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QA Software • Comprehensive TG-142 Imaging and Machine QA Automate the analysis of over 30 TG-142 recommended QA tasks without film TG-142 Imager and Machine QA The continual refinement of RT treatments into more advanced procedures dictates the need for superior, sustainable precision. However, imagers and machines degrade over time and recalibrations are required. TG-142 reconciles these divergent trends by recommending a multitude of daily, monthly and annual QA procedures. Though aimed at preventing clinically significant errors, these requirements further strain the busy schedules of RT professionals. PIPSpro Software efficiently executes and consolidates QA workload by incorporating TG-142 procedures into one easy-to-use platform. When used in conjunction with specialized phantoms, PIPSpro becomes an indispensable part of your QA process. • Assurance is Confidence Several manufacturers still include basic, qualitative phantoms, like the ‘Las Vegas’ test object, with their imaging systems. However, these phantoms do not provide quantitative data. In addition, these tests are done manually, without the aid of software to automate results. In contrast, Standard Imaging phantoms provide quantitative, repeatable results. This data can be compared to published performance values or between systems to ensure your imagers are operating to specifications. These powerful trending tools alert you of issues before loss of quality becomes clinically significant. Imager QC, Now TG-142 Recommended PIPSpro Comprehensive’s Imager QA, Star Shot and Stereotactic, when coupled with the appropriate phantoms, facilitate over 30 tests recommended by TG-142. (Phantoms appear in parentheses) Mechanical Planar MV Imaging [EPID] • • • • • • • • • • • • Light/radiation field coincidence (FC-2) Jaw position indicators [symmetric] (FC-2) Collimator rotation isocenter Gantry rotation isocenter Couch rotation isocenter Coincidence of radiation and mechanical isocenter Laser Alignment (MIMI) Multileaf collimation • • • • • • • Setting vs. radiation field for two patterns (MLC Phantom) Leaf position accuracy (MLC Phantom) MLC transmission (MLC Phantom) Leaf position repeatability (MLC Phantom) Coincidence of light field and x-ray field (FC-2) Segmental IMRT test (MLC Phantom) MLC spoke shot Scaling (FC-2) Spatial resolution (QC-3) Contrast (QC-3) Uniformity and noise (QC-3) Imaging and treatment coordinate coincidence [single gantry angle] (MIMI) • Imaging and treatment coordinate coincidence [four cardinal angles] (MIMI) Planar kV Imaging • • • • • Scaling (FC-2) Spatial resolution (QCkV-1) Contrast (QCkV-1) Uniformity and noise (QCkV-1) Imaging and treatment coordinate coincidence [single gantry angle] (MIMI) • Imaging and treatment coordinate coincidence [four cardinal angles] (MIMI) Cone-beam CT [kV] (PIPSpro using the Catphan) • • • • • • • Geometric distortion Spatial resolution Contrast HU constancy Uniformity and noise Imaging and treatment coordinate coincidence (MIMI) Positioning/repositioning (MIMI) Refined User-Interface The QA modules of PIPSpro feature a new, simplified user-interface. Since the interface is consistent across modules, it is easy to quickly learn all facets of PIPSpro. Additionally, this unified layout allows multiple modules to be open simultaneously - streamlining workflow during acquisition, reporting and analysis routines. New! Enhanced Imager QA Module The Imager QA module consolidates TG-142 testing for MV, kV and 3D CT (both cone-beam and diagnostic) into a uniform, easyto-use interface. Customizable profiles allow a variety of machine, imager, phantom and energy combinations to be quickly saved. Once a profile is selected, the user loads an image for analysis and PIPSpro does the rest. This “one-click” deployment provides three different figures of merit for calculating uniformity, including Phantom on surface of EPID 6 MV EPID f50 epi 10 - 25 MV f30 epi 0.18 ± 0.02 QA. This tool can generate and store custom baselines for every test calculated within PIPSpro, allowing for a breadth of metrics to be easily tracked. Once testing is complete, PIPSpro automatically generates comprehensive reports that can be 0.22 ± 0.02 0.22 ± 0.01 0.23 ± 0.01 0.25 ± 0.02 Varian aS500 • Unified interface allows for multiple modules of PIPSpro to be f50 iso 0.17 0.19 ± 0.01 PORTpro yellow or red for an easy overview of passing/failing results. Additional