Notes Flashcards
3 means that comprise TPS
-input data
-calculate
-output data
what does does calculation accuracy depend on?
-algorithm
-modeling of actual clinical radiation beams
quaterly TPS tests (or after hardware or software upgrade)
-CPU/server
-digitizer (check accuracy of known contour)
-electronic plan transfer- check that is transfer to treatment console
-plotter/printer- test by comparing against known contour
-backup recovery
-CT geometry/density
annual TPS tests
Check constancy of dose calculations using a standard set of at least four clinical plans covering a range of geometries, energies and modalities including extreme scenarios likely to be encountered clinically. Check DVH constancy.
Also check simple cases corresponding to beam data used for commissioning (PDDs, profiles)
End-to-end test performed as realistically as possible (anthropomorphic phantom; use immobilization devices)
how do you do the measuremnet for virtual source?
must be done in air with appropriate build up cap since only the primary beam is expected to follow the ISL (according to the position of the virtual source)
is dose verification sufficient QA of TPS?
-verifications do not check that CT sim images are correct with respect to the patient. Need e.g., QUASAR phantom with various inserts of known HU to check this aspect of the TPS.
what is in TG-53?
also includes information for administrators on required staffing levels, time commitment required to commission a TPS, a description of the roles of different staff members, and a description of the treatment planning process
different MLC aperture options
to middle of leaf end, to inner corner, to outer corner
-check these
some imaging artifacts
-finite voxel size
-partial volume effects
-streaking from heterogeneities
-MR distortion
what is involved in acceptance testing of TPS?
-CT input
-anatomical description- make sure you can view contours
-beam description- make sure all beam functions work
-photon and electron beam dose calculations- test out all MLCs, SSDs, inhomogeneities etc
-dose display and DVH
-no measurements are carried out for acceptance test- just make sure all features are working
overview of commissioning steps for TPS
-imaging inout (does imaging work, is orientation correct, is integrity maintained)
-anatomical structure considerations (display etc)
-dosimetry- is TPS calculating properly
-establish QA procedures
-train staff
-IT considerations
image input considerations at commissioning
-check for correct # of pixels, pixel size, slice thickness
-check DICOM formats are compatible
-check that multiplanar reconstruction and DRR work
-check that image orientation is correct
-check that text is correct
-check that window and level work
-check that image correction tools are working and that original and modified images are correctly identified
-check that image registration works
-chck that conversion of of CT number to electron density was done properly
TPS commissioning steps related to CT scanner
check that CT scanner delivers expected dose, has adequate image quality, and has correct RED curve
what kind of curve is RED curve?
bilinear
-a line is fit to data below HU=0; a different line is fit to data above HU=0
-slope of RED vs HU is smaller for higher RED/HU
-energy dependent, but studies showed same HU curve can be used for CT scanners between 120-140 keV; error > 1 %
what to do with RED curve for HU> 6000?
set plateau- 3.92
-makes sure you don’t end up with ridiculous values if the curve were extrapolated
-check this also as part of commissioning
mass densities of common materials
-air: 0.001 g/cc
-lung: 0.3 g/cc
-fat/muscle: 0.9-1.1 g/cc
-bone: 1.1 - 1.8 g/cc
-metal implant: 3.8 g/cc
HU values of common materials
air= -1000
fat = -20-100
muscle/blood = 40-60
lung = -300
2 HU related curves in Eclipse
-curve of RED vs HU and curve of mass density vs HU
-RED are used for scaling kernels and distances in AAA
-mass densities are used in eMC algorithm
in RED phantom, why do e measure the HU with inserts at various positions?
-make sure calibration curve is correct across the FOV
water insert in middle of RED phantom
used to renormalize the rest of the measurements, to correct for scanner fluctuations
for what scan parameters do you do the RED curve?
-should check for all possible kV for all protocols in use
-verify that variation with typical CT scanner energies is negligible
-if a protocol is noisy, acquire and average multiple scans
features relating to anatomical structure to check in TPS
-structure types work as intended (ie target could be different than OAR)
-display works
-contouring tools work
-auto-segmentation or auto-contouring works
-missing contours are handled as expected
-verify margin expansion/contraction
-verify that end of structures are based on contours
-check that HU overrides have intended effect
-test contouring under different window/level settings
-verify body contour is working- no dose should be displayed outside the body contour
beam limits to be aware of
-MU limit per arc (1000 for conventional, 6000 for stereo)
-max allowable SSD for extended SSD tx
-max gantry speed
-max MLC leaf travel speed
-min dose grid size should be pixel size of image used for planning
machine configuration vs beam configuration
-energy independent features fall under machine configuration
-energy dependent falls under beam configuration