|Part IV - Using adaPTprescribe Managing Beams | Baselining a Beam ‘Baselining’ means giving approval for treatment. Treatment beams must be baselined before you will be able to proceed to treatment. A beam that is not baselined is identified by the ( ) icon. Figure 29-7. Unbaselined Beams To baseline a beam: 1. Click Edit Patient. 2. Verify all beam data. 3. If all beam data is OK, click Baseline.
|Part IV - Using adaPTprescribe Managing Beams | Confirming Baselining in PBS When you are baselining a beam in the Pencil Beam Scanning treatment mode, the BEAM BASELINE CONFIRMATION appears (see Figure 29-8). Figure 29-8. Beam Baseline Confirmation Pencil Beam Scanning Confirming Excessive MUs When baselining a beam and the amount of Monitor Units (MU) is outside the specified clinical range, adaPTprescribe prompts you to override the configured value in order to proceed with the baselining process.
|Part IV - Using adaPTprescribe Managing Beams | Receiving the Baseline Notification Confirm the baseline action by entering your name and password. A notification appears momentarily to inform you that the baseline action has been performed successfully. The notification disappears after a few seconds. Figure 29-10. Beam Baseline Notification You can unbaseline a beam as long as it has not passed irradiation. To unbaseline a beam, click Unbaseline.
|Part IV - Using adaPTprescribe Managing Beams | Intentionally left blank IBA | 29-14 | Clinical User’s Guide Volume 1 - Treatment Session
Chapter 30 Using QA Features of adaPTprescribe •••••• In adaPTprescribe, a distinction is made between different kinds of patients, plans, and plan intents, as follows: Table 30-1.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Managing QA patients QA patients can be managed similarly to clinical patients.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Modifying the Treatment Machine Modifying the treatment machine of a given plan is possible for all patients (regardless of the type), for plans with any plan intent (not specific to MACHINE_QA), for all delivery techniques. However, in order for you to be able to modify the treatment machine of a given plan, the plan needs to meet the following conditions: The plan should be an internal plan (i.e.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Figure 30-1. Treatment Machine Field Creating a New PBS Beam from Scratch You may create a new PBS beam in a MACHINE_QA plan. In order to create a new PBS beam proceed as follows: 1. IBA | 30-4 | Click on the Create Beam button at the bottom left of the PLAN DISPLAY SCREEN.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Figure 30-2. Plan Display Screen 2. Select the type of beam that you want to create (in this case, a PBS beam). The LAYER EDITING SCREEN appears. 3. Proceed as explained in section Editing Layer and Spot Details On the Layer Editing Screen in order to add layers and spots to the newly created PBS beam.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | In addition to those features, from the beam details panel of beams belonging to MACHINE_QA plans it is possible to: Edit layer and spot details of PBS beams using the LAYER EDITING SCREEN. Import PLD (PBS Layer Definition) files to create new PBS beams. Note: The two options above are only possible for PBS beams belonging to a plan with plan intent ‘MACHINE_QA’.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | To access the layer editing screen, click the The LAYER EDITING SCREEN appears. button next to the No. Layers field. Layer details pane Spot details pane Figure 30-4. Layer Editing Screen The LAYER EDITING SCREEN contains the following elements: Layer details pane: this is a list of the layers of the selected beam. For each layer, the following information is listed: Index: this is automatically assigned and cannot be edited.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | This is an alternative to manually editing each field in the spot detail lines and may save you some time. Below the Rescale layer button, the ‘Final Cumulative Meterset Weight’ field displays the sum of the weights of all the layers in the beam. Note: Each beam is planned to deliver a total number of MUs. Each spot of the beam is assigned a certain weight, which is a percentage of the total number of MUs.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Editing Layer Details Using the Layer Editing Menu In the Layer Details Pane, right click on a given layer. The LAYER EDIT MENU appears: Figure 30-5. Layer Edit Menu Using this menu, you may perform the following actions on the layer on which you have right-clicked: Add a new layer before or after the selected layer. Delete the selected layer. Edit the selected layer. Copy the selected layer.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Using Keyboard Shortcuts to Edit Layers After selecting a given layer, instead of using the LAYER EDIT MENU, you may use the following keyboard shortcuts: Table 30-2. Keyboard Shortcuts - Edit Layer Details Press this key... To... Ctrl+I Add before Shift+I Add after Shift+V Paste before Ctrl+V Paste after Del Delete Ctrl+E Edit Ctrl+C Copy Adding Layers You can add one or more layers to the selected beam.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | 3. Fill in the fields in the INPUT LAYER INFORMATION DIALOGUE.The ‘Index’ field is not editable. 