Ipa BV 13 D
Ipa BV 13 D
1.2           References
B503361R01: Treatment Planning for Brachytherapy, BrachyVision Reference Guide
B503362R01: Treatment Planning for Brachytherapy, BrachyVision Instructions for Use
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2      Introduction
2.1           Scope
This Installation Product Acceptance (IPA) procedure provides testing procedures and data recording tables to
enable Varian to demonstrate that the Brachytherapy Standalone and Network Aria 13 has been successfully
installed and meets required manufacturer specifications.
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3      Safety
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4      IPA Tests Applicability
This acceptance procedure can be used for new installations, or for upgrades. Instructions are provided in
note boxes under various test section headings stating the applicability of tests for each scenario. Enter NA if
the component is not installed. Enter the actual values in any data table boxes where applicable.
NOTICE Access to the system can only be by a domain user with valid credentials.
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5      Preliminary System Configuration
                                                     MACHINE TYPE
 MACHINE TYPE                VARISOURCE                              GAMMAMED PLUS
 ID                          VariSource                              GammaMed Plus
 MODEL                       VariSource 0.5 cm                       GammaMed Plus
 INTERFACE                   VariSource                              GammaMed Plus
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5.2            Commissioning Source Model(s)
Introduced in Version 13 is Source Model Approval. There are 4 possible levels:
•        Unapproved – Source model cannot be used.
•        Commissioning – Source model can be used to create plan’s, but the plans cannot be exported.
•        Approved – Source model can be used for treatment.
•        Retired – Source model cannot be used.
                  If this step is not completed following an upgrade to V13, then the customer will not be able to
                  treat.
                                                    MACHINE TYPE
                             GAMMAMED PLUS HDR                          GAMMAMED PLUS PDR
    ID                       GM Plus HDR                                GM Plus PDR
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2. Select Workspace > Radiation & Imaging Devices
3. Select the Overview Tab.
4. Select New and select New Localization Jig
5. Enter the following:
    •    ID = Orthogonal
    •    Model = Orthogonal
6. Select the Create button.
7. Double click on the new device ID
8. Select the Geometry Tab and select the Orthogonal Type.
9. Select the Orthogonal Tab and enter the values displayed below.
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    •    Resolution: 75
    •    Bits Per Pixel: 8, 12, or 16 (depending on scanner capability)
    •    Image Type: X-Ray Film (Includes Magnification)
    •    Image Scale: Leave Unscaled
5. Press OK
5.6          Configuring the Software for Use with a Flat Bed Scanner
             (ScanMaker)
NOTICE This section is required if the system has a Flat Bed Scanner.
If a Standalone and network BrachyVision system was ordered with a flatbed scanner this software should
have already been installed, and therefore there should be no need to follow this procedure. In this case go to
the next section on installing the TIFF filter.
Install the Image Capture software supplied with the scanner following default instructions.
5.6.1 Installing the Tiff Filter for use with the Flat Bed Scanner
NOTICE This section is required if the system has a Flat Bed Scanner.
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2. Select Tools > Workstation Configuration
3. Select the COM Port from the drop down list. (Don’t configure the Digitizer resolution).
4. Press OK and select File > Save All
NOTICE This section is required if the DICOM Image Transfer is going to be used.
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3. If the correct service has not been entered, select Add New Service button and follow the instructions to
   configure the new service.
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6        System Verification Test Procedures
This chapter describes the steps required to complete the System Verification test. It consists of 9 different
test procedures (TP). Some of the tests are only required if the system configuration includes the relevant
hardware.
A basic understanding of the treatment planning functions is necessary to conduct the test. Please refer to the
‘Brachytherapy Planning Instructions for Use’ for further instructions. The test procedure will outline the
necessary BrachyVision commands shown in bold
Ensure that all of the necessary items have been configured. See Chapter 5.
                                  If you are using a VIDAR scanner, BrachyVision must be running for at least
                                  90 seconds prior to running this test as the scanner needs to fully connect.
