Beam commissioning. and annual Qa. ggggg fffff. Fastest, most accurate, most reliable relative dosimetry iba DOSIMETRY // 1

Transcription

1 Beam commissioning and annual Qa ggggg fffff 7 Fastest, most accurate, most reliable relative dosimetry iba DOSIMETRY // 1

2 relative dosimetry Fastest, most accurate and most reliable the Gold standard redefined the new Blue Phantom 2 For over 35 years IBA Dosimetry has been providing the highest quality dosimetry equipment and services, with more than 3,500 SATiSFieD WATeR phantom USeRS worldwide. The new Blue Phantom 2 embodies decades of expertise, research and experience in the development and clinical use of water phantom systems. Over 20,000 LinACS CoMMiSSioneD are testimony of IBA s leading competence! CoMMiSSioninG SeRviCe ADvAnTAGe! Book IBA commissioning service and get your linac commissioned much faster The Blue Phantom² is designed based on IBA s unique commissioning service field experience 5 TiMeS FASTeR DATA SCAnninG Dramatically cut your commissioning times with the Linear Diode Array: Complete profi le scanning at once Highest resolution down to 0.5 mm Find out more on page 7. FASTeST & MoST ACCURATe SeTUp WiTH ConFiDenCe The micro-leveling technology allows for extremely accurate alignment of the system to the water surface in just 2 minutes! Faster and more accurate than automated setup Avoids redundancy of validation needs of automated procedures No tank movement, no wave building certified accuracy better than ±0.1 mm CeRTiFieD ACCURACy Uncompromised commissioning accuracy for your advanced IMRT, IGRT and rotational treatments User Validated Setup: Visual checks provide highest confidence in setup accuracy. Only the Blue Phantom² is calibrated and certifi ed to guarantee highest accuracy and reproducibility of min ± 0.1mm! Have full trust in your beam profi le data! HiGHeST positioning ACCURACy Unique absolute measurements Cal alibration Cer ertificat ate Blue Phantom², Seria erial No.: Unique contact-less sensors Highest detector positioning accuracy without mechanical wear! Adaptive Scan Optimization X Y Z The Blue Phantom 2 is equipped with a unique high-precision sensor technology. Continuous absolute measurements of chamber position on all 3 axis The superior solution is a non-contact absolute position sensor (vs. typical indirect stepper motor measurements). UniQUe: ADApTive SCAn optimization Speed as well as Accuracy! ASO signifi cantly speeds up continuous and step-by-step scanning ASO overcomes the restrictions of all other systems that compromise speed vs. high resolution scanning iba Acquablue: water treatment for protecting mechanical parts and saving water from decay certified accuracy better than ±0.1 mm Looking at this new series of the Blue Phantom, I am happy to see a continuous and significant progress in accuracy, flexibility, long term mechanical stability and reliability since Wellhofer Dosimetry started Automatic scanning speed adaptation enables optimal accuracy for the different profi le segments as well as developing and producing water phantoms 35 years ago. fastest scanning where fewer data points are needed Take advantage of experience, knowhow and consequent Find out more on page 5. innovation by having a Blue Phantom 2. MANFRED WELLHÖFER 2 // iba DOSIMETRY PREDECESSOR OF IBA DOSIMETRY, INVENTOR OF WATER PHANTOMS iba DOSIMETRY // 3 You Tube Find out iba-dosimetry.com/bluephantom

3 the difference Between Good and excellent software? omnipro-accept workflow optimized omnipro-accept 7.4 Fully WoRKFLoW oriented, menu guided OmniPro-Accept software: designed to increase your efficiency and to reduce the commissioning and QA time of your Linac. SCAn optimization Select different scan speeds or data point densities in different regions of the scan. Uniquely optimizing the overall measurement time and resolution. Adaptive Scan Optimization Start page Queue Setup Data Acquisition Data Handling & Analysis RTpS Transfer ASO Adaptive Scan Optimization: This unique scanning mode ensures the shortest measuring time combined with a high spatial resolution. Time saving without compromizing accuracy! ADvAnCeD CoMMiSSioninG interface Menu guided workfl ow optimization Step-by-step and continuous scanning MoRe AUToMATeD FeATUReS Output factor determination Central axis correction via automated measurement routine TRUe WoRKFLoW efficiency QUeUe SeTUp DATA ACQUiSiTion DATA HAnDLinG & AnALySiS RTpS TRAnSFeR Advanced data processing with macros & various algorithms AUToMATiC QUeUe GeneRATion Fast & automatic data acquisition with predefi ned queues for all major TPS Save time with smart sorting algorithm for optimized scan sequences Sorting, prioritizing and multiple edits of scan queues to maximize effi ciency Intuitive setup of user specifi c queues Adjustable scanning parameters for optimized measurements 1D, 2D and 3D graphical and geometrical visualization of detector position during scanning Easy fi ltering and sorting Fast creation and export of data tables (PDD, TMR, OAR, etc.) Copy & paste to other applications, eg. MS Excel Exchange data with other IBA Dosimetry applications e.g. OmniPro-I mrt, OmniPro-Advance Accurate data analysis via standard and customizable protocols Analysis of TrueBeam / FFF scans Overlaying profi les for quantitative comparison 2D array and isodose calculation and display Library of mathematical smoothing and interpolation functions 4 // iba DOSIMETRY iba DOSIMETRY // 5