4. Click the OK button to save the new layer or the Cancel button to cancel the creation of the new layer. Deleting a Layer You can delete one or more layers of the selected beam. In order delete a given layer of the selected beam, proceed as follows: 1. In the LAYER DETAILS PANE, right click on the layer line that you want to delete.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Copying a Layer You can copy a layer of the selected beam. In order copy a layer of the selected beam, proceed as follows: 1. In the LAYER DETAILS PANE, right click on the layer line that you want to copy. The LAYER EDIT MENU appears. 2. Select the ‘Copy’ option from the LAYER EDIT MENU. Pasting a Layer You can paste a previously copied layer in the selected beam.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Using this menu, you may perform the following actions on the spot on which you have right-clicked: Add a new spot before or after the selected spot. Delete the selected spot. Edit the selected spot. Copy the selected spot. Paste a previously copied spot before or after the selected layer.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Figure 30-9. Input Spot Information Dialogue 3. Fill in the fields in the INPUT SPOT INFORMATION DIALOGUE.The ‘Index’ field is not editable. 4. Click the OK button to save the new spot or the Cancel button to cancel the creation of the new spot. Deleting a Spot You can delete one or more spots of the selected layer. In order delete a given spot of the selected layer, proceed as follows: 1.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Figure 30-10. Input Spot Information Dialogue 3. Modify the fields in the INPUT SPOT INFORMATION DIALOGUE.The ‘Index’ field is not editable. 4. Click the OK button to save the changes done to the spot or the Cancel button to cancel the changes done to the spot. Copying a Spot You can copy a spot of the selected layer. In order copy a spot of the selected layer, proceed as follows: 1.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | Importing a PLD (PBS Layer Definition) File Using the Import PLD file button at the bottom right of the LAYER EDITING SCREEN, you may import an existing PLD file. Then you may proceed to modify the imported data using the editable fields described in section Editing Layer and Spot Details On the Layer Editing Screen. In order to import a PLD file proceed as follows: 1.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | A PLD file contains a detail of the energy required for each layer and, for each layer, the number of MUs and the position of each spot to be irradiated. From these data, the system is able to calculate the setpoint to apply to the different system components (such as the scanning magnets, accelerator, etc.) for each layer as well as the threshold for all the checks that are done during the irradiation.
|Part IV - Using adaPTprescribe Using QA Features of adaPTprescribe | The blue number is the number of elements contained in the layer. There are 2 elements per spot, so this third number is 2 times the number of spots to be irradiated. The last number (green) is the number of paintings, meaning the number of times that the layer will be irradiated. The total number of MUs to be delivered on a spot is then divided by the number of paintings in order to keep the total number of MUs the same.
Part V Using adaPTdeliver Clinical User’s Guide Volume 1 - Treatment Session
Chapter 31 Introducing adaPTdeliver •••••• Introduction adaPTdeliver can be used in the following modes: Standalone mode using the batch importer and full standalone mode (see section “Using adaPTdeliver in Standalone Mode” on page 31-1) Worklist (OIS DEVC) mode, using the APPOINTMENT SELECTION SCREEN (see section “Using adaPTdeliver in Worklist Mode” on page 31-3) Using adaPTdeliver in Standalone Mode adaPTdeliver is the program that is used to: define a treatment session among a list of patie
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Treatment Plan BEV printouts Storage in PTS DB Beam Review adaPTprescribe baselining beam & plan Treatment adaPTinsight Alignment Verification DRs and/or CBCT DRRs Image Registration Correction Values adaPTdeliver Treatment Session Alignment Correction Figure 31-1.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Using adaPTdeliver, you are able to select one or several beams of a given patient for inclusion in one treatment session; next you can process each beam through the subsequent steps of beam selection, preparation, and treatment.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Treatment Plan DRRs & CT Oncology Information System (OIS) Worklist Appointment Selection Screen adaPTdeliver, Treatment Session adaPTdeliver activities Treatment Alignment Verification DRs Alignment Correction adaPTdeliver, Treatment Session Figure 31-2.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Starting adaPTdeliver Click the adaPTdeliver icon on the desktop in the Treatment Control Room (TCR) and in the Treatment Room (TR) to start up adaPTdeliver and a set of programs required in the treatment room. Figure 31-3. Start adaPTdeliver Icon Upon startup, the ADAPTDELIVER LOGO SCREEN briefly appears. Figure 31-4. adaPTdeliver Logo Screen After a few seconds, the ADAPTDELIVER LOGIN SCREEN appears (see Figure 31-5).
