Quantitative evaluation of 3D dosimetry for stereotactic volumetric‐modulated arc delivery using COMPASS

The purpose of this study was to evaluate quantitatively the patient‐specific 3D dosimetry tool COMPASS with 2D array MatriXX detector for stereotactic volumetric‐modulated arc delivery. Twenty‐five patients CT images and RT structures from different sites (brain, head & neck, thorax, abdomen, and spine) were taken from CyberKnife Multiplan planning system for this study. All these patients underwent radical stereotactic treatment in CyberKnife. For each patient, linac based volumetric‐modulated arc therapy (VMAT) stereotactic plans were generated in Monaco TPS v3.1 using Elekta Beam Modulator MLC. Dose prescription was in the range of 5–20 Gy per fraction. Target prescription and critical organ constraints were tried to match the delivered treatment plans. Each plan quality was analyzed using conformity index (CI), conformity number (CN), gradient Index (GI), target coverage (TC), and dose to 95% of volume (D95). Monaco Monte Carlo (MC)‐calculated treatment plan delivery accuracy was quantitatively evaluated with COMPASS‐calculated (CCA) dose and COMPASS indirectly measured (CME) dose based on dose‐volume histogram metrics. In order to ascertain the potential of COMPASS 3D dosimetry for stereotactic plan delivery, 2D fluence verification was performed with MatriXX using MultiCube phantom. Routine quality assurance of absolute point dose verification was performed to check the overall delivery accuracy. Quantitative analyses of dose delivery verification were compared with pass and fail criteria of 3 mm and 3% distance to agreement and dose differences. Gamma passing rate was compared with 2D fluence verification from MatriXX with MultiCube. Comparison of COMPASS reconstructed dose from measured fluence and COMPASS computed dose has shown a very good agreement with TPS calculated dose. Each plan was evaluated based on dose volume parameters for target volumes such as dose at 95% of volume (D95) and average dose. For critical organs dose at 20% of volume (D20), dose at 50% of volume (D50), and maximum point doses were evaluated. Comparison was carried out using gamma analysis with passing criteria of 3 mm and 3%. Mean deviation of 1.9%±1% was observed for dose at 95% of volume (D95) of target volumes, whereas much less difference was noticed for critical organs. However, significant dose difference was noticed in two cases due to the smaller tumor size. Evaluation of this study revealed that the COMPASS 3D dosimetry is efficient and easy to use for patient‐specific QA of VMAT stereotactic delivery. 3D dosimetric QA with COMPASS provides additional degrees of freedom to check the high‐dose modulated stereotactic delivery with very high precision on patient CT images. PACS numbers: 87.55.Qr, 87.56.Fc


Notice
This User's Guide is an integral part of OmniPro I'mRT System and should always be kept at hand. Observance of the manual instructions is required for proper performance and correct operation of OmniPro I'mRT System.
OmniPro I'mRT System and its accessories must not be used for any other purpose than described in the accompanying documentation (intended use). Violation will result in loss of warranty.
IBA Dosimetry does not accept liability for injury to personnel or damage to equipment that may result from misuse of this equipment, failure to observe the hazard notices contained in this manual, or failure to observe local health and safety regulations.
IBA Dosimetry shall under no c i r c u ms t a n c e s b e l i a b l e fo r i n c i d e n t a l o r coincidental damage arising from use of the equipment described in this document.
No part of the accompanying documentation may be translated or reproduced without written permission of IBA Dosimetry, unless reproduction is carried out for the sole purpose to be used by several people in the same department.
The user must treat the accompanying documentation like any other copyrighted material. Especially, if part of the accompanying documentation is provided in electronic form, these files shall not be modified in any way. IBA Dosimetry and its suppliers retain title and all ownership rights to the accompanying documentation (either in electronic or printed form).