4 most efficient & most accurate linac commissioning & Qa > 5 times Faster Beam ProFile measurements ADvAnCeD CoMMiSSioninG interface OmniPro-Accept Software is tailored to make your commissioning and annual QA faster and better Menu guided workfl ows enable easy operations Unique features like the ASO scanning dramatically shorten the procedures Advanced data handling and connectivity Pre-Programmed TPS data requirements LDA-99: DRAMATiCALLy ReDUCe your CoMMiSSioninG TiMe WiTHoUT CoMpRoMiSinG HiGHeST ACCURACy instant MeASUReMenT of entire profiles Start your treatments days earlier Consistent high accuracy measurements, according to TG-106 standards interactive MiCRo-LeveLinG SySTeM For most effi cient and user validated setup of the phantoms SinGLe HAnD ConTRoL increases efficiency For easy and intuitive control of the Blue Phantom² and water reservoir CCU (CoMMon ConTRoL UniT) Its compact design integrates a controller and two independent electrometers: Simultaneous support of diodes and ionization chambers Built-in pressure & temperature sensor interfaces prepared for automatic Kt,p correction in-plane and cross-plane scanning consistency of blue phantom 2 with CC13 chamber MoST ACCURATe & MoST ReLiAbLe Blue Phantom²: the right solution for your crucial Linac commissioning From the inventor of water phantoms > 20,000 Linacs commissioned Over 35 years of experience ConSiSTenTLy ACCURATe MeASUReMenTS in X AnD y Small ionization chambers like IBA s CC-13 ensure scanning direction independent accuracy, regardless of detector movement and orientation (according to TG-106 report). LeADinG TeCHnoLoGy Highest linear diode array resolution with 99 p-type semiconductor detectors Software controlled automatic LDA-99 shift and measurements: fastest data sampling resolution down to 0.5 mm Reliable commissioning and QA of dynamic wedges and MLC fi elds Suitable for photons and electrons Online Linac adjustment with real-time dose measurement & analysis In-water and in-air measurements LDA-99 00:03 3 secs for 2.5 mm pitch (198 data points) CoMMiSSioninG TiMe SAvinG WiTH iba UniQUe TeCHnoLoGy Conventional tank blue phantom² with LDA Tank setup pdd/output factor data collection pdd/output factor data collection Comparison shows a typical Linac / RTpS commissioning: * Typical step-by-step scanning with average data resolution takes minimum 7 days ** Profile and wedge scanning with LDA saves up to 6 days in Linac commissioning *** Data Modelling typically takes 5 days but can vary depending on RTPS CoMpARiSon of beam profile ACQUiSiTion MoDULeS LDA** The whole profile at once Continuous scanning Step-by-step scanning profile scanning step-by-step* profile scanning Data modeling*** Times shown are average, based on commissioning of 3 photon energies with average 765 profiles PDD / Output Factors; Times incl. changes in machine setup, wedges, breaks and starts 00:32 03:12 Data modeling*** p p p p p p commissioning completed 6 days earlier days days more patient treatment time I have been using IBA s Blue Phantom and the innovative linear diode array during the commissioning of my Trilogy and Novalis TX Linacs. The capability to acquire profiles instantly, allowed me to collect all beam data in a fraction of the time. The speed of the LDA-99 versus a single detector is unmatched in the industry. R. RODEBAUGH, PH.D. CHESAPEAKE GENERAL HOSPITAL, CHESAPEAKE, VA 6 // iba DOSIMETRY iba DOSIMETRY // 7

5 accessories to complete Your system TMR-SeT WATeR ReSeRvoiR Online measurement of tissue maximum ratio (TMR) with fi xed source detector distance Continuous TMR depth dose curve measurement with real-time display of dose vs. water level Unique IBA high-accuracy contact-less sensor technology to accurately measure the changing water level Separate tank trolley on wheels with a polyethylene water reservoir Pump for uni-directional or bi-directional water transport Electronic pump control for TMR/TPR measurement (option) blue phantom HeLiX The smaller tank for periodic quick QA tasks and for TomoTherpy commissioning & QA. Based on Blue Phantom² technology Operated with OmniPro-Accept software and Common Control Unit 3D movement enables scanning without tank repositioning ± 0.1mm detector positioning accuracy. Certifi ed! LiFT TAbLe Find out more at iba-dosimetry.com/bluephantom Compact design: Provides full tank access without lift table bumping causing setup failures (compare to other tables with extended legs) Easy to store and convenient to drive even through narrow mazes Convenient and fast positioning of the water phantom incl. leveling frame for vertical & horizontal fi ne adjustment (electrical version) Water phantom carriage with manual or electric (telescopic) lifting 2 fi xed and 2 steerable rollers with brakes, incl. storage compartments TeMpeRATURe SenSoR The water temperature measurement is used in combination with the pressure measurement (built-in pressure sensor provided in the CCU) Automatic Kt,p correction for output factor determination Easy setup in the water tank ±0.3 C measurement accuracy DeDiCATeD QUALiTy DeTeCToRS ACCURACy FoR ALL AppLiCATionS IBA Dosimetry offers a complete range of detectors, including ionization chambers and semiconductor detectors. The Universal Holders enable fast and fl exible mounting of all chambers and detectors in vertical and horizontal orientation Calibrated in our Calibration Laboratory, accredited by DAkkS and member of the IAEA/WHO SSDL ConneCTiviTy The Blue Phantom is connected to the hospital network via Ethernet: Standard Ethernet cable instead of special cables East to connect, easy and inexpensive to replace! The main things I look for in a scanning system are positional accuracy, reproducibility, and stability. The folks at IBA Dosimetry definitely got it right with this one. The typical potentiometers and stepper-motors of other systems are replaced with contact-less absolute measurement sensors. This ingenious piece of engineering provides 0.1 mm accuracy, ± 0.1 mm reproducibility, and unsurpassed l ong-term stability. Over 20 years, I have used many systems from many vendors. This is by far the best! SCOTT R. CONLEY, MS, DABR CAROLINAEAST HEALTH SYSTEM, NEW BERN, NORTH CAROLINA, USA 8 // iba DOSIMETRY iba DOSIMETRY // 9

