accordance with the laws of the State of Wisconsin If any provision of this agreement is judicially declared to be invalid unenforceable or void by a court of competent jurisdiction such decision shall not have the effect of invalidating or voiding the remainder of this agreement and the part or parts of this agreement so held to be invalid unenforceable or void shall be deemed to be deleted from this agreement and the remainder of this agreement shall have the same force and effect as if such part or parts had never been included PIPSPRO SOFTWARE Contains licensed program materials of Standard Imaging Inc Copyright Standard Imaging Inc Middleton Wisconsin USA This software is protected by U
18. PIPSpro File gt Import gt Varian examines the Varian image for such artifacts and corrects for them and in many cases the images can be imported with Dynamic Range 16 Importing 16 bit Images 1 Introduction Importing data by File gt Import gt Other will read data in 16 bit 3 Detailed Explanation of the Mapping Function Several steps are involved in forming the 8 bit image for display These steps are designed to permit the optimum use of the 8 bit range 255 gray levels in displaying the data which can have up to 65 535 gray levels for a 16 bit image or 4095 gray levels for a 12 bit image but usually have an effective dynamic range much smaller than this For example the actual data in a particular 12 bit image may range from 500 no signal to 1000 maximum signal If the whole range of 0 4095 were to be mapped to the 8 bit range of 0 255 the actual data would cover only the gray levels 31 62 and the image would have very poor contrast By selecting Normalize with lowest highest values PIPSpro will search for the minimum and maximum values in the image and automatically normalize the mapping function to cover just the range of actual data values so that in this example the data would be mapped from the range 500 1000 to the range 0 255 If this option is not selected the mapping will be done according to the dynamic range of the selected bit planes i e from 0 4095 for a 12 bit image After mapping the 16 bit or 12 b
19. Section 3 The QC 3 Phantom Parametric Analysis of Image Unsharpness 2 The pixel matrix P All EPIDs accumulate image data in the form of a matrix of pixels As the EPIDs have developed over the years the matrix sizes have also changed from one model to another The table shows some typical examples EPID Detector maine Pixel size P size cm mm mm Siemens 41 512 3 480 0 80x0 65 0 Beamview Siemens FP 41 1024 41 1024 0 40x0 40 0 am Si Philips SRI 100 38 x 30 512 256 0 74x1 17 1 17 Philips SRI 200 38 x 30 512 512 0 74x0 74 0 74 Elekta View 43 x 33 768 576 0 56x0 57 7 Elekta ViewGT 41 1024 41 1024 0 40x0 40 0 am Si Varian 32 5 256 32 5 256 1 27x1 27 1 27 PortalVision Varian aS500 40 x 30 512 384 0 78x0 78 0 78 am Si TheraView 40 x 0 512 x 2 0 78 0 78 0 78 IRIS am Si A1x 41 1024 x1024 0 40x0 40 0 40 Eliav PORTpro 43 x 32 568 753 0 57x0 56 0 57 Eliav PORTpro v3 904 x 634 The parameter P is equal to the pixel size width in mm To determine this value one needs to know the pixel matrix and also the physical size of the image detector Where the pixel is not square the longest dimension is used as this will be the limiting factor in determining image quality Note that the dimensions given in this table are approximate and are provided only as a rough guide Dimensions may be different for various EPID models and upgrades You should independently
20. Warning range as set in the System Manager Red results are within the Error range as set in the System Manager Don t Chart Sometimes there are data points saved to the database that can skew the graphical results in a negative way If you would not like to see the results from a particular test on the chart view click the Don t Chart box at the top of the listing The results will no longer be visualized in the chart when viewed on screen or printed Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will Zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button a will zoom the chart to the previous level Clicking the Zoom out all levels button Ql will Zoom the chart to the original level showing all data Archiving Data data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the column for the data that is to be archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View t
21. E3 Margaret Elizabeth 239 531 200 567 531 2004 1239 059000 0304207 8 4 2003 5 17 17 PM 424 2003 1 37 39 PM E3 Margaret Elizabeth 239 531 200 567 531 200 0 4 Margaret Elizabeth 239 531 200 567 531 200 0 4 Margaret Elizabeth 239 531 200 567 531 2004 121 4 059000 E Margaret Elizabeth 239 5312005 567 5312005 1209 059000 E3 Margaret Elizabeth 239 5312005 567 5312005 1204 059000 239 5312005 567 5312005 1194 059000 239 531 2004 567 531 2005 1 189 059000 239 5312005 567 5312005 1184 059000 0304207 8 4 2003 5 17 19 0 424 2003 1 37 39 PM 0304207 8 4 2003 5 17 18 PM 4 4 2003 1 37 39 PM 0304207 8 4 2003 5 17 20 PM_ 424 2003 1 37 39 PM 0304207 8 4 2003 5 17 20 PM_ 4 4 2003 1 37 39 PM 0304207 8 4 2003 5 17 20 PM_ 424 2003 1 37 39 PM 8 4 2003 5 17 18 PM 4 4 2003 1 37 39 PM 0304207 8 4 2003 5 17 19 424 2003 1 37 39 PM 0304207 8 4 2003 5 17 20 0 424 2003 1 37 39 oe gt Margaret Elizabeth E Margaret Elizabeth E3 Margaret Elizabeth The dialog box is resizable and can be minimised Images can be sorted by Image Position Patient Name Patient ID Study Date Time Study Description or Performing Physician Click on any column title to sort the list of images Click again on the sorted column title to toggle between sort ascending and sort descending Columns can be resized and reorganised Drag and drop the column title to reorder the columns 86 PIPSPRO SOFTWARE Section 6 Appendic
22. H S a c N A N A N A N A N A N A N A N A N A 90 00 90 00 4 5 5 Trending Layout C Relative Displacement Absolute Position 0 60 mm 1 20 mm Center 30 mm V 60 mm A chart view will now be shown on the bottom of the results window with a graphical representation of leaf position The chart can be viewed as a Relative Displacement default where the displacement from the correct in position is graphed or as an Absolute Position where the actual position millimeters from isocenter is graphed PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued Choosing another Linac for History View not available in off line mode Clicking on the Select Linac tab will open the Linac Select dialog Choose the linear accelerator you would like to see a history for and click Select Choose the settings and click Apply Exporting Data not available in off line mode Data that has been saved to the database can be exported out as a common comma delimited csv format allowing for analysis in the user s choice of software programs To export data click on the Export tab The Linac Select dialog will be shown Choose the linear accelerator you would like to export data for and click Select The Export Records dialog will appear
23. Paper printing Clicking the Print 5 button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Saving the data to the database not available in off line mode Clicking the Save Results button in the left hand panel will insert the data into the database for future trending and analysis 54 Section 2 Using PIPSpro Application Menu gt MLCQA continued Fiducial 1 The first fiducial needs to be placed over the spherical marker in the phantom that is aligned with isocenter Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere This first fiducial tells the software that this is isocenter and all measurements will be made from this point This allows the software to correctly determine the position of each of the MLC s and accurately determine the distance from isocenter the edge of the MLC is positioned at Fiducial 2 The second fiducial needs to be placed over the spherical marker that is furthest from the center marker in the direction of the opening of
24. Red results are within the Error range as set in the System Manager 48 Section 2 Using PIPSpro Application Menu gt MLCQA continued accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically In Off line Mode this dialog will not be shown Linac Select Manufacturer Varian Medical Systems Model 21 EX Select Cancel Choose the linear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings default for performing the analysis The default settings should work for most images If adjustments are needed for instance to account for tongue and groove broadening of the MLC leaf penumbra the following explanation of each setting parameter should assist with making them e Edge Strength The 50 default value describes the grayscale pixel intensity between the area of irradiation and the non irradiated area For example if the irradiated area has a pixel intensity of 20 and the non irradiated area had a pixel intensity of 240 and the edge strength is set to 50 the edge will be considered where the pixel intensity is 110 240 20 5 If the intensity is set to
25. SCUs simultaneously Asynchronous Nature The PIPSpro DICOM Server Module does not support asynchronous operations All operations will be performed synchronously Association Acceptance Policy The PIPSpro DICOM Server Module accepts associations for the activities listed below DICOM communication verification between the PIPSpro DICOM Server Module and a remote system Image transfer from a remote system to the PIPSpro DICOM Server Module Processing remote system queries Verify Communication with a Remote System The PIPSpro DICOM Server Module will send an echo response to verification requests made by remote systems DICOM Conformance Statement This document is the DICOM Conformance Statement for the PIPSpro Dicom Server Module Contained in this statement are detailed descriptions of how the Dicom Server Module collaborates with other medical imaging devices and applications that conform to the DICOM 3 0 standard The intended user of this document is involved with software design and system integration It is understood that this individual is familiar with the concepts and terms used throughout this document Readers unfamiliar with the DICOM 3 0 standard should consult the documentation prior to examining this conformance statement All necessary references and definitions have been taken from the Digital Imaging and Communications in Medicine DICOM standard parts 1 through 13 NEMA PS 3 1 13 All symbols and abb
26. Two fields of differing size should be created e g one field that is 10 cm wide and one field that is 20 cm wide The fields do not need to be symmetrical and could have one bank of leaves set at 5 cm and the other set at 10 cm 15 cm wide field Non rectangular fields can also be created and the module will report the exact position of each individual leaf but will report errors in position as it is expecting each MLC to be in relatively the same position a rectangular shape is utilized the software will analyze the image and determine the average position of the central leaves This value will then be rounded to the nearest millimeter that is a multiple of 5 This number will then be considered to be the correct value for each subsequent leaf The MLC phantom is set up and the EPID is raised to the highest position possible without a collision with either the couch or the phantom to ensure that as many of the MLC as is possible can be acquired on the imager For machines Varian in which the maximum imaging size is across the imager it is advisable to turn the collimator 90 degrees so that the MLC s travel is perpendicular to the maximum imaging size This will ensure that as many MLC s as possible will be imaged For some machines the imager is fixed at a distance from the source that makes it impossible to get all or close to all of the MLC in a single image In these situations it is advisable to take more than one image i
27. While this is convenient it can also cause some problems For example a digitized film may have the patient name written on the image with a black background which will be changed by the artifact removal routine In this case use File gt Import gt Other and set the parameters for a Varian image as shown in the previous example You will need to invert the image if you want it to appear exactly as if it was imported by File gt Import gt Varian PIPSPRO SOFTWARE Section 4 Additional PIPSpro Functionality DICOM Server Utility Dump1 bmp of x DICOM file directory C Program Files PIPSpro32 dicom 0 C Program Files PIPSpro32 DicomS erver mdb Database file mdb Start Build Cancel DicomBuilder exe is a utility program to rebuild the Dicom Server database if needed It regenerates records for all the Dicom files in the directory or subdirectories PIPSPRO SOFTWARE DICOM Server Utility The DICOM Server Utility allows the user to initiate a DICOM transfer to the DICOM Server from some remote node This may be a portal imaging device a CT or MR scanner or other device capable of DICOM transfer The remote node must first be configured to send images to the DICOM Server and the Server Utility must be properly installed A DICOM Conformance Statement is provided on page 100 The DICOM Server Utility can only be licensed to PIPSpro version 3 2 4 or later and is not a
28. Winning best poster at ESTRO Conf Edinburgh 1998 Use of CT Simulation in Radiotherapy Treatment Planning for Carcinoma of the Prostate M A Coe D J Husband C H M Lee J A H Littler H M O Mayles W P M Mayles V Nock Syndikus J Taylor Radiotherapy amp Oncology 48 149 1998 Image quality parameters for the production standard Eliay PORTpro portal imaging device A J Poynter Brit J Radiol 72 802 804 1999 Verification of electron field positioning H Lemnitzer U Wolf G Hildebrandt F Kamprad Radiotherapy amp Oncology 52 61 64 1999 Preprocessing of control portal images for patient setup verification during the treatments in external radiotherapy G Hilt D Wolf P Aletti Med Phys 26 2539 2549 1999 94 Section 6 Appendices Appendix PIPSpro Publications continued K Luchka R Rajapakshe S Shalev Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 8 11 Image quality performance of amorphous silicon electronic portal imaging devices J Figueredo P Greer Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 106 107 Initial comparison of three am Si EPIDs using the QC 3 phantom R Clements K Luchka J Pouliot J Sage S Shalev Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 108 109 Incorporating EPI into a comprehensive radiation therapy QA program J Wolters R Rajapakshe G
29. Workshop on EPI Brussels June 2000 Paper 29 A quantitative assessment of a flat panel portal imaging device K Luchka Proc 6th Int Workshop on EPI Brussels June 2000 Paper ols Dependence of image quality on user given parameters for the Philips SRI 100 EPID D Taylor S Hussein Proc 6th Int Workshop on EPI Brussels June 2000 Paper 39 Letter to the Editor K Luchka Interactions Canadian Medical Physics Newsletter 46 3 July 2000 p 118 Image acquisition properties of an amorphous silicon electronic portal imaging device P Greer Medical Physics 28 1974 2001 Initial experience with the Lumisys ACR 2000 Computed Radiography system for digital simulation imaging portal imaging and verification of IMRT treatments E Henderson H Alasti Medical Physics 28 1216 2001 The application of computed radiography imaging system for portal imaging a comparison of two commercial portal imaging systems J Vanhanen M Pitk nen S Peltola S Hyo6dynmaa Radiotherapy and Oncology 61 Suppl 1 S81 2001 Quality Asurance of EPI Systems K Luchka R Rajapakshe S Shalev Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 8 11 Image quality performance of amorphous silicon electronic portal imaging devices J Figueredo P Greer Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 106 107 10 11 12 13 14 15 16 17 78
30. as no calculations will be performed on the fiducial points or templates if any 1 2 Chamfer matching Fiducial tool For this option fiducial points must be delineated in both images Selecting the Fiducial tool will cause the chamfer matching to register the two sets of fiducial points This is quite similar in principle to the least squares technique for aligning fiducial points See Registration menu except that the algorithm is different and so the two methods may not give the same results for all situations NI Chamfer matching Template tool For this option templates must be delineated in both images Selecting the Template tool will cause chamfer matching to register the two templates This is similar in prin ciple to Template Registration See Registration menu except that the operator does not need to adjust the displacements rotations and scaling factors since this is done automatically by the chamfer routine Click to exit any of the above described features This is mandatory before exiting Edit Tool to return the mouse to a cursor 19 Edit Menu continued Saves the coordinates of the contour fiducial or template points or ROI Select the mode and click on this tool A dialog window will allow you to select a file name By default the file name is the same as the image file name Extension con is used for the contour points fid is used for the fiducial points to is used
31. determine the correct the values for your EPID 3 The source size S Image blurring will occur due to the finite size of the linac focal spot The focal spot size is usually unknown but a parameter S can be determined by experimental measurement with the QC 3 test phantom While the value of S determined in this test is an indication of the influence of focal spot size on image quality it is not true measure of the actual focal spot size since the focal spot will generally be asymmetrical and non uniform This model assumes that the three effects described above are inde pendent and that their effects on image unsharpness can be expressed as Gaussian functions 0 0 and o Their MTFs modulation transfer functions will be multiplicative EPID Pixel Source Total MTF MTF MTF MTF 1 exp 1T0 7 0 8 60 lt 0 6 2 and so 0 POs of g 3 where MTF and o are the total effective MTF and variance describing the blurring function 79 Parametric Analysis of Image Unsharpness This section describes a technique for making experimental measurements with the QC 3 phantom in order to evaluate the various components contributing to image unsharpness One important result is the determination of the relative contributions to image unsharpness from the EPID on one hand and from the linac focal spot size on the other While focal spot size is well understood and carefu
32. 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 or malfunction 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 103 Customer Responsibility 7 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
33. slightly different than the value when the X and Y Field Dimensions are multiplied together because of the different methodology of calculation e Jaw Positions the jaw positions based on the detected field edges measured from the spherical marker of the Center Marker Phantom 26 Section 2 Using PIPSpro Radiation Light Field Module continued Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button al will zoom the chart to the previous level Clicking the Zoom out all levels button al will zoom the chart to the original level showing all data Printing or Saving a History View Report A report of the data can be printed by clicking on the Print button in the Setting area in the left hand panel A report will be created with both the Table View and Chart View data and will be shown in the Preview Window Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save A button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF f
34. 2 0 OOOO 0000 Size 72 00MB Programs i Microsoft NET Framework 3 0 Service Pack 2 Size 208 00MB is Microsoft NET Framework 3 5 1 Size 28 05MB KAMENA Ga Microsoft Office Standard 2007 Size 308 00MB Microsoft Silverlight Size 19 44MB 4 Microsoft SQL Server 2005 Size 8 r J Microsoft SQL Server 2008 Management Objects Size 11 47MB Set Program Access and Defaults E Microsoft SQL Server Management Studio Express Size 118 00MB Click here for support information Last Used On 8 24 2011 To change this program or remove it from your computer click Change or Remove Change 9 Microsoft SQL Server Native Client Size 4 21MB i Microsoft SQL Server Setup Support Files English Size 8 Microsoft SQL Server SS Writer Size 0 66MB a E Microsoft visual C 2005 Redistributable Size 5 21MB a 2 From the PIPSpro Installer Dashboard select Step 2 Install SQL Server Express 3 Choose New installation or add features to an existing installation EEr lol x New installation or add features to an existing installation Launch 4 wizard to install SQL Server 2008 R2 in non chustered environment or to add features to an existing SQL Server 2008 R2 instance Upgrade from SQL Server 2000 SQL Server 2005 or SQL Server 8 Launch a wizard to upgrade SQL Server 2000 SQL Server 2005 or SQL Server 2008 to SQL Server 2008 2 Search for product updates Search Microsoft Update for SQL Server 2008 R2 product
35. 5 4 in 1st UK Radiation Oncol Conf UKRO April 2001 Clinical Oncology 13 Sup 2 p S9 2001 Radiotherapy technique Accuracy and reproducibility for head and neck bladder and prostate thorax and abdomen S Stanley Abstract 5 5 in 1st UK Radiation Oncol Conf UKRO April 2001 Clinical Oncology 13 Sup 2 p S9 2001 Quality control of treatment verification imaging software N C Bulmer M C Kirby Presented at the BIR meeting on Treatment Verification London 11 June 2001 Image acquisition properties of an amorphous silicon electronic portal imaging device P Greer Abstract in COMP Annual Meeting Kelowna July 2002 Medical Physics 28 1974 2001 Initial experience with the Lumisys ACR 2000 Computed Radiography system for digital simulation imaging portal imaging and verification of IMRT treatments E Henderson H Alasti Abstract in AAPM Annual Meeting Salt Lake City 2001 Medical Physics 28 1216 2001 The impact of virtual simulation in palliative radiotherapy for non small cell lung cancer M McJury P M Fisher S Pledge G Brown C Anthony M Q Hatton J Conway M H Robinson Radiotherapy and Oncology 59 311 318 2001 Treatment planning aids in prostate cancer friend or foe S Malone R Donker S Dahrouge L Eapen Aref G Perry J Szanto Int J Rad Oncol Biol Phys 51 1 49 55 2001 The application of computed radiography imaging system for portal imaging a comparison
36. Calculate button in the left hand panel to begin the analysis The green circle is the search radius The software will find the center of each projection as the search is completed around the circle The centers are then connected by the orange lines Great effort has been put into improving the algorithms that are used to When all projections have been delineated manually clicking on the identify the projections in the image There could exist a situation where Calculate button will complete the analysis based on the manually no adjustment of the threshold or the search radius will result in a correct delineated lines identification of the projections In this case the Starshot module allows the user to manually define the projections After placing a center fiducial and choosing the image type and the angle type right click anywhere over the image and a menu will be shown 31 0 ARO SOH TVA A E Section 2 Using PIPSpro Starshot Module continued Printing Results Once results have been calculated a detailed report can be printed to paper or saved as a PDF file for electronic record keeping by clicking on the Print button in the left hand panel In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Paper printing Clicking the Print 9 button in the previe
37. Comprehensive for analyzing starshot images to determine the isocentricity of each of the rotating components of a linear accelerator the collimator the gantry and the couch This module works with either portal images or film including Gafchromic and provides quantitative information about the minimum radius of a circle that will touch each of the projections e CBCT Comprehensive Only for analyzing three dimensional image sets of the Catphan 504 Varian or Catphan 503 Elekta phantoms included with linear accelerators capable of performing a cone beam CT scan with the kV imager This module provides quantitative information for all seven of the TG142 recommended parameters e Stereotactic Comprehensive Only for analyzing Winston Lutz test images to determine the isocentricity of the complete linear accelerator system in order to reduce target positioning error This module provides quantitative information about each image for the in plane and cross plane offset and a full three dimensional stand offset when a full eight image set is provided e MLCQA Comprehensive Only utilizes the MLC Phantom for analyzing individual leaf positions of multi leaf collimators MLC This module provides quantitative information for four different MLC tests leaf position non IMRT leaf position IMRT leaf width at isocenter and leaf transmission inter leaf and inter bank e IGRT Comprehensive Only for tracking and trending
38. Hovde J Moffat Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 168 169 Evaluation of View and MViewGT using the QC 3 phantom A multicentre study N Bulmer G Budgell R Clements A Glendinning M Kirby J Sage S Weston PIPSpro User s Meeting Manchester April 2003 7 8 Clinical Case Studies Head and Neck A Banbury Lung H Dalton Pelvis A Banbury PIPSpro User s Meeting Manchester April 2003 9 10 The use of image registratiopn methods in the optimisation of treatment accuracy M McJury J Conway C Anthony G Brown K Wilcock M Cooper M Robinson PIPSpro User s Meeting Manchester April 2003 11 12 Portal Image Verification of Siemens HD270 a software option for improving MLC resolution D Routsis B Gibson PIPSpro User s Meeting Manchester April 2003 15 Web based integration of PIPSpro into a radiotherapy department R Wyatt K Natarajan PIPSpro User s Meeting Manchester April 2003 17 18 Integrating PIPSpro and View J Sage PIPSpro User s Meeting Manchester April 2003 19 20 Accuracy of prostate radiation therapy using fiducial point pair registration technique based on the computer assisted portal image quality assurance program PIPSpro W Mermerstain Y Cohen Y Krutman Australasian Radiology 47 168 171 2003 Quality assurance measurements of a si epid performance Menon GV Sloboda RS Medical Dosimetry Spring 2004 Vol 29
39. Image Analysis 56 Results 56 Reset 56 Close Image 56 Printing Results 56 Saving the data to the database 60 Choosing another Linac for History View Exporting Data not available in off line mode IGRT Module 61 Using the IGRT Module 61 Entering Data 62 Entering data for another accelerator 62 History View Tab 63 Choosing another Linac for History View 63 The Reports Tab 63 Exporting Data not available in off line mode Application Menu gt Dewarp 64 Calibration procedure 65 Dewarping images 65 Image Enhancement Application Menu gt Image Analysis Tools Application Menu gt Image Analysis Tools continued Application Menu gt Transform Menu Application Menu gt Transform Menu continued Macro Menu Window Menu 60 61 64 69 70 71 72 73 74 File Menu Edit Menu 18 Edit Menu View Menu 20 View Menu Application Menu gt QC Quality Control 21 Configuration Management EPID QC 21 Acquiring Images 22 Image Analysis 23 Baseline Management 23 QC Trending Reports Radiation Light Field Module 24 Acquiring Images 24 Image Analysis 26 Results 26 Comments 26 Printing Results 26 Saving the data to the database 27 History View Tab 28 Choosing another Linac for History View 28 The Reports Tab 28 Exporting Data Starshot Module 29 Acquiring Images 29 Image Analysis 32 Results 32 Comments 32 Printing Results 32 Saving the data to the database 33 History View Tab 33 Choos
40. Layout Relative Displacement 7 Absolute Position Leaf 6 A chart view will now be shown on the bottom of the results window with a graphical representation of leaf position The chart can be viewed as a Relative Displacement default where the displacement from the correct position is graphed or as a Absolute Position where the actual position in millimeters from isocenter is graphed In the Relative Displacement view the graph will feature color coded bands in order to easily determine if an MLC is within acceptable ranges or not Green results are within the acceptable range as set in the System Manager Yellow results are within the Warning range as set in the System Manager Red results are within the Error range as set in the System Manager Don t Chart Sometimes there are data points saved to the database that can skew the graphical results in a negative way If you would not like to see the results from a particular test on the chart view click the Don t Chart box at the top of the listing The results will no longer be visualized in the chart when viewed on screen or printed 57 7 CAR History View Tab not available in off line mode As data is collected in the database viewing historical data to determine if the results are trending in a negative way can be a valuable exercise Clic
41. Med Biol Eng Comput 27 1989 pp 507 512 3 Pizer S M Zimmerman J B and Staab V Adaptive grey level assignment in CT scan display J Comput Assisted Tomography 8 2 1984 pp 300 305 4 Leszczynski K W S Shalev A robust algorithm for contrast enhance ment by local histogram modification Image Vision Comput 7 3 1989 pp 205 209 5 Pratt W K Digital image processing 2nd edn John Wiley amp Sons 1991 pp 294 297 Based on a presentation at the European Congress of Medical Physics 93 Puerto de la Cruz Tenerife Spain September 1993 by S Shalev Mani toba Cancer Treatment and Research Foundation Winnipeg Canada and G Gluhchev Institute of Informatics Bulgarian Academy of Sciences Sofia 91 Sequential Image Processing Portal images whether from film or electronic portal imaging devices exhibit poor contrast and low spatial resolution In order to facilitate visual perception of anatomical features and computer aided feature extraction image enhancement is required to improve the contrast sharpen the field edges and reduce the noise However the existing techniques improve the quality in one of these aspects and usually cause degeneration in the others The solution to the problem probably lies in a combination of enhancement techniques In an attempt to achieve a comprehensive improvement of the quality of portal images we propose a sequential approach consisting of contra
42. Multi leaf collimator QA MLC Module IGRT Module for tracking daily imaging and treatment beam coincidence and the Dewarp Module for removing warping effects from clinical images such as those from CT MR or PET imaging systems The Comprehensive version automatically ships with all phantoms including the QC 3 Phantom QCkV 1 Phantom MLC Phantom FC 2 Phantom and Center Marker Phantom Installing PIPSpro Upon installation a QC mdb file is automatically created in the PIPSpro installation directory if upgrading from a previous version of PIPSpro the existing QC mdb file will remain in the installation directory Sharing the QC mdb database it is desired to have the Q C mdb database shared between multiple installations of PIPSpro software follow this procedure Locate the QC mdb file in the installation directory For Windows XP users this will be C Program Files Standard Imaging PipsPro where C is the home directory for your computer For Windows Vista and Windows 7 users this will be C Users Public Standard Imaging PipsPro where C is the home directory for your computer Move the QC mdb file to a location of your choosing Make sure not to copy the file but to move it which will remove the QC mdb file from the current location Remove the QcDbLoc ini file from the installation directory NOTE This file will only exist if you have run PIPSpro Software after installation Run PIPSpro So
43. Opening PIPSpro Software version 4 4 2 2 2 3 10 Section 2 Using PIPSpro File Menu Edit Menu View Menu Application Menu gt QC Quality Control Radiation Light Field Module Starshot Module Starshot Module continued Starshot Module continued Starshot Module continued Starshot Module continued Starshot Module continued Application Menu gt CBCT Cone Beam Computed Tomography Application Menu gt Stereotactic Module Application Menu gt MLCQA Exporting Data not available in off line mode IGRT Module Application Menu gt Dewarp Application Menu gt Image Analysis Tools Application Menu gt Image Analysis Tools continued Application Menu gt Transform Menu Application Menu gt Transform Menu continued Macro Menu Window Menu 13 18 20 21 24 29 30 31 32 33 34 35 39 45 60 61 64 69 70 T1 72 13 74 Section 3 The QC 3 Phantom Analysis of Data from the QC 3 Phantom Summary of Published Data from the QC 3 Phantom Parametric Analysis of Image Unsharpness 76 T 19 Section 4 Additional PIPSpro Functionality Importing 16 bit Images DICOM Server Utility 84 86 Section 6 Appendices Appendix A The DICOM Format Appendix B Dewarping Distorted Images Appendix C Sequential Image Processing Appendix Stereo Algorithms Appendix E PIPSpro Publications 88 89 91 92 94 Section 7 Other Information Installing and Running the PIPSpro DICOM Server Utility
44. Radiosurgery K Luchka J Wolters Proc WESCAN Conf Kelowna March 1999 Evaluation of the use of ORFIT based on head and neck immobilisation in radiotherapy M C Kirby N C Bulmer A Davis R Foster L Hall J L Stief C Watson Physica Medica XV No 3 204 1999 A portal imaging test object for accurately assessing image registration algorithms M C Kirby A R Dowling N C Bulmer Physica Medica XV No 3 204 1999 Initial clinical experience with a video based patient positioning system L S Johnson B D Milliken S Hadley C Pelizzari D Haraf G T Y Chen Int J Rad Oncol Biol Phys 45 205 213 1999 Electronic portal imaging with an avalanche multiplication based video camera G Pang and J A Rowlands Med Phys 27 676 684 2000 Radiation therapy for breast cancer at the millenium H Jane Dobbs Radiotherapy amp Oncology 54 191 200 2000 A clinical evaluation of setup errors for a prostate immobilization system J E McGary W Grant Jounal of Applied Clinical Medical Physics 1 138 147 2000 Characterization of a high elbow fluoroscopic electronic portal imaging device for portal dosimetry J C J de Boer B J M Heijmen K L Pasma A G Visser Phys Med Biol 45 197 216 2000 A multidisciplinary approach to implementing effective portal imaging and review protocols J Stief and M C Kirby Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 5 Qualit
45. S copyright laws international treaties FDA regulations and other intellectual property laws and treaties This is a software license agreement to use the software product or products the product enclosed in this package and described in the applicable purchase order or other ordering document Standard Imaging Inc a Wisconsin corporation Standard Imaging hereby grants to the purchaser of the product Licensee the right to use the product together with its documentation and other related materials only in connection the computers or computer network system located at the site of use the site previously designated as such by Licensee and only if in strict compliance with the terms and conditions set forth below Any purchase and installation or use of the product shall constitute acceptance of and agreement by Licensee to be bound by the terms and conditions hereof Licensee also agrees that the agreement terms and conditions will prevail in the event of any conflict be tween the agreement applicable purchase order or other ordering document All rights not specifically granted to licensee under this software license agreement are reserved by Standard Imaging The Standard Imaging documented Warranty and Customer Responsibility statements shall be considered to be part of this agreement The term of this agreement and the licenses granted hereunder will continue in perpetuity unless sooner terminated by Standard Imag
46. SOFTWARE dU an dV Values A value is automatically calculated for dU and dV when each image is analyzed The dU value is based on the distance the ball marker is offset from the center of the field in the direction across the gantry inplane and the dV value is calculated along the gantry crossplane These values along with the gantry and couch angles are utilized to determine the X Y Z offsets 0 0 90 Search Offset The Search Offset value sets the size of the search area that the module uses to find the ball marker and identify the center of it The value is in pixels and measured from the edge of the radiation field towards the center The value will depend on the size of the collimated field and should be adjusted so that the search area blue box falls completely inside the collimated field edge green If there is not enough contrast between the post holding the ball marker and the ball marker itself the module will include part of the post in the analysis which can give false results Adjusting the search offset can help prevent this by increasing the offset until none of the post is included Performing Calculations Eight images only Once images are loaded and the Gantry and Couch angles are set the user is ready to perform calculations First check off that the Gantry and Couch angles have been verified Select the Calculate button in the lower left of the application The appl
47. Screen Color Depth CD ROM Drive Additional Software Windows is a registered trademark of Microsoft Corporation Product Standards Designed to meet IEC 60601 1 4 C CatPhan is a registered trademark of The Phantom Laboratory BEAMVIEW is a registered trademark of Siemens AG PortalVision is a trademark of Varian Medical Systems Inc iView and iViewGT are trademarks of Elekta Limited TheraView is a registered trademark of Cablon Medical B V is a registered trademark of Varian Medical Systems Inc Varian Elekta is a registered trademark of Electa AB PIPSPRO SOFTWARE Warnings and Cautions alert users to dangerous conditions that can occur if 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 CAUTION Federal law in the U S A and Canadian law restricts the sale distribution or use of this product to by or on the order of a licensed medical practitioner This product should be used under the guidance of a medical physicist CAUTION The Save and Save As functions of the PIPSpro System are intended solely to save solutions of interest or potential reuse Specific patient information or identifiers should not be saved using these functions CAUTION To minimize the potential for computer issues do not run PIPSpro concurrently with other software programs CAUTION Prope