Table of ContentsIntroduction
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | iii | I'MRT MatriXX consists of a 1020 vented ion chambers array detector, arranged in 32 × 32 grid. When irradiated, the air in the chambers is ionized. The released charge is separated by means of an electrical field between the bottom and the top electrodes. The current, which is proportional to the dose rate, is measured and digitalized by a non-multiplexed 1020 channels current sensitive analog to digital converter.
The measured data are transmitted t o a P C v i a a s t a n d a r d E t h e r n e t interface, available on most PCs.

MatriXX Evolution
MatriXX Evolution is an optimized 2D digital verification system for rotational therapy techniques. It operates with the OmniPro I'mRT software for complete plan verification and QA of ImRT, IGRT, and rotational treatments.

I'mRT Phantom
The I'mRT Phantom resembles the human body in shape and radiation properties. The cube, which can be used separately, resembles the human head.
After CT scanning of the phantom, a treatment plan is calculated, and the dose distribution data is imported into OmniPro I'mRT software. The I'mRT Phantom is then treated according to this plan, and the dose distribution or the absolute dose in singular points is measured, using films and ionization chambers respectively. The OmniPro I'mRT s o f t w a r e w i l l c o m p a r e t h e measurement values with the calculated dose distributions.
Safety information, technical information, and instruction for use for I'mRT Phantom are found in I'mRT Phantom User's Guide. OmniPro I'mRT System User's Guide contains health and safety information, installation, setup, and measurement instructions, and descriptions of the OmniPro I'mRT software functions for visualization, analysis, handling, and storing of measurement data.

I'mRT MatriXX and MatriXX Evolution
OmniPro I'mRT System User's Guide contains product information, health and safety information, instructions for installation, and instructions for setup and preparation of measurements for MatriXX.

Other Devices Supported by OmniPro I'mRT
OmniPro I'mRT S y s t e m U s e r ' s G u i d e c o n t a i n s i n s t a l l a t i o n , s e t u p , a n d measurement instructions, related to OmniPro I'mRT software. For general information, refer to the product specific manuals (see References).

DATA EVALUATION RESPONSIBILITY
The person managing the OmniPro I'mRT s y s t e m b e a r s t h e f u l l responsibility for critically evaluating every measurement result and/or manipulated measurements, before using data for verifying or modifying treatment plans, or using data for adjusting, checking, or servicing a radiation device.

GENERAL RESPONSIBILITY
OmniPro I'mRT i s i n t e n d e d t o b e u s e d b y t h e p h y s i c i s t o r e n g i n e e r responsible for the quality control of radiation therapy equipment and of treatment delivery.
The user of OmniPro I'mRT must have experience in radiation physics and radiotherapy, and must be familiar with the terminology used in the area of dosimetry.

WARNING FILM MEASUREMENT: SENSITIVITY MAY VARY FROM FILM TO FILM
The sensitivity of radiographic films is strongly dependent on parameters like type, age, batch, or storage conditions. Perform a film calibration when using films where one or more of the above parameters differ from the film used for the current film calibration.

WARNING FILM MEASUREMENT: OD VALUES OUTSIDE FILM SCANNER CALIBRATION RANGE
If a film is calibrated or measured outside the film scanner calibration range, the measurement values may not be correct. Never calibrate or measure a film outside the OD range for which the film scanner has been calibrated.

WARNING FILM MEASUREMENT: DOSE OUTSIDE THE FILM CALIBRATION RANGE
If a film is measured outside the film calibration range, the measurement values may not be correct. Never measure a film outside the dose range for which the film has been calibrated.

WARNING FILM MEASUREMENT: FILM BECOMES SATURATED
Depending on the choice of film, the saturation dose of the film may be lower than the maximum dose to be verified. Scale down the treatment plan or select an appropriate film.

WARNING FILM MEASUREMENT: MARKERS ON FILM
Markers for identification, orientation, or positioning may overlap or interfere with optical density, due to radiation. Mark your films outside the region where you want to determine the dose.