               NOTICE             There is also a 90 minute warm up period for the scanner itself, required prior
                                  to scanning films.
This test article is used to test the output from a VIDAR film scanner. The test articles can be downloaded
from:
GCS Data Center>Products>Brachytherapy>BrachyVision>IPA-BV-Test Articles
Scan the test images as follows:
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6. Once the image is scanned in the correct orientation, select listed image for import. Select the Arrow to
   continue to import or select Scan more. Place the LAT image (second image) in the scanner and select
   the Arrow to scan. If the scan is upside down or back to front, please correct the orientation and rescan it.
7. Once the LAT image is scanned in the correct orientation, select images to be imported in Browse to
   your patient.
8. Select Quicklinks > Treatment Planning > Brachytherapy 2D Entry
    •    You may need to open the patient and images in Selection.
9. Drag the images into the main windows. Select View > Measure / Distance to measure the distance of
   the upper vertical line and the horizontal line of the both test images. The distances should be 11.4 cm and
   12.0 cm, respectively. Enlarge the images if necessary by selecting View > Zoom / Zoom In
10. The test passes if the images are successfully scanned and loaded, and the measurements on the screen
    of each image are within 1.5 mm.
    •    To close the measurement tool, Select the X button.
11. Close this Patient by highlighting the patient in the top Left Focus window and select File > Close
Results
                           DATA TABLE: SECTION 6.1 - TP 1. VIDAR FILM SCANNER TEST
                                    NA IF VIDAR FILM SCANNER TEST IS NOT INSTALLED
                                                                             ACTUAL
      OBJECT TO MEASURE                                EXPECTED RESULT       MEASUREMENT       TOLERANCE
                                                                             IN CM
      Vertical Line                                    11.4cm
                                                                                               ±0.15cm
      Horizontal Line                                  12.0cm
                                  This image should be checked to ensure that it is to scale prior to using it for
               NOTICE             testing, printing and photocopying can rescale the images. (It should also
                                  only be printed on A4 otherwise the image will be rescaled).
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6. Once both images are scanned, close scanner software open BrachyVision. Select Quicklinks > DICOM
   > Import Export.
7. Select TIFF Import Media File Filter. and press the right arrow.
8. Locate the directory where the images are located by pressing the ‘…’ button. Then press the Refresh
   button if required.
9. Ensure the correct images are selected and press the Right arrow
10. Select New Patient
11. Enter the following:
    •    Last Name = CAP
    •    ID1 = flat scanner
12. Select OK. Select the Right arrow three times to save the images to the database.
13. Select Quicklinks > Treatment Planning > BrachyTherapy Planning
14. Open the CAP patient.
15. Under DICOM View, select the images.
16. Select Quicklinks > Treatment Planning > Brachytherapy 2D Entry
17. Drag the images into the main windows. Select View > Measure > Distance to measure the distance of
    the upper vertical line and the horizontal line of the both test images. The distances should be 11.4 cm and
    12.0 cm, respectively. Enlarge the images if necessary by selecting View > Zoom / Zoom In
18. The test passes if the images are successfully scanned and loaded, and the measurements on the screen
    of each image are within 1.5 mm.
19. Close this patient by highlighting the patient in the top Left Focus window and select
    File > Close
Results
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5. The system will automatically create a plan. Enter the following:
    •    If there is no default technique, select Interstitial
    •    Prescribed % = 100
    •    Prescribed Dose / Fraction = 6Gy (or 600cGy)
    •    Number of Fractions = 1
    •    Select OK button.
6. The system will display the following message.
                                  This image should be checked to ensure that it is to scale prior to using it for
               NOTICE             testing, printing and photocopying can rescale the images. (It should also
                                  only be printed on A4 otherwise the image will be rescaled).
12. Verify that Localization > Set Registration Point is selected. Select the AP Window and then, using the
    electromagnetic digitizer, digitize the + on the AP image. Select LAT Window and repeat for the LAT
    image.