6 BudGets may differ. customize to Your needs, without compromising on QualitY MAXiMUM FLeXibiLiTy FoR A WiDe RAnGe of USe AnD budget! The Blue Phantom2 is the only water phantom customizable to your specific requirements: Select among various premium value adding features Gain maximum flexibility to configure to your individual needs and budget Choose from advanced options designed to save time and increase accuracy and flexibility MAXiMiZe efficiency MAXiMiZe ACCURACy increase FLeXibiLiTy instant MeASUReMenT of entire profiles UniQUe ASo ADApTive SCAn optimization SoFTWARe ConTRoLLeD CoMMon ConTRoL UniT 5x faster scanning Combine speed AND accuracy! Selectable input: floated or grounded flexible use of various IBA detectors 3 secs for 2.5 mm pitch (198 data points) with LDA Without moving the tank, without wave building extend your SKiLLS physics SeRviCeS UTiLiZe iba MAnpoWeR AnD expertise CALibRATion SeRviCe CeRTiFieD ACCURACy FoR your TooLS output FACToR TAbLe Determination of output factors Comparison in graphic charts and tables AD AC E UpGRADe your efficiency in CoMMiSSioninG & AnnUAL QA! RFA -300 BLUE PHANTOM (generation 1) NEW BLUE PHANTOM 2 WeDGe CHeCK MoDULe In just 2 minutes CAX CoRReCTion Central axis check Measurements with automated CAX correction Continuous measurement of TMR curves with realtime display le nt p to ex e TRAininG CoURSeS Wedge factor and angle determination TMR-SeT 10 // iba DOSIMETRY iba ACADeMy TRAininG Y Fast and complete tank drainage without manual lifting Accurate horizontal alignment of the scanning mechanism enhance your existing AppLiCATionS ta SLAnTeD bottom MiCRo-LeveLinG FRAMe product UpGRADeS f ro m For fast and accurate measurements Optimal Workflows and Highest Efficiency Treatment safety with best QA standards M ConTinUoUS SCAnninG MoDe Define and automatically execute most optimal scan resolution vs. scan speed for different beam profile segments ise Your satisfaction as a customer and user of IBA equipment is in the center of all of our activities. Therefore we strive for innovative SoLUTionS AnD SeRviCeS with one goal in mind: to constantly improve your dosimetry and to enable you to do your dosimetry the FASTeST, MoST ACCURATe and MoST ReLiAbLe way! rt MoDULAR DeSiGn iba Advancements in Linac technology demand more and more data collection during commissioning. Ensure you keep up with unique IBA innovations that will enable you to save valuable time and provide highest accuracy. Enhance your knowledge, maximize your utilization, operate most efficient! Discover the curriculum of the International Competence Center ICC and our online webinars: Application Courses Product Training Clinical Sessions Adaptive Scan Optimization and LDA-99 provide dramatically faster data scanning with high accuracy THin WinDoW Highest accuracy with contact-less sensor technology, certified to +/- 0.1mm! Enabling horizontal irradiations through only 3 mm PMMA Software upgrades for your existing RFA-300 and Blue Phantom (generation 1): Boost your workflow efficiency and ease of use Find the latest upgrade solutions and CAReprogram information online! iba DOSIMETRY // 11

7 Reliability you can count on: Water Tank Exterior water tank dimensions (LxWxH): Blue Phantom 2 with OmniPro-Accept (V 7) 675 mm x 645 mm x 560 mm 480 mm x 480 mm x 410 mm Fastest, 0.1 mm Most Accurate and Scanning volume (LxWxH): Position resolution: Position accuracy: ± 0.1 mm Position reproducibility: ± 0.1 mm Speed: Positioning Speed: max. 50 mm/s; Scanning Speed: max. 25 mm/s Approximate volume: 200 l Wall thickness / material: 15 mm / acrylic Weight (empty): 45 kg Common Control Unit (CCU) For over 35 years IBA Dosimetry has been Maximum resolution: 0.5 fa at 0.4 na full scale; 5 fa at 40 na full scale; 0.5 pa at 4 ua full scale providing the highest quality dosimetry Full scale range: 0.4 na / 40 na / 4uA Leakage current: equipment < 200 fa, to typically more <20 than fa satisfied Time constant: 20 ms Bias voltage range: customers ± 50 through worldwide. ± 500 V Trigger interface: RS 485 (custom specific) The new Blue Phantom 2, with over 25,000 Common interface: ETHERNET (100BaseT) Main supply: Linacs 100 commissioned, 240 V AC ± 10 %; 50/60 embodies Hz decades LDA-99SC of expertise, research and experience in Number of diodes: 99 Diode spacing: the development 5 mm (center-to-center) of water phantom Diode specifications Type of silicon: systems. Hi-pSi diode detectors Chip size: 2.45 mm x 2.45 mm Diameter of active area: 2.0 mm ggggg Sensitivity: 35 gy/nc Effective measurement point: fffff <1 mm Positioning in phantom: 0, 45, 90 and 135 degrees Water Reservoirs Pump direction: bi-directional (HA05) / uni-directional (HA06) Tank volume: 220 l Flow control: 20 l/min Dimensions (LxWxH): 970 mm x 660 mm x 830 mm Weight (empty): 70 k Lift Tables Operation: manual (HA01)/ electric (HA03) Vertical range: mm / mm Vertical adjustable range (tilt): ± 15 mm / 20 mm Horizontal adjustable range: 15 mm in X/Y direction Rotation in XY plane: n.a. / ± 5 Table size: 635 mm x 635 mm / 680 mm x 680 mm Dimensions (LxWxH): 790 mm x 630 mm x 660 mm / 840 mm x 680 mm x 660 mm Weight (empty): 69 kg / 116 kg TMR Set (requires Water Reservoir HA05) Scan length: 30 cm Position reproducibility: ± 0.3 mm Filling / draining speed: 50 mm / min emxx Number of channels: 99+1 Measurement mode: dose, dose rate, real-time, simultaneous measurements of all channels Characteristics (Dose/Dose rate) Input range: 0 na to 500 na Accuracy: ± 1 % for currents > 10 pa Resolution: 100 fc (for charge values up to 0.2 mc) A/D converter: 128 simultaneous working A/D converters Dimensions (LxWxH): 320 mm x 265 mm x 70 mm Weight: 3.75 kg Minimum Computer Requirements Operating systems (US-English versions only): Processor: RAM: Graphics card: Screen resolution: Network: Free space on harddisk: Windows XP Professional, Service Pack 3, 32 bit Windows Vista Ultimate, Service Pack 2, 32 bit Windows 7 Enterprise, Service Pack 2, 32 bit and 64 bit Dual Core (or equivalent), 2 GHz or better 2 GB of RAM DirectX 9c compatible, 256 MB video RAM, no shared memory minimum 1280x1024 with 32 bit color Ethernet (RJ-45) connection to connect controllers (e.g. CCU, emxx) minimum 300 MB free disk space before installation and 80 MB after installation: For archiving of data, much more disk space is needed Made in Germany. Supported globally. info@iba-dosimetry.com Europe, Middle East, Africa IBA Dosimetry GmbH Bahnhofstr Schwarzenbruck, Germany Tel.: Fax: North America, Latin America IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133, USA Tel.: Fax: Asia Pacific IBA Dosimetry Asia Pacific No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing , China Tel.: Fax: Discover more Online RT-BR-BP2-Rev Q500 IBA 2012 All rights reserved Manufacturer: IBA Dosimetry GmbH Technical data is subject to change without prior notice. Depicted product images and specifications may differ from the actual scope of delivery // IBA DOSIMETRY