WARNING FILM MEASUREMENT: FILM AND FILM-ENVELOPE PRODUCE AN OFFSET
When inserting films in a body phantom, other film planes or slices are shifted, due to the thickness of the films and their envelopes.
When defining the offset information in the film setup, take into account the additional offset produced by the other films.

WARNING I'MRT QA/BIS MEASUREMENT: I'MRT QA/BIS CORRECTION IMAGE
The specification of the correction image file and the CCD area are mandatory. If you specify an incorrect or non-existing file and/or path, the measured image will not be corrected. If you specify an incorrect CCD area, the measured image will be incorrect. It will be very noisy and shifted, and may not appear fully on the screen.

WARNING I'MRT MATRIXX MEASUREMENT: I'MRT MATRIXX UNIFORMITY CORRECTION MATRIX
The application of the Uniformity Correction Matrix is mandatory. If the Uniformity Correction Matrix is not activated, the measured image will not be corrected.

WARNING SYMMETRY/FLATNESS: PARAMETERS MEASURED UNDER NON-REFERENCE CONDITIONS
Dosimetry protocols define the reference conditions for the determination of symmetry or flatness. Definition of water as medium, a certain depth, and a certain field is required, and also the type of detector to be used may be specified.
If measuring under different conditions (e.g. when using I'mRT QA/BIS in air), these parameters may differ from those measured under reference conditions.

WARNING ASCII EXPORT: LIMITED NUMBER OF DATA ROWS AND/OR COLUMNS
Some Windows applications support fewer rows and/or columns than the number of columns exported by OmniPro I'mRT (e .g . M icro s o ft EX C EL supports 256 × 65536).
If importing OmniPro I'mRT ASCII data to those applications, rows and/or columns exceeding the limit will not be imported.
If necessary, reduce the number of data by selecting a small region of interest.

WARNING TWAIN SCANNERS: 8-BIT GREYSCALE NOT SUFFICIENT
Using an 8 bit grey-scale scanner will give insufficient dose resolution, which will result in incorrect interpretation of data.
16 bit grey-scale is required.

WARNING DOSE EXPOSURE CHECKING: DOUBLE EXPOSURE
Double exposure will result in incorrect plan verification. When checking dose exposure for parts of a field or treatment, use a new film for each irradiation.

WARNING I'MRT MATRIXX: CALCULATION GRID
For correct comparison of treatment planning system (TPS) data and MatriXX data, the TPS grid resolution must be adapted to the MatriXX grid resolution. ■ have knowledge about safety procedures to be observed when working with radiation sources such as Cobalt-60 machines or linear accelerators.
■ are aware of safety precautions required to avoid possible injury when using electrical/electronic equipment.
Before using I'mRT MatriXX or MatriXX Evolution for measurements, the operator must verify the general functionality, safety, and duly condition of the device and the dosimetry system. The device must not be used if any blemish is noticed, and the manufacturer should be notified.

ACCESSORIES AND SPARE PARTS
No other accessories and spare parts than those provided or approved by the manufacturer must be used, otherwise operator safety, specified measuring accuracy, and interference free operation cannot be guaranteed. Violation of this prescription will result in loss of warranty. IBA Dosimetry cannot be held liable for any damages resulting from the use of accessories or consumables that are not provided or approved by the manufacturer.

Environmental Requirements
MatriXX are sensitive measuring systems and must be stored and used in a clean, dry, preferably air-conditioned area, at room temperature. Protect them from mechanical and thermal stress, and unnecessary moisture. Avoid exposure to solvents and aggressive vapors.

IMPORTANT NOTICE THE DEVICE MUST NOT BE USED UNLESS IT IS COMPLETELY DRY
If moisture has developed as a result of temperature changes, I'mRT MatriXX or MatriXX Evolution must not be used unless it has been completely dried.

