QA SoftwAre

• Comprehensive TG-142

ImaGInG and machIne QaAutomate the analysis of over

30 TG-142 recommended QA tasks without film

TG-142 imager and machine QaThe 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 ConfidenceSeveral 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.

Refined User -Inter faceThe 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.

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)

imager QC, now TG-142 Recommended

mechanical • 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

Planar MV Imaging [EPID]• 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)

Quantify the quality of your imagersCompare results to published values

Phantom on surface of EPID Phantom at isocenter

6 MV 10 - 25 MV 6 MV 15-18 MV

EPID f50 epi f30 epi f50 epi f50 iso f30 iso f50 iso

Measurements of spatial resolution in lp/mm

SRI-1000.18 ± 0.02 0.18 ± 0.02

0.30 ± 0.020.23

Siemens Beamview

0.18 0.170.21 ± 0.03 0.19 ± 0.010.21 ± 0.02 0.22 ± 0.02

Theraview 0.23 ± 0.01 0.22 ± 0.01

PORTpro0.26 ± 0.03 0.23 ± 0.01

0.25 ± 0.02

Elekta iView 0.24

Beamview TI 0.24 ± 0.01 0.29 ± 0.01

Varian Portalvision

MkII

0.26 ± 0.01 0.25 ± 0.010.285 0.27

0.33 ± 0.04 0.28 ± 0.01

Varian aS5000.39 0.34

0.60

Varian aS1000 0.45 .379

Elekta iViewGT0.77 0.49 - 0.58

0.46 0.77

Published reference performance values for spatial resolution

Enhanced Imager QA moduleThe Imager QA module consolidates TG-142 testing for MV, kV

and 3D CT (both cone-beam and diagnostic) into a uniform, easy-

to-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

PIU (ACR percent integral uniformity).

A comprehensive baseline manager lets users customize imager

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

quickly exported to a PDF file. These reports contain a summary

page detailing which values pass or are out of range, along with

images of each result. All data is automatically tagged as green,

yellow or red for an easy overview of passing/failing results.

additional New Features• Unified interface allows for multiple modules of PIPSpro to be

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.

new!

Quantify the quality of your imagers

Track and Trend Imager PerformancePublished image resolution data for PIPSpro’s QC-3 phantom

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.

validated Performance, documented ResultsWith 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,

allowing for the planar determination of resolution, contrast

and noise. Compare these results to published data for further

confidence in your QA.

QC-3 Phantom

QCkV-1 Phantom

Simple IGRT Trending

intuitive IGRTWhen 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.

MIMI Phantom

Specialized Phantoms, Superior QA

precise Winston-Lutz/Stereotactic Radiosurgery QAIn 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

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.

Winston-Lutz Phantom

Complete MLC QAThe MLC QA module analyzes a single, specialized phantom;

producing quantitative data to determine if your collimator can

accurately position leaves.

This module also follows TG-142 guidelines for reviewing

multiport or ‘picket-fence’ images. These test a MLC’s ability

to position individual leaves at multiple positions during single

treatments such as step-and-shoot and sliding window IMRT.

In addition, the module lets users measure inter-leaf and inter-

bank leakage and leaf-width, making PIPSpro the only software

necessary for comprehensive MLC QA. The MLC QA Module

meets TG-142 guidelines for the following tests:

• Qualitative test [i.e., matched segments, aka ‘picket fence’]

• Setting vs radiation field for two patterns [non-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

MLC Phantom

advanced Radiation Field/Light FieldThe 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.

• 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

Center Markerand FC-2 Phantom

Thorough service, knowledgeable support

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

P I P S p r o S o f t w a r e S P E C I F I C A T I O n S

Catphan® is a registered trademark of The Phantom Laboratory. Windows® is a registered trademark of Microsoft Corporation. Specifications subject to change without notice.

visit www.standardimaging.com or call 800-261-4446 for more details.

powerful Star Shot AnalysisPIPSpro’s Star Shot Module uses an EPID or film to measure the

stability of rotation of the linac gantry, couch and collimator.

Analysis of these images provides quantitative results for

mechanical procedures, including:

• 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

of measuring tolerances of ±1 mm from baseline.

Centralized Database Management PIPSpro can store data on a central network for quick

documentation and access for TG-142 test results and trending

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.

Over 55 publications validate the performance of PIPSpro.

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

To learn more call (800) 261-4446 or (608) 831-0025

Publications1. implementation of electronic portal imaging in a busy

radiation therapy treatment center. m. davis, r. sabey, r. rajapakshe. Proc. Workshop on Electronic Portal Imag-ing, 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 EPI-system (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. Wan-nenmacher. 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. Wan-nenmacher. 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 & Oncol-ogy 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 po-sitioning 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-multiplica-tion-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 im-mobilization 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 Imag-ing, 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 commisssion-ing 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 thermo-plastic 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: 155-162 (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 abdo-men. 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. her-man, 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. Raja-pakshe, 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 Imag-ing, 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 optimisa-tion 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 computer-assisted 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 perfor-mance. menon Gv, sloboda rs. Medical Dosimetry - Spring 2004 (Vol. 29, Issue 1, Pages 11-17).

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