8 3D Treatment Verification and Patient Dose Analysis COMPASS: Maximize Efficiency, Minimize Errors, Better Outcomes

9 2 IBA DOSIMETRY 3D PLAN VERIFICATION

10 Radiation Therapy is advancing rapidly, improving treatment accuracy but also introducing new uncertainties and risks. Ensure patient safety and better treatment outcomes by eliminating the unknown. COMPASS provides you critical details needed for confident plan verification and approval.

11 COMPASS 3D Treatment Plan Verification at a glance Physics Analysis Conventional phantom-based QA is a generally accepted method to validate the treatment plan based on comparison of measured vs. planned dose. These common QA techniques are reaching their limits* when advanced treatments require a more advanced analysis. In cases of discrepancies a full understanding of the clinical impact and relevance is needed. True Volumetric Measurement: Linac output and gantry angle COMPASS Efficiency: Fast pass / fail analysis reference measured comparison analysis [ ] We used the unique COMPASS solution for verifi cation of over 220 patient plans in the fi rst 18 months after introduction. COMPASS was primarily used for QA of complex IMRT treatment plans for H&N but also in some cases like prostate, sarcomas, and carcinomas of the skin. Erik Korevaar, PhD, Medical Physicist, Radiotherapy Department of the University Medical Center Groningen, Netherlands 4 IBA DOSIMETRY 3D PLAN VERIFICATION * Conventional IMRT QA Analysis Metrics Do Not Predict Clinically-Relevant Patient Dose Errors, Nelms BE, Zhen H, Tomé WA. Submitted for publication, May 2010.

12 Patient-based Clinical Evaluation COMPASS builds on our past knowledge and provides the power to verify dose based on the patient s individual CT data set in addition to the common QA tools: The Physicist and the Radiation Oncologist can now review plans on a common understandable platform, enabling better plan verifi cation and safer treatments. COMPASS Accuracy and Reliability: Evaluation of the clinical relevance of discrepancies relating physics analysis to 3D patient dose reference COMPASS 3D dose difference Patient CT DVH, 3D dose difference and 3D gamma analysis at organ level 5 IBA DOSIMETRY 3D PLAN VERIFICATION

13 COMPASS Efficiency: Fastest Plan Analysis COMPASS provides a fast and familiar plan QA solution based on standard physics acceptance criteria. This plan QA solution allows a rapid pass or fail analysis. In case of substantial dose discrepancies of plan vs. measurements COMPASS extends into 3D patient anatomy based analysis. reference measured comparison analysis Using the MatriXX-based pre-treatment confi guration it has been shown that the COMPASS system can achieve the necessary precision in plan verifi cation while shortening the time required for pre-treatment QA. Prof. Dr. Frank Lohr, University Heidelberg, Universitätsmedizin Mannheim, Germany 6 IBA DOSIMETRY 3D PLAN VERIFICATION

14 Measurement accuracy down to the details seamless measurement of the whole plan delivery accurate analysis of rotational plans individual check for each IMRT segment (step and shoot or dynamic) precise measurement of gantry angle per frame rapid response measurement with sampling rate up to 20 frames/sec Comprehensive analysis fast analysis of response difference (plan vs. delivered) precise evaluation per fi eld or for each segment/control point reliable check even for small MLC errors Fast overview of all frames (planned vs. measured) overview provides fast response comparison on control-point level analytic overview of delivery process check reference vs. planned consistency for small fl uctuations Predicted Measured Reporting fast one-click automatic generation of comprehensive report patient individual reporting for electronic records, print or export to Excel add patient anatomy to the equation 7 IBA DOSIMETRY 3D PLAN VERIFICATION

15 COMPASS Accuracy and Reliability: With Patient Anatomy COMPASS enables the Radiation Therapy Team to combine their physics and clinical expertise for a full treatment evaluation based on the clinical protocol. The team benefi ts from a complete understanding of the clinical relevance of dose discrepancies and necessary corrective action, speeding up processes and enabling earlier and better patient treatment. 3D dose difference reference COMPASS COMPASS output display on patient CT will be very beneficial for our physicians. [ ] COMPASS will take a significant place for our IMRT and Rotational treatment plan verification. Charles W. Coffey, Ph.D. and Jostin Brian Crass, M.S., Radiation Oncology Department, Vanderbilt-Ingram Cancer Center, USA 8 IBA DOSIMETRY 3D PLAN VERIFICATION

16 Fastest overview of the entire plan immediate FAIL alert if predefi ned prescription doses and tolerances are missed automatic OAR and PTV analysis based on your clinical protocols TPS DVH Measured comparative DVH enables fastest assessment of reference (TPS) vs. delivered dose full visualization fl exibility (all ROI s or one by one) Reliable analysis of dose discrepancy details the % difference between reference (TPS) and actual measured dose (Compass) is determined in the patient CT immediate understanding of dose discrepancies in single organs Most accurate verification of clinical relevance of errors patient dose guided decisions instead of traditional physics pass criteria analyze doses in absolute Gy (gray) values; verify target average dose and homogeneity, analyze OAR dose constraints understand clinical relevance, gain full treatment confi dence and better outcome Comprehensive Reporting indication specifi c template for consistent report generation including DVH, displays of planned and reference patient dose, dose difference etc. COMPASS: Maximize Efficiency, Minimize Errors, Better Outcomes 9 IBA DOSIMETRY 3D PLAN VERIFICATION