Storage
When the system is not in use, unplug the power supply from the mains connector.
Store MatriXX in a radiation protected area. Do not place the system near equipment generating a strong magnetic field.

WARNING DO NOT STORE THE MATRIXX ADJACENT TO OR STACKED WITH OTHER EQUIPMENT
MatriXX should not be stored adjacent to, or stacked with other equipment. If adjacent or stacked storing is necessary, the device should be observed to verify normal operation in the configuration in which it will be used.

CAUTION DO NOT STORE THE DEVICE IN THE ACCELERATOR ROOM
Due to the sensitivity of the electronics against radiation, never store MatriXX in the accelerator room. This would considerably shorten their lifetime. Move the device into the accelerator room only if you intend to make measurements.

Handling
Handle MatriXX with careavoid impact, excessive weight on the surface, and strong vibrations. Maximum load of build-up is 25 g/cm 2 .
Never irradiate other parts than the marked sensor area.
Do not handle the devices with wet hands.
If a handling incident occurs, always perform a check before using the device again. If the device has been covered with water, un-power the device, and wait approx. 1 minute before touching it.

Electrical Installations
The electrical installations in the rooms where I'mRT MatriXX or MatriXX Evolution with c o n n e c t e d e q u i p m e n t i s u s e d m ust comply with IEC recommendations. Always use a power cord with a grounding pin.

Rating Label
The power entry module of the device contains the rating label below:

HAZARDOUS VOLTAGE
Pay attention to the voltage ratings on the rating label. This determines the safety hazards for the power supply. Do not open covers.

WARNING EMC PRECAUTIONS
MatriXX need special precautions regarding EMC and must be installed and put into service according to the EMC information provided in this manual.

RF COMMUNICATION EQUIPMENT
Portable and mobile RF communication equipment can affect the performance of MatriXX.

Guidance and Manufacturers Declaration -Electromagnetic Emissions
MatriXX are intended for use in the electromagnetic environment specified below.
The customer or the user of I'mRT MatriXX or MatriXX Evolution should assure that it is used in such an environment.

Not applicable
MatriXX use RF energy only for their internal function. Therefore, its RF emissions are very low, and are not likely to cause any interference in nearby electronic equipment.
MatriXX are suitable for use in all establishments other than domestic and those directly connected to the public low-voltage supply network that supply buildings used for domestic purposes.

Guidance and manufacturer's declarationelectromagnetic immunity
The I'mRT MatriXX is intended for use in the electromagnetic environment specified below.
The customer or the user of the I'mRT MatriXX should assure that it is used in such an environment. 800 MHz to 2,5 GHz:

Immunity
where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m). Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey a, should be less than the compliance level in each frequency range b.
Interference may occur in the vicinity of equipment marked with the following symbol: NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies. NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people.
Field strengths from fixed transmitters, such as base stations for radio (cellular or cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which MatriXX are used exceeds the applicable RF compliance level above, MatriXX should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the MatriXX devices. In the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m. For calculating the dose for verification plans in the TPS a CT scan of the MatriXX is necessary. The verification plan will be calculated on the MatriXX CTs. The T P S p l a n e w h e r e t h e e f fe c t i ve p o i n t o f measurement of the chamber row is located will be exported. A calculated TPS dose plane and a 2D measurement at the same position are available for verification in the OmniPro I'mRT software.
During the CT scan the position of MatriXX at the linear accelerator should be exactly like during the subsequent measurement of the verification plans. In order to be able to measure the scattering, MatriXX is positioned either in the MULTICube or on a 5 cm thick layer of water equivalent material (RW3plates). Also, as build-up material a 5 cm thick layer of RW3-plates is positioned on the MatriXX measurement area. In this way the scattering resembles that of the human body.
If the gantry holder is used the same build-up and backscatter should be mounted for the verification measurement as used in the CT.
To use the CT data in the TPS system, the origin has to be precisely defined. MatriXX is positioned in such a way in the CT scanner that the central point of the measurement level is positioned exactly at the CT central axis. Thus point zero of the measurement system always coincides with point zero of the CT data set (DICOM origin). In the plan system the isocentre can be positioned precisely in the DICOM origin.

