参考案例成果3 preview

SourceTarget11Introductionto2Thesystemcomeswithapre-installedbeam3Inthefactory,themachineoutput,energy,andbeamprofilesareadjustedtomatchstandardbeammodeldata.4Machine-specificMLCpropertiesaremeasuredandenteredonyour在您的系统上测量并输入了特定于机器的MLC5Thefacilityshouldmakearrangementswiththeinstallerstoperformaradiationsurveyassoonaspossibleafterthesystemisabletoproduce6Followinginstallation,qualifiednelwillverifythatyoursystemmeets<25>Accuray</25>Incorporatedtolerances,asoutlinedintheAcceptanceTestProcedures,includingbutnotlimitedto:序”<25>Accuray</25Incorporated公差，78LINACalignedinIECXwithLINACIECXMLC9LINACalignedinIECYwithLINACIECYBeampointedinneofgantryLasersandcouchalignedwithbeamlineandDetectoralignedinIECYwithIECYBeamcharacteristicsforasinglerepresentativefieldLongitudinalandtransversePercentdepthOutputcalibrationusinghelicalIMRTmeasurements(Establishbaselineforfuturestaticoutput/energyconstancychecks)IMRT测量进行输出校准（建立基线以供未来的MVCTMVCTMachineprocedurefilesusedduringspecificationconformanceverificationaremadeavailabletothesitephysicistforfutureuse.Thesitephysicistwillalsoreceiveacopyofthereferenceanddata,spreadsheetssummarizingtestsperformed,andatestpatientforIMRTdosecalibration.测试的电子表格及测试患者以进行IMRT剂量校准。After<80>Accuray</80>Incorporatedhascompletedthespecificationconformanceverificationandacceptancetesting,thesitephysicistcanproceedwiththeremainingcommissioningtasks.>TG148 mendsthatpriortothestartofpatienttreatments,alldaily,monthly,quarterly,andannualQAtestsshouldbeTG148按月、按季度和按年QABeforecreatingtreatmentns,thesitephysicistwillalsoneedtoprepareaDensityModelforeachCTscannerinthefacilitythatprovidesimagesfor<81><82>Radixact</82></81>treatmentns.>Thesitephysicistmakesthefinaldecisionofwhenthemachineisreadytotreatpatients.1DosimetryfortheTreatment2DosemaybecalculatedforthetreatmentbeamusingamodifiedversionoftheTG-51protocol,asdescribedbyTG-148.TG-148TG-513TheTG-51protocolisnotdirectlyapplicabletothetreatmentbeambecausethe100mmx100mmfieldwidthisnotachievable.100mmx100mm的射野宽度，TG-514The850mmSADand850mmdiameterboreopeningofthesystemdonotallowsufficientspaceformeasurementsat1000mmSSDand100mmdepth,asprescribedbyTG-51.850mmSAD850mm直径的系统孔径开口提供的空间TG-511000mmSSD100mm深度下执量5Also,becausethesystemhasnoflatteningfilter,thebeamqualityspectrumisdifferentthanforaconventional6MVsystem.MV6TG-148prescribesmodificationstotheTG-51protocolto theuniqueaspectsofthedelivery:a"machine-specific-reference"factorisincludedintheTG-51dosecalculationtoaccountforthedifferencesingeometryandbeamqualityfromaconventionalsystem,anda"n-classspecificreference"factorisincludedforIMRTtreatmentTG-148TG-51方案的修改，以便适应实施的独特方面：TG-51剂量计算中包含“特定于机器的参考”因7Thecombinedscalingeffectofthebeamqualityfactor,machine-referencefactor,andn-classspecificreferencefactorisverycloseto1.0。