17 Workflow Driven Analysis Patient Data True 3D Volumetric Measurement MatriXX Evolution mounted on Gantry enables full 360 data acquisition for true 3D dose reconstruction and analysis Treatment Plan (reference) 10 IBA DOSIMETRY 3D PLAN VERIFICATION

18 Visualize, Verify, Validate Patient CT import Plan Delivery Verification Fast comparison and analysis planned & measured data import Patient Based Verification 3D dose comparison, DVH analysis Treatment Validation Protocol-based PASS/FAIL criteria, reporting in comparative DVH/table COMPASS provides instant and most reliable plan verification based on the user s individual clinical treatment protocol. Tolerances, maximum/minimum doses and dose homogeneity can be set per critical organ and treatment volume. 11 IBA DOSIMETRY 3D PLAN VERIFICATION

19 3D volumetric measurement with all 1020 detectors permanently in the beam PIC (Ionization Chamber Technology) for optimum detector performance and stability angle sensor to precisely correlate linac output and gantry angle upgrade path available for exisiting MatriXX users 12 IBA DOSIMETRY 3D PLAN VERIFICATION

20 Maximize Efficiency COMPASS relates to 3D patient dose revealing the clinical relevance of dose discrepancies. Minimize Errors COMPASS gives you the power to analyze the entire treatment chain from the plan to the patient. Better Outcome COMPASS provides a platform to combine the expertise of the RT team, putting the clinical protocol in the center of plan verification. 13 IBA DOSIMETRY 3D PLAN VERIFICATION

21 Add Patient Anatomy into your equation Plan QA + Patient Anatomy = Accuracy Gamma Analysis + Patient Anatomy = Efficiency Expertise + Patient Anatomy = Better Outcome 14 IBA DOSIMETRY 3D PLAN VERIFICATION

22

23 IBA Activities in a Nutsahell IBA delivers solutions of unprecedented precision with a focus in the fields of cancer diagnosis and therapy. Diagnostics Portfolio Safer Imaging, Earlier Cancer Detection Advanced quality assurance devices for Medical Imaging: Solutions for x-ray diagnosis and patient-dose monitoring Unique expertise in the design of cyclotrons: Solutions for radiopharmaceutical tracers incl. production and distribution Radiation Therapy Portfolio Fighting Cancer Undisputed leader in Particle Therapy: enabling the most precise and effective radiation therapy Industry leading QA and dosimetry solutions: maximizing efficiency, minimizing errors, better outcomes Imaging fiducial markers: Visicoil enabling high precision tumor targeting Sterilization & Ionization Improving Hygiene and Safety of Everyday Life Electron accelerators and high power X-Ray solutions: applied in many industries to sterilize medical devices, to cold pasteurize food products or to improve polymer properties IBA a Belgian company, is listed on the paneuropean stock exchange EURONEXT and its Annual Reports can be downloaded on the Website: Contact details: info@iba-dosimetry.com Europe, Middle East, Africa IBA Dosimetry GmbH Bahnhofstr Schwarzenbruck, Germany Tel.: Fax: North America, Latin America IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133, USA Tel.: Fax: Asia Pacific IBA Dosimetry Asia Pacific No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing , China Tel.: Fax: COMPASS software is developed in cooperation with RaySearch Laboratories AB. patent pending MatriXX was designed and built in cooperation with Torino University and INFN Technical data is subject to change without prior notice. RT-BR-E-COMPASS Rev IBA 2011 / All rights reserved Manufacturer: IBA Dosimetry GmbH

24 Quality Control in Medical x-ray Imaging Multimeter, kv-meter, Dosimeter

25 MagicMaX is the optimized solution for advanced beam verification and quality assurance in all x-ray imaging modalities Radiography Fluoroscopy Dental Mammography The multimeter solution Uniquely Efficient enabling one-shot full QA Uniquely Versatile integrating in any workflow and QA need Uniquely Powerful providing expert level comprehensive data Uniquely

26 Uniquely Efficient the one shot full QA solution 1 The one-shot full QA solution Position micro footprint detector on the test plate MagicMaX in combination with test plate Primus empowers fastest and earliest quality assurance. dose acceptance plus image quality in one single setup with only one x-ray exposure 2 Fastest workflow, shorter QA, higher machine uptime One single exposure fast setup on the imaging device plug and play solution by design one exposure only, no need for repeated room entering 3 Full QA with full beam data......and image quality with unobstructed view at the test plate

27 Uniquely Versatile adaptable to any workflow QA need MagicMaX for all needs Fully customizable solution to fit your needs, your workflow and your budget MagicMaX mas-clamp Unique invasive and noninvasive measurements integrated in one tool Flexible computer hardware Use your own laptop or optional IBA mini notebook MagicMaX Multimeter with connected: XR-multidetector for Radiography, Fluoroscopy and Dental XM multidetector for Mammography Connect a second dose sensor to the MagicMaX for simultaneous entrance and exit dose measurement Connect the MagicMaX masclamp* for unique invasive and noninvasive measurements integrated in one tool *availability pending Connect the MM-LS MagicMaX Light Probe and verify lux measurements of viewing boxes, image intensifier output and x-ray light fields within a measuring range of 0.1 lx - 10,000 lx Additional dose detectors attachable to MagicMaX: Detector RQM - flexible dose detector for mammography Detector RQA - flexible dose detector for radiography, fluoroscopy, dental

