TRUS Verification Quality Assurance

 
Institution: * RTF#: Date:
Name of the person performing the QA: *  
E-mail Address of the person performing the QA: *  
Ultrasound unit Manufacturer: Model: S/N:
Probe Frequency(MHZ): Model: S/N:
Phantom Manufacturer: Model: S/N:
 
Click the box to the right of the question to enter your response.  
1. Grayscale Visibility Test: Results: (Action limit: change>2 steps or 10% of baseline value)
Measured number of discrete steps/Gradient Distance:
Baseline Value:
Agreement:
 
2. Depth of Penetration Test: Results: (Action limit: change > 1cm from baseline value)
  Axial Plane Longitudinal Plane
Depth at which speckle pattern can be separated from electronic noise:
Baseline Value:
Agreement:
 
3. Axial and Lateral Resolution Test Results: (Action limit: change >1 mm from baseline value)
  Axial Plane Longitudinal Plan
  Current Baseline Difference (Abs/%) Current Baseline Difference (Abs/%)
Axial Resolution:            
Proximal
Distal
Lateral Resolution:            
Proximal
Distal
 

4. Axial and Lateral Distance Measurement Accuracy Test: Results: (action level: Axial – difference >2 mm or 2% from nominal value; Lateral – difference >3mm or 3% from nominal value)

  Axial Lateral (Proximal) Lateral (distal) Sketch:
Expected Distance
Measured Distance
Absolute Difference
Percent Difference
 

5. Distance, Area and Volume Measurement Accuracy Test: Results: (Action level: Difference >2 mm or 2% for distance; difference >5% of nominal for area and volume measurements)

  Top-Bottom Distance Left-Right Distance Area Measured Volume Measured
Expected
Measured
Absolute Difference
Percent Difference
 

6. Needle Template/Electronic Grid Alignment Test: Results: (Action level: alignment should be correct to within 3mm)

Coordinate of Greatest Discrepancy Error
 

7. Treatment Planning System Volume Test Results: (Action limit: The volumes calculated by the ultrasound system and the treatment planning computer should agree to within 5%)

  Target Volume(cc)   Absolute Difference(cc) Percent  Difference(%)
Known volume      
Measured with ultrasound Ultrasound volume relative to known volume
Measured with treatment planning system TPS volume relative to ultrasound volume
 
 
Note:

• It is reasonable to coordinate testing with the vendors, as long as you are confident that the vendor is competent in the tests he/she is doing.

• It is advised to use the CIRS Model 045 Brachytherapy QA Phantom to follow TG-128, although any phantom that allows the recommended tests is acceptable.

• Axial resolution is essentially independent of depth, however one may measure it at different depths, but it is generally unnecessary

• All tests should be performed with the probe frequency most commonly used during implants and the maximum power output.


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