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WS 582-2017: Specifications for testing of quality control in X and γ ray stereotactic radiotherapy system
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Specifications for testing of quality control in X and γ ray stereotactic radiotherapy system
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WS 582-2017
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Basic data | Standard ID | WS 582-2017 (WS582-2017) | | Description (Translated English) | Specifications for testing of quality control in X and �� ray stereotactic radiotherapy system | | Sector / Industry | Health Industry Standard | | Classification of Chinese Standard | C57 | | Word Count Estimation | 15,157 | | Date of Issue | 2017-10-27 | | Date of Implementation | 2018-05-01 | | Regulation (derived from) | State-Health-Communication (2017) 22 | | Issuing agency(ies) | National Health and Family Planning Commission of the People's Republic of China | WS 582-2017: Specifications for testing of quality control in X and γ ray stereotactic radiotherapy system
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Specifications for testing of quality control in X and γ ray stereotactic radiotherapy
ICS 13.280
C 57
WS
People's Republic of China Health Industry Standard
X, γ-ray stereotactic radiotherapy system quality control test specifications
system
2017-10-27 released
2018-05-01 implementation
Issued by the National Health and Family Planning Commission of the People's Republic of China
Foreword
Chapter 4 of this standard is mandatory, and the rest are recommended.
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
This standard consists of the quality control part of GBZ 168-2005 "X, γ-ray head stereotactic surgery radiological protection standards"
Transformed. Compared with the quality control part of GBZ 168-2005, the main technical changes are as follows.
--The scope is expanded to the items, methods and technical requirements of quality control testing of body X and γ-ray stereotactic radiotherapy systems;
--Modified the item name of "the maximum deviation of the irradiation field size from the nominal value" in the test items of the γ-ray stereotactic radiotherapy system
And testing and judging methods;
-The term "(γ-knife positioning) mechanical center" is modified to "positioning reference point";
--Added an informative appendix for the quality control test phantom of the body X and γ-ray stereotactic radiotherapy system.
Drafting organizations of this standard. Institute of Radiation Medicine, Shandong Academy of Medical Sciences, Institute of Radiation and Radiation Medicine, Academy of Military Medical Sciences, Guangzhou
Eastern Province Occupational Disease Prevention Hospital.
The main drafters of this standard. Lu Feng, Xie Xiangdong, Deng Daping, Huang Weixu, Song Gang, Chen Yingmin, Xu Jiaang, Bi Mingwei.
1 Scope
This standard specifies the requirements and methods for quality control testing of X and γ-ray stereotactic radiotherapy systems.
This standard applies to γ-ray stereotactic radiotherapy system (hereinafter referred to as "therapeutic system") and X-ray stereotactic radiotherapy
System (hereinafter referred to as "X-knife") quality control inspection.
This standard does not apply to quality control testing of robotic radiotherapy devices.
2 Normative references
The following documents are indispensable for the application of this document. For dated reference documents, only the dated version applies to this document.
For undated references, the latest version (including all amendments) applies to this document.
GBZ 126 Radiation Protection Requirements for Electron Accelerator Radiotherapy
3 Terms and definitions
The following terms and definitions apply to this document.
3.1
X and γ ray stereotactic radiotherapy system
Using stereotactic equipment, X-ray computed tomography equipment (hereinafter referred to as "CT") and other imaging equipment and radiotherapy planning system
System (hereinafter referred to as "TPS"), to determine the exact position and range of the diseased tissue and adjacent important organs, using X-rays or γ-rays to focus on
A device that targets radiotherapy.
3.2
Focus
In the treatment system, the intersection of all beam axes.
3.3
Reference localization point
In the treatment system, when the system is in the predetermined irradiation position, the calibration points of the treatment bed and the stereotaxic device are used to indicate the treatment system
Position the center.
3.4
Center of radiation field
In the treatment system, the focal point is perpendicular to and parallel to the multi-beam symmetry axis or the central axis of rotation in the plane, and the 50% isodose curve
The center point of the defined area.
4 requirements
4.1 See Appendix A for the quality control test items and technical requirements of X and γ-ray stereotactic radiotherapy systems. For the model used in Appendix A
For the inspection items completed by the body, the head model should be used for head treatment; the phantom should be used for body treatment; at the same time, the head
The body treatment should be done separately using a head model and a phantom.
4.2 The selection of inspection items for acceptance inspection and status inspection shall be carried out in accordance with Appendix A. The selected item does not meet the corresponding requirements in Appendix A
When required, it shall be stated in the test report.
4.3 The content of the report of acceptance inspection and status inspection shall at least include. basic information of the inspected unit, basic information of the inspected equipment, inspection items,
Test conditions, test results and test conclusions.
4.4 Acceptance testing and status testing results are equal to or better than the corresponding requirements in Appendix A as qualified.