8 mendsconvertingionchamberchargemeasurementstodoseusingtheformalismdescribedinTG-<28>Accuray</28>建议使用TG-148中所述的将电9However,when<29>Accuray</29>IncorporatedneldosefromtheA1SLionchambermeasurements,asimplifiedformulais>电离室测量确定剂量时，使用的是简化where<35>D</35>isthecalculateddose,<36>M</36>isthechargereadingthathasbeencorrectedforpressureandtemperature(theA1SLarrivescalibratedbyaUSaccreditedstandardslabat22Cand760mmHgabsolutepressure),>对压力和温度校正的电荷读数（A1SLUS认证标准在22C和760毫米柱绝对压力下进行的校准istheionchambercalibrationfactor,and<38>P<39>elec</39></38>istheelectrometercalibrationfactor.>Dosemeasurementswiththe<40><41>Tomo</41></40>Electrometeraremadeat+300Vtomatchthecalibrationconditions.>+300VDosecalculationsusingthesimplifiedformulaareveryclosetotheTG-148calculations.使用简化进行的剂量计算非常接近TG-148计算Thesimplifiedformulahelpstoreducetheriskofgrosserrorsbyreducingthenumberoffactors.ThetreatmentbeamiscalibratedtoachieveagreementbetweennningdosecalculationsandIMRTionchamber校准治疗射束，以使计划剂量计算与IMRTDependingonhowthevarioussystemparametersfallwithintheirtoleranceranges,thestaticopen-fieldoutputofthesystemmayvaryfromonemachinetoThemachine-specificstaticoutputrateofyoursystemwillbedeterminedduringcommissioningandusedhenceforthasaconstancyAtypicalstaticoutputrateforasystemwiththestandarddoserateconfigurationis850±30cGy/minat850mmSSD,15mmdepthin<53><54>VirtualWater</54></53>,and50mmx400mmfield850mmSSD850±30cGy/min、<53><54>VirtualWater</54></5315mm50mmx400mm的射野Atypicalstaticoutputrateforasystemwiththehighdoserateconfigurationis1025cGy/minat850mmSSD,15mmdepth850mmSSD1025cGy/min、<59><60>VirtualWater</60></59>,and50mmx400mmfieldWater</60></5915mm50mmx400mm的射野Aswiththestandarddoserate,themachine-to-machinevariationinthenominaloutputrateisexpectedtobeafewpercent.1Machine2ThebeammodelandothermachineparametersmaybeaccesseduserswithappropriatepermissionsfromtheTreatmentDelivery3Fromthe ,click<33>Edit4Fromhereyoucanlookatthedatatree,whichcontainssystemlevelproperties,aswellaspropertiesforthetreatmentandimage5Someparametersinthe<36>EditMachine</36>areaareusedbythesystemforncalculations,whileotherparameterscontrolvariousaspectsofbeamdeliveryandimagereconstruction.6Afewparametersarelabelsthatdonotcontrolanything,orarenotusedatall.7Severaloftheparametersdescribebasicsystemcharacteristicsthatarenotintendedtobechangedfromtheirdefaultvalues.8Theparametersaccessiblefromthemachinedataareaareintendedbemaintainedbytheservice可通过机器数据区域的参数预期由服务代表9Permissiontoaccessthe<39>EditMachine</39>areaoftheTreatmentDeliveryConsoleisassignedfromthe<40>UserAdministration</40>taskofthePrecision™TreatmentnningSystemsystem.区域的权限通过Precision™治疗计划系统Itis mendedthatthesitephysicistnotchangeanyparametersinthemachinedataarea,exceptthatthesitephysicistmaycalibratethemonitorunitdisy,asdiscussedin.。Severaloftheparameterscontainlistsofnumbers,andarenotorganizedinahuman-readableway.Theservicerepresentativehasspecialsoftwaretoolsforpopulatingthesedatafields.Thedatathatwasprovidedtoyoursiteby<44>Accuray</44>>SupportatthecompletionofAcceptanceTestingincludesreferencelongitudinalandtransverseprofiledata,PDDs,andenergyspectrumdatainaspreadsheetformat.据、PDD和电子表格格式的能量频谱数据。