DIFFERENT CT SCANS FOR DIFFERENT MATRIXX'S
For every MatriXX a CT is necessary. Otherwise deviations in dose calculation and measurements are possible. Ensure that the correct CT scan is used. The calibration of the MatriXX should be c a r r i e d o u t d i r e c t l y a f t e r t h e calibration of the linac. MatriXX has built-in pressure and temperature sensors. Therefore the input of pressure and temperature is not necessary during the calibration, nor during the subsequent measurements.
The measurement setup follows directly from the verification measurements and therefore directly from the setup during the CT scan.
The precise thickness of the water-equivalent layer over the MatriXX measurement level is known and therefore also the exact number of monitor units required for a certain dose (for more details please see chapter 7.4.4.1 Creating a kUser Factor).

Realization of the Measurement
The MatriXX setup is exactly like the setup used for the CT scan.
For the exact orientation of the measurement system, the gantry and collimator angles of the linear accelerator must be set at precisely 0°. The vertical orientation of MatriXX is carried out with assistance from the laser and the sideways positioned markers on MatriXX that indicate the exact position of the measurement level (for more details please see chapter 7 Setup of MatriXX).
After connecting the MatriXX with the computer, setting the measuring parameters in the software and measuring the background the first measurement can be started. Either all fields of the treatment plan can be irradiated in a queue as one measurement or one field after each other in single measurements to verify each single field. The raw data should be collected beforehand as copy in a separate order.

Analysis
The most common method to analyze the pre-treatment verification is using the Gamma Index Method.

Installation of SCSI Adapter and Scanner Drivers
The plug-and-play function recognizes the SCSI adapter, and starts the Add New Hardware wizard.
Select Search for the best driver for your device.
Find the Adaptec SCSI adapter in the list of installed hardware.
Restart the computer.
Select Settings/ControlPanel/System/Hardware/Device manager -SCSI adapters from the Windows Start menu. Check that the Adaptec adapter is present. If there is a yellow exclamation mark on the icon, there is a problem with the drivers. Select Properties and change driver.
Insert the Vidar Drivers and Toolkit Installation CD, and install the STI drivers and the Vidar Toolkit. (The CD is supplied with the scanner.) The STI driver and Vidar Toolkit for Windows® 2000 and XP are also available at the Vidar Systems' website: www.filmdigitizer.com/html/drivers.html.
The plug-and-play function recognizes the VXR scanner, and tries to install a driver for that device. It is found on the Vidar installation CD.
Step through the pages in the Found New Hardware w i z a r d , s e l e c t i n g t h e d e f a u l t alternatives. Finally, select Finish.

USB
The computer must have a USB 2.0 port. A USB 2.0 peripheral connected to a 1.1 port will not recognize the Vidar scanner.
A USB 2.0 adapter can be installed. The Adaptec™Model USB2Connect, part number AUA-2000 is recommended.
The scanner must be connected to the computer with a USB 2.0 cable. .NET Framework 2.0 must be installed (Internet Explorer 5.01 or higher is required for installation).
The validation of the software is done with the US versions of the operating systems. Troubleshooting or support in case of problems related to local language operating systems is therefore very limited.

SOFTWARE CONTROLLING MATRIXX
The software controlling the MatriXX is included as a part of Windows application softwares developed by IBA Dosimetry, and can be directly accessed from the application's main window. The latest type of computer is always recommended, especially if you are going to use large data sets or work with film scanners.

OmniPro I'mRT Installation Utility
The OmniPro I'mRT CD-ROM contains a setup utility that will install the necessary files and create a program group and icons.

START BY INSTALLING THE SCANNER
If you have a film scanner, the scanner must be installed prior to the installation of I'mRT software, otherwise the vscsi32.dll file might be overwritten.