28 Uniquely Powerful for conventional and digital applications Comprehensive! MagicMaX is designed to combine workflow efficiency with comprehensive data recording and analysis, making the solution the powerful tool from quick checks down to the most demanding expert level measurements. Proven, Certified & Calibrated MagicMaX has been proven by leading institutions such as the PTB Germany. High quality measurements for QA reliability Simultaneous measurements of kvp, PPV, time, dose, dose rate, filtration and more... Highest 0.1ms time resolution for best data quality Measurement of HVL (half value layer) Most accurate pulse information Anode ripples detectable kvp / PPV Dose Dose Rate Time HVL Waveform MagicMaX -Rad/Flu/Dent kv 50 ngy - 50 Gy 160 ngy/s mgy/s 0.2 ms s mm Al PPV, internal & external* dose rate, mas* MagicMaX -Mam kv * 50nGy - 50Gy 160 ngy/s mgy/s 0.2 ms s mm Al PPV, internal & external* dose rate, mas* MagicMaX -Dent kv 50 ngy - 50 Gy 160 ngy/s mgy/s 0.2 ms s mm Al PPV, internal dose rate, mas** * depending on Target/Filtration combination **depending on detector availability

29 Full Control at your Finger Tips the MagicMaX Software Efficiency and Power View of your choice : configure the screen to your needs, select between large digital display, scope type waveforms, tables or cards Powerful instant storage of screenshots or data export to Excel reports Saving all recorded measurements and waveforms for future analysis Retrieve and add entire measurement sessions at any time Run MagicMaX software on several computers and obtain software upgrades z z Real waveform figure Save & open sessions Favourite view generator Export via one click MagicMaX software

30 Fully Portable Solution the MagicMaX Case Remain flexible, stay mobile: The compact MagicMaX case enables you to have your QA kit with you whenever and wherever you need it. MagicMaX & Detector in one case Flexibility & mobility zequipment protection Expandable accessories

31 Full QA Solutions extending workflow efficiency in Medical Imaging Dose readings visible from Conrol Room MagicMaX & Test Plate Primus Multi-modality x-ray imaging QA ensuring quality beams and image quality LXcan & Display Q Quality Assurance for Medical Displays ensuring quality images for safer diagnosis one-shot full QA solution advanced beam and imaging checks fastest workflow, higher machine uptime Spot-Luminance-Meter: distance & screen contact measurements uniquely combined fastest workflow guided software Complete measuring set for digital and conventional radiographic and fluoroscopic x-ray units

32 IBA Activities in a Nutshell MI-BR-E-MagicMax Rev Q.:500 IBA 2011 / All rights reserved IBA delivers solutions of unprecedented precision with a focus in the fields of cancer diagnosis and therapy. Diagnostics Portfolio Safer Imaging, Earlier Cancer Detection Advanced quality assurance devices for Medical Imaging: Solutions for x-ray diagnosis and patient-dose monitoring Unique expertise in the design of cyclotrons: Solutions for radiopharmaceutical tracers incl. production and distribution Radiation Therapy Portfolio Fighting Cancer Undisputed leader in Particle Therapy: enabling the most precise and effective radiation therapy Industry leading QA and dosimetry solutions: maximizing efficiency, minimizing errors, better outcomes Imaging fiducial markers: Visicoil enabling high precision tumor targeting Sterilization & Ionization Improving Hygiene and Safety of Everyday Life Electron accelerators and high power X-Ray solutions: applied in many industries to sterilize medical devices, to cold pasteurize food products or to improve polymer properties IBA, a Belgian company, is listed on the paneuropean stock exchange EURONEXT and its Annual Reports can be downloaded on the Website: Depicted product images may differ from the actual scope of delivery. Images and technical specifications are subject to change without prior notice. Contact details: info@iba-dosimetry.com Europe, Middle East, Africa IBA Dosimetry GmbH Bahnhofstr Schwarzenbruck, Germany Tel.: Fax: North America, Latin America IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133, USA Tel.: Fax: Asia Pacific IBA Dosimetry Asia Pacific No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing , China Tel.: Fax: Distributed by:

33 MatriXX Evolution System The Solution for Rotational Treatment QA

34 Rotational therapy Rotational therapy techniques have shifted paradigms in terms of treatment efficiency and precision. Simultaneous modulation of gantry rotation speed, dose rate and MLC position at every gantry angle result in a highly accurate conformity of the dose delivery with greatly diminished treatment times. With this significant improvements, plans can now be tailored to each clinical case. With this increased dynamic, the need for fast and accurate dosimetric verification of planned vs. delivered doses as well as dedicated Linac QA is evident. Advanced treatment techniques require advanced Dosimetry solutions. 2 IBA DOSIMETRY ROTATIONAL QA

35 Maximize efficiency, minimize errors The fastest and most accurate way to validate your RapidArc, VMAT, Hi-Art or conventional IMRT treatment plan under exact treatment conditions. Easy set-up on the patient couch. MatriXX Evolution digital 2D Dosimetry: fastest sampling time, highest spatial resolution and lowest angular dependancy. Unique Plastic Water phantom for quick set-up and registration. Only one phantom needed throughout the entire process. Workflow driven efficiency in OmniPro-I mrt software. Gantry angle measurement for angular dependency optimization. 3 IBA DOSIMETRY ROTATIONAL QA

36 with software MatriXX Evolution is the optimized 2D digital verifi cation system for Rotational therapy techniques. It operates with the intuitive and user-friendly OmniPro-I mrt application software for complete plan verifi cation and QA of IMRT / IGRT / Rotational treatments: Air-vented pixel ionization chambers (~ 10 %). Parallel read-out of all ionization chambers without dead time. Down to 20 msec / sample. Highest spatial resolution: 1020 ionization chambers in an active area of 24 x 24 cm 2. Gantry angle sensor for: easy set-up on the gantry easy alignment indicated by the LEDs OmniPro-I mrt software platform: TPS import Visual comparison MatriXX Evolution and film measurement Mathematical analysis MatriXX was designed and built in cooperation with Torino University and INFN. 4 IBA DOSIMETRY ROTATIONAL QA

37 One, multiple configurations The MULTICube provides an efficient way to validate the dose under parameters mirroring those of the patient during treatment. The new MULTICube combined with MatriXX Evolution and OmniPro-I mrt software is the smart solution for all dynamic applications. The multiple configurations in 5 cm increments allow you to physically position the measurement plane of the MatriXX Evolution at a point in the phantom material that will resemble its position in the patient. The MULTICube enables you to position the MatriXX Evolution in different depths vertically by raising the measurement plane off the couch by up to 20 cm. Removable film cassette with registration points for independent film verification at same measurement plane as the MatriXX Evolution. 5 IBA DOSIMETRY ROTATIONAL QA