48. Set As A Set the second image as Image B From the Oper menu choose AminB You will now have a new image that is made up of the first two strips Now load the new image in as Image A and the third strip as Image B and repeat the procedure until all strips have been added together Save the new image as a TIFF tif or as a bitmap bmp using File Save As from the main menu The MLC phantom is set up and the EPID is raised to the highest position possible without a collision with either the couch or the phantom to ensure that as many of the MLC as is possible can be acquired on the imager For machines Varian in which the maximum imaging size is across the imager it is advisable to turn the collimator 90 degrees so that the MLC s travel is 51 Reset After an analysis has been performed the user has the option of resetting the image This will clear all results overlays and fiducial points allowing the user to start over This is done by selecting the Reset button Close Image To close the image select MLCQA Close Image or use the keyboard shortcut Ctrl W The application will close the currently displayed image If multiple images have been loaded the user must instruct the application to display the image they wish to close before instructing the application to close the image Printing Results Once results have been calculated a detailed report can be printed to paper or saved as a PDF file
49. User Name First Name Last Name MP ry Department SIRO Position v Divisions Physi ae z _ Modify List Initial Password Archive Save Cancel Begin creating a new user account by assigning a unique username to the user The user s first name last name and middle initial should be entered as it will be displayed on reports In addition the user s professional credentials should be entered in the Suffix field as they will appear on reports Adding a user s e mail address will enable future functionality 11 Click the New button at the bottom of the System Manager screen System Manager Departments Users Linacs Add Division Information Below Division Name Division Users Superuser required for all divisions Modify List Division Departments Modify List Save Close Enter a name for the Division At this time you will not be able to add Users or Departments until those are created in the next steps Click Save to commit the new Division information to the database If more than one Division is required for your organization repeat the previous steps until the desired Divisions have been added to the database After Users and Departments are created return to the Divisions screen and use the Modify List buttons to add them to the appropriate Division Adding Departments The next step in configuration is setting up at least one dep
50. Users list and the user information will be populated After all desired edits are complete click Save to save the changes to the database After the save is complete exit the screen by clicking Close 12 Section 2 Using PIPSpro PIPSpro Import File Format Ea Truncate Lower jo OF Upper jo a Cancel Dynamic Range ln Bits 12 Format Width In Pixels 256 IBM PC MACZUNIX Height In Pixels 256 Signed 16 bit Head Size In Bytes i O24 I Normalize With Lowest Highest Values Total Size OF the Image 132096 Pixel Size In Bits 16 Proportional Adjustment No C Yes By Insertion f Yes By Interpolation Click on Open and the Import File Format window appears Click on lt OK gt to accept the default image parameters or change the dynamic range as necessary for a 16 bit image with a 12 bit dynamic range it is usually best to set bits 0 11 and not set bits 12 15 The new values will be used as default when you open a 16 bit image again When opening a DICOM image the header and a backup of the im age are saved into the files header htm and dicom tmp respectively The user may specify where these files are to be saved by setting the path in the Configuration Settings dialog box otherwise the default is the same directory as PIPSpro Both files are overwritten every time a new DICOM image is opened The header file may be viewed by us
51. ViewGT Varian VARIS and Eliav PORTpro can export images in DICOM or bitmap format although DICOM is to be preferred as it is a 16 bit format The Elekta ViewGT internal file format is a 16 bit lossless compressed jpeg For DICOM bitmap and jpeg images use the File Open command instead of File lmport The table on the following page lists the parameters that should usually be used when importing images from some commercial portal imaging devices In some cases PIPSpro will obtain the necessary information automatically from the image header and it will be sufficient to click on lt OK gt unless some special conditions are required 13 File Menu Open The File Open command is used to open images that will be utilized in the imager QC module or images that require the use of the image enhancement or image manipulation functions The File Open command will open files of type bitmap bmp TIFF tif DICOM 3 dcm and jpeg jpg files It may be necessary to choose a different File of type from the drop down list at the bottom of the File Open dialog for all of your images to be shown in the list For example if you are opening a DICOM 3 dcm file you will need to change the File of type to Dicom DCM in order to see the dcm files in the list Look in VARIAN M 6 Name n Date modified Type 2 9 2006 5 25 PM DCM File 2 9 2006 5 25 PM DCM File aS500_QC_a dcm aS
52. Z be points in the un rotated and rotated couch coordinate system respectively If the couch is rotated through angle the two points are related by the relation K 0050 sing 0 X L sing cos O0 x Y M 0 0 1 Z Notice that the un rotated gantry and couch coordinate systems coincide Combining these two equations gives U 000 sin 0 X V cos sing cos cos sin x Y W sin sing 51100085 0 Z This equation can be simplified by identifying the fact that in images of the ball marker only U and V displacements can be identified as the film is always exposed at right angles to the W axis l X U cos sin 0 l l x Y V cos sing cos cos sind 7 This equation is represented in differential form as dU 0 ing 0 cos sin x dY dV 00508110 005000856 0 a where dU dV is the offset of the center of the marker with respect to the center of the radiation field and dX dY dZ is the offset of the head frame from the optimal target location PIPSPRO SOFTWARE Stereo Algorithms a a 6 a Ball Marker te s Radiation Field Edge Eight digital images of a small radio opaque ball marker within a circular radiation beam are used for the analysis Under ideal conditions the ball marker will always be at beam center however in practice its position will be offset for different gantry and couch angles Stereo computes th
53. a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Linac Information We Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save Al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Saving the data to the database not available in off line mode Clicking the Save Results button in the left hand panel will insert the data into the database for future trending and analysis PIPSPRO SOFTWARE Sometimes the search algorithm can get lost in finding the edge of the openings around the fiducials and will fail to correctly identify the area to be ignored this happens adjusting the Edge Strength on the left hand panel can solve this issue Click the Reset button to begin the analysis steps again and set the Edge Strength to 25 before proceeding Make further adjustments to the Edge Strength as needed to get a valid analysis Results The software will calculate the value of the inter leaf leakage and the inter bank leakage based on the background value measured and report those values as a
54. and the histogram is com puted for each region Each pixel is individually mapped to a new grey value according to the cumulative distribution function CDF obtained by bilinear interpolation between the four neighboring regions The algorithm used in PIPSpro was specially developed for processing low contrast portal images and optimized for speed of computation It uses a technique called overlapping regions to reduce artifacts in the processed image If an ROI has been selected the enhancement will be done only inside the ROI SRAHE Selective Region Adaptive Histogram Equalization SRAHE automatically finds the contour of the radiation field see Field Edge section under the Feature menu and selectively applies contrast enhancement inside this region This option should be used only for portal images in which the field is completely sur rounded by background and does not intersect the edge of the window If PIPSpro fails to detect the field edge a warning will be issued and if you respond OK the enhancement will continue for the whole image without the Selective Region option You can also define your own field edge see HINT 2 below in which case the automatic field edge detection will not be applied HINT It may be useful to select an ROI around the treatment field to cut out any noise text or other artifacts near the window edges The search for the field edge will then take place only within the ROI HINT You can define an arb
55. and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere This first fiducial tells the software that this is isocenter and all measurements will be made from this point This allows the software to correctly determine the position of each of the MLC s and accurately determine the distance from isocenter the edge of the MLC is positioned at Fiducial 2 The second fiducial needs to be placed over the spherical marker that is furthest from the center marker in the direction of the opening of the MLC s Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere The second fiducial tells the software the scale for the image and also which direction the collimator and MLC s are turned Click on the Leaf Width button to perform the analysis 50 Section 2 Using PIPSpro Application Menu gt MLCQA continued Saving the data to the database not available in off line mode Clicking the Save Results button in the left hand panel will insert the data into the database for future trending and analysis Multi Port Test TG 142 recommends testing the leaf position accuracy for IMRT fields on a monthly basis The MLC Multi Port Test accomplishes this important QA Aquiring Images It is recommended that a QA Patient be set up in th
56. as a WINZIP file reduces the storage space by a factor of about 2 1 Export images from VARiS using File gt Export gt Images and select the destination for example c temp or a images etc Depending on the export licences included in your VARiS software you can export the images in various formats bitmap bmp tiff tif DICOM ima CART crt ZIP z p and the original Varian format filename 007 etc If you export the images from VARIS in DICOM format dcm or ima remember to define the extensions in the Configuration Settings dialog box DICOM tab see User s Guide section 3 5 If you export the images in ima omp or tif formats use File gt Open to display them in PIPSpro If files in zip or original Varian filename 001 formats are imported into PIPSpro using File gt Import gt Other or File gt Import gt Varian gt Portal they will be 256 x 256 pixels and 16 bits in depth 6 Importing Varian Images from VARIS VISION 6 x In VARIS VISION 6 x images are stored in the internal database in a proprietary format and cannot be opened by PIPSpro You must use the Export facility to extract images from the database It is recommended that you export them in DICOM format and use File gt Open to display them in PIPSpro 7 Varian Artifact Removal File gt Import gt Varian examines the Varian image for artifacts and corrects for them so that the images can be imported with Dynamic Range 16
57. be compressed lossy compression The Quality Factor determines how much com pression will be applied and correspondingly how much loss will occur to the original data The Quality Factor is set in the Configuration Settings dialog box JPEG dialog box Successively compressing and decompressing a JPEG image will lead to progressive loss of data HINT The relationship between the Quality Factor and the degree of compression will depend on the image Try saving an image with different quality factors the degree of compression is reported as the image is saved Then compare them to the original by examining the difference between them in 2 Image Operation HINT Compression ratios up to 20 1 do not seem to degrade portal images significantly while a very large saving in storage requirements is achieved See Image Storage Requirements for Treatment Planning and Verification Shlomo Shalev Seminars in Radiation Oncology Vol 7 1997 pp 67 75 Configuration Settings Applications The Configuration Settings Applications area allows the user to set functionality parameters for the PIPSpro software and modules Login In most cases the configuration settings will only be shown to users with appropriate user rights Supervisor or above This can be overridden by checking the box on the Login tab in the Configuration Settings window and is set to true by default at installation This allows the user to access the configuration sett
58. each Department This allows for trending of pertinent information specific to the linac plus other future functionality To add a Linac to the database click on Linacs in the System Manager Click the New button at the bottom of the screen System Manager Divisions Depariment Users Linacs Active Linacs Edit Linac Information Below Machine ID 21 EX Department SIRO X Manufacturer Varian Medical Systems Couch Type Model 21 EX C 3D 60 Position thresholds Warning Error MLC Type 120 Leaf X 1 0 mm 2 0 mm EPID Mv Imager fasi 500 Reset IGRT Baseline OBl kv Imager Varian OBI X Archive Save New Close Enter a machine ID The machine ID should be unique for all linacs in the specified department From the Department dropdown list choose the appropriate department that the linear accelerator is associated with Choose the manufacturer of the Linac from the dropdown list Enter a model name and or number Choose the MLC that is installed on the Linac from the dropdown list Choose the EPID MV Imager that is installed on the Linac from the drop down list If no MV imager is installed choose None Choose the OBI kV Imager installed on the Linac from the drop down list If no kV imager is installed choose None Enter the position thresholds for Warning yellow and Error red for tests involving this linear accelerator Currently the Warning and Error thresholds are only used
59. each of the MLC s for each of the left and right banks and each strip If the strips were set up correctly the correct position for each of the banks should be e For the opening centered on 60 mm o Left Bank 70 mm o Right Bank 50 mm e For the opening centered on 30 mm o Left Bank 40 mm o Right Bank 20 mm For the opening centered on isocenter o Left Bank 10 mm o Right Bank 10 mm e For the opening centered on 30 mm o Left Bank 20 mm 5 Right Bank 40 mm e For the opening centered on 60 mm o Left Bank 50 mm o Right Bank 70 mm Results will be color coded based on the ranges set in the System Manager No background color results are within the acceptable range Yellow background color results are within the Warning range Red background color results are within the Error range Reset After an analysis has been performed the user has the option of resetting the image This will clear all results overlays and fiducial points allowing the user to start over This is done by selecting the Reset button Close Image To close the image select MLCQA Close Image or use the keyboard shortcut Ctrl W The application will close the currently displayed image If multiple images have been loaded the user must instruct the application to display the image they wish to close before instructing the application to close the image 53 The second fiducial tells the softwa
60. for electronic record keeping by clicking on the Print Results button in the left hand panel In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Linac Information Paper printing Clicking the Print Print dialog Choose the appropriate printer and click the OK button to button in the preview will open a standard Windows print PDF Save a Windows Save As dialog Enter a name for the file and navigate to the Clicking the Save button in the preview will open a standard directory in which the file should be saved Click the Save button to create the PDF file PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued A Window Level bar on the left of the image can be used to adjust the brightness and contrast P hero Comprehensive MC QAI gt Si W pie Application MLCOA Wirdew toe 1 Two fiducial marks need to be placed on the image Fiducial 1 The first fiducial needs to be placed over the spherical marker in the phantom that is aligned with isocenter Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere This first fiducial tells the software that this is isocenter and all measurements will be
61. from the last setting used See the description of Dynamic Bit Setting on the following page PIPSPRO SOFTWARE Section 2 Using PIPSpro File Menu continued pixels pixels bytes bits Range Adjustment BEAMVIEWM sv11 512 480 nso 8 110 BEAMviIEwe s v1 2 512 480 1014 8 Varian PortalVision 256 256 1024 1 on No Varianass00 2 36 o 6 os m export as bitmap or DICOM use OPEN Varian aS500 Philips SR 100 512 2866 s512 8 o7 23 bitmap or DICOM use OPEN bitmap or DICOM use OPEN Elekta View Elekta ViewGT jpeg or DICOM use OPEN CART 6656 Mt 8 TheraView 812 52 o0 16 Mac 1016 Eliav PORTpro bitmap or DICOM use OPEN see comments under Proportional Adjustment Truncate This function only applies when importing 16 bit images A 16 bit image to be imported is scaled to an 8 bit image in the range 0 255 If this option is selected the program will calculate the 16 bit histogram select pixel values between the limits set by Truncate Lower and Truncate Upper and renormalize them to a 8 bit image See the Importing 16 bit images section of this manual for an example of using the Truncate option Format Select the byte order low high for IBM PC high low for Mac UNIX Signed 16 bit Select this option for file formats using signed data Normalize with lowest hi
62. functioning properly and ready for use After repair the 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 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 YY Last two digits of the year e g 1999 99 2000 00 DDD Day of the year 1 lt DDD lt 365 X Unique unit ID Number 1 lt X lt 9 PIPSPRO SOFTWARE Software License Agreement The Licensee shall be solely responsible for the installation of the product and any updates provided by Standard Imaging Standard Imaging shall provide telephone technical support for the product for a period of 1 one year from the date of shipment Any updates upgrades and new releases to the product within the period of 1 year from date of shipment will be provided at no additional costs After the expiration of the period of 1 year from the date of shipment Standard Imaging will provide technical support and updates up
63. in pixela From Top in pels All displays of coordinates will now be shown in the new coordinate system This includes Measurement InfoDesk CopyCat Show Info About Fiducial Points etc HINT Use View 100 when setting the coordinate system or read ing coordinates PIPSPRO SOFTWARE PIPSpro Set Coordinate System 3 PIPSpro Histogram 2_port bmp highest 1309 Cumulated in pixel range C Selected ROI sat x 0 400 median 4 0 476 pixels 107951 std dey 4 192 2 55 Ee et Update Save Exit 2 lower bound higher bound 255 To see a cumulative histogram check Cumulated Changing the num bers in the fields lower bound and higher bound or clicking on the arrows above them will change the range of the histogram and only the grey levels within the range will be displayed Do not forget to click on Update This provides a better display of bins with small numbers of grey levels The following information is also displayed the maximum histogram value grey level for the maximum histogram range active number of bins with non zero histogram value the mean median and the total number of pixels in the whole image or selected ROI Also the vertical and horizontal pixel ranges and standard deviation are displayed Save the histogram data as a data file filename dat ASCII format comma delineated for export to Excel or other spreadsheet programs for detailed analysis Measu
64. is that the Varian option inverts the original 16 bit data during the import routine so that both the 16 bit and the 8 bit images are inverted relative to the incoming Varian data This is more convenient than using Import gt Other and then applying File gt Invert although the results will be the same Another difference is that File gt Import gt Varian gt Portal will determine whether the Varian images are compressed Varis 5 x and earlier and will uncompress them if necessary It will not uncompress the proprietary format images used in the internal data base of Varis 6 x The selections File gt Import gt Poseidon and File gt Import gt CART are specific to those formats Having several 16 bit import routines has the advantage that the default values image size bit selection etc remain in memory for the next time the routine is used so that for example the Import gt Varian option can be left with the defaults suitable for PortalVision images while the Import gt Other option may be used for images from a film digitizer CT MRI etc Some centers have EPIDs from several different vendors and the various selections can be set up with the necessary parameters There is no reason why you cannot use the File gt Import gt Siemens selection for example for importing images from a different vendor s system as long as you set the pixel size width height etc appropriately 2 Setting the Dynamic Range Whe
65. is then performed based on the known angles of the ramps to yield the slice width in mm Since these ramps are always in opposing pairs a phantom offset can also be calculated The expected slice thickness is determined from the image header All four wire ramp profiles are reported along with their mean and expected values Also based on the opposing ramps a rotation of the phantom about an axis perpendicular to the ramps can also be computed Since there are two pairs of ramps oriented along orthogonal directions then phantom rotations about both the vertical and horizontal axes can be estimated The reported values are accurate for rotations up to about 5 about either axis Uniformity Vertical and horizontal profiles are determined which pass through the center of the uniform module A 10 pixel wide area is used and The pixel size test uses the four calibration pins 3 air holes and 1 Teflon filled which are approximately 3 2mm in diameter and separated by 50mm The centroid of each pin is determined by an edge detection algorithm and computed in units of pixels Based on the known physical locations of these pins the pixel dimensions can be calculated for the x and y directions The expected pixel size is extracted from the image header Table position is also reported by computing the offset in the phantom center with respect to the center of the image matrix In addition a rotation of the phantom is calculated based on a le
66. it can be read by any simple text editor Dump ROI Select an ROI which is not too large as otherwise the dump file will be enormous Dump ROI saves the pixel values in the ROI to an ASCII file filename dat The file can be opened by File Open use extension dat or it can be read by any simple text editor The first row of the file gives the corner coordinate and the size of the ROI rows x columns Then each row in the data file corresponds to a row in the ROI with a sequential row number added in column 1 Data are comma delineated 70 Section 2 Using PIPSpro Application Menu gt Transform Menu The results are shown in a window The scaling rotation and shift be tween the images are shown and the corresponding centers of gravity for the two images The results are not saved to a file you need to copy them down To transform the treatment image to the same scale rotation and shift as the reference image select Display transformed image in Calibration under Configuration Settings PIPSpro Chamfer Matching Magnification Mx 1 01 My 1 01 Rotation 0 00 Shifts 0 0 mm Shifty 1 4 mm COG of reference 121 9 mm 116 3 mm COG of treatment 122 3 mm 116 3 mmn Manipulate This command allows you to manipulate an image by scaling rotation and shift Select the parameters from the dialog box as required For rotations you need to specify the center of rotation and also whether the i
67. license Click on Help License and the following screen will be shown Registration Update License or Release License Computer ID 201132701 42662112320 License Code Pe PO To remove the license from the computer enter your License Code and click the Release License Button The license can now be utilized on a different computer If your computer is not connected to the internet please contact Standard Imaging support for assistance Update License Certain Standard Imaging software products are offered with optional modules that are activated based on a license code If a product is purchased and in the future a new module is desired an update can be made to the license automatically Standard Imaging support services will contact you and you will be asked to click on the Update License button at the appropriate time PIPSPRO SOFTWARE PIPSPRO SOFTWARE Section 2 Using PIPSpro Listed by menu in order of appearance 46 Image Window and Level Adjustment 46 Acquiring Images 46 Image Analysis 48 Results 48 Reset 48 Close Image 48 Printing Results 49 Saving the data to the database 49 Aquiring Images 49 Image Analysis 50 Results 51 Reset 51 Close Image 51 Printing Results 51 Saving the data to the database 51 Aquiring Images 52 Image Analysis 53 Results 53 Reset 53 Close Image 54 Printing Results 54 Saving the data to the database 54 Adquiring Images 54
68. module without saving changes PIPSPRO SOFTWARE Section 2 Using PIPSpro Radiation Light Field Module The image should then be exported preferably in DICOM format to a location accessible by the PIPSpro software which will be used for the analysis An included DICOM server utility is included with the PIPSpro software installation if needed for instructions on how to export images from your treatment machine or record and verify system please contact the manufacturer of that system See the DICOM server utility section of the user s manual for setup information NOTE The Radiation Light Field Module will only open DICOM TIF or bitmap BMP images Image Analysis Open the Radiation Light Field Module by choosing Application Radiation Light Field from the menu 7 PIPSpro Comprehensive BETA Not for clinical use Eile Edit View Macro Window Help QC gt Radiation Light Field StarShot CBCT Module Stereotactic MLCQA IGRT Dewarp gt Image Enhancement gt Image Analysis Tools b The module will load in the window with the Image Analysis tab chosen by default The module features two window areas The area on left displays information pertinent to the operation that is being performed and the area on the right is for the display of the image and the results of the analysis The area of the left can be collapsed by clicking o
69. of two commercial portal imaging systems J Vanhanen M Pitk nen S Peltola S Hy6dynmaa Radiotherapy and Oncology 61 Suppl 1 S81 2001 Quality Asurance of EPI Systems PIPSPRO SOFTWARE PIPSPRO SOFTWARE 97 PIPSPRO SOFTWARE Section 7 Other Information 98 Installing and Running the PIPSpro DICOM Server Utility 100 DICOM Conformance Statement 100 DICOM Conformance Statement 103 Customer Responsibility 103 Warranty 104 Software License Agreement PIPSPRO SOFTWARE Section 7 Other Information Installing and Running the PIPSpro DICOM Server Utility Section 3 Working With PIPSpro PIPSpro DICOM Server is designed to work with PIPSpro so that you can easily manage the received DICOM images 1 Launch PIPSpro as usual by double clicking its desktop icon 2 From the File menu select item Show Received DICOM The Received DICOM dialog will be displayed If it is connected success fully to the DICOM Server an online indicator is appended to the dialog title The Received DICOM dialog displays all the DICOM images that have been sent to the PIPSpro DICOM server e Initiate a DICOM transfer to the PIPSpro DICOM Server from some remote node This may be a CT or MR scanner or other device ca pable of DICOM transfer Note The remote node must be configured to send images to the PIPSpro DICOM Server i e IP address AE title and port number of the PIPSpro
70. old image and the database will be updated accordingly COMMUNICATION PROFILE Supported Communication Stacks DICOM Part 8 is supported by the PIPSpro DICOM Server Module through TCP IP TCP IP Stack The TCP IP stack supported by the PIPSpro DICOM Server Module is inherited from the host operating system Microsoft Windows CONFIGURATION Configuration Parameters The following fields are configurable for the local application entity e Listening TCP IP Port SUPPORT OF EXTENDED CHARACTER SETS No support of extended character sets is offered by the PIPSpro DICOM Server Module at this time PIPSPRO SOFTWARE Notes 102 PIPSPRO SOFTWARE Warranty lt K T zx e__ _ 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
71. on the same image Once you have decided on the optimal technique and the best parameters run Macro and record your favorite technique under a suitable macro name Then you can run it again without any hassle Custom Filter The current active image will be processed by the custom filter if one has been loaded using Load Filter See File Load Filter for details PIPSPRO SOFTWARE EXAMPLE The following figure shows an original Varian PortalVision image left The center image has been processed by AHE clip 5 followed by edge sharpening and the blurred field edges are clearly seen The right image has been processed by AHC clip 5 followed by edge sharpening and the field edges are much better defined c images varian image1 001 ie Duplicated Edge Detect From a pop up menu the user may select different masks for Sobel and Frei edge detectors together with a threshold for the magnitude of the edges PIPSpro Edge Detect Sobel 1 Sobel 2 Sobel 1 2 Frei Chen 1 Frei Chen 2 ere Threshold Frei Chen 4 4 Frei Chen 5 Frei Chen 6 Mask Frei Chen 8 F E 1 23 4 F C 5 6 7 5 oe eceeeeeeeeee Morphology This includes the basic morphological operations erosion dilation and gradient applied to grey scale images The kernel size may be set up from a dialog window Morphological image processing operations in general are image op erations that change the spatial form or structure of ob
72. percentage A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window Leakage Profiles 50 160 170 180 190 200 210 220 230 240 250 260 270 Left Profile Right Profile Center Profile Left Base Right Base Inter Leaf Inter Bank Leakage Leakage At the top of the results window is a graphical representation of the measured leakage values in relation to the background In the lower half of the results window the value as a percentage of background will be reported for both the inter leaf and inter bank leakage Reset After an analysis has been performed the user has the option of resetting the image This will clear all results overlays and fiducial points allowing the user to start over This is done by selecting the Reset button 56 Section 2 Using PIPSpro Application Menu gt MLCQA continued Results will be color coded based on the ranges set in the System Manager No background color results are within the acceptable range Yellow background color results are within the Warning range Red background color results are within the Error range Trending can be accomplished on a per leaf basis by clicking the Trend Leaf box for the leaf you would like to see trended Left Bank Right Bank All Leaf Position Tests Lim om om m a Ke Trending
73. pipspro32 demo images d Oj x x PIPSpro Operation of 2 im X Img Oper Norm Img B Pine Length Sn 0 472 27 pxl 664x480 221 38 mm Sai Length A 0 472 27 pxl 664x480 221 38 mm PIPSPRO SOFTWARE 2 Image Operation This allows for simple image operations between two similar size images including addition subtraction and division An operational window will be opened that allows the user to select two images and a specific action These are algebraic operations A B A B A B 2 etc and Boolean operations AmaxB AminB AandB AorB The resulting image is stretched to the grey level range 0 255 if normalization is selected by Norm De c program files pipspro32 de Mi EY c program files pipspro32 de Mi lt PIPSpro Operation of 2 im EQ Imo Norm Img B B A A B B A AxB A B 2 A kB kB AmaxB AminB AandB Ao wU THRU COPY CAT HINT If you want to see the absolute difference between two images use A B and do not normalize The resulting image will show the exact difference in pixel values which can be read with InfoDesk If you want to see the qualitative difference between two images such as an image before and after processing use A B with normalization The resulting image will be stretched to the range 1 255 and the features will be more easily seen VU THRU found in the Oper menu is used to examine a portio
74. portal field select Trun cate Lower to say 30 or 50 and the contrast will be improved although at the expense of the loss of the low valued data To remove the higher valued pixels select Truncate Upper to say 5 or 10 Trial and error will be necessary to optimize the image Of course after importing the image PIPSpro provides windowing histogram stretching and other algorithms to optimize the contrast in the 8 bit image 4 7 Proportional adjustment should not be selected for Varian images which have square pixels and normally there is no need to adjust their aspect ratio You should determine whether images from your EPID have square pixels or if there is a need to change the aspect ratio using Proportional Adjustment 5 Importing Varian Images from VARIS VISION 5 x In VARiS VISION 5 x images are stored in a database on the server with a sequential file number which can be identified by using Edit gt Properties gt Technical in the VARiS VISION software The images may be in standard Varian format or in ZIP format Using Task gt Administration gt Storage you can select whether these stored images are to be compressed as a WINZIP file z p or saved in the original Varian format filename 001 filename 002 etc Note that compression to a WINZIP file is different from the compression used in earlier versions of PortalVision which used a different compression technique and did not change the file extension Compression
75. region darker than the surrounding area and if one is detected it will be displayed as a fiducial point The objects to be detected must be darker than the neighborhood and if necessary use Edit Invert to achieve this The parameters for this routine are set in the Configuration Settings dialog box Calibration Sensitivity adjusts the signal level for detecting a pin 1 is high sensitivity 10 is low Detect Size is the size of the search region around the cursor in pixels Field Edge This automatically detects the field edge from a portal image SPIE 1898 296 303 1993 It assumes that the field is surrounded by a dark region and that the field edge does not overlap the edge of the window The image may have the normal gray scale black white i e black is no radiation white is high signal or it may be inverted white black The detected contour is shown as red numbers with green circles or as green crosses These are the end points of straight line segments The F9 function key will switch back and forth between the number and cross modes Save As 21 x Save in a Demo_4 c ss Markport con Marksim con File name 2_port CON Save as type Contour Point CON Cancel Contour Point CON k Text file TXT You can save the coordinates of the detected contours The default file name consists of the image name with an extension con but you can also s
76. s travel is perpendicular to the maximum imaging size This will ensure that as many MLC s as possible will be imaged For some machines the imager is fixed at a distance from the source that makes it impossible to get all or close to all of the MLC in a single image In these situations it is advisable to take more than one image imaging half of the MLC and then moving the imager to capture the other side Image Analysis To load an image choose MLCQA Load Image from the menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your images choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically In Off line Mode this dialog will not be shown PIPSPRO SOFTWARE Printing Results Once results have been calculated a detailed report can be printed to paper or saved as a PDF file for electronic record keeping by clicking on the Print Results button in the left hand panel In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Linac Information
77. tests that meet or exceed TG142 recommendations for a variety of machine quality assurance PIPSpro Architecture E PIPSpro is a quality assurance tool that is intended for use by a clinic team to collaborate and store related QA tasks in a centralized library The software is designed as a two tier client server system a computing architecture that separates a client PIPSpro from a database server SQL Server and is implemented over a computer network Each instance of the client software sends data requests to a dedicated database server It is advised that an Information Technology professional be involved with the installation of the PIPSpro SQL Server Database Client installs can be performed at each workstation with the included Client Install CD ROM or can be pushed to each computer using commercially available remote installation software programs PIPSpro Versions and Modules PIPSpro Software is sold in a QC version and a Comprehensive version The QC version is the core version of PIPSpro and includes modules for imager QA radiation light field congruence and starshot analysis The QC version automatically ships with the QC 3 phantom the FC 2 phantom and the Center Marker Phantom If a site has kV imaging the QCkV 1 phantom can be purchased separately The Comprehensive version is identical to the QC version but includes modules for performing Cone Beam CT QA CBCT Module Stereotactic QC Stereo Module