13. Select Insert > New Applicator to insert a catheter into plan. Enter the following in the Applicator
    Properties window and select OK
    •    Applicator length (cm) = 130 cm
    •    Step size (cm) = 0.5
    •    First source position (cm) = 0
    •    Last source position (cm) = 0
14. Verify that Localization > Edit Shape is selected. Enter the catheter points using the electromagnetic
    digitizer from the test images on the lightbox. Start with the top most point with coordinate ( 5.7, 11.4) of
    the AP image (AP window active) and proceed to digitize all four corner points of the image. Repeat with
    the LAT image (LAT image active) starting with the coordinate (-5.7, 11.4).
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15. Once the catheter is entered, open the applicator properties (by selecting the applicator in the bottom left
    hand window and select Edit > Properties. Enter the following and select OK
    •    First source position (cm) = 16.5 cm
    •    Last source position (cm) = 17.5 cm
16. Ensure you can see two magenta boxes in the center of the catheter. (These are the sources.)
17. Select Edit > Properties and select Geometry in the Applicator Properties dialog box.
    •    Verify that the four points digitized have the following coordinates:
    •    Standard Planning coordinate system: (5, 5, 10), (5, 5, 0), (-5, -5, 0), and (-5, -5, -5).
    •    IEC 1217 Planning coordinate system: (5, 5,-5), (5, 0,-5), (-5, 0, 5), (-5,-5, 5)
    •    The test passes if the error for each point is less than 2 mm.
Results
                     5, 5, 0
                                                                                      ±0.20cm
                    -5, -5, 0
-5, -5, -5
                     5, 0, -5
                                                                                      ±0.20cm
                    -5, -0, -5
-5, -5, 5
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6.4        TP 4. TG43 Dose Calculation
                                  Test plans for this test can be downloaded from the GCS Data
               NOTICE             Centre>Brachytherapy>BrachyVision.
There is a separate test plan for each treatment unit, i.e. GMpHDR. In case there is a test plan that already
exists on the system, remove the dwell time and re-enter it to force recalculation.
The instructions for creating a test plan can be found in Appendix A Creating a Test Plan.
1. Import the test plan in Quicklinks > Brachytherapy Planning, by going to File > Import> Wizard>
   DICOM Media File Import Filter
2. If the plan is imported the Plan Prescription will default to 1Gy or 100cGy. Right click on the Plan and select
   Properties, change the prescribed dose to 6Gy or 600cGy. OK
3. For VariSource - Select Window > Brief report window and check the source activity.
4. For VariSource - Divide 106 by the activity to get the required dwell time for 106 milliCurie seconds.For
   example with an 8467 mCi source, the required treatment time would be 1,000,000 / 8467 = 118.1
   seconds.
5. For GammaMed machines the source activity should be normalized to 10000mCi for HDR and 1000mCi for
   PDR. Therefore the time for HDR units will be 100 seconds and for PDR 1000 seconds.
6. Select Planning > Modify Dose / Set all dwell times to set the required dwell times.
   Press OK.
7. Go to Planning > Calculate the 3D dose. Select Window > Brief report window. Print the brief report by
   selecting File > Print / View
8. Compare the printed values with those listed in Table 1 below. The results can be accepted if they are
   within 2% of the correct values. (Note that if you need more significant figures in the BrachyVision display;
   change the dose units to cGy. This is done in Varian Tools > Platform Portal, using a system
   administrator log in.)
9. Leave this plan open for TP5 or TP6, whichever is applicable.
10. Accepted results verify that the correct dose calculation parameters were set in the source configuration.
                                  This test checks the dose calculation on BrachyVision using Varian supplied
               WARNING            sources, however if custom sources have been entered it is the user’s
                                  responsibility to perform a manual dose check.
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                        Delete all GammaMed and VariSource HDR and PDR Radioactive Source Model data NOT used
                        for the Afterloader on location. Data to be deleted is in Administration > Clinical Data >
                        Radioactive Source Models.
                        Example: If GammaMed Plus HDR is the operational Afterloader - delete GMP Ir-192 PDR, VS
                        Ir-192 (5mm)..