LOG IN AS ADMINISTRATOR
When installing, log in as Administrator. Otherwise the installation will fail.
Follow these steps to install the software: Insert the CD-ROM in the CD-drive.

INSTALLED FILES
During the installation of this software some important files are placed in the same directory as the application. Since the application needs these files to be able to run properly, please do not move the OmniPro I'mRT application from the original directory.
Select Install OmniPro I'mRT. The Installation wizard starts. Follow the instructions on the screen.

WINDOWS VISTA
A message "An unidentified program wants access to your computer" might appear. The program is setup.exe. Select Allow to continue.
Follow the instructions on the screen:

Installation
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 39 | During installation of the software, an empty data base is created in a user definable folder, and a connection to this data source is established.
The database can be installed either locally on a computer, or in a network.

READ AND WRITE ACCESS
All users must have full read and write access to the OmniPro I'mRT folder where the equipment database is located, to be able to run OmniPro I'mRT.
If OmniPro I'mRT s h a l l b e i n s t a l l e d o n mo r e t h a n o n e c o mp u t e r , i t i s recommended to make the database available for all installations: Choose a directory that is shared via network.
Map this directory on each computer to a drive letter.

DRIVE LETTER
The drive letter must be the same for all users on an individual computer.

DESTINATION DIRECTORY
If an installation in a network is planned, the destination directory must be mapped to a driver letter. This driver letter must be the same for all users.
Select the shared drive letter as database folder. Follow the instructions on the screen.
Repeat the installation and select the shared driver letter on all computers.

SHARED DATABASE LOCATION
When installing OmniPro I'mRT o n s e ve ra l co mp u t e rs , s e le ct th e s a me shared database location as for the first installation. The installation program will detect that the database already exists, and will connect to it (instead of copying an empty database to the folder).

NO ACCESS TO THE NETWORK
Sometimes the administrator on the computer does not have access to the network. If that is the case, consult the chapter Troubleshooting.

SOFTWARE VERSION EARLIER THAN 1.4
If an earlier version than version 1.4 is used (e.g. if not all users in a network have yet been upgraded), the equipment database created in version 1.7 will not be accessible.

Test of the Installation
A test is available to ensure that the OmniPro I'mRT software has been installed correctly. Use the example file, delivered with the software, to check the installation:

WINDOWS VISTA
To be able to run OmniPro I'mRT correctly, and to create the computer ID, the program must be started with Run as Administrator the first time, even if you are logged in as administrator.
Right click the OmniPro I'mRT icon, and select Run as Administrator.
Select Accept when the message "An unidentified program wants access to your computer" appears.
Double-click the OmniPro I'mRT icon on the desktop, or go to the Windows Start menu. Select Program-IBA Dosimetry-OmniPro-IMRT. The program will start.
Select the menu command File:Open Workspace. A standard Open dialog opens.
Browse for an *.opw file. (It should be stored in the DATA folder). Open the sample file.
The Workspace opens. Depending on the type of data loaded, it will be displayed in either Plan Verification 2D or 3D mode.

Registration of the Software
After installation the software works for a limited time (30 days). Thereafter it will run only if it has been registered.

LOG IN AS ADMINISTRATOR
You must be logged in as Administrator when entering the license number and the license key.
When you start the program after installation, the About OmniPro I'mRT dialog will open.
Register the software at IBA Dosimetry in the following way: 8. Note the License Number and the Computer ID for each installation.
9. Contact IBA Dosimetry for registration via the Radiotherapy/Support section of the homepage www.iba-dosimetry.com.
Registration may also be made by e-mail or fax.
The following information must be included: ■ Name and address (do not forget email address). ■ Product serial number ■ Computer ID For more information check the Registration Form sent to you together with the installation CD.
After a few days a license key will be sent to you.
Open the About box (found under Help), and enter the License Key. From the list of installed programs, select OmniPro I'mRT a n d c l i c k Add/Remove. The Installation wizard starts. Follow the given instructions.

