STANDARD IMAGING: Solutions

Based Quality Assurance

What is Solutions based QA

Using various accepted protocols as a template 1) AAPM TG-51, TRS398, etc. (Absolute Dosimetry) 2) AAPM TG-142, etc. (Linac and Systems QA)

Performing routine scheduled QA for monitoring Linac performance and maintaining improved patient care with QA Tools offered from Standard Imaging.

Solutions Based QA covers most routine Quality Assurance for Linear Accelerators and associated systems (EPID, CBCT, OBI, Treatment Couch, etc.)

as well as Patient Specific QA

Standard Imaging, Inc. provides the full compliment of QA Tools and Software to allow you to perform almost all of your LINAC QA

A little about us • Incorporated in 1989

• ISO 13485 and

ISO 9001 Certified

• All Products are CE Marked as required

Solution Based QA

Adaptive Patient Dosimetry software

Daily QA (output)

• Output Constancy (Photons and Electrons, all energies)

• Beam Flatness

• Beam Symmetry

• Dynamic Rotational Check

QA Beam Checker Plus

QA BeamChecker Plus • Patented Wire-free & Wireless Capability

• No cables to wrap-up or replace • Radiation therapists do not need to use any

software

• Automatically Detects Energy • No need to control from PC or unit • Full Photon and Electron Range detection

• Inherent Build-up for Photons & Electrons • Automatically Stores and Records Data for

trending and reporting • Supports Many Modalities

• Traditional linac and rotational systems like Varian RapidArc™, Elekta VMAT,TomoTherapy®

• Works for Up to 9 Treatment Machines • FFF Capable for High Dose-rate beams

Powerful Trending and Analysis Software

• View measurement data trending — graph or table views

• Export raw data to file for further analysis

• Print reports to create historical record of daily linac or Tomo QA data

Daily QA (Machine) • Laser Alignment Accuracy

• Imaging and Treatment Coordinate Coincidence (2D MV and kV imagers)

• Imaging and Treatment Coordinate Coincidence (3D CBCT)

• Positioning/Repositioning (Automated

Couch Shifts)

MIMI Phantom

MIMI Phantom for Daily QA

Test Auto-Registration Capabilities • Perform a 2D/2D match with the

AP/Right lateral images and record the required shifts

• Perform a 3D/3D match with the

CBCT images and record the required shifts

• If all shifts are within 1mm then

isocenters agree within 1mm and no action needed

Monthly QA • Imager QA

• Planar MV

• Planar kV

• CBCT

• MLC QA (Image Based and Log File based)

• Dosimetric QA (Output Constancy Photon and Electron)

• Dosimetric QA (Beam Profile Constancy)

• Radiation Light Field Coincidence

• Jaw Position Indicators

Planar Imager QA

PIPS Pro Software

Planar kV and MV QA

• Resolution

• Uniformity

• Conrast

• Scaling

PIPS Pro Software

3D CBCT QA (with CatPhan)

• Geometric Distortion

• Spatial Resolution

• Contrast

• HU Constancy

• Uniformity and Noise

Monthly Multileaf Collimator QA

PIPS Pro Software

• Leaf Position Accuracy

• MLC Transmission

• Backup diaphragm settings (Elekta® machines only)

• Leaf Speed Accuracy

Monthly Dosimetry QA

• Photon Output Constancy (2%)

• Electron Output Constancy (2%)

• DoseRate Constancy (2% for IMRT)

• Wedge Factor for All Energies

DoseView 1D Water Phantom

Exradin Ion Chamber (A19 Farmer)

SuperMax Electrometer

DoseView 1D • Superior 0.05 mm accuracy of

position and repeatability • DoseView 1D Software s

integrates the DoseView 1D for intuitive operation and testing. • Adjustable intervals • Multiple acquisition per

position • Real-time plotting of data • Direct drive motor for

submillimeter adjustments

Exradin Ion Chambers

• Most Characterized for TG-51 and TRS-398

• Homogeneous Shonka C552 plastic construction – collector, guard, and shell, no metal or high Z material in the beam.

• Large Guard for more accurate non fluctuating collecting volumes

• No fragile graphite or conductive coatings to break down over time

• Repairable

SuperMax Electrometer

• 2 Independent Channels • Touch Screen User Interface • Comprehensive Built-in Chamber

Library • Check Source Database • Wide Range:

Rate: Low Range 0.001 pA – 500.0 pA, 1 fA resolution High Range 0.001 nA – 500.0 nA, 1 pA resolution Charge: Low Range 0.001 pC – 999.9 µC, 1 fC resolution High Range 0.001 nC – 999.9 µC, 1 pC resolution

• IEC 60731 Reference Grade – exceeds all the requirements set forth

by IEC 60731 for a reference grade electrometer

Monthly Dosimetry QA

Beam profile constancy (1% or 2%/2mm)

QA CrossChecker • 453 Vented Pixelated Ion Chambers • In and Cross Plane Reolution =5mm • Easy to use Software for analysis,

trending and reporting.

Annual Dosimetry QA

For Example:

• Photon/Electron Flatness (variation from Baseline)

• Photon/Electron Symmetry (variation from Baseline)

• Photon/Electron Output Calibration (TG-51)

• Check of Field Size Specific Output Factors (photons)

• Output Factors for Electron Applicators (Spot Check of one Applicator per energy)

• Photon Beam Quality

• Electron Beam Quality

• Output Constancy (photons and Electrons) and More!