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Stopping adaPTdeliver Whenever you want to stop adaPTdeliver: IBA | 31-6 | 1. Logout from adaPTdeliver, as described in Section “Logging Out From adaPTdeliver“ on page 31-8. 2. Click Exit from the ADAPTDELIVER LOGIN SCREEN (see Figure 31-5).
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Logging into adaPTdeliver Upon startup of adaPTdeliver, the ADAPTDELIVER LOGIN SCREEN appears. Figure 31-5. adaPTdeliver Login Screen (Typical) Enter your user name and password; both are case sensitive. In addition, select the following: your language. the mode in which you want to operate: Clinical or Physics. Note: On the adaPTdeliver screens, and therefore throughout this manual, the terms Clinical mode and Treatment session are used.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Figure 31-6. adaPTdeliver - Login Error Click OK to remove the message box, and enter your correct user name and password. Should you want adaPTdeliver to stop running, click Exit from the ADAPTDELIVER LOGIN SCREEN.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Screen Layout adaPTdeliver screens are intuitive to use and have a uniform layout. logo step indication step description treatment summary information time & date indicator remote positioning controls find area list area tabs footer session status bar information area header Figure 31-7.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | WARNING Treatment summary information: this area provides the identification of the patient, plan, and beam, delivery mode and PBS repainting type, along with some essential equipment (i.e., accessories, if any) and session information. Be aware that long patient names may not appear in full because they are truncated in the Patient Name field of the header. Truncated patient names are indicated by the ellipsis (i.e., ...) at the end.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Dealing With Error Messages adaPTdeliver can report messages back to you in the form of pop-up windows. Figure 31-8. adaPTdeliver - Typical Error Message Click OK and the pop-up window disappears. Standalone Mode Specific: Selecting a Patient, Study, Plan, or Beam From the SESSION DEFINITION SCREEN you can perform the following functions: Find a patient: for detailed information, refer to Section “Finding a Patient“ on page 31-13.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Figure 31-9. Session Definition Screen Data corresponding to selections that you make from the list area appear in the information area.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Finding a Patient You can quickly find the required patient or list of patients by entering some find parameters. The options to find a patient are: by name: fill out the name of the patient, in full or in part. You can use the patient’s name, first name, initials, or any combination of these, but only in this order. by ID: fill out the ID of the patient in full or in part. Click Find.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Working With Patients, Studies, Plans, or Beams in the List When you enter find parameters and click Find, or when you click All or Refresh from the Find area, the corresponding list of patients appears in the List area. Figure 31-11.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | A patient can have multiple studies; a study can have multiple plans; a plan can have multiple beams, and a beam can have multiple layers.
|Part V - Using adaPTdeliver Introducing adaPTdeliver | Intentionally left blank IBA | 31-16 | Clinical User’s Guide Volume 1 - Treatment Session
Part VI Using adaPTdeliver in Standalone Mode Clinical User’s Guide Volume 1 - Treatment Session
Chapter 32 Introducing adaPTdeliver Operating in Standalone Mode •••••• Note: Screen representations throughout this chapter and throughout this part may show ‘Control Mode: EMR-Centric’ or ‘Control Mode: DEV-Centric’ at the bottom. When working in Standalone mode, you will notice that the Control Mode indication reads ‘Stand-Alone’. Figure 32-1.
|Part VI - Using adaPTdeliver in Standalone Mode Introducing adaPTdeliver Operating in Standalone Mode | Introduction When you are logged into adaPTdeliver in a Treatment session, you can monitor and control the actual preparation and treatment of a patient. For information on how to start and log into adaPTdeliver, refer to Chapter 31, “Introducing adaPTdeliver“.
|Part VI - Using adaPTdeliver in Standalone Mode Introducing adaPTdeliver Operating in Standalone Mode | Treatment Plan Planning CTs Storage in PTS DB Beam Review adaPTprescribe baselining beam & plan Treatment adaPTinsight Alignment Verification DRs and/or CBCT DRRs Image Registration Correction Values adaPTdeliver Treatment Session Alignment Correction Figure 32-2.
|Part VI - Using adaPTdeliver in Standalone Mode Introducing adaPTdeliver Operating in Standalone Mode | Upon selection of a patient, study, and plan, you can specify one or more beams for selection into the treatment session. For detailed information on how to select a patient, study, plan, and beam, refer to Chapter 33 “Including One or More Beams into a Session”. WARNING In the nominal workflow, patient and beam are automatically selected in synchronization with the Radiation Therapy System (e.g.