78. that date from showing up in the charts e Chart View the data that matches the chosen setting are shown in charts Clicking on the legend name of any of the charted values turns on off that series on the charts PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Stereotactic Module continued Exporting Data not available in off line mode Data that has been saved to the database can be exported out as a common comma delimited csv format allowing for analysis in the user s choice of software programs To export data click on the Export tab The Linac Select dialog will be shown Choose the linear accelerator you would like to export data for and click Select The Export Records dialog will appear Export Records 21 EX Date Range Select Show All v Start Date 1 1 2000 End Date 1 1 2000 _ Export Cancel e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually Click the Export button to export the data A standard Windows Save As dialog will be shown Name the file and choose a location for saving and click on the Save button to create the file PIPSPRO SOFTWARE The Reports Tab not available in off line mode If you would like to create a report without going into the History View clicking on the Reports Tab will bring up the Linac Select dial
79. the mapping function They operate in much the same way 8 Opening JPEG Images Use File gt Open to display images in jpeg format This will also work with the 16 bit compressed lossless jpeg image format used by Elekta in the ViewGT as PIPSpro will automatically uncompress the image Before compression these images are 1024x1024 pixels and are about 2 MB in size When compressed they are about 1 MB as the lossless compression used in the iViewGT has a compression ratio of about 2 1 Select Preview to see a thumbnail of the selected image before it is opened An 8 bit image will be displayed and the uncompressed 16 bit image will be held in background The QC routine will use data from the 16 bit image When a jpeg image is opened a copy is saved to the directory specified in the Configuration Settings dialog box for temporary files For an original 8 bit jpeg image this saved file will be named jpeg bmp and will be in bitmap format When opening an Original 16 bit jpeg image two files will be saved an 8 bit image jpeg bmp and a 16 bit raw image no header joeg bmp raw with the same width height as the original image These images will be over written when the next jpeg image is opened unless thay are renamed or moved In some cases especially when the routine is first used you may find difficulty in using the File gt Open command to open a 16 bit compressed jpeg image or using Preview may display an error message If this occurs
80. updates SOL Server 2008 22 4 Choose accept the license terms Then hit next License Terms To instal SQL Server 2008 R2 you must accept the Microsoft Software License Terms License Terms SOFTWARE LICENSE TERMS SQL SERVER 2008 R2 EXPRESS WITH TOOLS SQL SERVER 2008 R2 EXPRESS WITH ADVANCED SERVICES likense terms are an agreement between Microsoft Corporation or based on where you live one of its affiliates and you Please read them They apply to the software named above ich includes the media on which you recetved it if any The terms also apply to any 433 J Copy Print accept the license terms Send feature usage data to Microsoft Feature usage data indudes information about your hardware configuration and how you use SQL Server and its components lt Back Next gt Cancel 4 5 During this process you may get a warning about the windows firewall being on and or Windows PowerShell failed Installing PIPSpro continued 77 10 The next screen will ask you to select the name of the server You can 15 Then next screen will be error reporting Leave this blank and choose check the Default instance Then click next next Mii SE SC Server 2008 R7 Setup Instance Configuration Error Reporting Specify the name and instance ID far the instance of SQL Server Instance ID becomes part of the installation path Hain Micro
81. values turns on off that series on the charts 5 Displacement Chart the displacement of the each of the results are shown Clicking on the shapes in the legend below the chart will toggle the results on and off o Jaw Position Chart if the data contains results for the jaw position Center Marker Phantom was used the jaw position results will be shown Clicking on the shapes in the legend below the chart will toggle the results on and off PIPSPRO SOFTWARE Section 2 Using PIPSpro Radiation Light Field Module continued Exporting Data not available in off line mode Data that has been saved to the database can be exported out as a common comma delimited csv format allowing for analysis in the user s choice of software programs To export data click on the Export tab The Linac Select dialog will be shown Choose the linear accelerator you would like to export data for and click Select The Export Records dialog will appear Export Records 21 EX Date Range Select Show A O O AIl Start Date 1 1 2000 End Date Test Type 6 10X10 10X10Adv C 15X15 C 15X15 Adv Export Cancel 4 e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Test Type Choose which type of test to trend by field size and whether the image contained the Center Marker Phantom Adv
82. verify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time Either a 10cm x 10cm or a 15cm x 15cm field is set up to be delivered with the gantry pointing straight down The FC 2 phantom is then set up on the couch top and positioned 100 cm from the source using the optical distance indicator ODI The light field is turned on and aligned to the appropriate square on the phantom After the FC 2 phantom is aligned the Center Marker Phantom can be placed on top Being careful not to shift the FC 2 phantom align the Center Marker Phantom so that the cross hair and the spherical marker are aligned to the center mark of the light field An image is acquired using a minimal amount of radiation 3 5 MU The acquired image should look similar to this sample Figure 1A 15cm x 15cm radiation light field image for instructions on how to obtain images on your treatment machine please contact your treatment machine manufacturer 24 Section 2 Using PIPSpro Radiation Light Field Module continued A Window Level bar on the left of the image can be used to adjust the brightness and contrast e PPSpro Comprehensive BETA Not for clinical use Radiation Light Field The yellow boxes represent the search areas within wh
83. view data file J Use right mouse button as middle button Do not save processed images Directory for temporary files C Program Files Standard Imaging PIPSpro4 1 Help Cancel e Use Windows Notepad to view data file On opening a data file Notepad will be used if available If not PIPSpro will use its own routine Check this button if you wish to use Notepad Use right mouse button as middle button when a 2 button mouse is used It is certainly better to run PIPSpro with a 3 button mouse However if you are using a 2 button mouse you can move the middle button tasks to the right button with this option Of course you then lose the tasks assigned to the right mouse button until you de select this option again Do not save processed images If an image has been changed by enhancement or other processing routines there is a danger when closing or saving the image that it may overwrite the original image Normally a warning will be displayed Image was changed Save it and overwrite the original image Reply lt NO gt if you do not want to overwrite the original image If you never want to overwrite original im ages check the Do not save processed images box and the warning will not be displayed Directory for Temporary Files Several routines in PIPSpro generate temporary or data files which will be saved to the path selected here The default directory is HINT If you are sharing yo
84. 0 x 3 Phantom Area 225 00 cm2 4 4 3 2 1 123 4 Field Area 226 16 cm Jaw Position Left Right 7 497 7 45 Radiation Light Field Displacement Radiation Crosshair Displacement Jaw Position Top Bottom 7 51 7 X Light Field Crosshair Displacement Result Comment Comment The software will display results for e Radiation Light field displacement the displacement in the X and Y directions between the centers of the radiation field and the light field e Radiation field Crosshair displacement the displacement in the and Y directions between the center of the radiation field and the spherical marker of the Center Marker Phantom e Light field Crosshair displacement the displacement in the X and Y directions between the center of the light field and the spherical marker of the Center Marker Phantom e Phantom Dimension the known light field size based on the spherical markers detected in the phantom either 15 00 x 15 00 or 10 00 x 10 00 e Field Dimension the measured field dimensions based on the detected radiation field edges e Field Rotation the measured field rotation based on the detected radiation field edges compared to the known light field position e Phantom Area the known field area based on the known light field size see Phantom Dimension e Field Area the field area computed by summing the total number of pixels within the detected radiation field This value can be
85. 10H whichever is smaller Be aware that using low noise scans might result in increased values for this parameter due to the integer values for CT numbers Coordinate Verification and Slice Alignment The results from the analysis of the slice width module contain a parameter called the Table Offset Verification of the scanner table incrementation accuracy can be checked by incrementing the table by 30mm and then returning the table to the starting position and scanning the module a second time The Table Offset values reported during analysis of these two images should be the same PIPSPRO SOFTWARE Relative position x axis MTF 4 43 0 2 1 0 0 0 0 4 0 6 0 3 0 12 0 Spatial Frequency 1 cem 38 Application Menu gt Stereotactic Module a Stereotactic Module The Stereotactic Module is based on a publication by Low et al Minimization of target positioning error in accelerator based radiosurgery Med Phys 22 4 in which the method is described The method consists of acquiring 8 separate images at differing gantry and couch angles of a spherical phantom positioned at isocenter as described by room lasers The treatment beam is collimated either by a stereotactic cone or MLC The distance between the center of the sphere and the center of the radiation field indicates if the radiation beam converges to a sufficiently small region for treatment A mathematical equation determines an appropriate
86. 2 www STANDARDIMAGING amp com PIPSPRO SOFTWARE Wa STANDARD IMAGING Version 4 4 User Manual STANDARD IMAGING INC TEL 800 261 4446 3120 Deming Way TEL 608 831 0025 Middleton WI 53562 1461 FAX 608 831 2202 Mar 2012 2012 Standard Imaging Inc www standardimaging com DOC 80490 05 General Precautions WARNING Where applicable Standard Imaging products are designed to be used with the versions of common radiation delivery devices treatment planning systems and other common computer software 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 It is the responsibility of the customer or user to determine if the Standard Imaging product can be properly used with these products or systems Requirements Microsoft Windows XP Windows Vista Windows 7 System Operating System Processor Intel or AMD 350 MHz or greater Memory 64 MB 256 Recommended Hard Drive 50 MB or greater 800 x 600 1024 x 768 or higher recommended 256 colors or greater 2X speed or greater Microsoft Excel required for Plot Selection and Plot All functions within QC Trending Screen Resolution
87. 203 1 731 SFT 204 1620 SFT 217 1730 SHAKEDOWN SHIFPING_HP5750 SL5 150 1640 SL5 152 1643 SL5 153 1645 51 5 1 56 2 Work off line Selected Server select Cancel Manual Using PIPSpro with a SQL database Choose the appropriate database from the list and click Select Many servers may be shown Contact your Information Technology professional to determine which server should be chosen In some cases the server will not be shown in the list or part of the name e g SQLEXPRESS is not shown When this happens click on the check box next to the word Manual and type in the correct information and then click Select Login with your username and password NOTE if this is the first time logging in utilize Username Superuser Password Superuser Then proceed to set up users under Setting up the PIPSpro Database on page 10 Using PIPSpro in Off Line Mode To use PIPSpro without a database click the Work off line box and then click Select The user should be aware that some functionality cannot be accessed in this mode 10 Section 2 Using PIPSpro Opening PIPSpro Software continued Division Membership and Default Division To add a new Department to an existing Division click on the Modify List button next to the Division Membership field A list of existing Divisions will be shown in the Eligible Divisions field Choose the appr
88. 4 mm Pressing the middle mouse button and moving the mouse over the image acts as a ruler and Length replaces Pixel The length of the straight line shown in the screen is evaluated in pixels and xx where xx indicates the units that were selected in the Configuration Settings dialog box for example mm The line disappears when the mouse is released if not do a double click in the active window For the evaluation of horizontal or vertical distance position the mouse at one of the end points press and hold down the middle mouse button hold down lt Shift gt or lt Ctrl gt respectively and move the mouse over the image If you do not have a 3 button mouse enter Configuration Settings from the File menu and select the Use right mouse button as middle button option so that the right mouse button can be used as the middle button to perform the above operations The calibration ratio of pixels to distance is set in the Configuration Settings dialog box PIPSPRO SOFTWARE View Menu Zoomin Lens A dialog window opens that allows for the definition of the lens size and power The final size of the lens in pixels is the product of the size and the power To activate this option press the right mouse button and move the mouse over the image PIPSpro Magnify Lens Power 11 45 Cancel Hint Use Aight Mouse Button For Magnity Lens HINT If you have a two button mouse it will be necessary to d
89. 500_QC_b dcm 4 File name Preview your DICOM images do not have the dcm extension you may define additional extensions in the Configuration Settings dialog box To open planar dose files from the Pinnacle treatment planning computer see the Technical Notes section of the Standard Imaging website JPEG compressed files can be opened by selecting the extension jpg Some vendors are now using a 16 bit lossless compressed jpeg file format e g Elekta VViewGT OREX File Open will normally work well with these images but if necessary you can select Show Import dialog in the Configuration Settings dialog box to display the Import Dialog box when a jpeg image is opened so that you can set the proper parameters See the Importing 16 bit images section of this manual Other forms of the jpeg format may also be encountered such as 24 bit color By selecting Convert to grayscale a 16 bit jpeg image will be uncompressed opened and displayed as an 8 bit 255 grey scale image Opening a 16 bit image is a little more complex than an 8 bit image since it may have only a 12 bit dynamic range i e data in the range 0 4095 or a 14 bit dynamic range data in the range 0 16 383 etc The Preview option displays information on the image size and the current Pixel Mask settings 1 indicates the bit plane is set 0 indicates it is not set These settings are the default values
90. 6 bit image is being imported For a 12 bit image select planes 0 11 only For an 8 bit image select planes 0 7 only PIPS Dynamic Bit Setting 89101121731415 7 6 2345 01 eR EF FPF lt lt lt lt gt Lower Bits Higher Bits lt Dynamic Bit Setting Proportional Adjustment when selected this option re sizes the image being imported using the specified horizontal to vertical ratio Columns or rows will be added to the image to change the aspect ratio and either of two techniques may be selected to achieve this Insertion duplicates col umns or rows and Interpolation creates new columns or rows by linear interpolation according to the values shown in rectangular pixel ratio The proper ratio should always be determined experimentally for each portal imager before clinical use 14 File Menu Continued Section 2 Using PIPSpro Save As Configuration Settings Images The Configuration Settings dialog box offers the following functions Automatically Open Note File When this is selected icons will appear on images when they are opened if there are any notes attached e Save header to text file On opening or importing an image the header can be saved to a text file for later review This option may be selected or de selected as required Configuration Settings xi General Calibration DICOM JPEG Save header to text file MV Use notepad to
91. 60 then the edge will be found where the pixel intensity is 132 240 20 6 e Pixel Size This value will automatically be determined from the image once the calibration marks have been placed A Window Level bar on the left of the image can be used to adjust the brightness and contrast ae GB BVUu we 2S eae SM Two fiducial marks need to be placed on the image 49 Paper printing Clicking the Print a button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save Al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Saving the data to the database not available in off line mode Clicking the Save Results button in the left hand panel will insert the data into the database for future trending and analysis Leaf Width Test Measuring the projected width of individual leaves at isocenter is sensitive to the source to MLC distance TG 53 recommends measuring the leaf width at isocenter and entering these values into the TPS during commissioning The Leaf Width Test allows for an easy and time saving way to obtain these measurements Aquiring Images It is recommended that a QA Patient be set up in the record and ve
92. CPVIP port Directory to receive DICOM TE Program FilessStandard Imagings PIP IMaAQes TCP IP port TCP IP port specifies the port the PIPSpro DICOM Server will listen to for incoming DICOM images For example if you want to send a dataset from a CT scanner to the PIPSpro DICOM Server the scanner needs to be configured with the same parameters as specified in the Config PIPSpro Dicom Server dialog box In addition you will have to specify the Application Entity AE Title and IP address of the computer where the PIPSpro DICOM Server is running The AE Title can be set to any valid name however it is useful to set it to the name of the computer where the PIPSpro DICOM Server is installed Directory to receive DICOM images This text box specifies the path to the storage location of all received DICOM images Note The path should point to a location where there is sufficient space for the storage of images NOTE Any change in this step would affect PIPS DICOM Server when it runs next time Section 2 Running PIPSpro DICOM Server PIPSpro DICOM Server is a Windows service application After you have followed the steps in Section 1 the DICOM server automatically starts when Windows starts and stops when Windows is shut down Usually you don t need to worry about starting and stopping PIPSpro DICOM Server In case you do want to manually start stop PIPSpro DICOM Server you should follow the standard procedure for
93. Clinical image after corrective de warping Figure 6 Difference image formed from Figures 4 amp 5 Results Figure 2 shows an image of the distortion phantom acquired at a gantry angle of 90 which exhibits a geometric distortion of 5 0 mm in the periphery of the field of view FOV Figure 3 shows the same image as in Figure 2 but after a corrective de warping has been applied which reduced the distortion to less than 1 0 mm within the FOV The overlay grid in Figure 3 marks the expected grid point locations based on the positions of the four central markers of the phantom and corresponds closely to the corrected marker positions Figure 4 shows a barrel distorted clinical image Figure 5 shows the same image after a corrective de warp has been applied and Figure 6 shows the difference between these two images The uniform gray regions in Figure 6 indicate areas in the original image that have little or no distortion The light and dark structures in Figure 6 originate in the raw and corrected image respectively and indicate the regions of the image that have the greatest distortion 90 Section 6 Appendices Appendix 6 Sequential Image Processing Grey level Pixel number 1 Crooks I and B G Fallone Contrast enhancement of portal images by selective histogram equalization Med Phys 20 1 1993 pp 199 204 2 Leszczynski K W S Shalev Digital contrast enhancement for on line portal imaging
94. DICOM server Images that are sent from the remote node are displayed in the list e To preview the DICOM image select the Preview button in the dialog toolbar e To view 8 DICOM image double click it The Import File Format dialog may come up so you can set up the correct parameters Once opened the image can now be processed using all the standard PIPSpro tools e To search a specific DICOM image select the Find button in the dialog toolbar e delete DICOM images select them and push the Delete key This effectively deletes the image files and their records in the database e To view the DICOM image header right click the image and select the Image Header menu item The header file will be shown in your default web browser e You can filter the images so that only those interesting to you are displayed To do that click the Filter button in the Dialog toolbar PIPSPRO SOFTWARE Installing and Running the PIPSpro DICOM Server on Microsoft Windows XP Windows Vista Windows 7 Section 1 Installation Step 1 Install the PIPSpro DICOM Server Control Panel Control From the startup disk select Install PIPSpro DICOM Server Step 2 Configure the PIPSpro DICOM Server Control Panel Control Open the Windows control panel and double click on the PIPSpro Dicom Server Config The configuration dialog Config PIPS Dicom Server will appear Contig PIPS Dicom Server Service T
95. De warping coefficients for gantry angles that fall between the 10 calibration angles can be interpolated from a sinusoidal fit of the calibra tion data After the calibration data set is acquired clinical images can be corrected by applying the appropriate corrective de warping based on the mode of operation and gantry angle of the imaging system PIPSPRO SOFTWARE Section 6 Appendices Appendix B Dewarping Distorted Images continued Discussion Tests on a Nucletron Oldelft Simulix HP MK II simulator showed that the zero order coefficients vary sinusoidally as a function of gantry angle which we suspect is due to the effect of the earth s magnetic field on electron trajectories in the Il Distortions as large as 5 mm were found which were reduced to less than a millimeter over the FOV after applying a corrective de warping Although the results presented here are based on images acquired on a radiotherapy simulator we have also observed and corrected geometric distortions in VEPIDS Calibration of a VEPID is identical to that of a simulator although the distortion phantom must be affixed to the detector front surface instead of being placed in a cassette holder The de warping algorithms have been incorporated into PIPSpro System calibration requires the operator to select four fiducial points on each image which correspond to the central four lead markers on the distortion phantom A computer algorithm automatically gene
96. Issue 1 Pages 11 17 A procedure to determine the radiation isocenter size in a linear accel erator A Gonzalez Castro and J A Martinez Medical Physics 31 1489 1493 2004 95 Dependence of image quality on user given parameters for the Philips SRI 100 EPID D Taylor S Hussein Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 39 Prospective analysis of patient motion in prostate conformal radiotherapy H Lau L Aubin A Conrad C Thompson K Hutchison R Rajapakshe Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 71 Letter to the Editor K Luchka Interactions Canadian Medical Physics Newsletter 46 3 July 2000 p 118 Comparison of setup accuracy of three different thermoplastic masks for the treatment of brain and head and neck tumors L Gilbeau M Octave Prignot T Loncol L Renard P Scalliet V Gregoire Rad amp Oncol 58 155 162 2001 Experiences in evaluating geometrical uncertainties in bladder radiotherapy C Hall A Gee S Hilton H Appleby A McKenzie J Graham Abstract 3 5 in 1st UK Radiation Oncol Conf UKRO April 2001 Clinical Oncology 13 Sup 2 p S6 2001 Double blind randomized trial comparing virtual and conventional simulation in palliative radiotherapy for non small cell lung cancer M McJury S D Pledge P M Fisher G Brown C Anthony M Q Hatton J Conway M H Robinson Abstract
97. Mkll Varian a8500 Varian a81000 Elekta iViewGT Siemens FP under development PIPSPRO SOFTWARE Section 3 The QC 3 Phantom Summary of Published Data from the QC 3 Phantom continued Initial comparison of three am Si EPIDs using the QC 3V phantom R Clements K Luchka J Pouliot J Sage S Shalev Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 108 109 Incorporating EPI into a comprehensive radiation therapy QA program J Wolters R Rajapakshe G Hovde J Moffat Proc 7th Int Workshop on Electronic Portal Imaging Vancouver June 2002 168 169 Evaluation of iView and iViewGT using the QC 3V phantom A multi centre study N Bulmer G Budgell R Clements A Glendinning M Kirby J Sage S Weston PIPSpro User s Meeting Manchester April 2003 7 8 Siemens Medical Solutions private communication with permission Average results from 4 Beamview systems Siemens Medical Solutions private communication with permission Average results from 7 Beamview TI systems Test phantoms for EPIDs A comparison between the Las Vegas and the QC 3 phantoms S Shalev Masthead Imaging Corporation PIPSPRO SOFTWARE 18 19 20 21 22 23 A practical method to routinely monitor resolution in digital images R T Droege Medical Physics 10 337 343 1983 Quantitative image analysis for the routine quality control of elec tronic portal imaging
98. ORMITY TOANY SPECIFICATION THE ENTIRE RISK AS TO QUALITY AND PERFORMANCE OF THE SOFTWARE IS WITH THE USER Copyright of the software and supporting documentation is owned by the University of California and free access is hereby granted as a license to use this software copy this software and prepare derivative works based upon this software However any distribution of this software source code or supporting documentation or derivative works source code and supporting documentation must include this copyright notice 101 Abstract Syntax Name UID 1 2 840 10008 5 1 4 1 1 2 Storage Storage Storage Storage Storage Storage 1 2 840 10008 5 1 4 1 1 4 1 2 840 10008 5 1 4 1 1 6 1 1 2 840 10008 5 1 4 1 1 7 1 2 840 10008 5 1 4 1 1 20 1 2 840 10008 5 1 4 1 1 128 SOP Specific Conformance Statement for SOP Verification Class The PIPSpro DICOM Server Module provides standard conformance for DICOM communication verification SOP Specific Conformance Statement for SOP Storage Class The PIPSpro DICOM Server Module conforms to the SOP s of the Storage SOP Class at Level 2 full No elements are discarded or coerced by the PIPSpro DICOM Server Module In the case of a successful CSTORE operation the object has successfully been written to disk in the PIPSpro Workstation database If an image is sent with the same SOP Instance UID 0008 0018 as one that already exists on the PIPSpro Workstation the new image will replace the
99. PID optical focus lens f stop camera adjustments and many other factors Similarly the value of S will depend on the type of linac thickness of the beam flattening filter beam energy beam focussing etc However after these parameters have been optimised during accep tance commissioning tests they may be subsequently monitored as part of the routine quality assurance program Any changes may indicate that appropriate maintenance is required 7 Application to EPIDs with fixed SDD Some EPIDs are at a fixed distance from the isocenter and so this test must be simplified to just two locations the phantom can be located either on the surface of the EPID or at isocenter while the EPID remains fixed The diagram illustrates this situation for an EPID with SDD 140 cm Source Source 100 cm Two measurements of f are made with the phantom on the surface of the EPID and at isocenter and their ratio is examined In the absence of blur ring due to the focal spot size the ratio would be expected to be equal to or 1 4 for this example However with a finite focal spot the ratio will be less and may even be as low as 0 8 for flat panel detectors where spatial resolution is dominated by the focal spot size Since P is known two measurements are sufficient to solve equation 4 for the unknown parameters E and S Define Vo 1 2f for the measurement with the phantom at isocenter Vai 1 2f for the measuremen
100. Server 2005 Management Studio Be aware that some default settings might be changed after you import your customized user settings were saved in step 2 i Do you want to import your customized user settings from SQL Server 2005 Management Studio k Microsoft SQL Server Management Studio Express File Edit View Tools Window Community Help Cancel ree Connect Object Expl 2 y 7 2 AF Connect Object Explorer d BA a Disconnect Object Explorer mai Summary 20 Then you will be prompted with a message about registered servers New gt 3 3 TE this system and again you can choose Yes Close Gay File with New Connection Microsoft SOL Server Management Studio 4 Fie Disconnected There are SQL Server 2005 Management Studio registered servers on this system Do you want to add them into Microsoft SQL Server Management Studio Adding the server registration information has no g save all Cirisshiftes effect on the servers themselves _ Name La Databases C Do not show this message again LI Security 4 Server Object Recent Files gt uj Replication 2 L Management 21 The Connect Screen will open In the Server name box use the drop 6 Select and Open Dbscript1 sal down menu and choose the server name with the SQLEXPRESS in r i i lz Microsoft SQL Server Management Studio h m 0
101. WARE The Reports Tab not available in off line mode If you would like to create a report without going into the History View clicking on the Reports Tab will bring up the Linac Select dialog Choose the linear accelerator you would like to create a report for and click Select The Generate Report dialog will appear Generate Report 21 EX Date Range Select Show All v Start Date 1 1 2000 End Date 1 1 2000 Image Type Image Type x Angle Type Angle Type 5 Ea e Date Range From the selection dropdown choose from one of 4 the standard time frames or choose Select Range to enter dates manually e Image Type Choose which type of test to trend either Regular or Hybrid e Angle Type Choose the angle type of test to trend Gantry Couch or Collimator Click the Generate button to create the report The report will be shown in the Preview Window The report can be printed to paper or saved as a PDF file Paper printing Clicking the Print a button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save Al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Exporting Data not available in off line mode
102. Zoom the chart to the previous level Clicking the Zoom out all levels button al will zoom the chart to the original level showing all data Printing or Saving a History View Report A report of the data can be printed by clicking on the Print button in the Setting area in the left hand panel A report will be created with both the Table View and Chart View data and will be shown in the Preview Window Paper printing Clicking the Print sa button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Archiving Data If data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the row for the data that is to be archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In th
103. a pixel intensity of 240 and the edge strength is set to 50 the edge will be considered where the pixel intensity is 110 240 20 5 If the intensity is set to 40 then the edge will be found where the pixel intensity is 88 240 20 4 e Offset This is the offset in millimeters from the corner of the identified edge that the search region for the spherical markers yellow box will start from e Search Area This is the size in millimeters of the search region for the spherical markers yellow box e Marker Threshold Based on the background non irradiated area pixel intensity this is the percentage of that value that the software will consider as a spherical marker For example if the background pixel intensity is 240 and the Marker Threshold is set to 5 then a spherical marker of at least 48 240 05 will be identified as a marker If noise in the image is being detected as a marker reducing the Marker Threshold can prevent this and improve results e Warning and Error thresholds These values are used to determine if the results are within acceptable ranges PIPSPRO SOFTWARE Section 2 Using PIPSpro Radiation Light Field Module continued Comments not available in off line mode The Comment Area allows the user to enter information related to the results that will be saved to the database and shown in reports Printing Results Once results have been calculated a detailed repo
104. able Range 9 575 0 635 Caution Range 0 575 0 635 01 02 03 04 05 G6 07 0S 09 10 Frequency Ip mm Save to Database Cancel Contrast Noise Detected level 252 698 246 433 5 Acceptable range 237 087 262 043 Caution range 237 087 262 043 Detected level 2 838 Acceptable range 2 696 2 980 Caution range 2 696 2 980 The graph shows the relative modulation transfer function RMTF for the two images along with vertical lines representing the 150 f40 and f30 values The detected values are shown for resolution contrast to noise ratio CNR and Noise along with the accept and caution ranges that are set in the Baseline Management section An easy to read stoplight icon quickly lets you know if there is a problem by lighting green for acceptable yellow for caution and red for a rejection reading Click on the Save to Database button in the results screen to save the results to the database for trending and future analysis PIPSPRO SOFTWARE Two images should be taken in succession with approximately 3 5 MU each MV for instructions on how to obtain images on your treatment machine please contact your treatment machine manufacturer It should be noted that for Varian machines images taken in IMRT or integrated mode tend to introduce noise into the images which can be unpredictable and cause the noise and contrast to noise calculations to report failures more often Two images are needed as t
105. ages choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued The software will place search profiles over the area of the image where the MLC s alternate between open and closed Dots are placed over the centers of each closed leaf red dots for the left bank blue dots for the right bank Results The software will analyze the image and measure the width at isocenter of each of the closed leaf portions of the image A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window Leaf Width o Left Bank Right Bank Left Bank Left Width Right Bank Right Width 10 4 49 104 48 20 3 20 2 10 5 49 104 204 n a 20 1 10 4 35 10 5 20 3 n a 20 1 At the top of the results window is a graphical representation of each MLC s apparent width measured in millimeters In the lower half of the results window a grid will report the apparent width of each of the MLC s for each of the left and right banks The test would then be repeated to acquire the apparent width of the opposite leaves PIPSPRO SOFTWARE Fiducial 1 The first fiducial needs to be placed over the spherical marker in the phantom that is aligned with isocenter Click anywhere near the marker on the image
106. any service applications Here are the steps 1 Open the control panel open Administrative Tools and double click the Services icon The Windows services dialog will appear 2 Double click PipsDSvr in the service list to bring up its property dialog Click Stop button to stop the service Click the Start button to start the service 98 Section 7 Other Information Installing and Running the PIPSpro DICOM Server Utility continued Under the Main Menu the Show Received DICOM is grayed out this occurs the PIPSpro DICOM database mdb has been accidentally moved or deleted Please ensure that DicomServer mdb is in the PIPSpro root directory If the database has been lost refer to Section 5 above to rebuild I need to do further troubleshooting with the PIPSpro DICOM Server Is there a way to monitor its operations The PIPSpro DICOM Server can provide a log file txt providing operational data To create a log file perform the following procedure Go to the Windows Control Panel and open Administrative Tools Open Services Find and open PipsDSvr Select Stop In the Start Parameter field type log without quotation marks Select Start Select OK Close Services Close Control Panel In the PIPSpro directory a PipsDSvr txt file has created and will record all PIPSpro DICOM transaction sessions P
107. artment If the PIPSpro system is to be used by a multicenter organization the main department if there is one should be added first Click on Departments in the File Menu at the top of the System Manager window Click on the New button at the bottom of the window to add a new department System Manager Divisions Users Linacs Active Departments Edit Department Information Below Department Name Standard Imaging Radiation Oncology Unique Department Identifier SIRO Department Address 31 20 Deming Way City Middleton State wi ZIP 53562 Master Department D Standard Imaging Radiation Oncology Phone 608 831 0025 Default Division Standard Imaging z Fax Division Membership Standard Imaging z Modify List Password Renewal Period 24 Month s lal Archived Departments All Departments Archive Save New Close In the first box enter the department name as it should appear on all reports and documentation generated by PIPSpro In the second box a unique name for the department should be entered NOTE This name should be unique to the department and should not contain any spaces Continue filling out the screen with the appropriate information PIPSPRO SOFTWARE Section 2 Using PIPSpro Opening PIPSpro Software continued Adding a Linac For full functionality of PIPSpro software it is necessary to enter information about the accelerators in
