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By: Michael Curry

Daily QA
Head Frame Attachment
Image Acquisition
Bubble Measurements
Treatment Planning
Treatment Begins
Spot checks that are Pass/Fail or Yes/No
Treatment
Couch In APS Couch Out
28. Helmet Changer (weekly)
Turn on APS
Wait for green lights to come on
Initiate QA test run
APS begins by moving to the Docking
position (100, 130, 100)
Check to see that the positioning is correct
Attach APS QA tool
Then APS will move to (100,100, 100) then (140, 42,
58.5)
Check to see that the positioning is correct
Then APS will check the z direction moving to 62.5
The long engravings are the 0 marks
Each of the smaller engravings are 0.1
and 0.5mm respectively
Tolerance on the x and y coordinates is 0.5mm
The spring loaded tip of the tool
presses against the helmet at z=62
The reading should be 0 0.5 mm on the
ruler jig attached to the tool
This test is done at tome left and
bottom right of the helmet
The frame attaches at four points
around the patient's head with pins
that penetrate about 2 millimeters.
Patient is given local anesthetics
Frame fitting takes approx. 20 mins
MRI
CT
Angiograph?
The Skull Scaling instrument bubble helmet
is used to calculate the distance between the
center of the Leksell stereotactic space and
the surface of the patient's skull for Leksell
Gamma Knife treatment
planning with GammaPlan
Leksell GammaPlan
Contour lesions
Determine helmet size and dosimetry
Usual prescription is 20Gy to the 50% isodose line.
After all steps have been completed the
treatment begins
Start with APS beams, then do those
requiring trunnions
Physicists are involved in every helmet
change, collision check, dock & verify, and
changing from APS to trunnion.
Complete all daily and weekly checks
Helmet sensor checks
Trunnion centricity check
Measurement of Absorbed Dose Rate
Dose Rate Linearity
LGP 30Gy calculation
Timer Accuracy
Couch Movement Time
UPS system
Helmet Sensor Checks
Cap Sensor Test
Green LED lit when cap in place
Helmet ID test
Yellow LEDs lit in code for which helmet
Helmet Microswitch Test
Place shim between microsensor
and adjustment ring. Red No LED
should light in helmet position
Helmet position
Helmet ID
Helmet Cap
Helmet ID Table Helmet Cap sensor
Adjustment Ring
Trunnion Centricity
Attach Trunnion
Attach the Helmet test tool
Push trunnion into bushing slots
and tighten the trunnions
The reading should be 1000.1mm
and the bushings should be able to
rotate.
Helmet test tool
Bushings
Data Acqusition
Attach trunnion and 18 mm helmet are
Mount the 16cm diameter polystyrene phantom
on the trunnion and insert the Exradin A16 I.C.
Take four 1 min measurements
Take one measurement for 4, 10, & 15 mins
Average the 1 min measurements (Av)
1min=R1, 4min=R4, 10min=R10,
15min=R15
Measurement of Absorbed Dose Rate (D
w
)
Determine transit error:
Tolerance <0.05min
Determine corrected Rdg/min:
Determine C
TP
:
Determine D
w
: [cGy/min]
Where:
4
4 1
4(Av)
(min)
R
R R
o

=

min
CRdg Rdg
t o
=
+
273.2 1013.2
295.2
TP
T
C
P
+
=
(Av) 21
TP
Dw CRdg C TG =
( ) ( )
21 /
plast
w
elec gas wall ion repl en
plast
air
TG C N L P P P =
Calculation of Absorbed Dose Rate
Determine Decay:
Using the time since the last calibration and the
output at that time we can calculate what the
Absorbed Dose Rate should be on the day:
Then compare the Calculated and Measured
absorbed dose rate.
Tolerance is <3%
1/2
(.693 ) t t t
e e

=
0
t
w w
D D e

=
Dose Rate Linearity
Determined by:
Tolerance <2%
Dose Rate Constancy
Determined by:
Tolerance <2%
max
min
1 100
linearity
CRdg
R t
CRdg
| |
=
|
\ .
1max
1
1min
tan ( ) 1 100
R
cons cy R
R
| |
=
|
\ .
LGP 30Gy calculation
Print the QA plan and see what time it says is
needed to deliver 30Gy
Divide the 3000cGy by the time given to get the
dose rate
Compare this to the previously Calculated dose
rate
Tolerance <2%
Timer Accuracy
Use an independent timer to determine the time
that the helmet is docked for a 15 minute
treatment run.
Tolerance: 0< t <6sec
Couch Movement Time
Start a treatment and press the pause button
Use the independent timer to measure the time
from interruption until the shielding door is
completely closed
Tolerance: 30< t <40sec
UPS system
Start a treatment run
Switch the input button off
The system should run on the backup battery for
20 minutes
If during that 20 minutes the output voltage falls
below a certain level a system alarm will occur
If a system alarm occurs contact Elekta
Indicator light Input button
Site Kit
Radiation Survey: Wipe test (semi-annually)
Source Housing (leakage)
Radiation Levels (outside rm)
Training: General Radiation Safety
Emergency Procedures
Accuracy in Dose Delivery
Precision in Dose Delivery
Output Factors (helmet factors)
Treatment process
Daily QA
Monthly QA
Annual QA

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