Chapter 33 Including One or More Beams into a Session •••••• Note: Screen representations throughout this chapter and throughout this part may show ‘Control Mode: EMR-Centric’ or ‘Control Mode: DEV-Centric’ at the bottom. When working in Standalone mode, you will notice that the mode indication reads ‘Stand-Alone’. Introduction From the list area you can select one or several baselined beams and include them into the treatment session. All selected beams must belong to the same plan.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | A beam that is not selected, i.e., a beam that is not listed in bold, cannot be displayed on the BEAM SELECTION SCREEN. Any beam that you selected already to be included in the session can still be deselected. To deselect any such beam, double-click that beam.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Selecting Some or All Beams You can quickly specify some or all beams that belong to a plan by repeatedly doubleclicking that plan. Three quick selection options exist: No beam selected All beams selected All previously selected beams selected Figure 33-1 illustrates the quick selection options at plan level. Selected beams appear in bold.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Beam: contains clinical data on the selected beam. For detailed information refer to (the) section(s) “Reviewing Clinical Prescriptions”. Layer: contains clinical data on the selected layer. For detailed information refer to Section “Displaying Layer Information”. Note: The information on these tabs is for display only.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Reviewing Patient, Study, and Plan Information From the Information area, select the Patient and Plan tab and the data on the selected patient, study, and plan appear. Figure 33-2.
|Part VI - Using adaPTdeliver in Standalone Mode IBA | 33-6 | Including One or More Beams into a Session | Intent: this is an indication of the intended use of the plan. The options are: Curative: an actual treatment plan. Verification: a QA prescription for a patient. Machine_QA: a dummy prescription for a QA patient (i.e., a virtual patient).
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Reviewing Clinical Prescriptions - for PBS From the Information area, select the Beam tab and the clinical data on that beam appear. This is the clinical data that is prescribed in the treatment plan. Figure 33-3.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Maximum Field Size FY (cm): in PBS, extension of the beam along the Yaxis, specified by means of parameters FY, Y1, Y2, expressed in cm. FX, FY are the difference in Xg and Yg coordinates between the center of the two extreme spots. X1, X2, Y1, Y2 are the edges spot center positions expressed in IEC Beam Limiting Device CS. Example: Field Size FX (X1..X2) [cm] 4.8 (-2.6 .. +2.2) ; Field Size FY (Y1..
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Distal Open Beam Range (g/cm2) 1: the range of the proton beam farthest away from the nozzle, without any beam modifying accessories (range shifter, block, range compensator, etc.). Accessories: Block: identifier of the block (optionally used). Compensator: identifier of the range compensator (optionally used). Snout ID Ridge Filter: identifier of the ridge filter (optionally used).
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Snout Extension (cm): as defined in the beam, as the distance between isocenter and the face of the block downstream the beam, or when there is no block, the face of the range shifter or range compensator upstream the beam (whether the beam definition comes from the DICOM plan created in TPS or is set internally by the batch importer). With the snout in the 10 cm position (i.e.
|Part VI - Using adaPTdeliver in Standalone Mode column width can be modified Energy/Layer graph range scale Including One or More Beams into a Session | list of layers layer palette spot map spot map legend Figure 33-5. Layer Information (Sample) The information area contains the following elements: Range scale: this is a graphic representation of the Range values listed in the list of layers. Possible ranges are between 0.5 and 32g/cm2.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | For each layer, the following information is listed: Range (g/cm2) 1 Dose (MU): in addition to the value of the dose, a graphic representation is also given in the form of a colored bar. Time (s) Spot Size X (FWHM) (cm): this is a parameter that defines the width of the Gaussian distribution of the beam along the X-axis, at Full Width at Half Maximum.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Visualizing Layers Click any of the listed layers and a visual representation of that layer appears in the spot map. Note: You can also click the desired layer from the range scale. In addition, the position of the layer in the entire beam is represented by the thick vertical green bar in the range scale. The most distal layer is positioned at the right.