Alternative procedure:
Insert the OmniPro I'mRT CD-ROM.
Select Install OmniPro I'mRT.
The installation program presents three alternatives. Select Remove.
All OmniPro I'mRT files, except for the calibration files, setup and equipment information, and measured data, will be removed.

Reinstallation of OmniPro I'mRT
IMPORTANT NOTICE

LOG IN AS ADMINISTRATOR
You must be logged in as Administrator to reinstall the program.
It may be necessary to perform a reinstallation of the software, e.g. when installing a new option.
Insert the OmniPro I'mRT CD-ROM.
Select Install OmniPro I'mRT. The installation program will present three alternatives. Select Modify. The installation starts.
During the installation, enter the new license number from the License Document.

DO NOT SELECT REPAIR
Do not select Repair to install new options, since OmniPro I'mRT will be reinstalled using the same settings as during the previous setup.

MOVING THE SOFTWARE TO ANOTHER COMPUTER
If it becomes necessary to move the software to another computer, e.g. after a computer crash, a new registration is necessary. Follow the instructions for a normal registration.

Computer settings for MatriXX
MatriXX can be connected directly to a PC, or to a local network (LAN), via an Ethernet cable.
Several devices can be connected to a network.
Administrator status is required to perform connections.

MATRIXX
In the instructions for connection to a PC or a local network ( The new firmware version will be installed.
Select Yes when you are prompted to restart the device.

RESTART
Manual restart of the device is necessary. Turn power off and on to restart the device.

Main Toolbar
The tool buttons provide shortcuts to common menu commands, such as "selection of the data set to be displayed": Displays dataset 1 in all panes.
Displays dataset 2 in all panes.
Displays two 2D data sets for comparison.
Displays two 3D data sets for comparison.
To get a brief description of the command, move the mouse over the tool button until a tool tip is displayed, or look at the information text in the status bar. Depending on the data displayed, some commands in the toolbar may not be available (dimmed).
To view/hide the toolbar, select Workspace:Toolbar.
Refer to the OmniPro I'mRT on-line help for detailed descriptions of all buttons.
The I'mRT QA/BIS toolbar contains status indicators, selection buttons for the measurement mode, start button, and a button for background definition.
6.1.6. I'mRT MatriXX Toolbar When I'mRT MatriXX is selected as the measurement device, the OmniPro I'mRT MatriXX toolbar will be expanded.
The I'mRT MatriXX toolbar contains status indicators, selection buttons for the measurement mode, start button, and a button for background definition.

Status Bar
The status bar, at the bottom of the main window, displays information about current actions, and provides brief help texts for menu and toolbar commands. To display or hide the status bar, select Workspace:Statusbar.

Panes
Four different panes are used to display the data. The type of data displayed depends on what kind of data is selected (one data set or two data sets for comparison).
The following general commands are used to select the view:

Toolbar icons
Shows the data as isodose contours.
Shows the data as a two-dimensional array.
Shows the data as a three-dimensional array.

Pane icons
Maximizes a single pane to full window display.
Restores a maximized window to the previous window size.
Resets all panes to default sizes. Array Pane: Shows the data as a 2D array.
Isodose or 3D-Pane: Shows the data either as Isodose contours or in a 3D view.
Profile Panes: Shows profiles along the main axes. The profile offset to the origin can be defined when selecting the View:Profile Cursor inside the Array Pane.
See also 9.4 Analyzing one single data set.