New Features 15-18 MV f30 iso 0.30 ± 0.02 0.23 0.18 Siemens 0.21 ± 0.03 Beamview 0.21 ± 0.02 Theraview 0.23 ± 0.01 0.26 ± 0.03 images of each result. All data is automatically tagged as green, page detailing which values pass or are out of range, along with f50 iso 0.18 ± 0.02 SRI-100 0.24 Elekta iView Beamview TI 0.24 ± 0.01 Varian 0.26 ± 0.01 Portalvision MkII quickly exported to a PDF file. These reports contain a summary 6 MV f50 epi Measurements of spatial resolution in lp/mm PIU (ACR percent integral uniformity). A comprehensive baseline manager lets users customize imager Phantom at isocenter Varian aS1000 Elekta iViewGT 0.29 ± 0.01 0.25 ± 0.01 0.285 0.33 ± 0.04 0.39 0.27 0.28 ± 0.01 0.34 0.60 0.45 0.46 .379 0.77 0.77 Published reference performance values for spatial resolution open simultaneously. • Supports the Catphan 600 and Leeds phantoms, as well as the independently calibrated QC-3 and QCkV-1 phantoms. • Phantom imaging does not require jaw or blade positioning. Compare results to published values 0.49 - 0.58 QC-3 Phantom QCkV-1 Phantom Validated Performance, Documented Results With performance supported by over 55 publications, PIPSpro Software, the QC-3 phantom (MV) and the QCkV-1 (kV) phantom are integral to meeting TG-142 standards. 11 regions of interest contain line pair patterns and materials of differing densities, Track and Trend and noise. Compare these results to published data for further Imager Performance confidence in your QA. Published image resolution data for PIPSpro’s QC-3 phantom allowing for the planar determination of resolution, contrast provide a known quantity for each imager, making it easy to evaluate the quality of baseline values and compare values between systems. Using these baselines, the built-in database and trending software shows how your imagers are performing over time. User-determined warning and rejection levels on all graphs let you easily detect declining image quality. Quantify the quality of your imagers MIMI Phantom Intuitive IGRT When using on-board imaging systems for patient positioning, it is imperative to verify that the imaging coordinate system is aligned with the treatment beam. TG-142 recommends testing this on a daily basis. This test is performed using the Standard Imaging MIMI (Multi-Image Modality Isocentricity) Phantom, providing results in either three dimensions (X, Y, Z) or in six dimensions adding pitch, yaw and roll. The new IGRT Module in PIPSpro is designed to collect this daily data and then automatically track and trend these values over time. The MIMI Phantom partners ideally with the IGRT module when performing daily checks of imaging and treatment coordinate coincidence. Bone rods running throughout the phantom make it easy to automatically register and quickly match and analyze 2D/2D and 3D/3D images. Simple IGRT Trending Precise Winston-Lutz/ Stereotactic Radiosurgery QA In linear accelerator based Stereotactic Radiosurgery, it is common to perform the Winston-Lutz test to verify machine isocentricity. For the Winston-Lutz test, a spherical marker is aligned to the laser described isocenter and a series of images are acquired at different gantry and couch rotation combinations. PIPSpro Comprehensive simplifies this testing, using your portal imaging system to acquire the images of the spherical marker instead of film. These images are automatically loaded and Winston-Lutz Phantom analyzed to determine the isocentricity. 3D offsets from isocenter are reported with 0.1mm accuracy allowing you to have more confidence in your setup and treatment. Testing can be done for each gantry and couch angle for MLC or cone-based systems. Specialized Phantoms, Superior QA MLC Phantom Complete MLC QA The MLC QA module analyzes a single, specialized phantom; In addition, the module lets users measure inter-leaf and inter- producing quantitative data to determine if your collimator can bank leakage and leaf-width, making PIPSpro the only software accurately position leaves. necessary for comprehensive MLC QA. The MLC QA Module This module also follows TG-142 guidelines for reviewing meets TG-142 guidelines for the following tests: multiport or ‘picket-fence’ images. These test a MLC’s ability • Qualitative test [i.e., matched segments, aka ‘picket fence’] to position individual leaves at multiple positions during single • Setting vs radiation field for two patterns [non-IMRT] treatments such as step-and-shoot and sliding