4.5 The items of stability testing should include at least the items indicated in Appendix A, and the testing frequency should not be less than the period indicated in Appendix A. Make
The user unit shall record and archive relevant information such as the date of stability test, test personnel, test results, etc.
5 Testing equipment and phantom
5.1 Dose detector
5.1.1 The ionization chamber detector is suitable for measuring the absorbed dose of X and γ-ray stereotactic radiotherapy systems.
5.1.2 The external dimensions of the effective collection volume of the ionization chamber detector should meet the measurement requirements.
5.2 Film and scanner
5.2.1 The film scanner shall meet the technical requirements for scanning film. Before use, the scanner should be sized. When scanning, you should
Select the scanning light channel and scanning direction as required.
5.2.2 The film should have low energy dependence, close to human tissue density and sufficient spatial resolution (at least 10lp/mm).
5.2.3 Regular maintenance of the film and scanner. When changing different types and batches of film, the dose-gray curve should be re-established. with
When a batch of film is used for a long time, the dose-gray curve should be updated regularly (generally not more than 3 months).
5.3 Phantom
5.3.1 The phantom should be made of homogeneous materials with a density similar to that of human tissues. Solid water materials are recommended. There are slots in the mold,
Used to insert film inserts or detector inserts.
5.3.2 The head mold should use a spherical phantom, and the phantom should use a cylindrical phantom with an oval cross section. For the recommended shape and size of the phantom, see
Appendix B.
5.3.3 The gap between the insert plate and the slot of the phantom, between the insert plate and the film, and between the detector and the socket should be as small as possible, so that the measurement is not
Prone to displacement.
5.3.4 There should be positioning holes on the film insert. The cross-sectional diameter of the positioning hole should not exceed 1.0mm. The recommended positioning hole distribution is shown in the attachment
Record B.
5.3.5 When the phantom is at an ambient temperature of 15℃～35℃, atmospheric pressure of 80kPa～110kPa, and a relative humidity of 30%～75%,
No size change should occur.
6 γ-ray stereotactic radiotherapy system detection method
6.1 The distance between the positioning reference point and the center of the irradiation field
6.1.1 Put the special measuring tool on the positioning pin of the positioning bracket and adjust the position according to the manufacturer's instructions.
6.1.2 Load the film into the special measuring tool, make the film in a horizontal position, press the pressure pin on the special tool, and pierce a film on the film
Hole, the special tool is sent to the predetermined irradiation position along with the treatment bed, and the smallest collimator is selected for irradiation.
6.1.3 Replace the film in the special measuring tool so that the film is in a vertical position, and repeat the piercing and irradiation operations in 6.1.2.
6.1.4 After scanning the film, use the film analysis software to give the dose distributions in the X-axis, Y-axis and Z-axis directions, and calculate the three dose distributions respectively.
The distance between the positioning reference point and the center of the irradiation field in the direction, calculate the distance between the positioning reference point and the center of the irradiation field according to formula (1)
6.2 Focus dose rate
6.2.1 Insert the ionization chamber detector insert into the phantom, fix the phantom according to clinical methods, and use CT scan to locate.
6.2.2 Import the positioning image into TPS, register it, and establish a coordinate system. On the central fault of the phantom, set the position of the ionization chamber measurement reference point
Set the center of the target area (that is, the focus position) as the treatment plan, and make a single-target radiation treatment plan with the largest collimator. According to about 300s
Exposure time preset exposure dose.
6.2.3 Transfer the phantom to the treatment bed and execute the radiation treatment plan.
6.2.4 After the start of irradiation, use a dosimeter to measure the water absorbed dose for 60s of irradiation time. Before the end of the irradiation, complete 3 identical measurements
Measure and take the average value as the measurement result.
6.2.5 When the phantom is a solid water material, the measurement result is the focal dose rate. When the phantom is a non-solid water material, the measurement result
A correction is made to take the absorbed dose of water at the same depth in the water medium as the focal dose rate.
6.3 The relative deviation between the planned dose and the measured dose
6.3.1 Perform measurement according to 6.2.1.
6.3.2 Import the positioning image into TPS, register it, and establish a coordinate system. On the measurement reference point fault of the ionization chamber, set the measurement reference point of the ionization chamber
The location is used as the center of the target area of the treatment plan, and a single-target radiation treatment plan with a collimator is made. 50% dose curve preset 5Gy
Then, use the volume element dose tool in TPS to read the planned dose at the measurement reference point.
6.3.3 Transfer the phantom to the treatment bed and execute the radiation treatment plan. Use a dosimeter to measure the actual output dose.