108. ask PIPSpro Edit Custom Mask x N cm 2o Cancel A custom sharpening filter mask can be entered using Edit Mask the Frame is larger than 3x3 the intervening pixels will be set to zero PIPSpro Sharpen Image gt lt Frame Fev E Scale i Erd Shift E Method C High Pass Degree 1 High Pass Degree 2 High Pass Degree 3 C Custom Filter Mask Edit Mask Click on ES to select an edge sharpening algorithm specially developed for portal images A suitable scaling factor should be selected typically in the range 1 3 For a description of this algorithm see the Sequential image processing section of this manual Contrast This provides several different contrast enhancement techniques See Tutorials 2 4 Global Histogram Equalization equalizes the histogram of the whole image The dialog window allows the user to select a particular grey scale interval for the histogram before and after equalization PIPSpro Global Equalize Stretch 3 To Range Lower lt 0 i 0 Upper lt 255 245 From Range Lower gt E Upper lt 255 255 Local Histogram Equalization includes the following adaptive histo gram equalization techniques PIPSPRO SOFTWARE C Average Smooth ance Aeevssvscnseesenssvscecerssnsscnccensnnsed Kernel 5 5 Sigma fico Operation Number Of Times 3 Non Linear
109. ast squares estimate of the pin locations relative to the orthogonal image matrix These results are valid for rotations up to about 5 Modulation Transfer Function MTF In this procedure the spatial resolution is measured by calculating the point spread function from the scan of a small tungsten carbide bead approx 250 microns in diameter Line spread functions are determined by integrating the PSF along vertical and horizontal directions The MTF is calculated from the discrete Fourier Transform of the LSF data after having corrected for the baseline CT value A cubic roll off function is also used to force the LSF curve smoothly to the baseline After calculating the transform corrections are made for the pixel size and the bead diameter The 50 10 and 5 MTF values are reported The 5 parameter is the default value in the phantom description file and can be adjusted if 5 is not suitable PSF A Line spread function 05 2 2 2 05 8 averaged along this width The single pixel noise value is also alalla 4 determined at the phantom center An acceptance range for the baa wel els vertical and horizontal profile is generated and used to compute fractional uniformity which is the fraction of points along the profiles E cl The ia Ba 1 that lie within the acceptable range This range is variable and is alal a 4 5 present in the phantom description file and the default settings are ata Pex sr le 5 20 of the mean or
110. at a 45 degree angle and should be positioned so the number 1 on the phantom faces the gantry Lines and marks on the surface of the phantom assist in lining it up to the central beam line 21 Application Menu gt QC Quality Control The QC Module The QC Module is designed to analyze images of the QC 3 or QCkV phantoms to provide quantitative information for the resolution contrast and noise of flat panel planar imagers Configuration Management EPID QC Before performing any EPID QC functions it is necessary to configure the database This database is required for the QC Trending Reports function to work properly Select Application QC Configuration Management Imager Name TC QC 001 Energy Level 6 MY Serial Number Description Add 3 1234575686 Remove Edit Cancel Apply To add a portal imager or Phantom click the appropriate Add button To edit an existing portal imager or QC 3 Phantom highlight the a previously created item and click the appropriate Edit button You may also Remove items by choosing the appropriate Remove button Add Edit a Portal Imager 1 Enter a name for your imager Choose the imager type from the drop down list 3 Add or Remove energies as needed only the energies that are planned for use with EPID QC functions are necessary 4 Complete Edge Detection Parameters Gradient Vendor Threshold Varian 30 7 70 0 i 0 0
111. ated ROI and Notes are ignored Rotate This command rotates a whole image through a selected angle 90 180 270 ROI if selected will be ignored Flip flop mirrors the im age about the vertical axis Contour fiducial points and ROI are also rotated Templates are not rotated HINT If you want to rotate an image by any arbitrary angle or ap ply a shift translation or change of scale magnification use the Manipulation routine in the Application Menu gt Image Analysis gt Transform Menu Invert This command inverts the grey scale ROI if selected will be ignored Show EditTool This command opens the edit tool and allows the operator to place contours points templates and notes in the image First the mode must be selected To do this select Contour Fiducial Template Chamfer Note or ROI from the Edit Tool Then select and use the various tools for placing deleting moving and editing contours fidu cial points templates notes and ROIs as described below The mode Chamfer is used for registration as described in the Transform menu section Edit Tool Ea Edit Tool ES Edit Tool Fa iG EE 18 Section 2 Using PIPSpro NI Chamfer matching Contour tool For this option contours must be delineated in both images Selecting the Contour tool will cause the two contours to be matched by the chamfer routine This will not provide any information on the position of the patient
112. ations have been performed results will be available for viewing 3D Results de rom dr rar d ron Mw Gantry and Couch H s verified Printing Results Saving Results not available in off line mode Once results are calculated either 2D or full 3D the results can be saved to the database by clicking on the Save button in the Results area in the left hand panel The 2D results for each image and the full 3D results if calculated will be saved Printing Results Once results are calculated either 2D or full 3D the a report of the results can be printed Clicking on the Print button in the Results area in the left hand panel will open the Print Preview screen Lo Sia a9 Stereotactic Print Preview S HDA OnI O Page 1 of 1 DED waa Pages Se et ce ee ee ee ee c ol0o a o gt Stereotactic Report Image Capture nt Standard Imaging Radiation Oncol Linac 21 5 Manufacturer Varian Medical Systems 1 Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file PIPSPRO
113. ave the points as an ASCII file filename txt for later review or export to a spreadsheet Select extension TXT to see the names of other text files and change the extension of the file to be saved to txt before saving it You can open this txt file with PIPSpro Notepad Write or similar programs HINT The Field Edge algorithm may not succeed in detecting the field edge if the image has been highly processed However in this case you can detect the field edge on the unprocessed image save the contour process the image and retrieve the contour from the disk using Edit Tool If a ROI is selected the algorithm will only search within the ROI This is useful if there is garbage on the outer borders of the image PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Image Analysis Tools continued Coordinates The standard PIPSpro coordinate system has the origin at the upper left corner of the window This can be changed by selecting one of the optional directions and entering the new origin coordinates in the dialog box Alternatively you can drag the Center Icon to a location in the image which is to be the new origin d pips32 3 2 1 d data white bmp Image Size in pels BE4 460 Center 0 0 Position Set the center position by dragging the Center Icon to the location and drop it or by entering the position in From Lett and From Top Coordinate Center Lcon From Lett
114. below and then to define these stock gantry and couch angles so the software will use them each time This saves the user time when importing and analyzing images in the Stereotactic Module If the latter method is being utilized check the Do not use stock angles radio button and the software will either prompt the user to enter these angles after import or will use the naming convention see pg to automatically apply the correct angles at import of the images Save options The Stereotactic Module has the capability of calculating a three dimensional stand offset for minimizing the effects of gantry sag and couch walkout If the user is not interested in calculating the full three dimensional offset the user can allow the software to save data for the two dimensional offsets in plane and cross plane only If this is desired check the radio button Allow saving 2D results for less than 8 images 2D results are also saved when the 3D calculation is enabled Then choose the minimum number of images that need to be analyzed before a save of the data is enabled The user can be automatically warned if data is being saved for 2D information only by checking the box Click Save to apply your changes and then Close to exit the Configuration Manager Clicking Close without clicking Save will exit the Configuration Manager with no changes Clicking the Restore Defaults button will restore the settin
115. can be placed on the image and the software will use this distance to calculate the DPI of the image based on the number of pixels measured between the calibration marks and the distance indicated If a DPI is read from the image and an attempt is made to place calibration marks on the image a warning will be shown confirming that the user wants to use the calibration distance instead of the DPI value The DPI value already exists Do you wish to calculate the DPI from the image instead eT e e Radius The radius in pixels of the circle that the software will use to search for the projections from the center of the intersections The software will automatically set this as 25 of the shortest side of 30 Starshot Module continued Section 2 Using PIPSpro If a fiducial mark is placed in the wrong position right clicking on the image will bring up a menu Clear Last Fiducial Marker Clear All Fiducial Markers Enable Line Drawing Clear Last Fiducial Marker Clear All Fiducial Markers Enable Line Drawing Choose Enable Line Drawing from the menu The cursor will turn into the fiducial marking tool Place fiducial marks on opposite ends of the The menu will give you the choice of clearing the last fiducial placed or all projections you would like included in the analysis and the points will be fiducials placed on the image connected by a line When the fiducials are positioned correctly click the
116. ccommodate the two other cardinal Gantry angles of 90 and 270 degrees PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued An image is acquired using a minimal amount of radiation 3 5 MU The acquired image should look similar to this sample for instructions on how to obtain images on your treatment machine please contact your treatment machine manufacturer The image should then be exported preferably in DICOM format to a location accessible by the PIPSpro software which will be used for the analysis An included DICOM server utility is included with the PIPSpro software installation if needed for instructions on how to export images from your treatment machine or record and verify system please contact the manufacturer of that system See the DICOM server utility section of the user s manual for setup information NOTE The MLC Module will only open DICOM TIF or bitmap BMP images Image Analysis To load an image choose MLCQA Load Image from the menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your images choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single
117. cquired using the CatPhan model 503 and 504 phantoms that are included with the purchase of a CBCT enabled system from Elekta and Varian respectively There are few initial items that can be set in the CBCT module prior to use Click on the Options Menu item to access them e Enter Facility Name The name entered will be shown in the module at the top of the screen and included on reports that are created e Include Images in PDF Report When this option is checked the images that were used for the analysis will be included in reports that are created e Include Graphs in PDF Report When this option is checked any graphs that can be displayed with the results will be included in reports that are created e Display ROI on Images Regions of interest will be overlaid on the images used for analysis showing the areas of the image utilized for the assessment It is very important to set up the Catphan phantom carefully and per the manufacturer s instructions The phantom should be set up at isocenter and precisely aligned Scan the phantom with a high quality imaging technique Using 2 5 mm slices is optimal for the module and using the smallest field of view is important so that the phantom takes up as much of the image as possible Utilize a full fan scan as half fan scans tend to introduce noise and artifacts which can reduce the quality or even prevent results from being produced Reconstruct the image at the highest resolution
118. creen or printed Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will Zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button will Zoom the chart to the previous level Clicking the Zoom out all levels button al will zoom the chart to the original level showing all data Archiving Data data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the row for the data that is to be archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the row for the data that is to be un archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status 60 Section 2 Using PIPSpro IGRT Module 4 The L
119. cted button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the column for the data that is to be un archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status Leaf Width Trend Analysis After clicking the Apply button each leaf width test will be shown in the results window for the chosen date range Tabs at the top of the results window allow the user to switch between data for the left bank versus the W PIPSpro Comprehensive MLC QA J gt Export Clome Oepertrert AIL 9 7 3 r Vatan Medo fode we ILC Type Barle Date arge Selec Jow A eo Type o Pesna Leet eet M Por Laat Trararramson Record Sass No Trending Selected Sew Mode Lotee wctrved Asche Selected Wh he eo Tie Section 2 Using PIPSpro Application Menu gt MLCQA continued In the Relative Displacement view the graph will feature color coded bands in order to easily determine if an MLC is within acceptable ranges or not Green results are within the acceptable range as set in the System Manager Yellow results are within the
120. ction ate Open ALTER DATABASE SISoftware SET ANSI_PADDING OFF Display name MKT 222 1790 SQL lt Browse for more gt so Login name _ STANDARDIMAGI ALTER DATABASE SISoftware SET ANSI_WARNINGS OFF 2 MKT 222 1790 SQI co te ALTER DATABASE SISoftware SET ARITHABORT OFF Name 1 lee The name of the connection Ready ini Coll Chi INS 7 Run the script by choosing Execute from the Query menu or the Execute button on the toolbar R Microsoft SQL Server Management Studio Express 22 Open the SQL Server Management Studio by choosing Start All File Edt Yiee Query Took Window Communty Help Programs Microsoft SQL Server 2008 R2 SQL Server Management Dine ery ya DB Tools 0 T 31 5 Ls LES Th i is point you will need to setup the database From the installation EE F lt O ARLOIMS250 0BScript isq dashboard choose step number 3 Create Update SI Database a 45 o Execute The Database Installation Type dialog will be shown l l This concludes the SQL Server 2008 installation and you should now be able to open PIPSPro and select the server and log into PIPSPro using Superuser for both the username and password Database Installation Type Update Existing Database a you are a new PIPSpro user choose New Installation If you are upgrading from version 4 3 or 4 3 1 choose Update Existing Database
121. daily IGRT tests recommended in TG142 The software can be set up to track both MV and kV imaging tests for either 3D X Y Z or 6D X Y Z Pitch Yaw Roll couches e Dewarp Comprehensive Only utilizes a simple pin phantom to calculate a dewarp map for dewarping images from different imaging modalities e There are also sets of image enhancement and image analysis tools that are specially designed for EPID and film based medical images which are included in both the QC and Comprehensive versions See the image enhancement and image analysis section of the user s manual for details on these tools PIPSPRO SOFTWARE PIPSpro was originally developed to give clinicians the ability to measure megavoltage MV portal imager quality The QC 3 phantom and software were designed to provide quantitative information for the resolution contrast and noise of any commercial electronic portal imaging device EPID quickly and easily As the software matured additional algorithms were developed to analyze images captured on EPIDs and sometimes radiographic film that would allow the user to perform important machine QA that was recommended in the literature Today PIPSpro software is an invaluable tool for professionals that are responsible for maintaining modern linear accelerators and the ancillary devices that are found with them PIPSpro s ever growing number of modules and included phantoms provides the ability to perform over 30
122. data for and click Select The Export Records dialog will appear Export Parameters 21 EX Date Range Select Show All Start Date 4 13 2011 End Date 12 20 2011 e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Imager Choose whether the data to be exported was collected on the MV imager or the kV imager e Comparison Type Choose whether the data to be exported were 2D orthogonal planar images or 3D 3D image set such as a Cone beam CT Click the Export button to export the data A standard Windows Save As dialog will be shown Name the file and choose a location for saving and click on the Save button to create the file 63 Adding Comments To add a comment to a data point in the history view highlight the row containing the data and click on the Add Comment button at the bottom of the Table View Enter the comment in the Add Comment dialog box and click the Save Comment button to commit the comment to the database Multiple comments can be entered for the same data point by clicking on the Add Comment button again Choosing another Linac for History View Clicking on the Select Linac tab will open the Linac Select dialog Choose the linear accelerator you would like to see a history for and click Select Choose the settings and click Apply
123. devices S Shalev R Rajapakshe K Luchka In Quantitative Imaging in Oncology Eds K Faulkner B Carey A Crellin R M Harrison Proc LH Gray Conf on Quantitative Imaging in Oncology Newcastle April 1995 BIR London 1996 pp 103 105 A quality control test for electronic portal imaging devices R Rajapak she K B Luchka S Shalev Medical Physics 23 1237 1244 1996 Techniques for commissioning electronic portal imaging devices S Shalev K Luchka R Rajapakshe Proc XII Int Conf on the Use of Computers in Radiation Therapy Salt Lake City May 1997 Medical Physics Publishing Madison WI 1997 272 275 Acomparison of clinical experience and quality assurance with a gantry mounted Philips SRI 100 and a mobile EPl system ELIAV PORTpro B Bannach T Doll D Lansing G Schmitt Proc Workshop on EPI Phoenix Oct 1998 pp 39 40 Image quality assurance for a Varian PortalVision EPID H J Kim R S Sloboda Proc Workshop on EPI Phoenix October 1998 pp 95 96 Quality control in digital portal imagers Abstract in English text in Dutch P H Vos G A N Coenen S A J M Versmissen Clinical Phys ics Journal of the Dutch Society of Clinical Physics 98 1 27 31 1998 Image quality parameters for the production standard Eliav PORTpro portal imaging device A J Poynter Brit J Radiol 72 802 804 1999 Clinical integration of an iView electronic portal imaging device K Luchka Proc 6th Int
124. displays the constant of perceptibility used in the calculation in the lower left corner Be aware that this constant will influence the predicted low contrast performance with a lower value giving a decreased performance However particular care needs to be used in interpreting contrast detail diagrams in which sensitivity specificity and the number of target signals may be varying Note Data for this test is NOT based on any measurements of the low contrast spheres approximately 3 contrast with diameters of 2 4 6 8 10 mm which are contained in the InnerVision phantom Furthermore these estimates are for cylindrical objects as contained in other Catphan Phantom Laboratories modules and not spheres which can be more difficult to detect Hence these test results should only serve as a guideline only CT Linearity Sensitometry The program computes the average CT value for each reference material contained in the module The number size description location and attenuation coefficients are specified in the phantom description file As shown in the figure above for the first module there are 4 sample materials present in this phantom These include Acrylic LDPE TEFLON and Air to encompass a broad range of CT numbers from approximately 1000H to 1000H A linear least squares regression is performed relating CT number and the linear attenuation coefficients listed in the table below as a function of energy The energy wh
125. dows with different sizes if need be and to place them on the screen in any manner This flexibility can be very useful especially when it is desired to compare or to operate on a number of images simultaneously However it also requires some degree of windows control in which the operator maintains a clean and well organized display Very large or very small images can be rescaled by Zoom in the View menu Images temporar ily not needed can be minimized Images of current interest can be placed over other images to save space The list of image windows can be seen under Window even if some of them are minimized or hidden You can change the display size from Control Panel gt Display gt Settings PIPSpro is best viewed with at least 800 x 600 preferably 1024 x 768 pixel display 256 colors HINT If you want to open or import the same image a number of times remember that the names of the last 4 images that were opened are listed at the bottom of the File drop down menu Click on one of them to open or import again 17 There are several different methods for doing periodic checks of the mechanical isocenter lasers versus the radiation isocenter Some users will perform this check with the same gantry and couch angles each time the test is performed Others will utilize specific gantry and couch angles from a particular treatment If the former method is utilized it can be advantageous check the Use stock angles define
126. e done quickly A stand is available for lateral imaging shown in the il lustration to the left Two images of the phantom are acquired under identical conditions preferably during the same irradiation sequence The images are imported to PIPSpro and rotated or flip flopped if required so that they appear on the screen in the orientation shown in the diagram 1 at the top 4 on the left Black white display If your image corresponds with the figure shown on this page where low dose is shown as black and high dose is shown as white the results page prepared by the Excel printout will be cor rect If your images are inverted black white LUT inverted then the contrast figures will be shown as negative values in the results page but all the quantitative results will be correct If you want to reverse the LUT use Edit Invert and answer lt Yes gt to the question Do the same to the original data Saturation Be sure that the image is not under or over saturated within the boundaries of the phantom use the portal rgb LUT in which grey levels 1 and 255 are blue and red respectively If the image is saturated use different acquisition parameters Image pair similarity The two images to be used in the analysis must be very similar so that the calculation of random noise will be correct Use 2 lmage Operation Copy Cat to check that the grey levels are similar in corresponding locations You can also use 2 lmage Opera tion A B t
127. e and click In the dialog box enter the note title up to 20 characters and text up to 500 characters Select the desired color and OK Click on button in top left corner of image window to see all titles Notes can be suppressed by deselecting auto open note file in the Configuration Serrings dialog box If the color RED is selected the note will be saved as a read only file and further editing or deletion will not be possible The icon is red and also displays a bright cross for the color blind 5 Read a new note Select this tool and then place the cursor on the cross at the top left of the note icon You can read or edit the note and change the color if desired a Show No show Note icons Use this button to switch the icons on or off PIPSPRO SOFTWARE Section 2 Using PIPSpro View Menu Pixel shows the grey level of the pixel at the current cursor position For an 8 bit image this value will be in the range 0 255 and will be indicated by 8 following the value If a 16 bit image was imported the grey levels of both the background 16 bit image and the displayed 8 bit image will be shown indicated by 16 and 8 respectively For example a 16 bit image with 12 bit dynamic range will have grey levels in the range 0 4095 If the image has been mapped to dose the dose values and units will also be displayed PIPS Information Desk RODI position Length 405 121 yi 53 00 pxl 323199 Y 24 8
128. e finite focal spot size Contrast resolution image degradation from the EPID and from the focal spot penumbra 16 is measured in terms of the contrast to noise ratio CNR The results may Full details of the methodology are available 23 as well as a comparison be used for optimizing EPID image quality 7 9 13 Time trend analysis of between the QC 3 phantom and the simpler Las Vegas test object used by some of the international EPID vendors 24 Spatial resolution is f50 and CNR may be incorporated into routine QA programs 19 and can indicate the deleterious effect of radiation damage 17 The phantom is also useful for quality control of CR detection systems and comparison of their image quality with EPIDs 14 15 measured in terms of the parameters 150 or 130 which are the frequencies Phantom on surface of EPID Phantom at isocenter 6 MV 10 25 MV 6 MV 15 18 MV EPID f50 epi 130 epi f50 epi f50 iso 30 iso f50 iso References Measurements of spatial resolution in Ip mm 22 4 10 12 15 6 10 12 18 18 24 20 18 18 7 0 27 0 28 0 01 0 49 0 58 0 30 0 02 0 22 0 02 0 25 0 02 0 29 1 5 0 33 0 04 0 18 0 02 0 17 0 19 1 0 22 0 01 0 23 0 01 0 25 0 01 0 18 0 02 0 23 0 18 0 21 0 03 0 21 0 02 0 23 0 01 0 26 0 03 0 24 0 24 0 01 0 26 0 01 Siemens Beamview Theraview PORTpro Elekta iView Beamview Tl Varian Portalvision
129. e head frame offsets from the optimal target location in 3 dimensions The purpose of this section is to describe the algorithms involved in generating the 3 dimensional shift from the optimal target position Edge detection A schematic diagram of the radio opaque ball marker and radiation field edge is shown on the right The first task of Stereo is to determine the center of the radiation field and ball marker This is performed by detecting the edge contours of both structures An eight directional chain code is initiated and starts its search from the edge of the image working its way inward until it finds a point on the radiation field edge In this application it is not crucial that the detected radiation field contour be the 50 isodose due to the circular symmetry of the structure After the first point is found the chain code traverses the entire radiation field edge until it closes on itself In a similar manner the edge contour of the ball marker is searched for inside the bounds of the radiation field A chain code traverses pixels on the edge of the ball marker until it closes on itself The U and V positions of every pixel along both contours are recorded and used to calculate the centers u v of each structure according to the following gt 1 gt are dane where n is the total number of pixels making up the contour and U V are the coordinates of pixels along the contour The dU dV offset of the center of the marker w
130. e location for the points in each pair If you wish to chamfer with templates prepare a template or set of templates in each image In all cases the feature contour points or template in the treatment image should be similar to or a subset of the feature in the reference image The Chamfer Tool window opens and you must select one of the im ages to be the reference and the other to be the treatment image this name applies even if you are matching CT images Select a suitable mask by experience In the EditTool on chamfer setting select Contour Fiducial or Template as appropriate Do Chamfer PIPS Chamfer Tool x Reference Mask Treatment PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Transform Menu continued CopyCat found in the Oper menu within 2 Image Operation under Feature menu is used to compare two images after they have been selected as image A and image B Two InfoDesk windows will be dis played Cursor operations in image A such as drawing a ROI reading cursor position or pixel value or drawing a line for length measurements are all duplicated in image B Pixel values in 8 bit 16 bit or dose units will be displayed as appropriate In the figure image A is 8 bit mapped to dose and image B is 8 bit unmapped OB PRU OZ eee c program files pipspro32 demo images d Mi Eg c lEn n e ae TE files pipspro32 demo images d e program files
131. e may need to be increased to a point where the projections are better defined Image Type There are two types of starshot images that can be analyzed with the StarShot Module e Regular a typical starshot image with multiple projections e Hybrid Can only be a collimator starshot in which a standard spherical marker phantom is aligned to the lasers and imaged The spherical marker image is then added to the collimator projections as described above A typical hybrid image looks like this and the analysis will include additional information about the distance from the center of the ball to the center of the intersections of the projections Angle Type Choose the type of starshot that is being analyzed Gantry Couch or Collimator Note that hybrid starshots only allow collimator to be chosen A Window Level bar on the left of the image can be used to adjust the brightness and contrast A single fiducial mark is made by clicking near the center of the intersections of the projections The mark only needs to be approximately placed as the software uses an algorithm to determine the actual center If the DPI is not read from the image header or the DPI that is read is incorrect and not known two additional fiducial marks can be placed on the image at a known distance apart pin pricks for a manual calculation of the DPI value PIPSPRO SOFTWARE Manufacturer Varian Medical Systems Choose the l
132. e menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your images choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically In Off line Mode this dialog will not be shown 29 The Starshot is a standard method for measuring the stability of rotation of the linac gantry couch and collimator and is a standard recommended test in TG 142 To achieve a starshot in most cases the main collimators are closed to form a slit and radiation is delivered through the slit to film gantry couch or EPID or film collimator at multiple angles The image is then analyzed and the smallest diameter of a circle intersecting the central rays is determined Acquiring Images For both couch and gantry starshots images need to be acquired on film Either standard radiochromic or the newer Gafchromic films can be utilized Once the film has been developed or in the case of Gafchromic film exposed the film needs to be digitized utilizing a film Scanner such as a Vidar or with a high quality flatoed scanner The film should be scanned as a grayscale image with a resolution of between 72 and 96 dpi and then saved in a
133. e record and verify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time This test consists of creating a series of openings with the MLC as they sweep across the field creating a pattern that looks much like the light coming through a picket fence This test checks the ability of the MLC to accurately position the leaves at different positions within the field during a single treatment such as a step and shoot or sliding window IMRT treatment It is important to set up the MLC positions accurately in order for the MLC application to perform correctly Each of the strips in the image should be 2 cm wide with a 1 cm space in between each The middle strip should be centered on the isocenter plane A single image should be obtained as an integrated image If the ability to capture an integrated image is not available on your linear accelerator a single image of each strip can be acquired and then combined into a single image using the 2 Image Operation capability found in the Image Analysis Tools Open all of the images in the main PIPSpro window Select Application Image Analysis Tools 2 Image Operation from the main menu Set the first image as Image A by choosing Img A Set As A from the 2 Image Operation window Operation of 2 images Oper Norm Img B
134. e resulting Table View highlight the row for the data that is to be un archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status PIPSPRO SOFTWARE Entering data for another accelerator Clicking on the Linac Select tab will open the Linac Select dialog Choose the linear accelerator you would like enter data for and click Select History View Tab As data is collected in the database viewing historical data to determine if the results are trending in a negative way can be a valuable exercise Clicking on the History View Tab will bring up the Linac Select dialog NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically Linac Select Manufacturer Varian Medical Systems Model 21 EX Select Cancel Choose the linear accelerator that the history would like to be viewed for and then click Select in the dialog In the left hand panel the Linac Info is shown along with the Settings area Settings e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e I
135. e select Use right mouse button as middle button in the Configuration Settings dialog box Zoom This command allows a user to shrink or stretch the image window from 25 of its original size to 200 The Undo function is not available for this option Just select a new value to change or restore the size Hand This command is used to grab and shift an over size image within the window Select the hand and click on the image with the left mouse button Keeping the button depressed shift the image left right or up down To cancel this option de select the hand View DICOM Header See Appendix C The DICOM Format in this manual for information The header file may be viewed by using View DICOM Header under the View menu See page 88 for more information Show InfoDesk This provides data on the ROI if selected and the current pixel coor dinates and pixel grey level value when moving the mouse PIPS Information Desk Fa ROI position pixel 17 44 coy 114 84 a 2 247 8 8 T 95 1788 16 HINT Use keys 1 9 on the keypad for more accurate positioning of the mouse This method moves the pointer one pixel at a time in any of the vertical horizontal or diagonal directions ROI shows the coordinates top left corner and size horizontal verti cal size in pixels of the ROI in the selected image The default values are the full image size Position shows the current coordinates of the cursor in the sel
136. e should be taken in measuring SDD in order to determine M and Mooi Measure from the center of the phantom to the sensitive surface of the detector and not simply to the outer surface of the EPID cover A Microsoft Excel file CalcES x s is available from Standard Imaging Inc to assist in solving equations 7 and 8 In the course of developing and testing the QC 3 phantom measurements were made on numerous EPIDs around the world A few typical results are shown in the following table all at 6 MV Values of and M used in these calculations are estimated and may not be very accurate These data are random samples from various centers and should not be used as standards for acceptance testing The focal spot size S dominates in two situations First it dominates when the focal spot size is very large such as in a Cobalt 60 irradiation unit Im age quality deteriorates rapidly with distance and the optimal distance for the EPID in the above example is only 92 cm Second the focal spot size dominates when P is particularly small such as in the flat panel detectors Siemens FP and Elekta ViewGT For these detectors optimal spatial resolu tion will be obtained with small values of M opt which implies that the EPID should be located close to the patient One does not expect the values of E to be identical for EPIDs from the same vendor especially for fluoroscopic detectors as the values will depend on prior calibration of the E
137. ected image 20 Section 2 Using PIPSpro Edit an Operator 1 Enter a first name middle name optional and last name optional 2 Click OK to exit Acquiring Images It is recommended that a QA Patient be set up in the record and verify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time For MV image acquisition a single field of approximately 15 cm x 15 cm should be delivered to the phantom The phantom should be completely visible in the image and a field edge should also be visible as it is utilized in the module s algorithm for locating the phantom in the image For kV imagers adjust the blades on the imager to achieve a similar image as seen below It is recommended that the phantom be placed in direct contact with the imager cover with the gantry pointing straight down This will remove any magnification from the calculations and any variations from the phantom not being placed in the same position each time Alternatively the phantom can be set up on the stand on the treatment couch with the gantry rotated 90 degrees If the imager can be positioned at different distances from the source a single distance should be used for all tests after baselines have been established at that particular distance The phantom is aligned