window IMRT. • Leaf position accuracy [IMRT] • MLC transmission [average of leaf and interleaf transmission, all energies] • Leaf position repeatability • Coincidence of light field and x-ray field [all-energies] • Segmental IMRT [step and shoot] test Filmless MLC QA in a single platform Advanced Radiation Field/ Light Field The FC-2 and Center-Marker phantoms expedite analysis of several TG-142 recommended machine QA procedures, including: • Light/radiation field coincidence: Meets TG-142 specifications of measuring tolerances of 2 mm or 1% on a side. Center Marker and FC-2 Phantom • Jaw position indicators (symmetric): Meets TG-142 specifications of measuring tolerances of 2 mm. • MLC Coincidence of light field and x-ray field (all energies): Meets TG-142 specifications of measuring tolerances of ±2 mm. Over 30 TG-142 procedures Powerful Star Shot Analysis PIPSpro’s Star Shot Module uses an EPID or film to measure the stability of rotation of the linac gantry, couch and collimator. Centralized Database Management Analysis of these images provides quantitative results for PIPSpro can store data on a central network for quick mechanical procedures, including: documentation and access for TG-142 test results and trending • Collimator rotation isocenter – Meets TG-142 specification of measuring tolerances of ±1 mm from baseline. • Gantry rotation isocenter – Meets TG-142 specification of measuring tolerances of ±1 mm from baseline. • Couch rotation isocenter – Meets TG-142 specification reports. QA results are shown in easy-to-read reports, charts, and graphs, which can be exported to PDF and ASCII files without additional software tools. An equipment manager stores an unlimited number of linear accelerators and phantoms, eliminating continual re-entering of clinical device data. of measuring tolerances of ±1 mm from baseline. The TG-58 Report encourages users to demand the use of a tool such as PIPSpro QC Software at acceptance to help ensure that the EPID is indeed operating at or above specifications.* * Michael G. Herman, et al, “Clinical Use of Electronic Portal Imaging: Report of AAPM Radiation Therapy Committee Task Group 58,” Med. Phys. 28 (5), May 2001 Over 55 publications validate the performance of PIPSpro. Visit www.standardimaging.com or call 800-261-4446 for more details. P I P S p r o S o f t w a r e specificatio n s operating system Windows® 7 Windows Vista® Microsoft® Windows® XP Processor Intel ® or AMD®, 350 MHz or greater Memory 64 MB (256 MB recommended) Hard Drive 50 MB or greater Screen resolution 800 x 600 (1024 x 768 recommended) CD–ROM Drive 2X speed or greater screen color depth 256-bit or greater product standards Designed to meet IEC 60601-1-4 Recommended Software Microsoft Excel Catphan® is a registered trademark of The Phantom Laboratory. Windows® is a registered trademark of Microsoft Corporation. Specifications subject to change without notice. Thorough service, knowledgeable support Publications 1.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. 2. 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. 3. Conformal treatment of the prostate utilizing intensity modulation and organ immobilization. W. Grant III, J. McGary, D. Bellezza, P. Nizin. Med. Phys. 24(6):1023 (1997). 4. 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). 5. A comparison of clinical experience and quality assurance with a gantrymounted (Philips SRI 100) and a mobile EPIsystem (ELIAV PORTpro). B. Bannach, T. Doll, D. Lansing, G. Schmitt. Proc. Workshop on Electronic Portal Imaging, Phoenix, Oct 1998. pp 39-40. 6.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. 7. 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). 8.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). 9.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). 10. Reproducibility in Radiation Treatment. I. Kristensen, T. Knoos. Winning best poster at ESTRO Conf. Edinburgh 1998 . 11. 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, I. Syndikus, J. Taylor. Radiotherapy & Oncology 48: S149 (1998). 12.Image quality parameters for the production standard Eliav PORTpro portal imaging device. A. J. Poynter. Brit. J. Radiol. 72: 802-804 (1999). 13. Verification of electron field positioning. H. Lemnitzer, U. Wolf, G. Hildebrandt, F. Kamprad. Radiotherapy & Oncology 52: 61-64 (1999). 14.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). 