IfyouneedacopyofthebeammodeldatathatwasinstalledonyoursystemandcannotfindyourATPdata,contact<63>Accuray</63>CustomerSupportforassistance.ATP<63>Accuray</63客户支持Donotchangethe<87>EditMachine</87>dataunlessyouarefullytrainedbyAccurayintheconsequencesofchangingaparticular<87>EditMachine（编辑机器）</87>数据，除非您在特定参数更改后获得了Accuray的充分培训：Inappropriatechangesmayresultindiscrepanciesbetweenncalculationanddeliverythatcouldcausedeathorserious异，从而可能导致或严重Inappropriatechangesmaycauseunnecessarywearonsystemcomponents,causingsystemdowntimeforrepairs.TheDoseControlSystem(DCS)iscalibratedbytheservicerepresentativeinaseparatesoftwareprogram.)Some<100>EditMachine</100>changeswilltriggerinterlocksthatrenderthesystemunabletorunthebeam,untiltheservicerepresentativerecalibratestheDCS.<100>EditMachine（编辑机器）</100>更改将触发EditingthemachinerequiresspecialTheonlytwoparametersthatthesitephysicistcouldhavelegitimatereasontoadjustarethe<126>ExpectedMU(MU/min)</126>andthe<127>MUperchamber<126>ExpectedMUMU/min)（MU</126><127>MUperchambercount（每个监测室计数MU）</127>。Thesetwoparametersinfluencethemonitorunitdisyandreporting,butdonotimpactthebeamdelivery(see出（）Changingmachineparameters(otherthanthe<129>Expected((MU/min)</129>and<130>MUperchambercount</130>)mayputthesysteminastatewhereitcannotbeuseduntiltheservicerepresentativeperformscalibration,destroymachinecomponents,orcauseamismatchbetweenbeampropertiesfordeliveryversusMUMU/min)）</129><130>MUperchamber（MU）</130>）可能会使系统进入1SystemLevel2ThissectiondescribessomeofthedatacomponentsthatareincludedintheSystemLevelportionofthe<22>EditMachine</22>tree.3Machine4The<34>Helicalstartangle(deg)</34>parameterisnotcurrently5The<39>Boresize(mm)</39>isthediameteroftheopeningintheborethroughwhichthepatiententers,andis850mm.(6The<44>Maxjawspeed</44>isexpressedinmillimeters(jawnumbers)persecond,andisusedduringEndofnningtoensurethatthedynamicjawmovementdoesnotexceedtheumspeed.7The<49>WaterTemperatureMinimumThreshold</49>and<50>WaterTemperatureumThreshold</50>determinethecolorofthe<51>WaterTemperature</51>indicatorintheupperleftcornerofthehomescreenoftheTDC,anddonotcontrolthemachine.<49>WaterTemperatureMinimumThreshold（水温最低阈值）</49>和<50>WaterTemperatureumThreshold<51>WaterTemperature（水温）</51>指示器的颜色，不8The<56>Facilitylightsmode</56>appliestotheindicatorlightsoutsidethebunker(power,radiation,etc.)In<57>MutuallyExclusiveMode</57>,onlyonelightwillbeilluminatedata<56>Facilitylightsmode（设施指示灯模式）</56>适用于9Innon-exclusivemode,multipleapplicablelightscanbeilluminatedatthesametime.<67>DoseReferencescalibrationfilessetbytheservicerepresentativetodefinetherelationshipbetweenDose1andPAC,andbetweeninjectorcurrentandguncurrent.参考服务代表设置的参考校准文件来定义Dose1Includeslimitsonthecouchspeed,aswellasparametersthatcontrolcouchinsertionfortreatmentnningandindicatesthefilelocationofthecouchimageusedfortreatmentnning.The<75>Outofboresetup</75>parameterssetthedefaultcouchpositionforMachineQAprocedurecreationtobringthecouchoutofthebore(whenthe<76>useDefaultCouchSetupPosition</76>parameterinthe<77>.xml</77>fileissetto<78>true</78>).<75>Outofboresetup（退出孔径设置）</75>参数设置机QA程序创建时的默认治疗床位置，以便将治疗床带出孔径（<77>.xml</77>文件中的Thisdefaultcouchpositionisalsousedasthe<79>ExpectedCouchPosition</79>forimagesandtreatmentswhenthereisnopre-definedorstoredcouchpositionavailable.