138. ection 2 Using PIPSpro Dewarp Choose the Add New with Pin Detect fiducial marking tool Place exactly four fiducial points on the four central pins in a clockwise Dewarp is used to correct images that suffer from spatial distortion such direction starting at the upper left hand corner pin as images acquired from the image intensifier of a simulator from a c users nmiller desktop pipspro demo im 3 fluoroscopic portal imager or from a camera based film digitizer An image must be acquired with a grid phantom not supplied which consists of a square grid of equally spaced pins An image is acquired of the calibration phantom and analysis of this image by MapWarp yields a coefficient file wap containing the dewarping parameters Other images acquired under the same conditions as the calibration image can then be dewarped by the Dewarp routine using the appropriate coefficient file Calibration procedure Acquire an image of the calibration phantom under a given set of experimental conditions For a simulator these will be magnification gantry angle etc For a portal image they may be gantry angle lens stop and other parameters specific to the EPID 2 Map the Warp Choose Application Dewarp Find Pins from the menu The software will automatically detect each of the pins in the image Import the image into PIPSpro by selecting File Open or File Import from Penta eo Ea the main me
139. ed platform Passed PowerShell Failed A Windows Firewall Warning lt Back net gt 6 resolve the Windows Firewall go to Start lt Settings gt Control Panel gt Windows Firewall and turn it off For the PowerShell you will need to download and install this Visit this site http support microsoft com kb 926139 to locate what version you need For example if you have a windows XP 32 bit operating system you will need download the PowerShell 1 0 WindowsxXP x86 file http www microsoft com download en details aspx displaylang en amp id 7217 Once you have resolve the above issues hit the Re run button to make sure everything passes Once everything passes you will be brought to the Feature Selection Choose all the features and hit next SQ Server 7008 A7 Setup Feature Selection rep Exprede rath Advanced Services features ba matal Setup Support aues Tiree Engine Services F Server Rephration Shared Features Management Tools Basit ESA Client Connectivity Ste Thadishbutable Pash PIPSPRO SOFTWARE E B Add or Remove Programs 0 of lt amp Currently installed programs Show updates Sort by Name hange Cenove rouse sute Size 7 a Programs A Microsoft NET Framework 1 1 Size 35 01MB rm Microsoft NET Framework 2 0 Service Pack 2 Size 8 Bat 5 Microsoft NET Framework
140. eft Bank Right Bank All Leaf Width Tests 10 25 2010 9 27 2011 12 02 16 PM 2 18 17 PM E E E a a a Leaf 6 Leaf Width mm be o A chart view will now be shown on the bottom of the results window with a graphical representation of leaf width in millimeters Don t Chart Sometimes there are data points saved to the database that can skew the graphical results in a negative way If you would not like to see the results from a particular test on the chart view click the Don t Chart box at the top of the listing The results will no longer be visualized in the chart when viewed on screen or printed Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will Zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button al will zoom the chart to the previous level Clicking the Zoom out all levels button ql will zoom the chart to the original level showing all data Archiving Data data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the column for the data that is to be archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When
141. es 88 Appendix A The DICOM Format 88 The DICOM Format 89 Appendix B Dewarping Distorted Images 89 Dewarping Distorted Images 91 Appendix C Sequential Image Processing 91 Sequential Image Processing 92 Appendix D Stereo Algorithms 92 Stereo Algorithms 94 Appendix E PIPSpro Publications 94 PIPSpro Publications PIPSPRO SOFTWARE Section 6 Appendices Appendix A The DICOM Format 2 The image file header PIPSpro strips the header from the image before display The header and a backup of the image are saved into the files header htm and dicom tmp respectively The user may specify where these files are to be saved by setting the path in the Configuration Settings dialog box page 15 otherwise the default is the same directory as PIPSpro Both files are overwritten every time a new DICOM image is opened The header file may be viewed by using View DICOM Header under the View menu NOTE The DICOM header file is opened in the default web browser The default browser must be set to Microsoft Internet Explorer for this to function 1 Zoomin Lens View d 5 Hand WE COM Header 3 Exporting DICOM images There are no facilities in PIPSpro to save or export an image in DICOM format 4 DICOM image file extensions The standard extension for DICOM images is dcm but some equipment vendors also use other extensions such as 5 0 ima img etc Enter additional extensions in the Configuration Set
142. for templates and not is used for notes To save the data to an ASCII file for later review or export to a spread sheet choose a suitable filename with the extension txt 5 Retrieves contour points filename con fiducial points filename fid templates filename tp or notes filename not for the currently selected image Select the type of points and click on this tool A dialog window allows you to select the appropriate file Fi Displays the coordinates of the fiducial points and the distances be tween them Also the 8 bit and if available the 16 bit and dose values at each fiducial point Template transform control TTC During registration by interactive templating the template in the reference image is copied onto the treat ment image The default condition TTC not depressed is to transform the reference template so that it is adjusted in scale translation and rotation to best fit the treatment image using a chamfer match between the field contours to determine the transformation parameters Then only a minimum amount of interactive adjustment should be required to align the templates with the actual anatomical landmarks in the treatment image If the TTC button is depressed the template will be copied from the reference image to the treatment image using scale and translation only no adjustment of rotation Insert a new note Select this tool and then place the cursor at the desired location on the imag
143. ftware and choose Application QC Configuration Management from the menu The following dialog will be shown Unable to find the QC database file QC mdb Do you want the software to create a fresh database at the default location Click NO to browse for the QC mdb file e e Choose No and a standard Windows dialog will be shown Navigate to the location you moved the QC mdb file to and then click Open The data will be shown and a new QcDbLoc ini will be created in the directory which will contains the information for the software on the location of the QC mdb file going forward Install SQL Server Express 1 IMPORTANT NOTE PIPSpro requires Microsoft SQL Server 2008 or later in order for full functionality of the software Installation Procedure Only perform this step if you have already installed Microsoft SQL Server 2005 Express with the Management tools You will need to uninstall the Management tools before proceeding If you have not installed Microsoft SQL Server 2005 Express then you can skip to 2 To do this Open your Start Menu gt Settings gt Control Panel gt Add Remove Programs Programs and Features in Windows 7 Locate the Microsoft SQL Server management Studio Express and remove it 1 1 Insert the Installation CD into your CD ROM drive 2 Ifthe installation program does not start automatically click the Start button and select Run Then type D Setu
144. ghest values This option only applies when importing 16 bit images A 16 bit image to be imported is scaled to an 8 bit image in the range 0 255 Selecting this option will normalize the 16 bit data so that the conversion to 8 bit data will be mapped from the lowest highest values to the range 0 255 For example if the dynamic range is set to 12 bits bit planes 0 11 set but the highest data value is only 900 instead of the possible maximum of 4095 then the mapping will be from 900 to 255 and not from 4095 to 255 This is generally a useful option un less there are artifacts in the image with very high values which would give rise to anomalous normalizations In such cases do not select this option and set the number of bit planes to cover the desired range of data values HINT There is not a lot of difference between the various import options For example the only difference between import for Siemens Philips and TheraView is that the defaults have been set to the values shown in the table If you change these values the new values will become the default and will re appear next time you use this import option However the Varian import will decompress Varian images if necessary and also includes an Invert operation so that Varian PortalVision images will be displayed in the black low white high type of display If you prefer to use the white low black high display you can apply Invert to the image The Poseidon import includes the
145. grades and new releases for an additional fee Standard Imaging shall not be liable for any amount in excess of the product costs actually paid by the Licensee giving rise to any claims hereunder In no event shall Standard Imaging be liable whether in contract tort or otherwise for any indirect incidental or consequential damages arising out of the subject matter of this agreement In the event of breach by Licensee of any of the terms and conditions of this software license agreement Standard Imaging shall be entitled to enforce all legal rights and remedies conferred upon it by State of Wisconsin federal and or international law Standard Imaging and Licensee acknowledge that because breach by Licensee of any of the terms or conditions of this agreement will likely cause irreparable harm to Standard Imaging injunc tive relief would be an appropriate remedy for Standard Imaging resulting from any such breach by Licensee In the event that action suit or legal proceedings are initiated or brought to enforce any or all of the provisions of this agreement the prevailing party shall be entitled to such attorney s fees costs and disbursements as are deemed reasonable and proper by a court of law or an arbitrator In the event of an appeal of an initial decision of a court or of an arbitrator the prevailing party shall be entitled to such attorney s fees costs and disbursements as are deemed reasonable and proper by such appellate court
146. gs to the default state Do not use stock angles and Save only if 3D results calculated Print This command will print or save the inside part of the active window with the possibility for the proper adjustment of the printed object to the page boundaries The available options are stretching the image best fitting scaling by number and fixing page margins PIPSpro Change Print Size m Method Page Margin In Inch C Stretch To The Whole Page Top Best Fit The Page 0 00 C Scale By Number Left 0 00 0 00 Right Scale Size fo o0 Bottom Cancel PIPSPRO SOFTWARE Edit Menu Section 2 Using PIPSpro Edit Menu z Undo Redo Use pens for the placement of points when delineating contour points or fiducial points or when drawing templates To place a point in the image position the mouse at the desired pixel and click the left button Contour points will be shown as small red numbers with green circles or as green crosses Fiducial points are shown as small red numbers with red crosses Templates are shown as red dots joined by red lines Use the function keys F7 toggle the templates ON OFF F8 remove numbers from fiducial points and F9 switch fiducial and contour points from crosses to numbers To see the number more clearly position the mouse over the point and press the right button Be sure that in the Configuration Settings dialog box the option Use Right M
147. gth The 50 default value describes the grayscale pixel intensity between the area of irradiation and the non irradiated area For example if the irradiated area has a pixel intensity of 20 and the non irradiated area had a pixel intensity of 240 and the edge strength is set to 50 the edge will be considered where the pixel intensity is 110 240 20 5 If the intensity is set to 40 then the edge will be found where the pixel intensity is 88 240 20 4 e Pixel Size This value will automatically be determined from the image once the calibration marks have been placed A Window Level bar on the left of the image can be used to adjust the brightness and contrast MPSpre Comerehersive JMLC QAJ O Ele Application WRCQA Window tjeip Linac into Two fiducial marks need to be placed on the image Fiducial 1 The first fiducial needs to be placed over the spherical marker in the phantom that is aligned with isocenter Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued In the lower half of the results window a grid will report the absolute position of each of the MLC s for each of the left and right banks along with the offset from the correct position Results will be color coded based on the ranges se
148. h both the Table View and Chart View data and will be shown in the Preview Window Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save lal button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Archiving Data If data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the row for the data that is to be archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the row for the data that is to be un archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status Choosing an
149. 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 Consumables Equipment Manufacturer 0 90 days 100 of ADCL Calibration Costs 91 182 days 75 of ADCL Calibration Costs 183 365 days 50 of ADCL Calibration Costs 366 639 days 25 of ADCL Calibration Costs days from date of shipment to customer Warranty Period Resale Products ADCL Product Calibration Standard Imaging uses the UW ADCL for recalibrations required under warranty 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 All transportation charges including customs tariffs duties and brokerage fees are the buyer s responsibility This warranty extends to every part of the product except consumables fuses batteries or glass breakage Standard Imaging Inc
150. he noise calculation has been found to be more accurate when calculated between the two images For kV imaging systems we recommend utilizing 80kV and the lowest mAs settings available on your machine The images should then be exported preferably in DICOM format to a location accessible by the PIPSpro software which will be used for the analysis An included DICOM server utility is included with the PIPSpro software installation if needed for instructions on how to export images from your treatment machine or record and verify system please contact the manufacturer of that system See the DICOM server utility section of the user s manual for setup information Image Analysis When two images have been acquired and are available for analysis the images need to be opened For information on opening images for the QC module see the section on the File Menu in this manual Select Application QC Quality Control from the menu to open the QC module Choose QC from the drop down menu in the module Select the first image by clicking on it and click the Set Image 1 button in the QC module Then repeat with the second image and the Set Image 2 button to display the images in the small boxes as shown Clicking Do QC will launch the analysis routine and display the dialog box QC Setup Choose settings for Imager Phantom Type and Energy Level to match the conditions of the analysis images QC Setup Imager Phant
151. hows another example of a PortalVision where the focal spot size was exceptionally large S gt 4 and was the dominant contributor to image unsharpness at SDD gt 140 cm For optimal image quality it would be best to keep the EPID close to the patient in this case Flat panel detectors using amorphous silicon technology are gradually replacing the older systems using video or ion chamber detectors The flat panel EPIDs are characterised by much higher spatial resolution and CNR With pixel dimensions as small as P 0 4 mm the influence of the focal spot size becomes the dominant factor in determining spatial resolution and the value of M opt is usually very close to 1 This means that spatial resolution will deteriorate as the detector distance increases In EPIDs where the detector distance is fixed this is of only academic interest although the focal spot size should be monitored on a regular basis In EPIDs where the detector position is adjustable it may be worthwhile to minimize the patient detector distance where possible PIPSPRO SOFTWARE 4 The experimental technique Source For this test the phantom is located at isocenter and the EPID is progressively moved farther away Images are acquired at intervals of 10 cm for example and f is determined using Optional Module OM Q in PIPSpro Re writing equation 3 in terms of M P S and f gives the unsharp ness blurring function 2 a 4 where M is def
152. ication will then perform the calculation of the suggested stand offsets in 3 dimensions X Y and Z 42 Section 2 Using PIPSpro Application Menu gt Stereotactic Module continued Zooming in chart view Clicking within the chart and dragging to another position in the chart will zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button 8 will Zoom the chart to the previous level Clicking the Zoom out all levels button al will zoom the chart to the original level showing all data Printing or Saving a History View Report A report of the data can be printed by clicking on the Print button in the Setting area in the left hand panel A report will be created with both the Table View and Chart View data and will be shown in the Preview Window Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Archiving Data data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View
153. ich the software will automatically recognize the outer spherical markers in the phantom and the center spherical marker if it is present and place red dots on the image to identify them Based on the position of the outer markers the software then can determine the positioning of the FC 2 phantom and the red solid line is used to identify the known light field based on that information The green line identifies the radiation field edge based on the edge detection parameter chosen The blue boxes at the 12 3 6 and 9 o clock positions represent the position at which the jaw positions will be determined if the center marker is present 25 Linac Select SIRO 21 EX M3 Manufacturer Varian Medical Systems Model 21 EX Choose the linear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings default for performing the analysis The default settings should work for most images If adjustments are needed the following explanation of each setting parameter should assist with making them e Edge Strength The 50 default value describes the grayscale pixel intensity between the area of irradiation and the non irradiated area For example if the irradiated area has a pixel intensity of 20 and the non irradiated area had
154. ich yields the best correlation coefficient is then used in the final analysis to determine the appropriate linear attenuation coefficients to use The mean CT numbers for each material and the Contrast Scale are reported in the output e 365 00 arr 186 210 Pee 3 oo ars 3 27 Co on oo m 25 Ca 36 oo o 25 Ca 3 00 are Ce oo are 20 re 36 00 208 o 3 oo as 207 o ae oo 109 34 oo 6 108 Water Equivalent solid Other materials besides those listed in the table above could be used instead since the information that is relevant to this analysis is stored in external text files and are not encoded within the program itself PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Stereotactic Module continued Setting a Load Folder The first step in loading images into the Stereotactic module is setting a Load Folder In order to set a load folder the user will begin by selecting Stereotactic Set Load Folder from the main menu bar ma Window Help Set Load Folder 4ubo Load Images Cbrl ShiFE L alculake Resul led 5 Hide Markups Window Level Selected Only agnirier Options The Linac Select dialog will be shown Choose the linear accelerator that the images being loaded we
155. ile Archiving Data If data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the row for the data that is to be archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the row for the data that is to be un archived by clicking on it Multiple rows can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status Show Detail To show the details for a result in the History View in the Table View highlight the row for the date that the details would like to be viewed for Then click on the Show Details check box at the bottom of the left hand panel A detail view similar to the results that are shown at the time of the analysis will be shown 27 History View Tab not available in off line mode As data is collected in the database viewing historical data to determine if the results are trending in a negative wa
156. in the MLC module A future version will allow for the setting of individual thresholds for each test performed in PIPSpro PIPSPRO SOFTWARE Choose a Primary Department from the dropdown list For certain functions of the software a department needs to be chosen before proceeding The Primary Department will automatically be chosen by default when the user is logged in Select a position that describes the User s function from the dropdown list Assign a security level from the dropdown list The user levels are as follows Administrator Full access to the software including all features of the System Manager Supervisor Full access to the software but can only access the Linacs section of the System Manager User Full access to the software but no access in the System Manager Enter an initial password for the user This password can be changed by the user after the initial login The Divisions that a user is part of can be assigned from the Add User screen Click on the Modify List button and choose the Divisions from the Eligible Divisions list to include Click on the Add Division button to move the chosen Division s to the Associated Divisions list Clicking OK will commit the changes to the database Editing a User To edit an existing user click on Users in the System Manager From the Department dropdown choose the Primary Department for the user to be edited Choose the user from the Active
157. inac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single accelerator will be chosen automatically Entering Data Once an accelerator has been chosen the Image Analysis interface will be populated with the appropriate fields to enter the data from the imaging system If your system is set up to record 3D data fields for the X Y and Z deviations will be shown If your system is set up to record 6D data fields for the Pitch Yaw and Roll deviations will also be included Linac Info Department 3D deviations 6D Deviations SIRO Linac 21 EX Manufacturer X Deviation Pitch Deviation Varian Medical Systems Model 21 EX Mv Imager Type aSi 500 kv Imager Type Varian OBI Couch Type 6D Settings Imager Cc C scx y Y Deviation Yaw Deviation Comparison Type 2D 2D C Save Results Z Deviation Roll Deviation In the left hand panel choose which type of data is being entered e Imager Choose whether the data is being collected from the MV imager or the kV imager e Comparison Type Choose whether the images being analyzed are 2D orthogonal planar images or 3D 3D image set such as a Cone beam CT Enter the appropriate data and click the Save Results button to commit the data to the database 61 TG 142 recommends pe
158. indows XP Windows Vista Windows 7 The PIPSpro DICOM Server starts when the system is started and shuts down when the system is turned off The PIPSpro DICOM Server supports image reception as well as the processing of query requests Accepted Presentation Contexts Presentation Context Table Abstract Syntax Transfer Syntax Extended Negotiation 1 2 840 10008 1 2 SCP PIPSPRO SOFTWARE VR Little Name Verification 1 2 840 10008 1 1 Implicit Endian 100 Section 7 Other Information DICOM Conformance Statement continued Accepted Presentation Contexts Presentation Context Table for Receive from a Remote System Transfer Implicit VR Implicit VR Receive Images from a Remote System A remote system pushes i e sends images to the PIPSpro DICOM Server Upon completion of the transfer the images are available locally and can be selected for display COPYRIGHT The DICOM Server Utility was developed with partial use of source code originating from the University of California Davis on the condition that the following copyright notice be included in the documentation Copyright C 1995 University of California Davis THIS SOFTWARE IS MADE AVAILABLE AS IS AND THE UNIVERSITY OF CALIFORNIA DOES NOT MAKE ANY WARRANTY ABOUT THE SOFTWARE ITS PERFORMANCE ITS MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR USE FREEDOM FROM ANY COMPUTER DISEASES ORITS CONF
159. inear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings for performing the analysis If adjustments are needed the following explanation of each setting parameter should assist with making them e Image Size The size of the image in pixels non editable e DPI value The resolution of the image in dots per inch DPI read from the header of image Images of type TIFF tif bitmap bmp and DICOM 3 dcm generally have this value available in the header and the software will attempt to read that information automatically It is advisable to double check this value to make sure it has been read correctly The value is editable if needed e Threshold The percentage of difference between a background non irradiated area pixel intensity and an irradiated area of a projection that the software will use to determine whether a projection has been discovered For example if the background intensity is 240 and the Threshold has been set to 33 default then a projection would have to have a pixel intensity of approximately 79 2 to be considered a valid projection during the search e Cal Distance In the situation where a DPI value is not available from the image header or the DPI is not correct and is not known two additional calibration marks
160. ined as the ratio of the source detector distance SDD to the source phantom distance SPD Gir Gir SH 100 cm 5 Values of M and f for optimal spatial resolution From equation 4 we determine the value of M opt which is the magnification required to minimise the blurring function i e to ensure optimal image quality and the corresponding value of f EC P S M opt S 5 6 fso Opt When treating a patient at isocenter the source phantom distance SPD is replaced by the source isocenter distance SID and the optimal value of SDD is equal to M opt xSID However only some types of EPID have adjustable SDD Note that this simple model for calculating M opt only takes into account the spatial resolution blurring Other factors must also be considered when selecting the best position of the EPID for clinical use such as image noise and effective field of view both of which depend on the value of M 6 Examples The following two examples demonstrate how experimental measurements and analysis are performed The experimental data for f are converted to unsharpness 1 2f and fitted to equation 4 with the value of P set as a fixed parameter Values for E and S are found from the analysis 80 Section 3 The QC 3 Phantom Parametric Analysis of Image Unsharpness continued Then S Ni Vso 7 Vapi 1 Mpi 1 7 7 E Mia Misa 17 2 8 Car
161. ing Licensee may a Use the product only on a single computer or single network system at the site of use and b Make backup copies of the product only for back up recovery and ar chival purposes Licensee may not and shall not a Make copies of the product except as otherwise permitted herein b Rent lease sub lease or otherwise permit any third party to use the product c Redistribute any portion of the product its software programs documenta tion or other related materials d Other than as set forth in section 1 b above copy the product any of its software programs documentation or other related materials without the express written permission of Standard Imaging e Remove or obscure copyright and or trademark notices appearing on the product f Reverse engineer the product in order to derive or appropriate for any reason or purpose the source code or any other trade secret or other pro prietary information or g Transfer the software program of the product to another site or to a third party purchaser without the express written permission of Standard Imaging and agreement to all the terms and conditions of the then current software license agreement utilized by Standard Imaging by the authorized representative of the new site or such third party 104
162. ing View DICOM Header under the View menu See The DICOM Format section of this manual Import This provides options to import 8 or 16 bit images with various formats NOTE You must set a valid path for temporary files in the Configura tion Settings dialog box located in the File menu before using Import The default path is the same as the PIPSpro program files If no path is set or if the path is not valid no corresponding directory the Import routine may hang while it searches for the non existent directory Avoid this problem by setting a path in the Configuration Settings dialog box first and make sure that the path is valid the directory exists Import Other is a general import routine and several special purpose routines are included for specific file formats These include Siemens BEAMVIEW YS portal images Philips SRI 100 portal images Varian 16 bit PortalVision images Varian CT images Theraview portal images Poseidon and CART images When an image is selected the Import File Format window is displayed and permits adjustment of the image parameters The Set and Truncate options appear only for 16 bit images If Import Varian is selected PIPSpro will determine whether Varian images are compressed or uncompressed and auto matically uncompress them if necessary For further information on importing 16 bit images see the Importing 16 bit images section of this manual Note that Elekta View
163. ing another Linac for History View 34 The Reports Tab 34 Exporting Data Application Menu gt CBCT 36 Varian 36 Elekta 37 Creating Reports Application Menu gt Stereotactic Module 39 Using the Stereotactic Module 40 Stereotactic Configuration 42 Saving Results 42 Printing Results 43 History View Tab 43 Choosing another Linac for History View 44 The Reports Tab 44 Exporting Data Application Menu gt MLCQA 45 The MLC Phantom 45 Opening MLCQA Application 45 Loading Images and Selecting a Linac 13 18 20 21 24 29 35 39 45 PIPSPRO SOFTWARE Section 2 Using PIPSpro Opening PIPSpro Software version 4 4 Changing From Off Line Mode or Changing Databases after starting to use PIPSpro in off line mode a database is installed and made available it will be necessary to connect to the new database It may also be necessary to change the database in the future The next time PIPSpro software is started the login screen will be shown 6 PIPSPRO SOFTWARE Beta Version Please login Work off line Select Server Start Exit Click on the Select Server button and follow the instructions above under Using PIPSpro with a SQL Database User Name Password Setting up the PIPSpro Database If utilizing the SQL database with PIPSpro there are several steps that need to be undertaken to initialize the database for use Creating a Divisi
164. ings before a database is connected no usernames passwords have been set Once the database has been set up it is advisable to uncheck the Allow access to Configuration Manager for users working off line so that users without sufficient privileges do not inadvertently change settings Stereotactic The Stereotactic Module has several configuration settings that will affect the functioning of the module Configuration Manager Use Stock Gantry and Couch Angles Save Options iDo not angles Save only if 3D results calculated Sol st incl all 8 2D result pairs C Use stock angles define below Allow saving 2D results for less than 8 images Define Stock Gantry and Couch Angles Options for saving 2D results Image Gantry Angle Couch Angle Minimum images for 2D savel 8 mage 1 JV Warn when about to save less than 3D Image 2 mage 3 0 mage 4 Ss 2 270 mage 5 2 mage 6 gt 90 mage 7 270 e8 qh mage 8 20 Restore Defaults Save Close PIPSPRO SOFTWARE File Menu continued Configuration Settings General Calibration DICOM JPEG Pixel unit fog pixels 100 mm Fin detect Sensitivity f Detect size 2o Change units mm Registration Image view percent W Display transformed image Cancel Apply Help HINT The values are integers and if you require sub millimeter ac curacy use smaller units such as tenths of a mm
165. installation directory of PIPSpro and could not be made available as a shared database on the network which was desired by users To address this need version 4 4 of PIPSpro allows for the placement of the QC mdb database in any local or network location Placing the QC mdb file in a network location would allow multiple installations of PIPSpro software to communicate save and retrieve data to and from the single QC mdb file PIPSPRO SOFTWARE Installing PIPSpro continued gt SOL Server 2008 R2 Setup a 2 Setup Support Rules Setup Support Rules identify problems that might occur when you install SQL Server Setup support files Failures must be corrected before Setup can continue Setup Support Rules Operation completed Passed 8 Failed 1 Warning 1 Skipped 1 Feature Selection Installation Rules Instance Configuration Disk Space Requirements Server Configuration Database Engine Configuration Rul Error Reporting Fusion Active Template Library ATL Passed Installation Configuration Rules 9 Unsupported SQL Server products Passed Installation Progress Performance counter registry hive consistency Passed Complete Previous releases of SQL Server 2008 Business Inteligence Develop Passed Previous CTP installation Passed 9 Consistency validation for SQL Server registry keys Passed Computer domain controller Passed Microsoft NET Application Security Not applicable Edtion wow
166. is selected there is a choice of a median filter or a Kuwahara filter With the median filter the user may choose one of the following options m Method a C Row Only Cancel Column Only C Cross prerereseressssssesesesseseen Frame 3x3 7 Row Only 1 D filter will be applied to the image rows Column Only 1 D filter will be applied to the image columns Cross 2 D filter using pixels from the horizontal and vertical lines through the current pixel Whole Area full 2 D filter will be used The kernel size can be selected from the dialog window HINT The median filter is a standard image processing technique particularly useful for removing salt and pepper noise from images without reducing the fine details The Kuwahara filter is designed to reduce noise without degrading the sharpness or position of edges PIPSpro Kuwahara Filter gt lt Size The following image shows a test image from the QC 3 phantom and three different filtering operations using the average 3x3 median whole area 3x3 and Kuwahara 5 filters a loj xj E c kuwahara bmp Sharpen Image This provides the capability of high pass filtering with different weight coefficients The kernel size Frame scaling factor and shift of the grey scale can be selected from the corresponding fields of the dialog window 66 Section 2 Using PIPSpro The figure shows a
167. it data to 8 bits truncation is carried out if selected For example Truncate Lower 20 would renormalize the data from 51 255 to 0 255 and all data lt 51 would be lost Similarly Truncate Upper will delete the selected upper fraction of the data and renormalize to the full 8 bit range 4 Example of Importing a 16 bit Image The following example shows how to import a 16 bit image from the Varian PortalVision imager However the procedure is similar for other 16 bit images 4 1 Load the image on a or b drive or in a suitable directory on c drive 4 2 Select File gt Import gt Varian gt Portal PIPS Import File Format Truncate Lower Upper fo z Total Size of the Image 132096 Pixel Size in bits 16 Dynamic Range in bits 6 ea Width in pixels 256 Height in pixels 256 Signed 16 bit Head Size in bytes 1024 IX Normalize with lowest highest values Format IBM PC C MAC UNIX Proportional Adjustment No C Yes by insertion C Yes by interpolation Show bit histogram Yes No 4 3 Select the drive directory and file you want to import and lt OK gt 4 4 Width and height should be selected by default to 256 and the header size should read 1024 this is obtained from the total image size less the width x height 4 5 Selecta pixel size of 16 bits click and in the command select a 16 bit dynamic range insert X in planes 0 15 Select nor
168. ith respect to the center of the radiation field is then given by dU u u dV v v where u v and u_ v _ are the coordinates of the center of the radiation field and ball marker respectively 92 Appendix D Stereo Algorithms continued Section 6 Appendices Least squares fit The equation dX dU cos sin 0 gt dY dV cos sing cos cos sin 7 can be represented in vector form as u 4 cos sing 0085000856 0 gt lt 4 cos p sin d 0 images of the ball marker are acquired with unique gantry and couch rotations an over determined set of equations can be constructed giving u 4 Ug A Xg In order to determine the offset of the head frame from the optimal target location this equation must be solved for dX dY dZ A powerful technique called Singular Value Decomposition SVD is used to solve this over determined set of equations in a best fit least squares sense A detailed discussion of the SVD technique is beyond the scope of this manual however the reader is referred to Press et al Numerical Recipes in C The art of scientific computing Cambridge University Press 1992 93 PIPSPRO SOFTWARE Section 6 Appendices Appendix PIPSpro Publications Clinical Implementation of a new Electronic Portal Imaging System L Aubin A Conrad C Thompson R Rajapakshe Proc WESCAN Conf Kelowna March 1999 Quality Assurance in Stereotactic