|Part VI - Using adaPTdeliver in Standalone Mode Including One or More Beams into a Session | Intentionally left blank IBA | 33-14 | Clinical User’s Guide Volume 1 - Treatment Session
Chapter 34 Proceeding to Beam Selection •••••• Note: Screen representations throughout this chapter and throughout this part may show ‘Control Mode: EMR-Centric’ or ‘Control Mode: DEV-Centric’ at the bottom. When working in Standalone mode, you will notice that the mode indication reads ‘Stand-Alone’. Introduction As soon as a beam appears in bold in the selection area, you can proceed to the next step in the irradiation process, i.e., to actually select it for preparation for treatment.
|Part VI - Using adaPTdeliver in Standalone Mode Proceeding to Beam Selection | Proceeding With an Incomplete Plan Whenever you want to proceed without having selected all the baselined beams of the plan (only baselined beams are visible at this stage), a pop-up message prompts you for confirmation. Figure 34-1. Beam Selection Confirmation Prompt Click OK if you want to proceed with your selection, else click Cancel.
|Part VI - Using adaPTdeliver in Standalone Mode Proceeding to Beam Selection | Figure 34-2. Beam Selection Screen The header now displays the type of accessory, if any, and its identifier, as follows: Pencil Beam Scanning: No accessory: no accessory type One accessory: accessory type and identifier The list area is now filled with the beam(s) that you selected from the SESSION DEFINITION SCREEN. If there are multiple beams in the list, click the beam that you want to process first.
|Part VI - Using adaPTdeliver in Standalone Mode Proceeding to Beam Selection | Similar to the SESSION DEFINITION SCREEN, the Patient & Plan, Beam, and Layers tabs are also available on the information area of the BEAM SELECTION SCREEN. Initially, most of the fields in the information area of the BEAM SELECTION SCREEN are blank; only the patient name, study, plan, and beam are listed in the list area. To have the fields in the information area filled out, click the required beam in the list area.
Chapter 35 Preparing the Equipment for Irradiation •••••• Note: Screen representations throughout this chapter and throughout this part may show ‘Control Mode: EMR-Centric’ or ‘Control Mode: DEV-Centric’ at the bottom. When working in Standalone mode, you will notice that the mode indication reads ‘Stand-Alone’. Getting Started With Equipment Preparation To proceed with the equipment preparation, do any of the following: Double-click the desired beam.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Equipment Preparation for a Setup Beam From the EQUIPMENT PREPARATION SCREEN you have to enter the positioning corrections and confirm the corrections to indicate that preparation has finished. As long as the colored state bar does not read Ready (indicated by the orange color), you will not be able to proceed to irradiation. Figure 35-1.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Roll (°) For detailed information on how to interpret the positioning values, refer to Section “Interpreting Positioning Values” on page 35-4. In addition, the panel indicates the inserted or extracted position of Flat panel A, Flat panel B, and the retractable X-ray tube.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | In tolerance: all listed positioning parameters are within tolerance, also indicated by the green background of the status indication. Out of tolerance: at least one of the listed positioning parameters is out of tolerance, also indicated by the orange background of the status indication.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-2. PMS Interface Panel Positioning Parameter Values All positioning parameter values appear in three columns: Target: the position that is currently selected: 'SETUP', ‘TREATMENT’, 'LOAD', 'Gantry 270', etc. Positioning preparation will only be complete if the SETUP or TREATMENT position is confirmed (and acknowledged, if out of tolerances). Current: the current position.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Entering Corrections The Patient Position Verification System (PPVS) software is used to perform the correction vector calculation. For detailed information on how to use adaPTinsight, refer to the related documentation listed in chapter “About this Manual”. When the correction vector is calculated, it is sent directly from adaPTinsight to the patient positioner.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-4. Equipment Preparation Screen (Completed) Click the Back to selection button to select another beam from the list area of the BEAM SELECTION SCREEN. Setup beams for which preparation has been successfully completed appear with the green checkmark ( ) adjacent to the beam icon in the list area of the BEAM SELECTION SCREEN. ‘Completed’ indications Figure 35-5.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Equipment Preparation for a Treatment Beam Preparing the Treatment Room Before starting an irradiation, the following final preparations shall be completed in the Treatment Room (TR): 1.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Preparing the Equipment for Treatment - PBS Dedicated Nozzle The EQUIPMENT PREPARATION SCREEN is composed of four panels. Figure 35-6. Equipment Preparation Screen PBS Dedicated Nozzle (Treatment Beam) Each individual panel has a colored state bar. Initially, most of these colored state bars are orange, indicating that some conditions exist that prevent you from proceeding with the intended irradiation.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Room Interlocks: to monitor room interlocks; for detailed information, refer to section “Verifying the Room Interlocks“ in this chapter. The order in which the panels become valid is irrelevant. The beam request will be submitted only when all the panels are Ready.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Verifying the PBS Dedicated Nozzle The PBS DEDICATED NOZZLE PANEL of the EQUIPMENT PREPARATION SCREEN displays two different tabs: Overview: for information, refer to section “Overview” on page 35-11. Nozzle Devices Details: for information, refer to section “Nozzle Devices Details” on page 35-14.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Nozzle devices prepared For accessories: Accessories list confirmed by user: the checkmark is present when you have put a checkmark in the checkbox at the bottom of the tab, to confirm that these and only these accessories are present.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-8.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Nozzle Devices Details The NOZZLE DEVICES DETAILS tab provides detailed feedback information on some equipment states and operational modes, such as TCU, ISEU, etc. Figure 35-9. PBS Dedicated Nozzle Panel Nozzle Devices Details tab When all feedbacks have the proper state, the colored state bar reads Ready (indicated by the green color).