<79>ExpectedCouchThe<80>Outofboresetup</80>positionisdeterminedatthetimetheprocedureisdelivered.<80>Outofboresetup（退出孔径设置）</80>Ifyouchangethe<81>Outofboresetup</81>position,aMachineQAprocedurewillusethenewonenexttimeitruns.<81>Outofboresetup（退出孔径设置<86>MVCT<86>MVCTSettings（MVCT设置Containsparametersrelatedtoimageacquisitionand<91>AirscanContainsparametersrelatedtoacquisitionandysisofairscan<96>LinearityContainsparametersforautomatedysisoftheCTcalibrationCTProvidesbasicinformationonthedetectorgeometry,andallowsservicerepresentativetoidentifybadchannelsthatshouldnotbeusedforimagereconstruction.<106>GantryReferencesconfigurationfilesforgantrycalibrationbytheservice<111>JawTheservicerepresentativeadjuststhesevaluestoensurethatthebeamispointedintheneofgantryrotation,andtocontrolthewidthofthelongitudinalprofiles(onesetofjawencodervaluescontrolsallthefield<116>MLC<116>MLCSettings（MLC设置ContainssettingsfortheMLCrelatedtonningand包含与计划和实施相关的MLCThe<121>Minimumtimeperprojection(ms)</121>is230<121>Minimumtimeperprojectionms)（The<126>Numberofprojectionsperrotation(proj/rot)</126>is51forallhelicaltreatmentnscreatedonthe<127>Precision</127>nningStation.<127>Precision</127计划工作站上创建的所有螺旋治疗计划，<126>Numberofprojectionsperrotation(proj/rot)（(proj/rot)）</126>为The<132>umactiveleafcyclespersecond</132>istheumnumberofleaftransitions(opentocloseorclosetoopen)thatanMLCmayperformpersecond.<132>umactiveleafcyclespersecond（每秒的最活动叶片周期）</132>MLC每秒可执行的叶片转Thisisen datEndofnningtoavoiderrorsduetolowairpressure(p aticleavesaredrivenbyfacility-dairpressure).Thenumberofleaftransitionspersecondiscalculatedasamovingaverageoverthe<133>Leafcyclesbuffertime(s)</133>.<133>Leafcyclesbuffertime(s)（叶The<138>Leafthreshold(ms)</138>issetto<138>Leafthresholdms)（(ms)）</138>被设置18。AtEndofnning,leafopentimeslessthanorequalto18msarediscardedfromthen.18msThe<143>Openlatencyactivation(ms)</143>istheexpectedtimedelayfromwhenaleafopencommandisissueduntiltheleafactuallybeginstoopen.<143>Openlatencyactivationms)（The<144>Openlatencytransit(ms)</144>istheexpectedtimerequiredfortheleaftofinishopening.<144>Openlatencytransitms)（Theseparametersareusedtoadjustthetimingofwhenleafopencommandsareissuedinthedelivery.The<149>LeafBounceTolerance(ms)</149>indicatestheamountoftimethataleafcanstayinthebouncestatebeforecountingaleaferror.<149>LeafBounceTolerancems)（The<154>LeafOvertravelTolerance(ms)</154>indicatestheamountoftimethataleafcanstayintheovertravelstatebeforecountinganovertravelerror.<154>LeafOvertravelTolerance(ms)（叶片超行程公差Indicatestheallowedbiasrangeonthedosemonitor1BeamLevel2Eachsystemcontainstwobeams:atreatmentbeamandanimaging3Ifanyadditionalcustombeamsexist(e.g.,foraresearchcollaborationwith<21>Accuray</21>Incorporated),theyarenotavailablefortreatmentnning.