38 Speed, Accuracy, Versatility Speed Display of each frame as a function of the gantry angle Composite dose distribution measurement. Total delivery time 76 sec Accuracy MatriXX Evolution, highest reproducibility and accuracy of measurements Angular dependency optimized by the gantry angle measurement 6 IBA DOSIMETRY ROTATIONAL QA

39 Versatility: both patient and Linac QA Patient QA using MatriXX Evolution Measured (MatriXX) Profiles Planned (TPS) Analysis Linac QA using MatriXX Evolution Measured (MatriXX) Profiles Planned (TPS) Analysis 7 IBA DOSIMETRY ROTATIONAL QA

40 The workflow 4 simple steps towards treatment RapidArc, VMAT PLAN 2) Treatment plan is recalculated with chambers at isocenter distance; Dose Maps are calculated and information is exported to OmniPro-I mrt 1) CT of MatriXX Evolution with MULTICube and export to TPS Hi-Art 2) Treatment plan is recalculated with chambers at isocenter distance; Dose Maps are calculated and information is exported to OmniPro-I mrt 8 IBA DOSIMETRY ROTATIONAL QA

41 Accept: Patient ready to treat 3) Set-up and deliver plan to MatriXX Evolution and MULTICube 4) MatriXX Evolution data is compared to plan data using the palette of intuitive evaluation tools with OmniPro-I mrt Reject: Further evaluation is needed 4) MatriXX Evolution data is compared to plan data using the palette of intuitive evaluation tools with OmniPro-I mrt Accept: Patient ready to treat 3) Set-up and deliver plan to MatriXX Evolution and MULTICube Reject: Further evaluation is needed Export to DQA for analysis 9 IBA DOSIMETRY ROTATIONAL QA

42 Clinical proof RapidArc VMAT The introduction of a novel treatment delivery technique as RapidArc asks for effi cient and accurate methods to verify the calculated dose distributions. At the VU University medical center of Amsterdam, the Netherlands, we choose to perform the patient specifi c QA in arc-based plans with both fi lm dosimetry and with MatriXX Evolution measurements. In contrast to fi lm measurements, MatriXX Evolution measurements are displayed instantaneously and they provide a very fast way to verify the dose calculations. With the introduction of new techniques like RapidArc, it is important to have a fast method to measure the stability of plan delivery in time, for which the MatriXX Evolution is a suitable detector. We hope that in the future we can fully replace fi lm measurements with MatriXX Evolution dosimetry. Dr. Wilko Verbakel Medical Physicist, Dept of Radiation Oncology VU University Medical Center De Boelelaan 1117 NL-1081 HV Amsterdam VMAT is a very fast and effi cient treatment delivery technique and it is thus imperative to have a time effi cient QA tool. Verifi cation of composite treatment plans has been the preferred approach for patient specifi c IMRT verifi cation at the Department of Radiotherapy, Medical University Vienna/AKH Vienna since Using a similar approach for rotational high precision RT techniques was thus obvious to us. MatriXX Evolution allows to perform QA in a very effi cient manner and provides direct online and multidimensional information about dosimetric deviations. Assoc. Prof. Dietmar GEORG, Ph.D. Head, Div. Medical Radiation Physics Department of Radiotherapy Medical University Vienna / AKH Vienna Währinger Gürtel AT 1090 Vienna Hi-Art We have used the MatriXX Evolution at St. Agnes Cancer Center for approximately 1 year and have found it to provide accuracy that is similar to point ion chamber measurements while also being an acceptable alternative to fi lm for dose localization. In addition, the use of the MatriXX Evolution has reduced our IMRT plan verifi cation times by over 50% by eliminating the extra steps of fi lm processing and digitization, and the conversion of point ion chamber readings to obtain absolute dose. Timothy Holmes, PhD Director, Medical Physics/RSO St. Agnes Cancer Center 900 Caton Ave, Baltimore, MD USA IBA DOSIMETRY ROTATIONAL QA

43 Technical specifications MULTICube Size MULTICube: Approximate weight: Removable film cassette: Material: Size MULTICubeLite: Approximate weight: Removable film cassette: Material: 31.4 cm (L) x 34 cm (W)) x 34 cm (H) 33 kg 4.1 kg Plastic Water within 0.5% from 150 kev to 100 MeV of true water dose 31.4 cm (L) x 34 cm (W) x 22 cm (H) 19.8 kg 4.1 kg Plastic Water within 0.5% from 150 kev to 100 MeV of true water dose MatriXX Evolution Number of chambers: 1020 Active area: 24.4 x 24.4 cm 2 Sensor layout: matrix in a plane arranged in a 32 x 32 grid Pixel distance: 7.62 mm center-to-center Chamber type: vented pixel ionization chambers Chamber size: 4.5 (Ø) x 5 (h) mm, chamber volume 0.08 cm 3 Typical sensitivity: 0.42 nc/gy Effective point of measurement: 3 mm from surface Accuracy of angle sensor: +/- 0.6 Minimum computer requirements (OmniPro-I mrt) Operating system: Microsoft Windows (XP, VISTA * 32-bit) Processor: Pentium (or equivalent), 1.8 GHz or better Memory (RAM): 2 GB (recommended for real-time mode) Hard disk: with at least 160 MB available, recommended 40 GB for data archiving Monitor and graphics: supporting a resolution of 1024 x 768 pixel at True Colour (32-bit) Ports: available Ethernet connection (RJ-45 for I mrt MatriXX) interface to film scanner, USB 2.0 Import of planned data: CadPlan (dose / fluence), CMS (dose / fluence), BrainLAB (dose / fluence), Plato (dose), Pinnacle (fluence) and from all TPS that support DICOM RT or RTOG formats Technical data is subject to change without prior notice. TomoTherapy and TomoTherapy Hi-Art are trademarks of TomoTherapy Plastic Water is a trademark of CIRS RapidArc TM is a trademark of Varian Medical Systems Inc. * Some accessories might not be Microsoft Windows Vista TM compatible (e.g. Film scanner) 11 IBA DOSIMETRY ROTATIONAL QA