DoseView 3D Water Phantom

DoseView 3D Key Features • Consistent and Accurate Measurements

• Single piece cast frame, stepper motors, proven lead screw design

• New high speed DoseView 3D Electrometer

• Fast and Convenient Setup • Wireless communication, 0.1 mm step

pendant • On-board electrometer/motion control

system • Lift and Reservoir Cart, Precision Positioning

Platform • Detector Alignment System

DoseView 3D continued

• Easy to use, flexible software • Wizard or manual setup, Auto

Acquisition Mode • Variable resolution step sizes • Automatically locate beam center • Full suite of post processing tools

• All major planning systems supported and included standard in version 1.2:

• Varian Eclipse™ • Philips Pinnacle® • Elekta/CMS XiO®

• Prowess Panther®

SRS QA End to End SRS QA for your complete Stereotactic Process.

• LUCY Phantom

• Small Volume Exradin MicroPoint Chambers

• Winston Lutz Tools for Machine QA

• CyberKnife Specifc Tools as well (Accuray Partnership).

Lucy 3D QA Phantom End to End Stereotactic QA

Image Transfer QA and TPS QA Self-referencing markers in CT, MRI, X-ray, target

volumes and known spatial relationships

Patient Dosimetry QA Verify dose plans, prior to patient treatment

Stereotactic Frame Interfaces Precisely position the Lucy 3D QA Phantom within

exact coordinate systems of mfg. head frames

Radiation Alignment Machine QA

Lucy® 3D QA Phantom High Precision Imaging and Dosimetric Phantom for SRS and IGRT

What does End-to-end SRS QA Mean with LUCY?

Imaging

CT MRI

Treatment Planning Delivery

QA Stereochecker

Filmless QA for Cyberknife

High-resolution Flat Panel Imager (aSi)

200 micron resolution

High frame rate

Portable and compact

Seamlessly and efficiently performs Iris QA, AQA-style test (PANDA), and MLC garden fence – DAILY, using clinical pathways

QA Stereochecker

Cuts morning QA time down from over an hour to 15 minutes

Get quantitative results (meeting or exceeding vendor recommendations) about your machine daily (as opposed to monthly or annually)

Uses clinical treatment pathways, no manual manipulation of the robot

No attachment to collimator

Designed to be used by physicists and therapists

Patient QA

Pre-treatment QA Pre-treatment plan delivered in-air to the portal

imager Saves time, more accurate, higher resolution than

arrays

In-vivo QA Monitors both beam delivery and patient position Automatically provides analysis and notifications Includes easy troubleshooting and report

generation

Adaptive QA Quantifies how changes in patient anatomy and

setup will affect the cumulative patient treatment QUANTEC and RTOG-based evaluation parameters

give puts actionable data in the hands of doctors to improve outcomes.

The next generation of patient dosimetry is here.

Pre-treatment QA Pre-treatment plan delivered in-air to the portal imager Saves time, more accurate, higher resolution than arrays

In-vivo QA Monitors both beam delivery and patient position Automatically provides analysis and notifications Includes easy troubleshooting and report generation

Adaptive QA Quantifies how changes in patient anatomy and setup will

affect the cumulative patient treatment. QUANTEC and RTOG-based evaluation parameters give puts

actionable data in the hands of doctors to improve outcomes.

Lung Patient Sample

Patient misaligned on fraction 18

Today’s tumor location

Planned tumor location

Adaptive module showed:

Planned dose:

Fraction 18 dose:

Lung Patient Sample

Fraction 18 daily DVH

Cumulative DVH up to and including Fraction 18 treatment

Physician now has the information to determine whether this single day’s misalignment will compromise the patient’s overall treatment!

H&N Patient Sample • Patient lost weight throughout

treatment

• Mask was poorly made: inconsistent daily setup

• Effect of these changes are tracked in Adaptivo

Decreasing target volume

Significant differences between planned and delivered dose

DVH differences between planned and delivered cumulative doses

Streamlines and automates pre-treatment QA Provides daily treatment delivery monitoring Determines both daily and cumulative delivered dose by

using the most recent CBCT not only the plan CT. Automates calculation and notification Provides a complete integrated solution for Patient

Dosimetry

ADAPTIVO In Summary:

Additional Tools

LinacView™ Log file Analysis Software • Logfile analysis for every patient.

Analyze machine performance for each fraction automatically with no impact on patient workflow.

QA Pilot Delivers on Data Integrity

• QA Pilot uses Amazon Web Service (AWS) Infrastructure. • Physical Security

– Physically dispersed, hardened data centers. – Data backed up in a minimum of 3 places.

• Network Security – Best in class network architecture and practices. – Data encrypted while at rest and in transmission.

• Operational Security – Full HIPAA/HITECH compliance – Best in class personnel access management.

• Ask yourself if your organization’s IT department has the same resources and depth of experience and track record as Amazon.

• They may be very good but are they absolutely world–class?

Standard Imaging your Solution Based QA Resource

Adaptive Patient Dosimetry software

Thank you!

Please visit the Standard Imaging Booth in the Exhibition area for more information.