<21>Accuray</21Incorporated合作的研究），不可将其4AsdescribedinintheSystemOverviewchapter,thepulserate,energyspectrum,andoutputrateofthetreatmentbeamarehigherthantheimagingbeam,requiringdifferentmachinesettingstocontrolthebeamproducing5The<24>Controls</24>and<25>MonitoredSignals</25>settingsaremaintainedbyyourservicerepresentativefortheimagingandtreatmentbeamstoensurethatthemachineisoperatingwithsettingsthatwillnotdamagemachinecomponents,andwithoversightfromthecustomerphysicisttoensurethatthetreatmentbeamisperformingconsistentlywiththebeammodelusedbythenning<25>MonitoredSignals（监测信号）</25>设置由您的服务代表，用以确保机器工作时采用的是不会损坏机6The<28>Beams</28>sectionforthescanbeamalsoincludes<29>Measurements</29>sectionwithinformationspecific<30><31>CTrue</31></30>acquisitionandimage<30><31>CTrue</31></30>获取和影像重建信息的7Thetreatmentbeamdoesnotcontaina8The<35>Beams</35>sectionforthetreatmentbeamalsocontainsbeam9ThebeammodelisusedbythenningsystemtoperformdoseThescanbeamdonothaveabeammodel,sincenodosecalculationsareperformedforthescanbeam.AllsystemswithSerialNumber100andlaterhavea"twinned"beammodelthatincludesacombinationofstandardized(<38>Twinnable</38>)andmachine-specific(<39> Twinnable</39>)parameters. Formoredetailsonthebeammodeldata,see<40/>intheAlgorithmsTheparametersontheTreatmentDeliveryConsoleshouldbemaintainedtoachieveconsistencybetweendeliveryandnning(whichisbasedonthebeammodelContactAccurayCustomerSupportforassistanceifchangestothemachinedataareneeded.如果需要对机器数据进行更改，请与Accuray1SpecialPhysicsConsiderationsfor>2Inthissection,additionalphysicsconsiderationsforproperuseof<24><25>TomoDirect</25></24><26>Radixact</26>treatmentmodalityfeaturesarediscussed.>1PatientandCouch23Usethebeamanglesdisyonthe<37>Register</37>taboftheTreatmentDeliveryConsoletocheckdailytargetcoverage.4Setthe<38>Balance</38>sliderto<39>n</39>toseethennedcoverage,orto<40>Scan</40>toseetheexpecteddailycoverage.划）</39><40>Scan5Similartothe<41>EntireTreatment</41>optiononthenningStation<42>BeamAngles</42>tab,the<43>Register</43>tabbeamdisyoneachsliceshowsthebeamcoverageonallslices,and<42>BeamAngles（射束角度）</42>选项<41>EntireTreatment（整个治疗）</41>选项相似anybeamextensiondueto<43>Register（配准）</43>选项卡6Inanygiventreatment,beamsmayenterthroughthetreatment7Duringthetreatmentnningprocess,thecouchinthenningCTimageisrecedwithanimageofthe<50><51>Radixact</51></50>在治疗计划过程中，计划CT>8Inthisway,thedosecalculatoraccountsfortheattenuationandscatterofbeamsthatpassthroughthecouch.9Fora<54><55>TomoHelical</55></54>treatment,minordiscrepanciesinthewaythatthecouchimageaccountsforthepositionandattenuationofthecouchtendtoaverageoutduetothelargenumberofbeam<54><55>TomoHelical</55></54治疗，通过治疗床Withonlyafewbeamanglesin<58><59>TomoDirect</59></58>treatments,moreattentionisneededtoensureacceptableagreementbetweencalculationsandmeasurements.<58><59>TomoDirect</59></58治疗中只采用几Thedelivereddosecanbesensitivetothedailycouchsetuppositionforbeamsthatenterthroughthecouch,especiallyfornswithfewAgantryrolladjustmentcanalsochangetheintersectionofthebeamwiththecouchandthusthedosedistributioninthepatient.The<84><85>Precision</85></84>Treatment nningSystemcalculatesdoseinthegeometryofthepatient nningimage.>The<86><87>Radixact</87></86>systemdoesnotadjustthedosecalculationtoaccountfordailysetupvariations.