44 IBA Activities in a Nutshell IBA delivers solutions of unprecedented precision with a focus in the fields of cancer diagnosis and therapy. Diagnostics Portfolio Safer Imaging, Earlier Cancer Detection Advanced quality assurance devices for Medical Imaging: Solutions for x-ray diagnosis and patient-dose monitoring Unique expertise in the design of cyclotrons: Solutions for radiopharmaceutical tracers incl. production and distribution Radiation Therapy Portfolio Fighting Cancer Undisputed leader in Particle Therapy: enabling the most precise and effective radiation therapy Industry leading QA and dosimetry solutions: maximizing efficiency, minimizing errors, better outcomes Imaging fiducial markers: Visicoil enabling high precision tumor targeting Sterilization & Ionization Improving Hygiene and Safety of Everyday Life Electron accelerators and high power X-Ray solutions: applied in many industries to sterilize medical devices, to cold pasteurize food products or to improve polymer properties Contact details: info@iba-dosimetry.com Europe, Middle East, Africa IBA Dosimetry GmbH Bahnhofstr Schwarzenbruck, Germany Tel.: Fax: North America, Latin America IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133, USA Tel.: Fax: Asia Pacific IBA Dosimetry Asia Pacific No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing , China Tel.: Fax: RT-BR-E-MatriXX Evolution Rev IBA 2011 / All rights reserved Manufacturer IBA Dosimetry GmbH IBA a Belgian company, is listed on the paneuropean stock exchange EURONEXT and its Annual Reports can be downloaded on the Website:

45 What You See Is What You Treat VISICOILTM

46 Next generation implantable linear tissue marker for high precision real-time Image Guidance Magnified image of VISICOIL * Usable with conformal RT, IMRT, IGRT and adaptive RT Visible under ultrasound, X-Ray, portal imaging, CT and MRI imaging Allows for accurate targeting when using a localized radiation field Helps reduce subjectivity of daily patient positioning Makes organ movement and deformation visible Designed to be stable and non-migrating in soft tissue Multiple lengths ensure differentiation of markers, thus making volume, size and orientation easy to determine Only 2 coils needed (compared to 3-5 conventional markers for the same accuracy) * patent pending 2 IBA DOSIMETRY VISICOIL

47 Flexible helical coil structure Conforms to highly mobile tissue as it changes shape, orientation and position Sterile, ready to use delivery systems Coil length used per implant site Coil Diameter 0.35 mm 0.75 mm 1.10 mm Needle carrier Enables easy, accurate placement and deployment Multiple lengths Available in three dedicated diameters (0.35 mm, 0.75 mm and 1.10 mm) as well as four lengths (0.5 cm, 1 cm, 2 cm and 3 cm) Visibility * 0.5 cm length not available for 0.35 version * Pre-loaded markers* Existing diameters: 0.35 mm, 0.75 mm, 1.10 mm Available in 17, 18 or 19G needles Unique design Less traumatic Fewer needle punctures Allows for placement in more delicate tumors Prostate 1 cm, 0.5 cm, 0.5 cm, 2 cm 1 cm, 2 cm 1 cm, 2 cm Breast* 0.5 cm, 0.5 cm, 1 cm 1 cm Lung* 1 cm, 0.5 cm, 0.5 cm, 2 cm, 1 cm, 2 cm, 1 cm, 2 cm, 3 cm 3 cm 3 cm Cervix* 0.5 cm, 1 cm, 2 cm Pancreas* 1 cm, 2 cm, 3 cm * Implantation techniques in organ sites other than prostate not currently validated by RadioMed. Coil lengths indicated are suggested lengths based on early clinical work. Specifiic coil length/diameter needs to be determined by the implanting physician. (0.75mm VISICOIL) TRUS BAT Visible under all common imaging modalities Ideal for image fusion Portal Imaging MRI CT X-Ray Recommended visualization techniques CT-Fluro-TRUS MRI Trans-Abdominal Ultrasound EPID-Portal KV, OBI MV 0.35 mm 0.75 mm 1.10 mm * CE marked 3 IBA DOSIMETRY VISICOIL

48 IBA Activities in a Nutshell IBA delivers solutions of unprecedented precision with a focus in the fields of cancer diagnosis and therapy. Diagnostics Portfolio Safer Imaging, Earlier Cancer Detection Advanced quality assurance devices for Medical Imaging: Solutions for x-ray diagnosis and patient-dose monitoring Unique expertise in the design of cyclotrons: Solutions for radiopharmaceutical tracers incl. production and distribution Radiation Therapy Portfolio Fighting Cancer Undisputed leader in Particle Therapy: enabling the most precise and effective radiation therapy Industry leading QA and dosimetry solutions: maximizing efficiency, minimizing errors, better outcomes Imaging fiducial markers: Visicoil enabling high precision tumor targeting Sterilization & Ionization Improving Hygiene and Safety of Everyday Life Electron accelerators and high power X-Ray solutions: applied in many industries to sterilize medical devices, to cold pasteurize food products or to improve polymer properties IBA a Belgian company, is listed on the paneuropean stock exchange EURONEXT and its Annual Reports can be downloaded on the Website: Contact details: info@iba-dosimetry.com Europe, Middle East, Africa IBA Dosimetry GmbH Bahnhofstr Schwarzenbruck, Germany Tel.: Fax: North America, Latin America IBA Dosimetry America 3150 Stage Post Drive, Suite 110 Bartlett, TN 38133, USA Tel.: Fax: Asia Pacific IBA Dosimetry Asia Pacific No.6, Xing Guang Er Jie Beijing OPTO-mechatronics Industrial Park (OIP), Tongzhou District Beijing , China Tel.: Fax: IM-BR-E-VISICOIL Rev IBA 2011 / All rights reserved VISICOIL is a trademark of IBA Dosimetry VISICOIL is manufactured by RadioMed, Inc.; 3150 Stage Post Drive, Suite 110, Bartlett, TN 38133, USA