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-10.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Intentionally left blank IBA | 35-16 | Clinical User’s Guide Volume 1 - Treatment Session
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Verifying the Position of Devices From the PMS INTERFACE PANEL you have to enter the positioning corrections to indicate that positioning preparation has finished. Note: The optional position corrections that you can perform on the setup beam influence the initial Prescribed value of the next treatment beam(s).
|Part VI - Using adaPTdeliver in Standalone Mode Rotation (°) Pitch (°) Roll (°) Preparing the Equipment for Irradiation | For detailed information on how to interpret the positioning values, refer to Section “Interpreting Positioning Values” on page 35-4. In addition, the panel indicates the inserted or extracted position of Flat panel A, Flat panel B, and the retractable X-ray tube.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Out of tolerance: at least one of the listed positioning parameters is out of tolerance, also indicated by the orange background of the status indication. Note: Should you want to perform treatment with one or more positioning parameters out of tolerance, you can do so but you will be prompted to sign an acknowledgment first.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | If yet another treatment beam (Tx2) is necessary, the adjusted Setup beam (S1 plus Δ) is taken as a basis, NOT the adjusted previous treatment beam (Tx1 plus Δ).
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | To manually enter a correction vector, click Enter correction from the PMS INTERFACE PANEL and enter the corrections that are obtained from the PPVS software (i.e., adaPTinsight) in the corresponding fields on the BEAM CORRECTION SCREEN that appears. Figure 35-12. Beam Correction Screen Click Apply and the correction values appear on the PMS INTERFACE PANEL.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-13. PMS Interface Panel (Completed) Requesting Beam On the Beam panel of the EQUIPMENT PREPARATION SCREEN you have to launch your beam request. As long as the colored state bar does not read Ready (indicated by the green color), you will not be able to proceed to irradiation.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Obtaining Authorizations First of all you have to make sure that the required authorizations are present. These authorizations are listed immediately under the state bar: Room Interlocks: if the state of the interlocks is not OK, perform the operations as described in Section “Verifying the Room Interlocks” on page 35-25.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Select the desired type of request. The state in the colored state bar changes into : Beam Requested: indicating that the room interlocks are not ready. Beam Allocated: indicating that the room interlocks are ready. The beam will be prepared automatically without any further intervention from your side. Note: If the automatic beam preparation fails, a popup message appears (see Figure 35-15).
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Operating mode: the actual switching of magnet power supplies to direct the beam to a specific treatment room is performed from the Energy Selection and Beam Transport System (ESBTS) panel of the Beam Operation Manager (BOM), which is running in the Main Control Room (MCR). The scheduling mode can be Automatic or Manual. Figure 35-16.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-17. Room Interlocks Panel - Not Ready When all room interlock information is available to enable irradiation, the colored state bar reads Ready (indicated by the green color). The ROOM INTERLOCKS PANEL - NOT READY indicates the status of the following safety devices: Room master key switch: the master key is inserted in the key switch on the MCR Control Panel and the key switch is turned on.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Figure 35-18. Room Interlocks Panel - Ready Proceeding to Treatment When the color of the state bars of all four panels on the EQUIPMENT PREPARATION SCREEN is green, the Next button at the bottom of the screen is enabled, which means you can proceed to the last step, Irradiation. Figure 35-19.
|Part VI - Using adaPTdeliver in Standalone Mode Preparing the Equipment for Irradiation | Intentionally left blank IBA | 35-28 | Clinical User’s Guide Volume 1 - Treatment Session