Results
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     6. Select the Calculate in water and Start Calculation
     7. Once the calculation has completed close the dialogue and select Window > Brief report window. Print
        the Brief report by selecting File > Print / View
     8. Compare the printed values with those listed in Table below. The results can be accepted if they are within
        2% of the correct values. . (Note that if you need more significant figures in the BrachyVision display;
        change the dose units to cGy. (This is done in Varian Tools > Platform Portal, using a system
        administrator log in.)
     9. Leave this plan open for TP6. Accepted results verify that the correct dose calculation parameters were set
        in the source configuration.
     Results
     In some areas, particularly around the tip and tail of the source in high anisotropy areas, TG43 and Acuros
     calculations in water may disagree. This is due to several factors in the TG43 calculation employed by
     BrachyVision, and the published data that it is based on, - particularly the angular resolution of the anisotropy
     data, that reference point doses are calculated exactly to that point, rather than on the 3D dose grid.
     Acuros has been extensively validated against Monte Carlo models, as well as experimental methods, and we
     are confident that it better reflects the real dosimetry in water than the TG43 calculations.
     Finally, check that the treatment plan is correctly transferred to the treatment unit.
     1. Highlight Applicator 1, Channel 1 object in the lower left-hand focus window.
     2. Select Window > Dwell Control Window and enter 75 sec for the dwell time.
     3. Select Planning > Calculate 3D Dose
     4. Select Window > Brief report window followed by File > Print / View to print Brief report.
     5. Right mouse click on the plan, select Plan Approval from the options on the list. Make sure that structures
        are approved and select Continue to the warning.
     6. Select Quicklinks > EMR> Treatment Preparation
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7. Select Reference Points tab and fill out the Dose limit (Session, Daily and Total)
8. Select Quicklinks > Treatment Management > Treatment Preparation
9. Select Scheduling tab and click on Schedule The fraction will be scheduled.
10. Select Approve for Treatment approval of the plan.
11. Select Quicklinks > Treatment Planning > Brachytherapy Planning
12. Select File > Export > Plan to Treatment Unit and make sure to select the location specified in the
    Afterloader properties in RT Admin.
13. Result is accepted if the file is created in the folder configured in section 6.1 step 6.
Results
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6. From the [Users] table, select an existing user and verify that it is possible to define the localized language
   for that user. This can be accomplished using command Edit User double clicking on the user.
7. Use command Add User to add a new user with the following credentials:
Password NlsTest
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7       Reproducibility Tests
The following table indicates some events for which Varian recommends the system be re-tested.
                                          REPRODUCIBILITY TESTS
 EVENT                                                                 TESTS TO RUN
 Frame grabber or Film scanner repair or replacement                   TP1 or TP2
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APPENDIX A                        CREATING A TEST PLAN
1. Go to Quicklinks > Treatment Planning > Contouring, then select Workspace > Selection followed by
   File > New Patient
2. Enter a Last Name and ID
3. Select Quicklinks > Treatment Planning > Brachytherapy 2D Entry to generate a digitizer based plan.
   Select Insert > New Radiograph Set. The system will automatically create a plan. Enter the following and
   press OK:
    •    Prescribed % = 100
    •    Prescribed Dose / Fraction = 6 Gy (or 600 cGy)
    •    The system will ask if you want to continue to work without images. Confirm it.
4. From the list of imaging geometry, select the Orthogonal imaging. Verify that in the Localization Jig
   Properties the Orthogonal type under Geometry tab are selected. Select OK
5. Select Insert > New Applicator and enter the following:
    •    Applicator length = 130
    •    Step size (cm) = 0.5
    •    First source position = 0
    •    Last source position (cm) = 0
6. Select the Geometry button and enter two points for the catheter.
7. Once the catheter is entered in Applicator Properties enter the following and select OK
    •    First source position (cm) = 0 cm
    •    Last source position (cm) = 0.5 cm
8. Select Quicklinks > Treatment Planning > Brachytherapy Planning. Select Insert > New Reference
   Point and Location to enter a new reference point. Click in the transverse view then enter an ID and
   None for the patient volume. Select the Location tab to enter this coordinate from the keyboard: (0.0,
   2.0, and 0.0). Select OK
9. Repeat step 8 starting at Insert > New Reference Point and Location until you have 3 points with the
   following coordinates.