15. Clinical Implementation of a new Electronic Portal Imaging System. L. Aubin, A. Conrad, C. Thompson, R. Rajapakshe. Proc. WESCAN Conf., Kelowna, March 1999. 16. Quality Assurance in Stereotactic Radiosurgery. K. Luchka, J. Wolters. Proc. WESCAN Conf., Kelowna, March 1999. 17. 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). 18.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). 19. 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). 20.Electronic portal imaging with an avalanche-multiplication-based video camera. G. Pang and J.A. Rowlands. Med. Phys. 27: 676-684 (2000). 21.Radiation therapy for breast cancer at the millenium. H. Jane Dobbs. Radiotherapy & Oncology 54: 191-200 (2000). 22.A clinical evaluation of setup errors for a prostate immobilization system. J.E. McGary, W. Grant. Journal of Applied Clinical Medical Physics 1: 138-147 (2000). 23. 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). 24.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. 25. Quality Assurance of EPI Systems. R. Rajapakshe, S. Shalev, K. Luchka. Proc. 6th. Int. Workshop on Electronic Portal Imaging, Brussels, June 2000. 26.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. 27. Clinical integration of an iView electronic portal imaging device. K. Luchka. Proc. 6th. Int. Workshop on Electronic Portal Imaging, Brussels, June 2000. Paper 29. 28. 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. 29. 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. 30.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. 31.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. 32. Letter to the Editor. K. Luchka. Interactions - Canadian Medical Physics Newsletter. 46(3) July 2000. p. 118. 33. 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. & Oncol. 58: 155162 (2001). 34. 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). 35.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 5.4 in 1st UK Radiation Oncol. Conf. (UKRO), April 2001. Clinical Oncology 13(Sup. 2) p. S9 (2001). 36. 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). 37. 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. 38.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). 39. 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). 40. Clinical use of electronic portal imaging: Report of AAPM Radiation Therapy Committee Task Group 58. M. Herman, J. Balter, D. Jaffray, K. McGee, P. Munro, S. Shalev, M. Van Herk, J. Wong. Med Phys 28 (5); 712-727 (2001). 41. 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). 42. Treatment planning aids in prostate cancer: friend or foe? S. Malone, R. Donker, S. Dahrouge, L. Eapen, I. Aref, G. Perry, J. Szanto. Int. J. Rad. Oncol. Biol. Phys. 51(1): 49-55 (2001). 43. The application of computed radiography imaging system for portal imaging; a comparison of two commercial portal imaging systems. J. Vanhanen, M. Pitkänen, S. Peltola, S. Hyödynmaa. Radiotherapy and Oncology 61 Suppl. 1, S81 (2001). 44. Quality Asurance of EPI Systems. K. Luchka, R. Rajapakshe, S. Shalev. Proc. 7th. Int. Workshop on Electronic Portal Imaging, Vancouver, June 2002: 8-11. 45.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. 46.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. 47.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. 48. Evaluation of iView and iViewGT 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. 49. Clinical Case Studies: Head and Neck: A. Banbury. Lung: H. Dalton. Pelvis: A. Banbury PIPSpro User’s Meeting, Manchester April 2003: 9-10. 50. The use of image registration 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. 51. 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. 52. Web-based integration of PIPSpro into a radiotherapy department. R. Wyatt, K. Natarajan. PIPSpro User’s Meeting, Manchester April 2003: 17-18. 53. Integrating PIPSpro and iView. J. Sage. PIPSpro User’s Meeting, Manchester April 2003: 19-20. 54. Accuracy of prostate radiation therapy using fiducial point-pair registration technique based on the computerassisted portal image quality assurance program PIPSpro. W. Mermerstain, Y. Cohen, Y. Krutman. Australasian Radiology 47, 168-171 (2003). 55. Quality assurance measurements of a-si epid performance. Menon GV, Sloboda RS. Medical Dosimetry - Spring 2004 (Vol. 29, Issue 1, Pages 11-17). To learn more call (800) 261-4446 or (608) 831-0025 www.standardimaging.com 800-261-4446 . ph 608-831-0025 . fax 608-831-2202 3120 Deming Way Middleton WI 53562-1461 USA © 2013 Standard Imaging, Inc. 1251-27 (12.13)