169. itrary region using contour points with the EditTool SRAHE will use this contour as the field edge and process only within the contoured region AHC Adaptive Histogram Clip segments a portal image into back ground field edge and field pixels and applies AHE with different clip levels in each segment You select the clip level for the field area in the dialog box There is no artificial field contour line and contrast enhancement usually is good right up to the field edge It is somewhat slower than AHE but in many cases gives a bet ter result For those users who wish to evaluate this technique in greater detail two files are saved in the directory set in the Configuration Settings dialog box as the path for temporary files Chart omp shows the segmentation results on a 2D plot of contrast ordinate and grey level abscissa and Cluster bmp shows the corresponding regions For further details see the Technical Notes section of the Standard Imaging website When one of these techniques is selected a dialog window opens allowing for the selection of the clipping level degree of contrast A clipping level of 5 7 is very strong and will usually over enhance the contrast except for very flat images A clipping level of about 3 is often found to be the most useful A clipping level of 1 3 is useful for images with quite good contrast or for diagnostic images from a simulator CT or MRI PIPSPRO SOFTWARE Section 2 Using PIPS
170. jects within the image Erosion dilation and gradient or skeletonization are three of the basic morphological transforms Erosion uniformly shrinks an object in an image Dilation effectively grows an object in the image in spatial extent Gradient detects edges in an image resulting in what is often called a stick figure representation of an object PIPSpro Morphology ES ERE 11x11 2 13x13 x Area Size 68 Application Menu gt Image Analysis Tools Section 2 Using PIPSpro Image Analysis Tools Profile This opens a window where the cross section will be displayed Pin Detect PIPSpro Cross Section x Row Column f Skew MW Track Help Wwe are using skew The highest pixel value is 249 at 440th pixel Load Save Exit To obtain a horizontal or vertical profile select its type hold down lt Shift gt position the mouse at the corresponding line and click To obtain a skew cross section select skew hold down lt Shift gt position the mouse at the starting point hold down the left button and move the profile To obtain an updated profile when moving over the image check the track field hold down lt Shift gt press the left mouse button and move the mouse over the image A profile can be saved to a file filename prf or retrieved using the Save and Load controls It will also be saved to a data file filename txt which can be read by any simple tex
171. king on the History View Tab will bring up the Linac Select dialog NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically Linac Select Manufacturer Varian Medical Systems Model 21 EX Choose the linear accelerator that the history would like to be viewed for and then click Select in the dialog In the left hand panel the Linac Info is shown along with the Settings area Settings e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Test Type Choose which type of test to trend Clicking Apply will apply your settings and the results will be shown in the right hand panel Leaf Position Trend Analysis After clicking the Apply button each leaf position test will be shown in the results window for the chosen date range Tabs at the top of the results window allow the user to switch between data for the left bank versus the right bank Left Bark Fight Bank All Lest Position Tests No Trending Selected PIPsPRO Section 2 Using PIPSpro Application Menu gt MLCQA continued Trending can be accomplished on a per leaf basis by clicking the Trend Leaf box for the leaf you would like to see trended L
172. lease Note If the log feature is left on for many days it can grow to be very large To turn off this feature follow the procedure above and delete log in the Start Parameter field Ce Sole ei 99 Section 4 Trouble Shooting If you cannot receive DICOM images check your TCP IP port setting in Step 2 of Section 1 Then check the remote node that is to send images to the PIPSpro DICOM Server check the IP address AE title and port number of the PIPSpro DICOM server Perform the following to set up logging capability PIPSpro DICOM Server can be configured to record its activity in a log file The log file PipsDSvr log is created in the same directory as where the PipsDSvr exe file resides which by default is the PIPSpro installation direc tory If configured the log file is created every time the PIPSpro DICOM Server is started and provides useful information for tracing errors To configure the PIPSpro DICOM Server to generate the log file you need to provide the command line option log do not include the quotations do this follow the steps 1 Open the control panel open Administrative Tools and double click the Services icon The Windows services dialog will appear 2 Double click PipsDSvr in the service list to bring up its property dialog Click Stop button to stop the service 3 Type log do not include quotations in the Start Parameters text box 4 Click
173. lick Save to create the report If the options to include images and or graphs has been set under the Options menu the report will contain them 37 You will now be shown results for the analysis CBCT Module EOSS Analyze Reporting Functions Options Quit About sF Standard Imaging CBCT Module 3 0 Verification Phantom ID Varian 504 Phantom Orientation 1 Phantom Center 256 256 CT of Module Material 77 82 11 04 HU Spatial Resolution Critical Frequencies cy cm MTF 50 4 10 8 2 20 88 Warning exceeds Nyquist frequency of 10 64 1 mm Pixel Size Expected mm X Axis mm Y Axis mm 0 47 047 0 47 047 7 Phantom Rotation 0 3 degrees Phantom Center is 0 00 mm RIGHT OF CENTER and 0 00 mm BELOW CENTER CT Linearity Contrast Scale 0 000197 Effective Energy 60 keV R 0 999086 Material Teflon Air LDPE Delrin Acrylic Polystyrene PMP CT 992 8 995 9 97 2 358 7 121 4 42 5 189 2 Slice Thickness Expected mm X Axis mm Y Axis mm 2 50 249 2 57 2 57 2 47 Avg Slice Width 2 52 mm Table Position Offset 2 10 mm Vertical Angle 0 5 degrees Horizontal Angle 0 4 degrees 3 Low Contrast Model Contrast 1 65 1 24 0 99 0 83 0 71 0 62 0 55 0 50 0 45 0 41 0 38 0 35 3 Detail mm 3 00 4 00 5 00 6 00 7 00 8 00 9 00 10 0 11 0 12 0 13 0 14 0 15 0 Low Contrast Diameter of Smallest Object Visualized mm 4 2007 8 All Rights Reserved 080152 Edward Hospital 05 07 2006 Some of the results ca
174. linac will be chosen automatically In Off line Mode this dialog will not be shown Manufacturer Varian Medical Systems Choose the linear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings default for performing the analysis The default settings should work for most images If adjustments are needed the following explanation of each setting parameter should assist with making them e Edge Strength The 50 default value describes the grayscale pixel intensity between the area of irradiation and the non irradiated area For example if the irradiated area has a pixel intensity of 20 and the non irradiated area had a pixel intensity of 240 and the edge strength is set to 50 the edge will be considered where the pixel intensity is 110 240 20 5 If the intensity is set to 40 then the edge will be found where the pixel intensity is 88 240 20 4 e Pixel Size This value will automatically be determined from the image once the calibration marks have been placed 52 Section 2 Using PIPSpro Application Menu gt MLCQA continued At the top of the results window is a graphical representation of each MLC s position measured in millimeters In the lower half of the results window a grid will report the absolute position of
175. linac will be chosen automatically In Off line Mode this dialog will not be shown Linac Select Linac 21 EX Manufacturer Varian Medical Systems Model 21 EX Select Cancel PIPSPRO SOFTWARE Image Window and Level Adjustment On the left side of the image window is a slider style window and level adjustment An effort is made by the MLC module to set the window and level correctly for each image as it is opened If adjustment needs to be made clicking on either of the arrow controls allows the user to slide them up and down to change the contrast of the image It may be necessary to adjust the window and level in order to see the radio opaque markers in the phantom Leaf Position Test TG 142 recommends on a monthly basis to test setting versus radiation field for two patterns of MLC s The MLC Module Leaf Position test accomplishes this test easily and accurately for the user by reporting the exact position of each MLC that is imaged and analyzed Acquiring Images It is recommended that a QA Patient be set up in the record and verify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time Two different fields should be setup The module is designed to analyze simple rectangular fields that are created with the MLCs
176. lly monitored in diagnostic radiology its impact on image quality is generally ignored in megavoltage portal imaging This however is a mistake as an abnormally large focal spot will significantly reduce image quality especially if the detector is quite far from the isocenter Furthermore when there is a reduction in image quality and maintenance is required it is very useful to know whether the problem lies in the EPID or in the linac as usually quite different support personnel are involved This note does not describe how to acquire images with the QC 3 phantom or how to determine the spatial resolution parameters from the data as these subjects are covered elsewhere It is only concerned with describing the analytical model and the determination of the variable parameters A simple 3 parameter model of the portal imaging system is used for the purpose of differentiating between the most significant contributing factors to image unsharpness blurring The model assumes that the image pixels are square equal width and height and approximations are applied when this is not the case It further assumes that the three parameters used in the calculations are independent and are constant under the various situations in which test images are acquired While this model does not claim to be scientifically precise it is useful for the limited purposes of routine quality assurance of the EPID 1 The detector E This component incorporate
177. lossless image format such as TIFF tif or bitmap bmp A collimator starshot can be achieved on an EPID either by acquiring a single image for each projection or using an integration mode to capture all projections in a single acquisition If each projection is acquired as a single image the PIPSpro image processing tools can be utilized to combine them into a single image showing all projections Open all of the images in the main PIPSpro window Select Application Image Analysis Tools 2 Image Operation from the main menu Set the first image as Image A by choosing Img A Set As A from the 2 Image Operation window Operation of 2 images Oper Norm Img B Set As A Set the second image as Image B From the Oper menu choose AminB You will now have a new image that is made up of the first two projections Now load the new image in as Image A and the third projection as Image B and repeat the procedure until all projections have been added together Save the new image as a TIFF tif or as a bitmap using File Save As from the main menu PIPSPRO SOFTWARE Section 2 Using PIPSpro Starshot Module continued the image It may be necessary to adjust this value if the software is having a problem finding the projections at the default distance For instance if an image is overly exposed the projections might not be well defined at the default distance and thus the distanc
178. lvis NOTE The macro routine was re written for PIPSpro version 3 2 4 and is not backwards compatible with macros prepared under PIPSpro version 3 2 3 or earlier Here are some examples of macros that have been found useful on different images from a range of EPIDs AHC Contrast LHE AHC Med Smooth Non linear Median BM blurred mask ES Sharpen ES HS Histogram PIPSPRO SOFTWARE Window Menu Section 2 Using PIPSpro SET The Window Menu contains standard operating system features The file The Help Menu contains two items for accessing information about PIPSpro names Ota Wels piay ed Mage ale ISEA WINA CHEER MAAA ne Clicking User Manual will launch your default internet browser to reference active window the PIPSpro User Manual in PDF format stored on the Standard Imaging website If no internet connection is found a message box will appear Cascade Clicking About PIPSpro will launch the PIPSpro splash screen which shows l FOET l PIPSpro version information and information on how to contact Standard This option will organize all open files in an overlapping fashion This is Imaging useful if you have many images open at once and you only want to see them one at a time Keyboard Controls can be used in many situations This is often faster than using the mouse to open a drop down menu and select a specific item Tile The keyboard controls available in PIPSpro are listed below This option will organize all ope
179. made from this point This allows the software to correctly determine the position of each of the MLC s and accurately determine the distance from isocenter the edge of the MLC is positioned at Fiducial 2 The second fiducial needs to be placed over the spherical marker that is furthest from the center marker in the direction of the opening of the MLC s Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere PIPSPRO SOFTWARE perpendicular to the maximum imaging size This will ensure that as many MLC s as possible will be imaged For some machines the imager is fixed at a distance from the source that makes it impossible to get all or close to all of the MLC in a single image In these situations it is advisable to take more than one image imaging half of the MLC and then moving the imager to capture the other side Image Analysis To load an image choose MLCQA Load Image from the menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your images choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single
180. mage is to be allowed to change size Shift and scale can be specified for both X and Y directions PIPS Manipul Ea r Rotate Center of Image 332 240 C Center of ROI 332 240 Ean Center of Fiducial 0 0 Center of Contour 0 0 C Center of Template 0 0 C Other Center 00 0 0 Change Size Angle Shift Scale x 30 0 pixels m 71 Transform Menu The Transform Menu within the Feature Menu provides a number of im age transformation routines outlined below FFT This command is a Fast Fourier Transform for images It includes forward or backward transformation of an image and display of the power spectrum In its present form this routine is not very useful as there are no filters available in frequency space the capability for filtration is under development Chamfer This routine will chamfer one image onto another It is not as compre hensive as Registration which operates on both the image contours and the patient s anatomical features Chamfer can operate on con tours fiducial points or templates so you need to prepare them on the images For example if you wish to chamfer using contours prepare a contour on each image This may be the field edge for a portal image the skull outline in a CT scan etc If you wish to chamfer using fiducial points prepare a set of points in each image with correspondence between each pair of points Same order and relativ
181. mager Choose whether the data to be trended was collected on the MV imager or the kV imager e Comparison Type Choose whether the data to be analyzed were 2D orthogonal planar images or 3D 3D image set such as a Cone beam CT Clicking Apply will apply your settings and the results will be shown in the right hand panel e Table View all of the data that matches the chosen settings will be shown Values that are outside of the acceptable range will be color coded yellow background for warning and red background for failure 5 Don t Show clicking the Don t Show check box will prevent the data from that date from showing up in the charts e Chart View the data that matches the chosen setting are shown in charts Clicking on the legend name of any of the charted values turns on off that series on the charts 5 Positional Displacement the displacement of the each of the X Y and Z results are shown Clicking on the shapes in the legend below the chart will toggle the results on and off 62 Section 2 Using PIPSpro IGRT Module continued Exporting Data not available in off line mode Data that has been saved to the database can be exported out as a common comma delimited csv format allowing for analysis in the user s choice of software programs To export data click on the Export tab The Linac Select dialog will be shown Choose the linear accelerator you would like to export
182. maging half of the MLC and then moving the imager to capture the other side 46 Section 2 Using PIPSpro Application Menu gt MLCQA continued This first fiducial tells the software that this is isocenter and all measurements will be made from this point This allows the software to correctly determine the position of each of the MLC s and accurately determine the distance from isocenter the edge of the MLC is positioned at Fiducial 2 The second fiducial needs to be placed over the spherical marker that is furthest from the center marker in the direction of the opening of the MLC s Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere The second fiducial tells the software the scale for the image and also which direction the collimator and MLC s are turned Click on the Leaf Position button to perform the analysis 47 Choose the linear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings default for performing the analysis The default settings should work for most images If adjustments are needed the following explanation of each setting parameter should assist with making them e Edge Stren
183. maliza tion click on Normalize with lowest highest values to insert X This should be satisfactory The image demo_7 varian varian 001 has pixel values in the range 0 322 so that the resulting 8 bit image will be mapped to the 8 bit range 0 255 If the image has artifacts pixels with zero values and if you are using an early version of PIPSpro or if the artifact correction does not work set a lower dynamic range place X in bit planes 0 15 or 0 14 until the displayed image is satisfactory 4 6 The Truncate Upper and Truncate Lower controls give you fine PIPSPRO SOFTWARE format and store a 16 bit image in memory At the same time an 8 bit image will be formed from the original 16 bit data by normalization and truncation The image displayed by PIPSpro is the 8 bit image derived from the original 16 bit data which is stored in background The pixel values of both the 8 bit and the 16 bit image can be read using Edit InfoDesk Most operations and all image processing are performed on the 8 bit image although some operations such as invert and rotate ask the user whether the operation is to be applied to the 16 bit images as well The original 16 bit data are used in the analysis of the QC 3 quality control phantom You can also import 16 bit data by selecting File gt Import gt Siemens and File gt Import gt Philips File gt Import gt Varian gt Portal The main difference between these options and Import Other
184. n 0 0 392 5 J 0 372 0 412 10 0 353 0 431 CNR 287 677 10 4 258 909 316 445 15 4 244 525 330 829 Noise 2 702 20 2 162 3 242 30 1 891 3 513 Generate Baseline l QC Trending Reports Cancel Apply Choose the Imager Energy and Phantom to be baselined Click on the Generate Baseline button Choose the QC Results you would like to include in the baseline generation by clicking on the box to the left of the results NOTE The Baseline is an average of the selected QC Results and a larger sample size will give more accurate results m la Replace Baseline Old Value New Value 0 594 0 594 1 7 394 Resolution Fad 2 Resolution F30 Resolution F40 CHR 117 353 117 353 Moise 1 9 271 4 The new baseline values are shown along with the old baseline values You can also manually enter values that you would like to use for your baseline e g values from the table on page 60 5 Suggested values for Accept and Caution ranges are 5 and 10 percent respectively for all values except noise where 10 and 20 percent is suggested due to the fact that noise tends to fluctuate more than the other parameters Note Caution levels must be higher than Accept levels 6 You can then click Apply to apply your changes OK to apply changes and exit or QC Trending Reports to apply changes and go directly to the reports screen 7 Clicking Cancel will exit the Baseline Management
185. n be double clicked to show a plot of the results these include MTF CT Linearity Low Contrast Model Noise and Uniformity Spatial Frequency 50 5 25 1icm 10 19 53 1icm 2 20 89 1 6 Edward Hospital 05 07 2006 Varian Phantom SN 080152 Image 1 NIS kV NIS mA N S msec 241cm Filter Unknown 2 50mm Axial Results can then be printed to a printer or exported to a PDF for record keeping Under Options you can choose to include images and graphs in the PDF report Options Enter Facility Mame Include Images in POF Report Include Graphs in POF Report w Display ROI on Images PIPSPRO SOFTWARE Application Menu gt CBCT continued Section 2 Using PIPSpro SS Pixel Size Noise This procedure computes the mean and standard deviation of the CT numbers within several regions of interest over a uniform module The number size and location of these ROPs are variable but typically five are defined one at the phantom center and the other four along the axes at the same radius covering a 15x15 pixel area These values are reported along with other relevant header parameters that influence these values Slice Width After locating each wire or ramp a profile is generated along the orientation of each ramp A baseline value is determined and then subtracted from each profile The FWHM is then computed for each of the ramps in this test module using linear interpolation A trigonometric conversion
186. n distance from isocenter usually 40 or 60 cm The images are then imported into PIPSpro and analysed with the QC routine The diagram shows the numbered regions of phantom QC 3 The large numbers in the corners are used for subjective qual ity control as they are visible on the image with increasing density Number 1 is machined into a lead block to a depth of 1 mm number 2 to a depth of 2 mm etc The small numbers indicate the region numbers Regions 1 5 are bars with different spatial separations and are used for the analysis of the spatial resolution f Regions 6 11 contain blocks of lead or plastic PVC with increasing thicknesses Oooo S O o Region Bar resolution Ip mm Bar thickness mm 15 mm lead a2 is mm ead 9 po 15 O 8 mm 880 O po mm ead 00 10 Emm iead O 00 8 15 680 These are nominal values Actual values may be different for a specific phantom A calibration card is provided with every phantom Acquiring QC images The phantom is setup on the EPID or at isocenter on a bridge support oriented at 45 to the sagittal plane as shown in the diagram The large number 1 points towards the gantry Lines and marks on the surface of the phantom assist in lining it up to the central beam line For routine daily or weekly quality control it is advisable to mark the surface of the EPID with paint or tape so that placement of the phantom can b
187. n example of processing 2_port omp by AHC with clip level 3 Original image Processed c images demosidemo_ Miel EA O Ed Global Histogram Stretch is equivalent to a simple stretch of the dynamic range A dialog window allows the user to define the initial and final range PIPSpro Global Equalize Stretch E4 To Range Lower lt 0 li Upper 4 255 245 Lancel From Range Lower lt 0 jo Upper 255 255 EXAMPLE This figure shows the difference between Global Histo gram Equalization center image and Global Histogram Stretch right when applied to the demo image 2_port bmp left Both routines used ranges from 40 180 to 1 254 e inages demos demo_ ld Duplicated Duplicated ISIE 229 HINT The AHE algorithm is quite widely known and is provided in one form or another in most of the commercial portal imaging systems A major drawback is that this technique while enhancing the contrast of anatomical structures tends to blur the field edges This is highly undesirable since the field edges are used to define field placement errors in portal imaging The AHC algorithm provided in PIPSpro was developed specifically to address this problem 67 Application Menu gt Dewarp continued AHE Adaptive Histogram Equalization This is a well known technique for improving the contrast see References section The image is divided into regions of 16x16 pixels
188. n files so that none of them overlap This is Function keys useful if you have many images open at once and want to see them all at the same time F1 Help 009 F2 Place insert or delete contour fiducial and template points can be used with magnifying glass Arange teone F5 Select whole image This option will arrange all currently open amp minimized image windows in F7 Toggle templates ON OFF F9 Toggle numbers ON OFF on contour points Close All Keyboard Commands Clicking this option will close all open files at once This cannot be undone Ctrl o open Ctrl s save Ctrlt F4 close Ctrl p print Ctrl d duplicate Ctrl z undo Ctrl c copy Ctrl v paste Ctrl r registration Shft F4 tile Shft F5 cascade Alt F4 exit 74 PIPSPRO SOFTWARE 75 PIPSPRO SOFTWARE Section 3 The QC 3 Phantom 76 Analysis of Data from the QC 3 Phantom 76 Analysis of Data from the QC 3 Phantom 77 Summary of Published Data from the QC 3 Phantom 77 Summary of Published Data from the QC 3 Phantom 79 Parametric Analysis of Image Unsharpness 79 Parametric Analysis of Image Unsharpness PIPSPRO SOFTWARE Section 3 The QC 3 Phantom Analysis of Data from the QC 3 Phantom The QC 3 phantom The QC 3 phantom is used to test the image quality from electronic por tal imaging devices EPIDs Megavoltage portal images are acquired with the phantom placed on the surface of an EPID or at isocenter with the EPID at some know
189. n importing a 16 bit image the pixel values may range from zero to 65 535 2 1 In many cases the useful information is limited to a much smaller range such as 0 4095 when a 12 bit analog to digital converter is used Setting Dynamic Range to 16 select all 0 15 bit planes will normally map data from the range 0 65 535 to the 8 bit range 0 255 and result in a black 8 bit image However if you set Normalize with lowest highest values the conversion will be applied only to data between the lowest and highest pixel values thus ensuring an optimal 8 bit image In this case you can set Dynamic Range 16 even though the original data has only a 12 bit range In some cases the Varian PortalVision will acquire images with artifacts these being lines or individual pixels with zero value Using the File gt Import gt Varian option these artifacts are inverted to 65 535 and so the Normalize with lowest highest values control is ineffective and the 8 bit image will appear totally black This problem can be overcome by setting a lower dynamic range usually 11 or 12 so that the artifacts no longer control the mapping function If you have such an image and it appears black when importing with Dynamic Range 16 try importing with Dynamic Range 15 14 13 12 until the 8 bit image is properly displayed Note that with Importing 16 bit Images continued Section 4 Additional PIPSpro Functionality SS SSS control over
190. n menu or using the keyboard shortcut Ctrl L The user will then be presented with a standard Open dialog in which they may browse for and select the desired image The user will then select Open The image will be loaded into the main view Click on the pull down menu for Linac Manufacturer under the Accelerator Information area and choose the appropriate manufacturer name for your machine Linear Accelerator Information Linac Manufacturer Varian Medical Systems Varian Medical Systems KL T omotherapy Ine Elekta Oncology Siemens Medical AccuR ay Ine Then choose the MLC type from the pull down menu Linear 4ccelerator Information Linac Manufacturer Varian Medical Systems MLC Type BrainLab M3 BrainLab M3 The user can then proceed to setting fiducial points and performing the appropriate analysis 45 MLCQA Purpose Multi leaf collimators MLC are utilized on most modern treatment machines to shape fields to achieve a more conformal delivery in order to spare healthy tissues while delivering maximum dose to the disease site Most MLC feature anywhere from 50 to 160 individual leaves that are designed to be positioned very exactly The motors that drive the leaves can become worn out over time or the leaves themselves can become loose in the carriage and periodic QA is required to determine if any issues exist TG 142 recommends several tests that should be carried out on a monthly or yearly ba
191. n most computers The underscore can then be followed by any other naming conventions Browse List the user would like to add E 4Program Files Standard Imagi A file with the name of 60120090 SRS _Sample_Image dcm would be read in and the gantry angle of 120 and the couch angle of 90 would SAS 1 11 07 0 dcm SAS 1 11 07 120 dem SAS 111 07 170 dem loaded SRS 1 11 07 225 dem Manual To load images manually the user begins by selecting one of the eight SRS 1 11 07 315 dem image boxes SRS 1 11 07 90 dem automatically be entered into the appropriate fields when the image is Gantry Couch l l The images appearing in the Browse List are now available for use in the mm per pix Stereotactic application DEN Loading Images OTS Auto dU mm dV mm The user may elect to have the application load images automatically l This process is similar to setting a load folder From the main menu the user selects Stereotactic Auto Load Images or Ctrl Shift L as a keyboard shortcut The Linac Select dialog will be shown Choose the linear accelerator that the images being loaded were acquired on NOTE This dialog will not be shown in off line mode The background will change to white to show that the image box is now active Next the user selects which image they would like to load into that particular image box highlighting it in the Browse List Then from the main menu the user selec
192. n of one image displayed on the other Select two images for this opera tion by clicking on one window at a time and selecting A or B in the operational window Using the right mouse button move the cursor around in image A and a portion of image B is displayed in the view ing area The size of this area is controlled by Zoom Magnify Lens The size shown in the left list box is multiplied by the power shown in the right list box to give the final size of the viewing area Fk 08 c program files pipspro32 demo images demo_4 m E3 c program files pipspro32 demo images demo_4 m P E3 72 Section 2 Using PIPSpro Macro Menu Shift Changing some of the parameters will be necessary to optimise performance for different images 1 AHC 3 0 Med area 5x5 ES 5x5 scal 1 shift 0 2 Med cross 5x5 BM average 15x15 3 1 0 AHC 3 0 ES 5x5 scal 1 shift 0 Invert BM average 15x15 3 1 0 AHC 3 0 ES 3x3 scal 1 shift 0 AHC 4 2 Med cross 5x5 ES 5x5 scal 1 shift 0 Med col 5x5 BM average 15x15 3 1 0 AHC 3 0 HS scale 0 7 5x5 254 1 invert Invert Med col 5 BM average 15x15 3 1 0 AHC 3 0 Duplicate BM average 11x11 3 1 0 AHE 3 0 Med cross 7x7 0 et Ol HINT If you start your macro with Duplicate see example 8 you will have the original image to compare with the processed image 73 The Macro Menu creates and names a sequence of image processing routines including rotate inve
193. n the bar in between the two areas to allow for more viewing area of the image or the results if needed To load an image choose Radiation Light Field Load Image from the menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your images choose the appropriate image and click Open in the dialog The Linac Select dialog box will be shown NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically In Off line Mode this dialog will not be shown PIPSPRO SOFTWARE The Radiation Light Field Module utilizes images of a combination of two specialized phantoms to determine the coincidence between the light field projected from the head of the linear accelerator and the actual radiation field being delivered When the FC 2 phantom is used in conjunction with the Center Marker Phantom the position of each of the jaws can also be determined The FC 2 phantom features two engraved squares of 10 cm x 10 cm and 15 cm and 15 cm on its face with spherical markers embedded inside each corner The Center Marker Phantom features an engraved cross hair with a single spherical marker embedded in the center of the cross hair Acquiring Images It is recommended that a QA Patient be set up in the record and
194. nalysis Consequently these images must be corrected for spatial distortions before they are used for image registration and analysis of field placement errors This procedure is referred to as de warping Materials and Methods We have developed a test phantom and computer algorithm which char acterizes and corrects distortions found in VEPIDs and Ils The phantom is constructed from a 46 x 38 x 1 cm acrylic sheet in which is embedded a square 12 x 12 grid of lead markers spaced 26 mm apart The distortion phantom can be mounted on the detector surface of a VEPID or in the film holder mounted on the II Each mode of operation of a particular imaging system is calibrated by acquiring images of the phantom at regularly spaced gantry angles for our tests we used 10 gantry angles Images are analyzed by comparing the difference between the predicted and observed marker locations Using this information a set of coefficients can be derived and used to perform if necessary an 11 coefficient 3 order corrective de warp 10 20 30 40 50 60 70 80 ZerothOrder Coefficient 110 O 30 60 90 120 150 180 210 240 270 300 330 360 Gantry Angle Figure 1 Zero order coefficient versus gantry angle Figure 1 shows a plot of the x and y coordinate zero order coefficients versus gantry angle for phantom images acquired on a Nucletron Oldelft Simulix HP MK II simulator which vary sinusoidally as a function of gantry angle
195. nd pixels e Center of Circle The millimeter and pixel position of the center of the circle that will touch each of the projections at the point of intersection For a Hybrid Starshot these additional values are shown e Marker CoG The millimeter and pixel position of the center of the spherical marker in the image e Center Displacement The radial distance between the center of the spherical marker and the center of the circle that touches each of the projections e Closest Approach The shortest distance between the center of the spherical marker and each of the projections Comments not available in off line mode The Comment Area allows the user to enter information related to the results that will be saved to the database and shown in reports 32 Section 2 Using PIPSpro Starshot Module continued Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button al will zoom the chart to the previous level Clicking the Zoom out all levels button ql will zoom the chart to the original level showing all data Printing or Saving a History View Report A report of the data can be printed by clicking on the Print button in the Setting area in the left hand panel A report will be created wit
196. nu c users nmiller desktop pipspro demo im amp Choose Application Dewarp Map Warp from the menu A standard Windows Save dialog will be shown Save the Dewarp Map to the appropriate location giving it a unique name coeff wap is default 1 Delineate the pins in the image Open the Edit Tool by choosing Edit p 9 P 9 y J The Dewarp Map will be applied to the calibration image for Show Edit Tool from the menu or by clicking on the Show Edit Tool a verification of the routine The image should now have any warping button f in the Tool Bar Choose Fiducial from the dropdown removed menu c users nmiller desktop pipspro demo im amp jes Fiducial 64 PIPSPRO SOFTWARE Application Menu gt Dewarp continued Section 2 Using PIPSpro Dewarping images Image Enhancement Once a Dewarp Map has been created the map can be utilized to dewarp The Enhance Menu provides a number of different image processing techniques Often no single process will provide the required degree of enhancement without degrading either the signal to noise ratio or the spa tial resolution and then a sequential application of several routines may 1 Open the image to be dewarped by selecting File Open or File Import be required This can be done with the Macro facility See Macro menu from the main menu For some suggestions on sequential proces
197. o Archived by clicking on the appropriate radio button In the resulting Table View highlight the column for the data that is to be un archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status 59 Multi Port Trend Analysis After clicking the Apply button each Multi Port test will be shown in the results window for the chosen date range Tabs at the top of the results window allow the user to switch between data for the left bank versus the 5 55 55 55 59 59 59 59 59 Ep 10 6 2010 1 59 17 PM 10 11 2010 9 35 47 AM 10 25 2010 12 03 gt right bank For each 0316 5 results the position for each of the five strips shown W Competensive MLC QAJ Fie Appicrtion MLCOA Window No Trending Selected Results will be color coded based on the ranges set in the System Manager No background color results are within the acceptable range Yellow background color results are within the Warning range Red background color results are within the Error range Trending can be accomplished on a per leaf basis by clicking the Trend Leaf box for the leaf you would like to see trended Left Bank Right Bank All Multiport Tests
198. o subtract one image from the other to check for artifacts PIPSPRO SOFTWARE 2 3 3 sci Analysis of Data from the QC 3 Phantom When setting up the QC 3 on a portal imager use the positioning shown in the diagram below to achieve ideal final image orientation When setting up the QC 3 on the included acrylic stand place it on the couch using the positioning shown in the diagram below to achieve ideal final image orientation One points towards gantry 76 Summary of Published Data from the QC 3 Phantom Section 3 The QC 3 Phantom iie Summary of Published Data from the QC 3 Phantom at 50 or 30 maximum of the relative modulation transfer function RMTF The method was originally proposed by Droege 1 and further Prepared by Shlomo Shalev l developed by Rajapakse and colleagues for quality control of electronic The QC 3 phantom is used for evaluating image quality from electronic portal imaging systems 2 3 Portal images are acquired either with the portal imaging systems EPIDs during acceptance testing commissioning phantom placed directly on the surface of the EPID f50 epi to evaluate and routine quality control It determines quantitative objective parameters the detector characteristics or with the phantom at isocenter f50 iso to for spatial and contrast resolution as well as the relative contributions to include the blurring effect of th