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                                       0                2                0
0 4 0
-4 0. 0
10. There should be a total of 4 reference points together with the primary reference point.
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8       Reference Information
8.1        Revision Information
                                                  REVISION INFORMATION
REV        DATE                   DESCRIPTION OF CHANGE                                      AUTHOR NAME
                                  Template Transfer TMP-GE-IPA_SW-A
                                  Updated Section 7.1 Vidar Film Scanner Test added
                                  instruction to download test articles from the GCS Data
                                  Center. Updated Data table.
                                  Updated Section 7.2 Flatbed Film Scanner Test added
                                  instruction to download test articles from the GCS Data
                                  Center. Updated Data table.
D          29 Jan 2021            Updated Section 7.3 Digitiser Test Step 11. Updated Data   Steve Carey
                                  table.
                                  Updated Section 7.4 Dose Calculation TP4 table
                                  Updated Section 7.5 Acuros BV Dose Calculation TP5
                                  table
                                  Removed Appendix A Test Articles
                                  Removed References to PSE website
C          28 January 2016        Update Acceptance Form to remove Header Product            Stephen Marchesi
                                  Name PCSN line.
8.2        Glossary
CPAD                Customer Product Acceptance Document (generated in Lotus Notes)
CSR                 Customer Service Representative (Varian employee)
FSN                 Field Safety Notice
HIM                 Hardware Installation Manual
IPA                 Installation Product Acceptance
IPAD                Installation Product Acceptance Document (generated in Lotus Notes)
NA                  Non-applicable
PC                  Personal Computer
PN                  Part Number
PNL                 Product Notification Letter
SIM                 Software Installation Manual
STB                 Service Technical Bulletin
V                   Version (normally used before software version number)
VMS                 Varian Medical Systems
WS                  Workstation
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8.3        Document Information
                NOTICE      Information in this document is subject to change without notice and does not
                            represent a commitment on the part of Varian. Varian is not liable for errors contained
                            in this document or for incidental or consequential damages in connection with the
                            furnishing or use of this material.
                            This document contains proprietary information protected by copyright. No part of this
                            document may be reproduced, translated, or transmitted without the express written
                            permission of Varian Medical Systems, Inc.
      TRADEMARKS            Varian products referenced herein are either registered trademarks or trademarks of
                            Varian Medical Systems in the U.S. and/or other countries. The names of other
                            companies and products mentioned herein may be the trademarks of their respective
                            owners. Any rights not expressly granted herein are reserved.
       CONTACTING           Support services are available without charge during the initial warranty period. If you
         SUPPORT            seek information not included in this publication, contact Varian support with the
                            following number or link:
                            Telephone support – 1.888.VARIAN5 (1.888.827.4265)
                            For International telephone numbers - Varian Contacts
                            To contact the support location nearest you for service, parts, or support, see the list at
                            the Varian Medical Systems website: VMS Worldwide Contacts
                            You may use MyVarian for all means of contacting Varian. Click Contact Us. No
                            registration is required but is recommended.
                            If you are unable to access MyVarian, use the following email address for support:
                            support@varian.com
         COPYRIGHT          2021 Varian Medical Systems, Inc. All rights reserved. It is strictly prohibited to copy
                            this document or disclose the contents to unauthorized recipients.
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8.4        Acceptance Form
              BrachyVision Standalone
                          Workstation
                                        H6B:
                  BrachyVision Network
                           Workstation
                                        H48:
                                  Institution:
                                   Address:
                                                 The signature above indicates that all applicable and required tests
                                                 within this document, have been satisfactorily performed and met the
                                                 required product specification.
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