>The<88><89>Precision</89></88>TreatmentnningSystem<90><91>Radixact</91></90>TreatmentDeliveryConsolecallattentiontotheimportanceofconsistentdailysetupfor>><92><93>TomoDirect</93></92计划的一致性日常摆位Onthe<96>BeamAngles</96>tabofthenningSystem,<97>Notice</97>listsanybeamsthatpassthroughthecouchbeforereachingthetarget.<96>BeamAngles（射束角度）</96>选项卡上Thedosimetryinthetargetforthesebeamswillbesensitivetothepathofthebeamthroughthecouch.<104>Tools</104>tabNotice >Onthe<112>Register</112>taboftheTreatmentDeliveryConsole,iftheacceptedregistrationresultswouldcauseadifferencebetweennninganddeliveryinthepercentageofabeamthatintersectsthecouch,awarningmaybedisyed:CouchPositionWarningDuringPatientThiswarningisonlydisyedifthenumberofbeamsenteringfrombelowthecouchisgreaterthanthenumberofbeamsenteringabovethe(Ifmostofthebeamspassthroughthecouchbeforereachingthepatient,thecumulativedosedistributionwillbemoresensitivetothebeamintersectionwiththecouch.)Thiswarningdoesnotaccountforthepathofthebeamthroughthevariouscouchcomponents(i.e.,doesnotconsiderwhetherthebeampassesthroughtheupperpalletonlyortheupperpalletandlowerArecordofacceptanceofthiswarningisincludedinthedeliveryAchangeintheintersectionofthebeamswiththecouchcanresultinoverdoseorunderdose.ConsidertheIndexingpatientsforsimulationandtreatmentcanhelptoreducetheneedforcouchadjustmentsandgantryrollcorrectionsthatmaychangetheintersectionofthebeamswiththecouch.Whenselecting<161><162>TomoDirect</162></161>beams,avoidbeamanglesthatpasswithin2.5cmoftheedgesofthecouch,sincetheintersectionofthesebeamswiththecouchwillbeverysensitivetodailycouchshifts.>Iftherearemorebeamsenteringfrombelowthecouchthanabovethecouch,prepareanactionnincasethewarninginthepreviousimageappearsontheTreatmentDeliveryConsole.Tocheckifdailyregistrationresultshavechangedtheamountofbeamintersectionwiththecouchforthewarning,thesoftwaremustrelatetheXandZcouchpositionvaluesdisyedonthe<192>PositioningControlPanel</192>toisocenter.<192>PositioningControlPanel（定位控制面板）</192>XZ治疗床位See<193/>fordetailsontheparameters lOffset</194>请参阅<193/>了解有关参数<194>La lOffset（横向偏移）</194>和<195>IsocenterRelationship（等中心关1PotentialforHot2<21><22>TomoDirect</22></21>treatmentsmayhavehighfluenceregionsnearthebeamedges.>3Thissectiondescribeshowappropriatecontouringmayreducehighfluenceregions,andhowtocheckforhighfluenceregions.4Beamletselectionforoptimizationisdiscussedin5Theinitialbeamletselectorusesatransversebeamletprojectionforeachindividualbeamletthatis0.4leafwidthswiderthanthegeometricalleafprojectiononboththe<26>+Xg</26>and<27>-Xg</27>sidesoftheMLC.初始选择器将横向投影用于叶片宽度比MLC>>0.4个叶片宽度的各个6Beamletsareconsideredavailableforoptimizationifanypartofbeamletprojectionpassesthroughatarget,andifnopartofthebeamletprojectionpassesthroughablockedstructure.如果投影的通过靶区且投影中没有任何部分通过受阻挡的结构，则认为可用于优化。7Ifonlytheedgeofabeamletprojectionintersectswiththetarget,theoptimizerwouldneedtoincreasethebeamletweightingsignificantlytohaveaneffectonthetargetvoxels,sincemostofthebeamletcontributionisfrom如果仅投影的边缘与靶区交叉，则优化器需要大大提高