199. of the mechanical isocenter lasers versus the radiation isocenter Some users will perform this check with the same gantry and couch angles each time the test is performed Others will utilize specific gantry and couch angles from a particular treatment If the former method is utilized it can be advantageous check the Use stock angles define below and then to define these stock gantry and couch angles so the software will use them each time This saves the user time when importing and analyzing images in the Stereotactic Module If the latter method is being utilized check the Do not use stock angles radio button and the software will either prompt the user to enter these angles after import or will use the naming convention see pg 41 to automatically apply the correct angles at import of the images Save options The Stereotactic Module has the capability of calculating a three dimensional stand offset for minimizing the effects of gantry sag and couch walkout If the user is not interested in calculating the full three dimensional offset the user can allow the software to save data for the two dimensional offsets in plane and cross plane only If this is desired check the radio button Allow saving 2D results for less than 8 images 2D results are also saved when the 3D calculation is enabled Then choose the minimum number of images that need to be analyzed before a save of the data is enabled The user can be au
200. og Choose the linear accelerator you would like to create a report for and click Select The Generate Report dialog will appear Generate Report 21 EX Date Range Select Show All v Start Date 1 1 2000 End Date Generate Cancel e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually Click the Generate button to create the report The report will be shown in the Preview Window The report can be printed to paper or saved as a PDF file Paper printing Clicking the Print 5 button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save Al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file 44 Section 2 Using PIPSpro Application Menu gt MLCQA Opening MLCQA Application To open the MLCQA application the user must first launch and log into the PIPSpro application From there the user will then select Application MLCQA from the main menu The MLCQA application will then open inside of the PIPSpro frame Loading Images and Selecting a Linac Off Line To load an image begin by selecting MLCQA Load from the mai
201. om type Qc3 V v Cancel Energy Level 6MV v Click OK to continue 22 Application Menu gt QC Quality Control contiuned Section 2 Using PIPSpro Baseline Management QC Trending Reports Select Application gt QC gt QC Trending Reports lac Trending Reports Imager aani ERE Operator a Phantom Erom Eneroy omy J w Spatial Resolution CNR Noise Table view ra Cr Cro 1 Select desired imager phantom energy for report 2 Select which operator or all and set dates for report Spatial Resolution Contrast to noise Ratio CNR and Noise Using the tabs and radio buttons view graphs for the f30 f40 and f50 values for Spatial Resolution CNR and Noise The Baseline value is shown by the blue line The green area is within the acceptable parameters the yellow areas represent the caution levels and the red areas represent the reject levels Table View Represents the values in the graphs in table format Show Intermediate Result Shows the raw numbers from each ROI on the QC Phantom that are used in calculating the results in the table Export Selection s Exports the table values in a delimited file format Note Control click or Shift click to choose multiple results to export to a single file Plot Selection s Users can choose which data they would like automatically exported to Microsoft Excel where a Macro automatically creates g
202. on PIPSpro Users and Departments are assigned to a Division therefore the first step in configuration is setting up at least one Division If the PIPSpro system is to be used by a multicenter organization it may be necessary to add more than one Division Divisions can be used to prevent any Department s or User s from viewing information from Department s or User s of other Divisions or can be used to create more manageable groups of Departments or Users Note A Master Division is created at startup This should not be utilized for normal operation of the software Choose File System Manager from the Main Menu The System Manager will be shown System Manager Departments Users Linacs Active Divisions Edit Division Information Below Division Name Master Group Division Users Modify List Division Departments Modify List Archived Divisions All Divisions Save New Close PIPSPRO SOFTWARE To open PIPSpro Software double click the shortcut icon that was placed on the desktop during installation Or you can start the program by clicking on the Windows Start button All Programs Standard Imaging PIPSpro 4 4 Running P IPSpro the first time The first time the program runs it will present you with the following screen Select PIPSpro Database Server NEAL LAPTOPSSULE PRESS 51 5 1 51 5415 ENG 122 1 706 MET 225 16639 PAD 13 1 64 PAD 137 1765 SFT 121 1718 SFT 201 43K SFT
203. on the Start button to re start the service This will set up the logging capability for DICOM Server To remove the logging capability follow the exact same steps but in 3 make the Start parameters text blank NOTE Configuring PIPSpro DICOM Server to log is not recommended un less you run into problems Logging will slow down PIPSpro DICOM Server and the log file could be very large Section 5 Rebuilding the DICOM Server Database DICOM images received are stored in the specified directory see Step 2 of Section 1 for specifying the directory and their records in the DICOM Server database This database file is located in the PIPSpro installation directory Usually you don t need to worry about this file But in case you want to rebuild your database you can do so by using the utility program DicomDbBuilder exe again located in the PIPSpro directory Section 6 Troubleshooting PIPSpro DICOM Server Pm running on Windows XP and after installation the DICOM Server fails to start This typically occurs because the firewall is enabled To solve this problem perform the following procedure 1 Inthe PIPSpro directory find and double click UnregDSvr bat This will un register your PIPSpro DICOM Server Go to the Windows Control Panel and open PIPS DICOM Server Config Write down the port number and close Return to the Windows Control Panel and open the Windows Firewall Select Exceptions
204. opened See page 85 for more detailed information Other forms of the jpeg format may also be encountered such as 24 bit color By selecting Convert to grayscale a 16 bit jpeg image will be uncompressed opened and displayed as an 8 bit 255 grey scale image File Menu continued Section 2 Using PIPSpro De a Use Stock Gantry and Couch Angles Group Print To print a few images in a single page select the number of columns and rows from the dialog window Make the first image window active and click on Add The image icon will be shown in the field of the dialog window Make another image active and click on Add Continue until you have filled all the matrix locations If you do not like the image arrangement click on Reset and change the number of columns and rows After the selection of all images click on Print Up to 24 images 4 horizontal 6 vertical can be placed on a single page PIPSpro Group Printing OF Columns 2 OF Rows eo HINT It is advisable that all the images have similar size as they will be scaled according to the largest image HINT Most of the commercial software systems for portal imaging provide only two windows one for the reference image and one for the treatment image They are usually of fixed size so that the images are arbitrarilty scaled to fit PIPSpro takes a less rigid approach and per mits the operator to open any number of image win
205. opriate Divisions to add and click on the Add Divisions button This will move the chosen Division s to the Associated Divisions list Clicking OK will complete the process of creating the Division Memberships Once Division Memberships have been established a Default Division can be chosen from the dropdown list Setting a Default Division means that all new Users who are assigned to this Department will also be automatically added as Users in the Default Division Password Policy Choose how often you would like the Users in this Department to change their user passwords by entering the appropriate number of months Editing a Department A PIPSpro administrator may change any of the department information entered when the department was created Select the department to be edited from the list on the left This will populate the right portion of the form with the departmental information After all desired edits are complete click Save to save the changes to the database After the save is complete exit the screen by clicking Close Adding Users Once Divisions and Departments are set up the next step is setting up the users In the System Manager window click on Users in the main menu A Superuser account is automatically created during the initial database setup and will be shown Click the New button to create a new user System Manager Divisions Departments Users Linacs Add User Information Below
206. or not Click the Export button to export the data A standard Windows Save As dialog will be shown Name the file and choose a location for saving and click on the Save button to create the file PIPSPRO SOFTWARE Choosing another Linac for History View not available in off line mode Clicking on the Select Linac tab will open the Linac Select dialog Choose the linear accelerator you would like to see a history for and click Select Choose the settings and click Apply The Reports Tab not available in off line mode If you would like to create a report without going into the History View clicking on the Reports Tab will bring up the Linac Select dialog Choose the linear accelerator you would like to create a report for and click Select The Generate Report dialog will appear Generate Report 21 EX Date Range Select Show All v Start Date 1 1 2000 End Date Test Type 6 10X10 C 10X10 Adv 15X15 C 15X15Adv Generate Cancel 4 e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Test Type Choose which type of test to trend by field size and whether the image contained the Center Marker Phantom Adv or not Click the Generate button to create the report The report will be shown in the Preview Window The report can be printed to paper or saved as a PDF file
207. or the IGRT module Using the IGRT Module Open the IGRT Module by choosing Application IGRT from the menu PIPSpro Comprehensive File Edit View Macro Window Help o gt Qc Radiation Light Field StarShot CBCT Module Stereotactic MLCQA IGRT Dewarp b Image Enhancement gt Image Analysis Tools b The module will load in the window with the Image Analysis tab chosen by default W PiPSero Comprehersive DORT O fe Appication IGRT Window Hep image An 19 Export Click on the Linac Select button to open the Linac Select dialog PIPSPRO SOFTWARE Section 2 Using PIPSpro IGRT Module continued o Rotational Displacement if the data contains 6D data the results for Pitch Yaw and Roll will be shown Clicking on the shapes in the legend below the chart will toggle the results on and off o Standard Deviation The standard deviation for each of the results will be shown at the bottom of the Chart View These values can assist the user in deciding if a data point even though it may be in the acceptable range is sufficiently different from previous values to warrant further investigation Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will Zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button 8 will
208. other Linac for History View not available in off line mode Clicking on the Select Linac tab will open the Linac Select dialog Choose the linear accelerator you would like to see a history for and click Select Choose the settings and click Apply 33 History View Tab not available in off line mode As data is collected in the database viewing historical data to determine if the results are trending in a negative way can be a valuable exercise Clicking on the History View Tab will bring up the Linac Select dialog NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically Linac Select Manufacturer Varian Medical Systems Model 21 EX Select Cancel Choose the linear accelerator that the history would like to be viewed for and then click Select in the dialog In the left hand panel the Linac Info is shown along with the Settings area Settings e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually Image Type Choose which type of test to trend by Image Type and Angle Type Clicking Apply will apply your settings and the results will be shown in the right hand panel e Table View all of the data that matches the chosen setting
209. our ID to Standard Imaging and a unlock code will be returned to you within 1 working day Run the software in DEMO mode If you are evaluating the software before purchase click on the demo button LA and the following screen will be shown Registration Product Activation Demo Mode 30 days Clicking the Start button will allow you to use the software application for a period of 30 days Once this period has expired and you have not Registration Each Standard Imaging software application is issued a software key The key is a series of numbers attached to the CD ROM packaging Each key is capable of registering a set number of computers In the case of a computer failure it will be necessary to contact Standard Imaging to release the license that was used on the computer before another computer can be licensed using the supplied key NOTE in the case of a computer requiring repairs any changes to the computer hardware could result in the failure of the license for that computer Upon running the software for the first time you will be shown the registration form Registration Product Activation Please Enter License Code Don t haye an account Create one Login to Nalpeiron Trusted Activation Username Password Forgot your password Click Here Cancel Authorization of a computer with internet access Enter the License Code provided on the CD ROM packaging you have previously licen
210. ouse Button As Middle Button option is not selected 6 HINT To delineate templates click on the template pen symbol Click move the mouse click etc to designate a structure Close the first structure by clicking on the target symbol and then again on the pen to start a new structure When all the structures are complete click on the target symbol to return the mouse to operation as a pointer HINT For more precise work you can also use the magnifying glass by pressing the right mouse button Then points can be placed or deleted by simultaneously clicking on the left mouse button If you don t like to use both mouse buttons at the same time you can place and delete points using your left hand to depress function key F2 while holding down the right mouse button for the magnifying glass 44 Inserts a new contour or fiducial point between any two already existing points Position the mouse at the desired pixel and click on this tool The keypad can also be used here to move the pointer but be sure to select the image first by clicking on the title bar of the image Anew point willbe included and point numbers will be updated automatically Deletes a single point or note Position the mouse at the point or note you want to delete and click Point numbers will be updated automatically gt gt Deletes all points of a given mode or all notes Click on the image and reaffirm your choice when a dialog window a
211. p exe where D is the drive letter of the CD ROM drive 3 You will be shown the PIPSpro version 4 4 Installation Dashboard PIPSPro 4 4 0 Deployment Dashboard Installation Steps ha 9 1 Install PIPSPro 4 D 2 Install SQL Server Express STANDARDIMAGING 3 Create Update SI Database 4 Install PIPSPro DICOM Server 4 Click on the button labeled 1 step 1 to install PIPSPro version 4 4 Accept the default Destination Folder or choose another folder and then click Next NOTE The default folder is C Program Files Standard Imaging PIPSpro 6 The installation program will install the necessary fles Click Finish when complete Working in Off line Mode versus Connected to a Database Several modules in PIPSpro have been designed to be connected to a Microsoft SQL database engine Connecting these modules to the database allows results and other pertinent data to be archived allowing for future review of the data including trending of the data where applicable It is highly recommended that the database be installed and utilized with PIPSpro software However if the decision is made to not install the database the software will allow you to work in off line mode The user should be aware that some functionality cannot be accessed in this mode The QC Database The QC module for performing imager QA in PIPSpro software utilizes a Microsoft Access database titled QC mdb In past versions this database was located in the
212. possible After acquisition export the DICOM RT CT data set to a directory that PIPSpro has access to Open the CBCT module Application CBCT Module and click on Analyze Select Phantom Images EJ CBCT Module Reporting Functions Select Phantom Images Reprocess Last Selection Show Info on Last Selection Click on the drop down list for DICOM 3 0 Directory and navigate to the directory that the image set to be analyzed was stored in PIPSPRO SOFTWARE Application Menu gt CBCT continued Section 2 Using PIPSpro Varian After finding the correct starting slice click on the Auto Select button and the CBCT module will automatically choose the correct Using the arrow button on your keyboard arrow down until you find slices for analysis the image with the MTF bead and the high contrast bar patterns If you hover your cursor over the small thumbnail a larger image will Auto Select be shown Click on the Begin Analysis button and choose whether you would like to save the analysis results in either of the databases or if you prefer a Report Only You may see a warning regarding Gantry Tilt angle This module was originally designed for CT machines which require this analysis Click OK to continue Catphan 504 only The Low contrast module will be shown and you will be asked to identify which size disk you can visualize in the image This is the only subjective portion of
213. ppears PaPa This tool allows you to connect or disconnect contour points by straight line segments This feature is not valid for fiducial points Jn Readjusts the position of a point or note Position the mouse over the point or note press the left button and drag to a new position PIPSPRO SOFTWARE This command cancels the last image processing step A second click on Undo will restore the result from the last step The menu item will switch to Redo after an undo operation has been performed HINT If you make a series of processing steps on an image perhaps with a macro or by selecting one process after another you will only be able to Undo the last step It is a good idea to always select Duplicate first so that the processing will apply to the duplicate image and the original will remain unchanged Copy This command allows the user to copy the part of an image inside an ROI Region of Interest if one has been selected or a whole image Contour fiducial points and templates are ignored Paste This command will paste the copied image in another window If this window contains an image it will be replaced Contour fiducial points and templates are ignored Duplicate This command is used to make a copy of the active window This is faster than Copy New Paste You can make as many duplicate copies as you wish by repeating the Duplicate command Contour fiducial points and templates are also duplic
214. pro Application Menu gt Dewarp continued Emboss This is a filter which creates an impression of an image that has been illuminated by an imaginary source of light Blurred Mask This is a standard image processing procedure The original image A is very heavily blurred to form image B and the final result is the difference A kB where k is a selected mixing factor From the first dialog box select the type of smoothing Average or Gaussian the kernel size and sigma value for Gaussian smooth ing The number of times you want to smooth the image number of passes is set under Operation Number Smooth r Method OF Cancel Average smooth Gaussian smooth Kernel Sigma 7 Operation number of times Bo HINT To do a good smoothing job you will probably want to select a large kernel say 7x7 or 9x9 or even larger If you use Gaussian Smoothing select a sigma value about the same as the kernel size i e 7 or 9 in this example Operation Number 3 or larger will take a little more time but will result in a smoother image The best factor k will depend on your image the amount of noise and the degree of sharpening that is required Try values in the range 0 5 lt k lt 1 5 for best results PIPSpro Dialog Factor k Cancel HINT You should try enhancing your image with a number of tech niques and compare the results For example try AHE CLAHE and Blurred Mask
215. r use of this product depends on careful reading of all instructions and labels CAUTION For accurate results in the MLC QA Module the MLC QA Phantom must be positioned carefully to ensure that the corner spherical marker is aligned to isocenter and that the supporting arm is perpendicular to the gantry rotation CAUTION Only one PIPSpro module can be utilized at a time Switching from one module to another will automatically close the currently open module Make sure to save all information before switching or closing modules CAUTION The MLC module expects all tests to be performed with the collimator at either 0 90 180 or 270 degrees Collimator angle accuracy should be verified before acquiring images for analysis in the MLC module Variance in the expected angle could result in incorrect positions being reported for individual MLC leaves WARNING Issues identified through the use of this product must be investigated and appropriately resolved and or noted WARNING Proper application of the QC 3 Phantom QCkV 1 Phantom and or FC 2 Phantom requires the use of the PIPSpro Software gt gt lt lt D gt lt Table of Contents PIPSPRO SOFTWARE Wa STANDARDIMAGING lt 3120 DEMING WAY MIDDLETON WI 53562 1461 USA WWW STANDARDIMAGING COM General Precautions Section 1 Introduction PIPSpro Purpose PIPSpro Architecture PIPSpro Versions and Modules Installing PIPSpro
216. raphs of the data The data can then be printed or manipulated further by the user Plot All Button Exports all of the data from the chosen date range to Microsoft Excel where a Macro automatically creates graphs of the data This feature is similar to the Plot Selection s function under Table View except all dates are exported The data can then be printed or manipulated further by the user Export All Button Exports all of the data from the chosen date range in a delimited file format This feature is similar to the Export Selection s function under Table View except all dates are exported 23 Before the QC Trending Reports can function correctly baseline values for Resolution Contrast to Noise Ratio CNR and Noise must be established After acceptance testing is completed or after a calibration of your imager a series of one to two QC tests per day over the first 5 10 days should be completed see Quality Control for electronic portal imaging devices EPIDs The results of these tests will be used to create the baselines for the QC Trending Reports Select Application QC Baseline Management QC Baseline Management Imager YaUnitl v Energy 6 MY Phantom oca Baseline Accept Deviation Accept Range Caution Deviation Caution Range Low High Low High Resolution F30 0 6 5 0 570 0 630 10 J 0 540 0 660 Resolution f40 0 472 5 0448 6 10 J 0 425 o5i9 Resolutio
217. rates the calibration parameters used in the de warping equations After initial calibration minimal operator involvement is required to de warp an image and only the mode of operation and acquisition gantry angle must be entered to proceed References 1 E Coste D Gibon and J Rousseau Assessment of image intensifier and distortion for DSA localization studied BUR 70 70 73 1997 2 gt Luchka and S Shalev Image distortion in the Beamview S electronic portal imaging device Med Phys 23 8 1491 1996 3 V Howard and Rosen Correction of spatial distortion in radiotherapy simulator fluoroscopic images Med Phys 23 8 1996 4 E Morton P Evans M Ferraro E Young and W Swindell Development of video frame store and distortion correction facilities for an external beam radiotherapy treatment simulator BJR 64 747 750 1991 5 D Chakraborty Image intensifier distortion correction Med Phys 14 2 249 252 1987 6 L Casperson P Spiegler and J Grollman Characterization of aber rations in image intensified fluoroscopy Med Phys 3 2 103 106 1976 Based on a presentation at the XIIth ICCR May 27 30 1997 in Salt Lake City Utah USA by Kurt Luchka Rasika Rajapakshe and Shlomo Shalev entitled Characterization and Correction of Geometric Distortions in Clinical Radiotherapy Images PIPSPRO SOFTWARE Figure 4 A clinical image exhibiting a geometric barrel distortion Figure 5
218. re acquired on NOTE This dialog will not be shown in off line mode Linac 21 EX Manufacturer Varan Medical Systems Model 21 EX Select Cancel A keyboard shortcut of Ctri F will also open the Set Load Folder screen Browse For Folder Select the folder that you wish to load image files From DEMO_7 3 8 O DEMO_9 gt DEWARP QC O RadLight O Starshot O Stereo O SRS Autoload user routines OB varian O QA BeamChecker Plus RadLight Alpha O RTWorkspace O RTWorkspace 2 0 5 SeedLoc NET Pheweebenti g Alsk v PIPSPRO SOFTWARE Stereotactic Configuration The Stereotactic Module has several configuration settings that will affect the functioning of the module Configuration Manager Login Stereotactic Use Stock Gantry and Couch Angles Save Options Do not use stock angles Save only if 3D results calculated includes all 8 2D result pairs C Use stock angles define below C Allow saving 2D results for less than 8 images Define Stock Gantry and Couch Angles 1 Options for saving 2D results Image Gantry Angle Couch Angle a Minimum images for 2D save 8 7 Warn when about to save less than 3D maes D mae4 if mae5 00 Imge6 mae S images Restore Defaults Save Close Use Stock Gantry and Couch Angles There are several different methods for doing periodic checks
219. re the scale for the image and also which direction the collimator and MLC s are turned Click on the Multi Port button to perform the analysis The software will place search profiles over each MLC and determine the field edge at each of the right and left bank MLC s for each strip The left banks are denoted with red dots while the right banks are denoted with blue dots Results The software will determine the position of each individual leaf in each of the five strips A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window MLCQA Multi Port Results pF SEP Oy Ee ee ee ee a a a 40 co ce auc co oc enc ce encom aco oun ca A A gt 4 9 4 7 9 gt 7 8 6 6 0 8 6 8 0 0 0 8 6 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 8 9 1011 12 13 14 15 16 17 18 19 4 Left Bank 60 Right Bank 60 Left Bank 30 amp Right Bank 30 1 Left Bank Center Right Bank Center 4 gt Left Bank 30 Right Bank 30 Left Bank 60 Right Bank 60 Left Bank 30 Left Bank Center Left Bank 30 Left Bank 60 Right Bank 60 Right Bank 30 Right Bank Center Right Bank 30 Right Bank 60 gt 40 49 7 49 7 49 7 49 8 49 7 49 8
220. rement This provides tools for measuring area angles and distance Area Select Area Click on the image sequentially to define the area to be measured There is no limit to the number of points you may use Close the contour by clicking on or near the starting point The area will be displayed on the image and recorded in the results window in the units selected in the Configuration Settings dialog box The coordinates of the corner points will also be recorded Angle Select Angle and click three times on the image to create an angle The angle and coordinates of the three points will be recorded in the results window Distance Select Distance and click on the image at one point and again on another point The distance will be recorded in the results window in pixels and in the units selected in the Configuration Set tings dialog box Also the coordinates of both points will be recorded Measurement 2_port dem gt No Type Measurement 1 Area 563 0 mm2 211 77 231 92 220 110 205 106 203 92 34 Ange 125 deg 124 372 131 389 149 393 37 Dis 138 pls 138mm 70 1 70 67 308 Ar Angl Dist fea ngle istance Close 1 2 The size of this dialog box is resizeable just drag any border You can delete any line by selecting it and clicking on Delete Save the report as an ASCII file filename dat and retrieve it with Load The file can be opened by File Open use extension 081 or
221. reviations used herein are described in the Digital Imaging and Communications in Medicine DICOM standard parts 1 through 13 NEMA PS 3 1 13 Readers should note the following points This document should not be interpreted as a guarantee of connectivity between the PIPSpro DICOM Server Module and any equipment and or applications offered by other vendors Integration of the PIPSpro DICOM Server Module with the equipment and or applications of different vendors are outside the scope of the DICOM 3 0 standard and product conformance statements Integration and interoperability of different equipment applications are the sole responsibility of the user In the case of any possible connectivity inferred by a user to exist between the PIPSpro DICOM Server Module and another product the user is responsible for testing and verifying the inferred connectivity Future changes to the DICOM 3 0 standard may require alterations to be made to the PIPSpro DICOM Server Module Standard Imaging Inc reserves the right to modify the PIPSpro DICOM Server Module architecture as needed in order to meet changing standards The user should ensure that any existing DICOM equipment also changes with the future developments of the DICOM standards Failure to keep pace with any alterations in the DICOM standards may result in decreased or lost connectivity Implementation Model The PIPSpro DICOM Server Module runs as a service on Microsoft W
222. rforming a test of the imaging and treatment coordinate coincidence on a daily basis to verify that the kV imaging system used to position the patient is aligned to the actual treatment beam Standard Imaging s MIMI Multi lmage Modality Isocentricity Phantom is an example of a phantom that can be utilized to perform this important test The phantom is placed on the couch and aligned to isocenter using the lasers A set of 2D projection images are taken of the phantom using the megavoltage beam and imager These images are then analyzed with the linear accelerator s image analysis system using a 2D 2D matching algorithm The analysis will provide the X Y and Z offsets of the phantom compared to the reference images If the system has the capability the pitch yaw and roll offsets will be provided also This tests the alignment of the lasers with the treatment beam Any offsets are generally applied and then either 2D projection images or a full 3D image set is acquired with the kV imaging system Using either the 2D 2D or 3D 3D matching algorithms on the imaging system the offsets are measured to determine the alignment of the kV imaging system with the treatment beam The IGRT module allows the user to track and trend these offsets which is an important method for detecting possible machine issues that could lead to clinically relevant errors Because the IGRT module requires the ability to save data to the database there is no off line mode f
223. rify system so that the fields that need to be delivered in order to acquire the necessary images can be created Having these fields set up will allow easier setup and will ensure that the images are acquired in the same manner each time To perform this test a comb pattern is created with the MLC leaves All leaves are opened to create a 10 cm wide opening then every other leaf on each bank is opened another 5 cm This can be done as a symmetric or asymmetric comb The MLC phantom is set up and the EPID is raised to the highest position possible without a collision with either the couch or the phantom to ensure that as many of the MLC as is possible can be acquired on the imager For machines Varian in which the maximum imaging size is across the imager it is advisable to turn the collimator 90 degrees so that the MLC s travel is perpendicular to the maximum imaging size This will ensure that as many MLC s as possible will be imaged For some machines the imager is fixed at a distance from the source that makes it impossible to get all or close to all of the MLC in a single image In these situations it is advisable to take more than one image imaging half of the MLC and then moving the imager to capture the other side Image Analysis To load an image choose MLCQA Load Image from the menu or use the Ctrl L keyboard shortcut A standard Windows File Open dialog will be shown Navigate to the folder that contains your im
224. rt and duplicate To generate a macro open an image and select Record A Macro Record ing window will be opened Now process the image using a sequence of operations Each process will be displayed in the Macro Recording window together with its parameters To end the processing sequence click on Stop Record from the Macro menu and enter a name and optional description Note that the size of this dialog box is resizeable just drag any border FIFS pro Macro Recording MedianCrass 5 Blurrnask 0 7 415 3 0 1 0 4HC 16876 3 00 ES 23 cal 1 shitt 0 To delete an already existing macro click on Delete Macro select its name from the list that will be displayed and click on Delete This dialog box also allows you to edit the name or description but not the macro steps To process an image using a macro first open the image and then select a macro from the drop down list The description and processing steps will be displayed Any of the steps can be selected or de selected by clicking on the check boxes Select lt OK gt to process the image x Record Stop Record PIPS pro Macro Execution Description of the Macro Delete Macro Median filter cross a Cancel Res ave 15815 3 k 1 0 Cancel Seq AHE 8 Sharpen ES 3x3 Sharpen N Duplicate Lung 25h MedianCross 5x5 H H Ghd Blurmask 0 1515 3 0 1 0 H H 2 y 1 50 shitt Pe
225. rt can be printed to paper or saved as a PDF file for electronic record keeping by clicking on the Print button in the left hand panel In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Linac Information Paper printing Clicking the Print button in the preview will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save A button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Saving the data to the database not available in off line mode Clicking the Save button in the left hand panel will insert the data into the database for future trending and analysis PIPSPRO SOFTWARE Results A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window 15x 15 351000 RadLightdem Coincidence Results Displacement Chart Radiation Light Field Disp X Y 0 14 0 87 mm 4 Radiation Crosshair Disp xmo 0 04 mm 3 Light Field Crosshair Disp XY 0 13 0 91 mn 2 SS 1 Phantom Dimension X 15 00 X 15 00 cm Field Dimension X Y 14 94 X 14 98 cm 1 Field Rotation 0 05
226. s all the physical effects occurring in the detector that may impact the image quality and introduce blurring ef fects In a fluoroscopic EPID this includes the electron path length in the conversion plate and phosphor the optical system camera and data image processing In a liquid ion chamber and a solid state detector am Si the effects include the electron path length in the conversion plate and the liquid solid detector material and the data read out and processing techniques The parameter E is generally unknown and can be determined by experimental measurement with the QC 3 test phantom Changes in the value of E may indicate problems with the optical system electronic components signal acquisition or other contributing factors to the final image PIPSPRO SOFTWARE Section 3 The QC 3 Phantom Parametric Analysis of Image Unsharpness continued Figure 1 P 1 27 mm 1722 5 Unsharpness at isocenter mm 100 120 140 160 180 200 Source to detector distance cm Figure 2 P 1 27 mm E 1 77 S 4 65 0 100 120 140 160 180 200 Source to detector distance cm The values of E for these two EPIDs are almost identical but there is a very significant difference in the focal spot size parameter S and the optimal distance for locating the EPID Figure 1 is typical of a Varian PortalVision Mark 2 and indicates that the source to detector distance SDD should be gt 140 cm for optimal spatial resolution Figure 2 s
227. s will be shown Values that are outside of the acceptable range will be color coded yellow background for warning and red background for failure 5 Don t Chart clicking the Don t Chart check box will prevent the data from that date from showing up in the charts e Chart View the data that matches the chosen setting are shown in charts Clicking on the legend name of any of the charted values turns on off that series on the charts 5 Displacement Chart the displacement of the each of the results are shown Clicking on the shapes in the legend below the chart will toggle the results on and off PIPSPRO SOFTWARE Section 2 Using PIPSpro Starshot Module continued The Export Records dialog will appear Export Records 21 EX Date Range Select Start Date 1 0 End Date 1z 17200 Image Type Image Type o Angle Type Angle Type 5 caw e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually Image Type Choose which type of test to trend either Regular or Hybrid e Angle Type Choose the angle type of test to trend Gantry Couch or Collimator Click the Export button to export the data A standard Windows Save As dialog will be shown Name the file and choose a location for saving and click on the Save button to create the file PIPSPRO SOFT