6.3.4 Calculate the relative deviation vD between the planned focal dose and the measured dose according to formula (2).
6.3.5 The irradiation field of the collimator that is not suitable for the measurement of the ionization chamber detector, the relative deviation between the planned dose of the collimator and the measured dose can be
It can be obtained indirectly after measuring the output factor of the collimator irradiation field using a semiconductor detector.
6.4 Dimensional deviation of irradiation field
6.4.1 Load 1 piece of film into the film insert, insert the film insert into the phantom in the horizontal or vertical direction, and fix the phantom according to clinical methods.
After setting, use CT scan to locate.
6.4.2 Import the positioning image into TPS, register it, and establish a coordinate system. On the fault of the center positioning hole of the film insert, place the center positioning hole
The position of the film is used as the center of the target area of the treatment plan, and a single-target radiation treatment plan with a certain collimator is made. Preset dose for 50% dose curve
The radiation dose of the film can be kept within the best linear region of the dose-gray curve.
6.4.3 Transfer the phantom to the treatment bed, replace the new film in the film insert, and execute the radiotherapy plan. After the irradiation is completed, from the phantom
Take out the film insert, and drill holes in the surrounding positioning holes.
6.4.4 Take out the film and mark the direction of the irradiation field. Use the film scanner to scan the film and save the image.
6.4.5 Use film analysis software to import images, and determine the target area of the treatment plan according to the geometric position relationship between the surrounding positioning holes and the center positioning holes
The position of the center on the film. According to the dose value of the center position of the target area on the film and the dose curve value of the corresponding point in the TPS, the film dose is
Perform normalization.
6.4.6 On the film analysis software, find out the 3 axes (X-axis, Y-axis, Z-axis) passing through the center of the target area of the treatment plan and 50% of the agent
The intersection of the volume curve. Measure the distance between two intersections on the same axis and compare it with the corresponding distance given in TPS, according to formula (3)
Calculate the size deviation vS of the irradiation field on the axis.
6.5 Penumbra width of the irradiation field
After operating according to 6.4.1～6.4.5, on the film analysis software, find the 3 axes (X axis, Y axis,
Z axis) and the intersection of 80% isodose curve and 20% isodose curve. Measure the two intersection points on the same axis on the same side of the center of the target area
Take the largest distance as the penumbra width of the irradiation field on the axis.
7.Ray stereotactic radiotherapy system detection method
7.1 Isocentric deviation
7.1.1 Isocentric deviation of X-knife without floor stand
7.1.1.1 Clamp a film with two built-up material boards with a thickness of not less than 10mm and make them stand perpendicular to the treatment bed along the LAT direction
The center of the film is positioned on the axis of the radiation beam, and the source-gel distance is the normal treatment distance. The upper tungsten door of the accelerator is opened, the lower tungsten door is closed,
Leave a narrow slit, and rotate the large frame to 0°, 45°, 90°, 135° to irradiate the film and develop, the maximum distance between the intersections of the different black lines
1/2 is the rotation deviation of the large frame.
7.1.1.2 Clamp a film with two built-up material boards with a thickness of not less than 10mm, and place them horizontally on the treatment bed so that the center of the film
On the radiation beam axis, the source-gel distance is the normal treatment distance. The upper tungsten door of the accelerator is opened and the lower tungsten door is closed, leaving a narrow gap to divide the small head
Do not rotate to 0°, 45°, 90°, 135° to irradiate the film and develop it. 1/2 of the maximum distance between the intersections of different black lines is the rotation of the small head
deviation.
7.1.1.3 Clamp a film with two built-up material boards with a thickness of not less than 10mm, and place them horizontally on the treatment bed so that the center of the film
On the radiation beam axis, the source-gel distance is the normal treatment distance. The upper tungsten door of the accelerator is opened and the lower tungsten door is closed, leaving a narrow gap to divide the treatment bed
Do not rotate to 0°, 45°, 90°, 135° to irradiate the film and develop. The maximum distance between the intersections of different black lines is 1/2 of the rotation of the treatment bed
deviation.
7.1.1.4 Calculate the isocenter deviation of X-knife according to formula (4)
7.1.2 Isocentric deviation of X-knife with floor stand
7.1.2.1 Install the zero-pointer checker, and adjust the laser beams to converge to the tip of the pointer. Set the coordinates of the 3D coordinate headstock center
Is (0, 0, 0). Make the center coordinates of the known target point consistent with the isocenter of the system, install the clamping device, and install the film. Choose a common function
The diameter of the collimator can be selected from 26mm to 30mm. According to each combination position given in Table 1, expose separately.
7.1.2.2 Use the film analysis software to give the dose distribution of the isocenter plane, and determine the radiation field and the known
The geometric center of the target point, measure the distance between the two geometric centers (irradiation field, known target point) at each combined position, take the largest one and use the millimeter
Meter (mm) represents the unit.