228. sed a Standard Imaging product using the Nalpeiron licensing system enter the Username and Password previously created If you do not remember your password click on the Forgot Your Password link and you will be directed to the Nalpeiron website where you can retrieve it If you continue to have problems please contact Standard Imaging support NOTE Please do not create a second account To create a new account click the Create button and the following screen will be shown Registration Product Activation Please fill out the form then select register License Code 1 23456789 Usemame TADE ETE Password J l Confirm Password First Name Last Name Email Company Name Position In Company Phone Number Address City or Town Fax Number State or Province Zip code or Postal code Country PIPSPRO SOFTWARE Installing PIPSpro continued 7 purchased a perpetual key the registration software will disable the use of the software Transferring a license All Standard Imaging software licenses are tied to the specific ID of the computer the software is installed and registered on If your software is going to be removed from a computer or if the computer that the software is installed on is no longer going to be utilized it is necessary to release the license that is in use for the installation Removing a
229. sequence Rotate 180 flip flop Invert Scale x0 5 in order that the images will be displayed in a convenient format The CART import is specific to this image format PIPSPRO SOFTWARE Dynamic Range is the amount of useful information stored in an image usually expressed in significant bits Original Varian PortalVision images have a dynamic range of 12 bits and are stored in 2 byte 16 bit memory using the IBM PC byte order The other images listed in the table have a dynamic range of 8 bits Most film scanners as well as Poseidon and CART images have a 12 or 16 bit range For 10 12 14 or 16 bit images use Dynamic Range 16 unless the displayed image is not acceptable in which case refer to the Importing 16 bit images section of this manual Pixel Size the number of bits required to store each pixel The options available are 8 or 16 bits Width Pixels number of pixels in the horizontal direction Height Pixels number of pixels in the vertical direction Head size in bytes the size of the data segment immediately before the start of pixel data PIPSpro calculates this value by subtracting width x height N from the total file size where Loe is the number of bytes per pixel byte t Dynamic Range in bits allows the user to set the dynamic range of the image being imported by selecting or unselecting the individual bit planes in the Dynamic Bit Setting window This option appears only when a 1
230. sing see Tutorial 5 and the Sequential image processing section of this manual images acquired with the same setup Usually image processing is done within a pre selected ROI Region Of Interest To select a ROI just press the left mouse button and move it over the image A rectangle will be displayed Click again to delete the ROI The pixel coordinates of the ROI are displayed in the Information Desk The de fault ROI is the whole image which can also be set by Edit Select Whole PIPSpro does not provide ROIs with arbitrary shapes PIPSpro Anthmetic Operation UpperBound 254 Cancel J LowerBound 2 Choose Application Dewarp Dewarp from the main menu A standard Windows Open dialog will be shown Navigate to the location where Arithmetic Operation This allows shifting and or scaling the grey level scale of the image The Map will be applied to the image and the dewarped image will be either inside or outside the ROI if present All values larger than 255 displayed will be set to 255 and all values less than 0 will be set to 0 by default The corresponding values for shift scale and the range can be selected from a dialog window the Dewarp Map has been saved Choose the file and click Open In the example shown in the figure all pixels inside the ROI will have their grey values increased by 50 subject to an UpperBound of 254 Histogram Shift For a description of this algorithm see
231. sis which the MLC module will assist the user in completing The MLC Phantom A specialized phantom is included with the MLC application along with the Standard Imaging In Air Comparison Jig REF 72193 The Jig is utilized to position the phantom so it is aligned with the isocenter of the treatment machine without having the Couch in the way of the beam When assembled the phantom and Jig will look like this The phantom contains five 5 radio opaque spheres that are embedded in an Ll shape The marker that makes the corner of the L shape should be aligned to isocenter using the in room lasers NOTE It is imperative that the phantom be aligned carefully The corner marker should be aligned to the central axis and the phantom should be leveled to the isocenter plane The two sides of the phantom should be aligned as carefully to the field alignment lines either from the projected light field or the lasers whichever is most convenient Failure to align the phantom carefully could result in erroneous values being reported for leaf positions With a single setup the phantom can be positioned so that the Collimator can be positioned at 0 degrees or at 90 degrees which on many machines will allow more of the field to be captured on the EPID Images can then be obtained of the MLC shapes for Gantry angles of 0 and 180 degrees with the same single setup The base of the phantom that is inserted into the Jig can be rotated 90 degrees to a
232. soft improve SOL Server features and aersices Setup Support Rules Default istae Setup Support Fukss 1 EEEE A ated als ol abet falas lass et eat are opboral trewis 2 of 6 Cond 7 E R E fares soe SoS ears ee Sas Instance Configuration Irtance Configuration Disk Space Requrements Instance DD o ee Dn Instance roct directory C Program Files Microsoft SQL Server Error Reporting E 5 Installation Configuration Rules SQA Server drectory C Program Files Microsoft SQL ServerM55QL10_S0 MSSQUSERVER Configuration Fuses SQLEXPRESS SQLENgine SQLENg Express 9 00 1399 05 lt Shared Componen Tools Took Too s 9 00 1399 06 3 lt 4 11 The next screen will ask what credential to use Click on Use the 16 The next screen will show the installation progress This will take same account for all SQL Server services several minutes to complete 12 Then hit the drop down menu next to Account name and select NT Authority System fa SQL server 200802 setup Server Configuration Specify the service accounts and collation configuration Setup Support Rules Service Accounts Collation Feature Selection Installation Rules Microsoft recommends that you use a separate account for each SQL Server service Instance Configuration Service Account Name Password Startup Type Disk Space Requirements SQL Server Database Engne
233. st enhancement noise reduction and edge sharpening The difficulty in applying a sequential enhancement process stems from the impact of each step on the results obtained by previous steps Consequently the algorithms to be applied and their sequential order must be carefully selected Low contrast seems to be the major deficiency of portal images It may be improved by the application of one of the many histogram equalization techniques 1 2 3 4 PIPSpro provides a selection of routines based on Adaptive Histogram Equalization AHE and Adaptive Histogram Clip AHC The increased noise in the image after contrast enhancement requires the application of a noise reduction filter At the same time the edges and enhanced contrast must be preserved For this reason we prefer to use a median filtration 5 Its drawbacks are an increased amount of computation and the annihilation of thin lines PIPSpro has an optimized median filter with selectable shape and size The final step should be some form of edge sharpening and PIPSpro provides a variety of routines including ES Edge Sharpen which was specially developed for portal images The objective of this step is to sharpen the boundaries between regions of different grey level values The ES technique is based on the evaluation of the maximal offset of the grey level value of the pixels from an average value in the horizontal and vertical directions It can be described in the following way Le
234. stand offset that will minimize the distance between the accelerator isocenter and the target There is a list of Gantry and Couch angles used in the Low paper which are listed here although any combination of Gantry and Couch can be used Gantry Couch 60 180 130 180 230 180 300 180 60 90 130 90 230 270 300 270 Using the Stereotactic Module Opening and Closing Stereotactic To open Stereotactic the user will select Application Stereotactic from the PIPSpro main menu The Stereotactic application will then be displayed in the PIPSpro frame aes Stereotactic Window Help Search Offset a Ay Results I Gantry amp Couch s verified 270 S To close the Stereotactic application the user will select the Close button Calculate dX mm dY mm dZ mm from the upper right of the application Stereotactic will close but the PIPSpro frame will remain open Selecting the red in the upper right of the PIPSpro frame will close both Stereotactic and PIPSpro simultaneously 39 Application Menu gt CBCT continued Low Contrast This procedure calculates a theoretical Contrast Detail curve based on the noise value at the center of the uniformity module This represents a conservative estimate of the minimum contrast level required so that a cylindrical object of the given diameter should be discernible The result screen
235. t E denote the grey level of the pixel ij of an image where and j 1 2 m 1 2 are pixel screen coordinates in the x and y directions respectively is changed to a new value according to the formula J E KOE 1 where AE if 0 gt AE AE AEY otherwise 2 AE Ej 0 j 0 3 AE Ej Ej j p 4 and the scale factor k is a positive number The figure illustrates the performance of ES in the one dimensional case The solid line denotes the initial grey level image consisting of 18 pixels Vertical lines at pixels 5 and 12 delineate the gradient which is to be sharpened Dashed and dotted lines show how the pixel value will be changed at k 2 and k 5 respectively The proper value of k will depend on the character of the image and the desired effect Parameter p is selected by setting the filter size Experiments with portal images suggest that suitable values are 3 lt psf PIPSPRO SOFTWARE Section 6 Appendices Appendix D Stereo Algorithms Coordinate transformation Consider an un rotated gantry coordinate system as shown on the right K L M and U V W are M points in the un rotated and rotated gantry coordi nate systems respectively If the gantry is rotated through an angle 0 the two points are related by the expression U 1 0 0 K 0 cos sind x L W 0 sin 0 M Similarly let K L M and X Y
236. t bank is denoted with red dots while the right bank is denoted with blue dots Results The software will analyze the image and determine the average position of the central leaves This value will then be rounded to the nearest millimeter that is a multiple of 5 This number will then be considered to be the correct value for each subsequent leaf For example if the average position of the middle ten leaves on the left bank is 10 34 mm the software will determine that the programmed position for that bank was 10 00 mm All results are then measured from this position A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window EEEN eae Farce Gee Weems ey ese ay ey Ses ea ee ey ee Soar Fe Sam ee en Canes ag PD Pek ae ee ae ay Le Ee a ae ds a ee fae i de les ed Heme ere BT Beat for Ot ta R Pt el Pe OM et ee PE a eee fe Wt mt ioe tte eet Heme te hig tl bags Wie malian ert ht deat te Be Right Bank N A N A 51 6 514 5 514 5 5 At the top of the results window is a graphical representation of each MLC s position measured in millimeters The graph will feature color coded bands in order to easily determine if an MLC is within acceptable ranges or not Green results are within the acceptable range as set in the System Manager Yellow results are within the Warning range as set in the System Manager
237. t display bitmap format and it can be processed manipulated and saved using the usual PIPSpro commands The 16 bit image is held in the background and both the 8 bit and 16 bit image pixel values can be read with the Information Desk tool d pips32 images dicom1 dem EG Position pixel 8 187 22 32 16 723 88 Section 6 Appendices Appendix B Dewarping Distorted Images ey yH 4 GREEDY GRRE lt i gt Figure 3 Same image as Figure 2 but after de warping 89 Dewarping Distorted Images Introduction The verification of patient setup accuracy in radiotherapy is often accom plished by comparing a portal verification image with a gold standard typically a digitized simulator film an image acquired from a fluoroscopic image intensifier Il mounted on the simulator or a digitally reconstructed radiograph The location of anatomical landmarks in relation to the treatment field contour is compared in both images and it is a reasonable expectation that this procedure should be accurate to better than 1 mm However im ages obtained from video based electronic portal imaging devices VEPIDS from camera based film digitizers or from II tubes may exhibit significant geometric distortions which would introduce errors of more than 1 mm into any quantitative image registration or field shape a
238. t editor save 85 Ippe Profile PR Profile gt PAF Text File TT Select extension TXT to see the names of other text files and change the extension of the file to be saved to txt before saving it You can open this txt file with PIPSpro Notepad Write or similar programs This file shows the row or column of the profile the highest value and location and the profile data points only the first 8 data values are shown here Highest pixel 147 At position 8 182 Histogram This creates a histogram of the whole image or ROI When selected a dialog window opens with different options To obtain a histogram of the whole image select Whole Image and Update To obtain a histogram of an ROI draw the ROI select Selected ROI and Update 69 This detects small objects such as markers or pins Edit Tool E or gold seeds Once detected they are saved as Fiducial fiducial points and all the usual features of EditTool for fiducial points apply save retrieve delete move export as a data file and so on This feature will be especially useful if you have pins or gold seeds in both the reference and treatment images and want to use them for registration If you click on Pin Detect the EditTool will open and you can select the Pin Detection cursor Using the Pin Detect cursor and clicking on the image will initiate a search around the cursor for a pin or seed defined as a small circular
239. t in the System Manager No background color results are within the acceptable range Yellow background color results are within the Warning range Red background color results are within the Error range The sum of the two positions will also be shown Reset After an analysis has been performed the user has the option of resetting the image This will clear all results overlays and fiducial points allowing the user to start over This is done by selecting the Reset button Close Image To close the image select MLCQA Close Image or use the keyboard shortcut Ctrl W The application will close the currently displayed image If multiple images have been loaded the user must instruct the application to display the image they wish to close before instructing the application to close the image Printing Results Once results have been calculated a detailed report can be printed to paper or saved as a PDF file for electronic record keeping by clicking on the Print Results button in the left hand panel In Offline mode when a request to print a report is made the module will request the user to enter a Department Name and a Linac ID to include in the report header Linac Information Page PIPSPRO SOFTWARE The software will place search profiles over each MLC and determine the field edge at each of the right and left bank MLC s The lef
240. t with the phantom on the surface of the EPI Magnification with the phantom at isocenter Me magnification with the phantom on the surface of the EPID EPID Linac P Resolution f _lp mm M 5 5 M opt isocenter on EPID PortalVision 2300CD 1 27 0 309 0 266 1 44 1 03 1 46 2 95 1 43 Varian aS500 CL21 EX 0 78 0 443 0 392 1 50 1 032 1 06 2 13 1 38 Beamview MX2 0 80 0 299 0 267 1 44 1 015 1 72 3 36 1 32 Siemens FP 0 40 0 485 0 621 1 44 1 015 0 71 2 82 1 08 SRI 100 SL 25 1 17 0 247 0 195 1 64 1 030 2 37 3 15 1 70 Elekta Miew SL 20 0 57 0 243 0 188 1 64 1 030 2 68 3 08 1 79 Elekta ViewGT Precise 0 40 0 342 0 451 1 64 1 030 1 06 3 30 1 12 TheraView Saturn 41 0 78 0 295 0 240 1 44 1 015 1 97 207 1 58 PORTpro Cobalt 60 0 57 0 141 0 162 1 60 1 02 3 09 7 87 1 16 Based on the presentation Image quality in electronic portal imaging devices A quantitative comparison S Shalev K B Luchka Manitoba Cancer Treatment amp Research Foundation Winnipeg Canada and R Rajapakshe British Columbia Cancer Agency Vancouver Canada AAPM Annual Meeting Philadelphia 21 25 July 1996 Medical Physics 23 1131 1132 1996 81 PIPSPRO SOFTWARE PIPSPRO SOFTWARE 83 PIPSPRO SOFTWARE Section 4 Additional PIPSpro Functionality 84 Importing 16 bit Images 86 DICOM Server Utility 86 DICOM Server Utility PIPSPRO SOFTWARE Importing 16 bit Images Section 4 Additional PIPSpro Functionality
241. ted area has a pixel intensity of 20 and the non irradiated area had a pixel intensity of 240 and the edge strength is set to 50 the edge will be considered where the pixel intensity is 110 240 20 5 If the intensity is set to 40 then the edge will be found where the pixel intensity is 88 240 20 4 For the Leaf Transmission module this value is used for the software to correctly determine the area of the openings around the fiducials so these areas can be ignored in the analysis e Pixel Size This value will automatically be determined from the image once the calibration marks have been placed A Window Level bar on the left of the image can be used to adjust the brightness and contrast Two fiducial marks need to be placed on the image PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt MLCQA continued Close Image To close the image select MLCQA Close Image or use the keyboard shortcut Ctrl W The application will close the currently displayed image If multiple images have been loaded the user must instruct the application to display the image they wish to close before instructing the application to close the image Printing Results Once results have been calculated a detailed report can be printed to paper or saved as a PDF file for electronic record keeping by clicking on the Print Results button in the left hand panel In Offline mode when a request to print
242. th File Edit View Query Debug Tools Window Community Help 6 name oF 3 U master Execute gt v i My GHG E S EAL 4 Object Explorer 2 X DBScripti sql MKT 222 1790 2 x vax 5 Connect to Server i Connect 3 a 2 Current connection parameters MKT 222 1790 SQLEXPRESS SQL Server 9 0 5 USE master EHAA Datab Mi fte GO E Aggregate Status 0 m Gi Security panenna Object Database SISoftware Script Date 11 04 2008 14 46 12 Connection faks GA Server Objects CREATE DATABASE SISoftware ON PRIMARY Elapsed time gt m C Replication NAME N SISoftware FILENAME N C Program Files Microso ft SQL Server A Management LOG ON 6 NAME N SISoftware_log FILENAME N C Program Files Microsoft SQL Ser Name ME EAT Go Rows returned 0 EXEC dbo sp dbcmptlevel dbname N SISoftware new_cmptlevel 90 Start time GO State Open 5 D b E IF 1 FULLTEXTSERVICEPROPERTY IsFullTextiInstalled Connection erver type ata ase ngine begin Connection name MKT 222 1790 SQI EXEC SISoftware dbo sp_fulltext_database action enable Connection Details 7 A end 6 lap o ps Server name S CASCO56E 76CA 5 c ALTER DATABASE SISoftware SET ANSI_NULL_DEFAULT OFF ns 51 00 0505 76C4 co Co sr ALTER DATABASE SISoftware SET ANSI_NULLS OFF Connection start uthentication 2 7 a S CASCO56E 7BCA SGLEXPRESS Conne
243. the appropriate data is highlighted click on the Archive Selected button in the left hand panel Record Status To un archive data switch the Record Status View to Archived by clicking on the appropriate radio button In the resulting Table View highlight the column for the data that is to be un archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Restore Selected button in the left hand panel Record Status PIPSPRO SOFTWARE Zooming in chart view For either of the charts clicking within the chart and dragging to another position in the chart will Zoom the chart in on the data that was encompassed in your drag area Clicking the Zoom out one level button a will zoom the chart to the previous level Clicking the Zoom out all levels button will Zoom the chart to the original level showing all data Archiving Data data is saved to the database that is not relevant the data can be archived so that it does not show in either the Table View or the Chart View To archive data in the Table View highlight the column for the data that is to be archived by clicking on it Multiple columns can be chosen by using the Shift continuous or Alt multiple choice keys when clicking When the appropriate data is highlighted click on the Archive Sele
244. the MLC s Click anywhere near the marker on the image and the software will perform a search for the marker and automatically place the fiducial over the center of the sphere The second fiducial tells the software the scale for the image and also which direction the collimator and MLC s are turned Click on the Leaf Transmission button to perform the analysis The software will place profiles at 5 cm from isocenter in either direction to measure a background value for the image Two profiles will then be placed 2 cm from isocenter to measure the amount of inter leaf leakage A single profile will be placed at isocenter to measure the inter bank leakage ignoring the open areas 55 Linac Select SIRO 21 EX M3 Linac 21 EX Manufacturer Varian Medical Systems Model 21 EX Choose the linear accelerator that the image was acquired on and then click Select in the dialog The image will be shown in the right hand panel of the screen The linear accelerator data will be shown in the left hand panel along with the settings default for performing the analysis The default settings should work for most images If adjustments are needed the following explanation of each setting parameter should assist with making them e Edge Strength The 50 default value describes the grayscale pixel intensity between the area of irradiation and the non irradiated area For example if the irradia
245. the analysis Simply type in the size of the disk you can visualize and then Return Enter Unknown degrees Field 241 mm Table 42 50 Filtetm Unknown 4 5 msec varian Imaging Laboratones 080752 Switzefland Elekta Using the arrow button on your keyboard arrow down until you find the image with the CT density plugs and the ramps for the calculation of the slice thickness shown Choose the slice that has the ramps at the 12 3 and 9 o clock positions and the four alignment marks on the border of the phantom Enter the smallest of the 1 rods visualized mm 36 SOFTWARE Section 2 Using PIPSpro Application Menu gt CBCT continued Creating Reports Choose Reporting Functions from the menu to create reports that can either be viewed onscreen printed or saved as a PDF file Display Report This function will display a screen version of the report This report will not contain any images or graphs Clicking the Print button in the view will send a version of the report to the default printer Print Test Results A report will be sent to the default printer This report will not contain any images or graphs Save Report as PDF File A report will be generated and a standard Windows Save As screen will be shown Choose the location that the PDF file should be stored default is the Test Reports folder in the PIPSpro installation directory and c
246. tings dialog box DICOM tab separated by a colon so that File gt Open will recognise these files as DICOM format General Calibration DICOM DICOM File Extension e g DCM SLC f DCM SLC IMG Reset PIPSPRO SOFTWARE The DICOM Format 1 Opening image files in DICOM format PIPSpro will open files written in DICOM format The files must be saved to the C drive of the computer in which PIPSpro is installed or be available on another drive accessible by PIPSpro The command File gt Open displays a browse window and the operator selects the path and a file filename dcm with the DICOM extension dcm Dicomt dem Files of type Dicom DCM Cancel File name Mapping File DMP All Files PIPSpro Import File Format Total Size OF the Image 2 Pixel Size ln Bitz Dynamic Range In Bits 16 ane width In Pixels 256 Height In Pixels 256 Head Size In Bytes jo Signed 16 bit W Normalize With Lowest Highest Values Proportional Adjustment No 7 Yes By Insertion Yes By Interpolation The Import File Format window is then displayed The pixel size width height and format are set automatically from data extracted from the image header The operator may adjust the truncate settings if required but usually it is sufficient merely to click on lt OK gt The image will then be displayed This is an 8 bi
247. tomatically warned if data is being saved for 2D information only by checking the box Click Save to apply your changes and then Close to exit the Configuration Manager Clicking Close without clicking Save will exit the Configuration Manager with no changes Clicking the Restore Defaults button will restore the settings to the default state Do not use stock angles and Save only if 3D results calculated 40 Application Menu gt Stereotactic Module continued Section 2 Using PIPSpro The application will present the user with a standard Browse for Folder built intelligence into the Stereotactic Module which will recognize the dialog in which the user will select the desired folder The selected folder gantry and couch angles if included in the file name For the automatic should contain files of the appropriate type to be viewed manipulated in detection to function the file name should be in the following format the Stereotactic application The user will then confirm the browse dialog GHHECHHH AnyOtherFileName dcm The application will list the file names found in the selected folder in the It must start with the letter G upper or lower case followed by Browse List the numeric gantry angle followed by a C upper or lower case followed by the numeric couch angle which then must be immediately Analyze Images Results History followed by an underscore _ shiftthyphen o
248. ts Stereotactic Load Image or Ctrl L The application then loads the selected image and automatically analyzes the position of the ball marker in relation to the field center The user Saude Department l Varian 52 SIRO repeats this process until each of the eight boxes contains an image Setting Gantry and Couch Angles Once the images are loaded the user must enter Gantry and Couch angles for each of the images This is done by simply entering the values into the piece appropriate fields next to each image a Gantry Select Cancel 4 mm per pixel 02 The application then presents the user with a standard Browse for Image File Folder dialog in which the user will select the desired folder and 000 58560 confirms the dialog The application will then list the file names found m dU mm dV mm in the selected folder in the Browse List The application will also load 2 02 the first eight images and automatically analyze them Auto Load and Gantry and Couch Angles The DICOM standard does allow for the inclusion of the Gantry and Couch settings during an image acquisition Unfortunately most vendors choose not to include that data in their DICOM exported images To speed up the analysis for our users Standard Imaging has 41 PIPSPRO SOFTWARE Section 2 Using PIPSpro Application Menu gt Stereotactic Module continued Once the calcul
249. ur computer with a colleague set up your own directory for temporary files and let your colleague set up another one Calibration Tab specifies the ratio between the number of pixels in a horizontal segment and its length You can select which units are to be used up to 3 characters such as mm cm inc and so on To set the calibration you need to view an image with a known field size or an object of known length Use InfoDesk and the middle mouse button to measure the length of the object in pixels and then enter this value and the proper length in the Configuration Settings dialog box 15 The active image may be saved to disk with the selection of the path and file name This is useful if you want to save a processed image in which case the name and or path should be changed in order not to overwrite the original image Also you may wish to save the image in a different file format than the original For example a 12 or 16 bit image can be saved as a bitmap bmp so that it can be opened by another application Or an image may be saved as a Tiff file t f or as a compressed JPEG file Save File 1mm shift horizontal bmp 2 GI 2 5mm45 degree offset bmp My Recent El 2mm shift horizontal bmp Documents 6 Desktop My Documents 98 My Computer My Network File name HybridStar bmp a Places Save as type Bitmaps BMP M Cancel Saving a file in a JPEG format filename jpg
250. use the option in the Configuration Settings dialog box to show the Import Dialog box This will be displayed when you next attempt to open a jpg image and you can set the parameters to 16 bits width 1024 Height 1024 and Format IBM PC After using this option once it should be possible to deselect it so that it will not be displayed when subsequent jpeg images are opened PIPSpro Import File Format Truncate gt Total size of the image 2097152 0 x OK Pixel size in bits 16 id Upper fo A Caen Dynamic range in bits 16 Format width in pixels 1024 IBM PC C MAC UNIX fos Height in pixels fi 024 0 Head size in bytes igned 16 bit M Normalize with lowest highest values Proportional Adjustment No Yes by insertion C Yes by interpolation General Calibration DICOM JPEG Open JPEG image I Show Import dialog for 16 bit grayscale image Save JPEG image Image quality factor 0 100 75 Cancel Some jpeg images may be found in 24 bit format although this is not common in medical imaging They can be converted to 8 bit format 255 grey levels by selecting this parameter in the Configuration Settings dialog box JPEG tab In practice you can leave this parameter selected for most applications in medical imaging 85 as windowing If you are not interested in the lower valued pixels for example if they are background outside the
251. utilizing intensity modulation and organ immobilization W Grant Ill J McGary D Bellezza P Nizin Med Phys 24 6 1023 1997 Setup reproducibility in radiation therapy for lung cancer A comparison between T bar and expanded foam immobilization devices R Halperin W Roa M Field J Hanson B Murray Int J Rad Oncol Biol Phys 43 1 211 216 1998 A comparison of clinical experience and quality assurance with a gantry mounted Philips SRI 100 and a mobile EPl system ELIAV PORTpro B Bannach Doll D Lansing G Schmitt Proc Workshop on Electronic Portal Imaging Phoenix Oct 1998 pp 39 40 Image quality assurance for a Varian PortalVision EPID H J Kim R S Sloboda Proc Workshop on Electronic Portal Imaging Phoenix October 1998 pp 95 96 Quality control in digital portal imagers Abstract in English text in Dutch P H Vos G A N Coenen S A J M Versmissen Clinical Physics Journal of the Dutch Society of Clinical Physics 98 1 27 31 1998 Erfahrungen mit dem Hochenergie Bildsystem Siemens Beamview Plus im klinischen Routine Einsatz O Schramm B Gagel G Sroka Perez M Eble M Wannenmacher Strahlenther Onkol 174 92 1998 Vergleich des Hochenergie Bildsystem Siemens Beamview Plus mit konventionellen Verifikationsfilmen B Gagel O Schramm W Harms M Eble M Wannenmacher Strahlenther Onkol 174 92 1998 Reproducibility in Radiation Treatment l Kristensen T Knoos
252. vailable with earlier versions Images that are sent pushed from the remote node are displayed on the PIPSpro screen and selected fields from the image header information are displayed in a list Dump3 bmp Iof x Current Filter Patient Doe Jane Received After Saturday July 05 2003 17 44 31 IV Patient X After 7 542003 5 44 31 PM Filter image selection by Patient or date E Display a preview thumbnail image of the selected image To open an image and display it in the PIPSpro workspace first select the required row Click on the Open DICOM tool button or double click on the row or right click and select the context menu The following example shows a list of received images one of which is selected and shown as a thumb nail Received DICOM Online Filter open X Delete 8 Search Preview Filter Patient Margaret Elizabeth id 0304207 Patient Name Image Position Pationt ID Received Study Date Time E Margaret Elizabeth 239 5312004 567 531 2005 1 274 000000 0304207 8 4 2003 5 17 18PM 4 4 2003 1 37 39 PM E Margaret Elizabeth 239 531200 567 531200 1264 000000 0304207 8 4 2003 5 17 18PM 4 4 2003 1 37 39 PM E Margaret Elizabeth 239 531200 567 531200 1259 000000 0304207 8 4 20035 17 20PM 4 4 2003 1 37 39 PM E Margaret Elizabeth 239 531 200 567 531200 1249 000000 0304207 8 4 20035 17 19PM 4 4 2003 1 37 39 PM
253. w will open a standard Windows Print dialog Choose the appropriate printer and click the OK button to print PDF Save Clicking the Save Al button in the preview will open a standard Windows Save As dialog Enter a name for the file and navigate to the directory in which the file should be saved Click the Save button to create the PDF file Saving the data to the database not available in off line mode Clicking the Save button in the left hand panel will insert the data into the database for future trending and analysis PIPSPRO SOFTWARE Results A new tab will be shown at the bottom of the image area called Results Clicking on the tab will bring up the results window Image Data Pixel Size 00 35 an 100 00 mm Fair 100 Image Search Di i 573X714 Pixels Radius 143 Pixels lteration Data Minimum oaz Diamel 00 47 mm 101 34 Pixels Minimum a 7777 os Radius 00 24 mm 100 67 Pixels Center of 9557 12753 mm 27084 36139 Pixels Circle of Peaks 24 of Spokes 12 Threshold figs o 144 18 Image Results The software will display results for e Minimum Diameter the minimum diameter of a circle that will touch each projection at the point of intersection shown in both millimeters and pixels e Minimum Radius the minimum radius of a circle that will touch each projection at the point of intersection at the point of intersection shown in both millimeters a
254. will require the input of a Quality Factor This determines how much compression will be applied and correspondingly how much loss will occur to the original data The Quality Factor is set in the the Configuration Setting dialog box JPEG dialog box Successively compressing and decompressing a JPEG image will lead to progressive loss of data Configuration Settings xi General Calibration DICOM JPEG IV Convert to grayscale Show Import dialog for 16 bit grayscale image Save JPEG image Image quality factor 0 100 75 Open JPEG image Cancel HINT The relationship between the Quality Factor and the degree of compression will depend on the image Try saving an image with different quality factors the degree of compression is reported as the image is saved Then compare them to the original by examin ing the difference between them in 2 Image Operation HINT Compression ratios up to 20 1 do not seem to degrade portal images significantly while a very large saving in storage requirements is achieved PIPSPRO SOFTWARE Section 2 Using PIPSpro Configuration Settings General Calibration Dicom JPEG Open JPEG image Sonn onde asconscnsacnaacnsanoionernesioneresniancnes Show Import dialog for 16 bit grayscale image Save JPEG image Image quality factor 0 100 E Cancel Apply Help When saving an image in jpeg format the data will
255. y Assurance of EPI Systems R Rajapakshe S Shalev K Luchka Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Refresher Course Paper 24 Accepting and commisssioning an upgraded fluoroscopic electronic portal imaging device EPID M C Kirby N C Bulmer Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 28 Clinical integration of an iView electronic portal imaging device K Luchka Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 29 A quantitative assessment of a flat panel portal imaging device K Luchka Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 31 The electronic portal imaging system Siemens Beamview Plus and the conventional verification films CEA TVS and Du Pont CQL 7 a comparison of subjective image quality B Gagel et al Proc 6th Int Workshop on Electronic Portal Imaging Brussels June 2000 Paper 38 PIPSPRO SOFTWARE PIPSpro Publications Implementation of electronic portal imaging in a busy radiation therapy treatment center M Davis R Sabey R Rajapakshe Proc Workshop on Electronic Portal Imaging Amsterdam 1996 pp 10 11 Picture archival and communication system PACS for electronic portal imaging R Rajapakshe R Sabey R Lewis D Henkelman Proc Workshop on Electronic Portal Imaging Amsterdam 1996 p 10 Conformal treatment of the prostate
256. y can be a valuable exercise Clicking on the History View Tab will bring up the Linac Select dialog NOTE If only one linear accelerator has been set up in the System Manager see Setting up the PIPSpro Database in this manual the Linac Select dialog will not be shown and the single linac will be chosen automatically Linac Select Manufacturer Varian Medical Systems Model Choose the linear accelerator that the history would like to be viewed for and then click Select in the dialog In the left hand panel the Linac Info is shown along with the Settings area Settings e Date Range From the selection dropdown choose from one of the standard time frames or choose Select Range to enter dates manually e Test Type Choose which type of test to trend by field size and whether the image contained the Center Marker Phantom Adv or not Clicking Apply will apply your settings and the results will be shown in the right hand panel e Table View all of the data that matches the chosen settings will be shown Values that are outside of the acceptable range will be color coded yellow background for warning and red background for failure 5 Don t Chart clicking the Don t Chart check box will prevent the data from that date from showing up in the charts e Chart View the data that matches the chosen setting are shown in charts Clicking on the legend name of any of the charted

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