7.2 Treatment positioning deviation
7.2.1 Fix the phantom equipped with the target according to the clinical method, and perform CT scan with a thickness of not more than 2mm. Send scan data to treatment
The planning system calculates the coordinates of the target point and locates it to the isocenter of the system. Select a common energy and a common collimator of the system, respectively
Take anterior and lateral films of the target point.
7.2.2 Use the film analysis software to give the dose distribution in the three directions of LAT, AP, and VERT, and measure the radiation field in the three directions respectively.
The distance between the heart and the target center is calculated according to formula (5)
7.3 The maximum deviation of the irradiation field size from the nominal value
7.3.1 Select the commonly used energy of the system, place the film in the center of the isocenter plane, place the accelerator frame at 0°, select the appropriate dose,
A certain collimator completes an exposure.
7.3.2 Use the film analysis software to give the dose distribution, measure the width corresponding to the half-peak dose and compare it with the nominal value to find the maximum deviation.
The unit of the result is expressed in mm.
7.4 Penumbra width of irradiation field
7.4.1 Perform measurement according to 7.3.1.
7.4.2 Use the film analysis software to give the dose distribution, and measure the width from 80% maxD dose point to 20% maxD dose point.
The position is expressed in millimeters (mm).
7.5 Relative deviation between planned dose and measured dose at isocenter
7.5.1 Insert the ionization chamber into the phantom, fix it according to the clinical method, and perform CT scan with a thickness not greater than 2mm.
7.5.2 Send the scanned data to the TPS, make the measurement reference point of the ionization chamber coincide with the target point, and make a radiotherapy plan. Select a collimator,
Set the absorbed dose of the target point, perform simulated treatment irradiation and measure the treatment dose. After the measurement results are processed, the isocenter is calculated according to formula (2)
The relative deviation between the planned dose and the measured dose.
7.5.3 The irradiation field of the collimator that is not suitable for the measurement of the ionization chamber detector, the relative deviation between the planned dose and the measured dose at the isocenter of the collimator
It can be obtained indirectly after measuring the output factor of the collimator's irradiation field using a semiconductor detector.
7.6 The performance test of the medical electron accelerator supporting the X-knife treatment mode is carried out according to GBZ 126.
Appendix A
(Normative appendix)
Quality control test items and technical requirements
A.1 The quality control test items and technical requirements of γ-ray stereotactic radiotherapy system are shown in Table A.1.
a The nominal size of the maximum collimator irradiation field for head treatment should not be greater than 30 mm.
b The nominal size of the radiation field of the largest collimator for body treatment should not be greater than 60 mm (the radiation field of special shape can be a size equivalent to a circle with a diameter of 60 mm).
c During the acceptance test and stability test of the penumbra width of the irradiated field, all collimators should be measured; during the state test, the first gear commonly used collimator can be measured.
A.2 X-knife quality control test items and technical requirements are shown in Table A.2.
B.1 Material of phantom
The phantom can be made of solid water, polystyrene or plexiglass, and solid water materials are recommended.
B.2 The structure of the phantom
The head mold is composed of a sphere structure, a film insert, a detector insert, etc. The phantom consists of a cylindrical structure with an oval cross section and a film insert.
It is composed of boards, detector plug-in boards, etc.
B.3 Head mold size
The head mold is a sphere with a diameter of 160mm, which is composed of two hemispheres and connecting pieces. There is a slot between the two hemispheres for inserting film
Socket and detector socket. The detector plug-in board has a center detector socket and an off-center detector socket for inserting the detector. Head die ruler
Schematic diagram of the size and the position of the detector socket is shown in Figure B.1.
B.4 Phantom size
The phantom is an elliptical cylinder. The length of the long axis of the cross section of the elliptic cylinder is 280mm, and the length of the short axis is 240mm. The height of the elliptical cylinder is
200mm. There are slots on the elliptical cylinder for inserting film inserts and detector inserts. There is a central detector jack on the detector board
And off-center detector socket for inserting the detector. The schematic diagram of the phantom size and the position of the detector socket is shown in Figure B.2.
B.5 Positioning hole of film inserting board
There are positioning holes on the film inserting plate of the phantom. According to the location of the positioning holes, it is divided into a center positioning hole and a peripheral positioning hole. Horizontal of positioning hole
The cross-sectional diameter does not exceed 1.0mm. During measurement, the center positioning hole is used to identify the center of the target area (that is, the focus position) of the treatment plan. Centered
Do not position the film with acupuncture at the location hole, so as not to affect the normalization of the film dose curve;
Bit. On the film, the position of the center positioning hole can be determined according to the relative position relationship between the center positioning hole and the surrounding positioning holes. When measuring, according to
To measure the size of the irradiation field, use films of different sizes and select the corresponding peripheral positioning holes for hole positioning. Positioning hole distribution of film board
The intent is shown in Figure B.3.
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