Panes during Plan Verification
When Plan Verification 2D or 3D is selected, two panes are used to display the two single data sets. The other two panes are used for comparison.
Data Set 1 (or 2) Pane: Displays the data set 1 (or 2) as a 2D array, an Isodose contour, or in a 3D View.
Comparison Pane: Displays isodoses or profiles of both data sets in the same window.
Result Pane: Displays the result of a mathematical comparison between the two data sets. Possible operations are, for example, Difference, Gamma method, or DTA method.
In the Comparison Pane you can either compare isodoses or profiles: Shows the isodose levels of both data sets in one single pane. Isodose levels can be defined when selecting View:Isodose Levels inside the data set 1 and 2 panes. For example, click in data set 1 pane, select View:Isodose, and then View:Isodose Levels. (Or right click in the isodose pane and select Isodose Levels Set 1 (or 2)).
Shows one profile of each data set along one of the main axes. The offset to the origin can be defined when selecting View:Profile Cursor inside the Array Pane of each data set. To switch over to the other axis, right click in the pane and select the other axis.

File type Description
*.opw OmniPro I'mRT workspace file. The workspace file does not contain any 2D dose distribution data itself, but rather information about where data that belong together are saved. It can contain the link to two data set files (*.opd) and one result file (with the name workspace name_res.opd). Additionally it can contain Absolute Dose verification data and comments. If you want to add the data to the open data set, check Append to current data set. Use the Field list dialog to select data from the data set. To select all data in the Field list, press <Ctrl + A>.

Configuration of OmniPro I'mRT Software
The OmniPro I'mRT system needs to have information about the equipment that is used with the system, such as the clinic, scanners, detectors, film type and the radiation device. Normally this is done directly after you have installed OmniPro I'mRT. Prior to measurements it is then quite easy to select the used equipment from a drop down list. (It is possible to add, modify, or remove equipment at any time.) Choose the category of equipment that you want to configure from the Equipment menu:

Clinic:
Enter administrative data about your clinic. This information will be stored together with the measurements.
Radiation Devices: Specify the accelerators including energies, wedges, etc.

MatriXX Evolution: Define the MatriXX Evolution .
Film: Define the type of films you are going to use.
Film Scanner: Define the settings for the film scanner to be used with OmniPro I'mRT.
Body Phantom: Define the body phantom.

Detectors: Not applicable in this SW version.
See the on-line help for detailed descriptions for the configurations.

Specify Units and Parameters
There are a number of items, related to parameter calculation and the user interface, which can be defined according to your preferences. This is done in the Options dialog. Open the dialog by selecting the menu command Tools:Options. The parameters will be displayed in the profile view: The calculation methods are described in 14 Algorithms.

User-defined Protocols
To define a customized protocol, options for calculation methods for field width, penumbra, flatness, symmetry, and deviation, are available.

INTENSITY MODULATED FIELDS
The FermiFit algorithm is not intended to be used on intensity modulated fields.
When a parameter in one of the pre-defined protocols is changed, the protocol name will be cleared. Thus the user-defined protocol will not have a name assigned to it. ■ Define the size and location of the region of interest (ROI).
Search distance: This is the search range for the Gamma algorithm. It should always be larger or equal to the criterion of acceptance. Normally it is sufficient to set the value exactly the same as Delta Distance.
However, if you also like to have values larger than 1, regarding the local aberration with the Gamma method, you must search also beyond this limit. Thus you will see if the gamma value is not correct (Gamma > 1), and the size of deviation as well (e.g. Gamma = 1.5).
Relevant Signal: Defines a threshold value to take underground signals (non irradiated areas) out of statistics.

Invalid Result:
Value assigned to all pixels that are below the threshold value. If you assign i.e. -1 for these pixels they will be displayed in the histogram later on but will not be taken into account.
Refer to the OmniPro I'mRT online help for further description. ■ Define the output resolution for Copy/Paste to an external application.
Refer to the OmniPro I'mRT online help for further description.

Setting up I'mRT MatriXX
The diagram below shows the general placement of the MatriXX, the power supply, the PC, and the connections between them.
For measurements the MatriXX is placed under the gantry head, either on the treatment couch or on a lifting table, as shown in the figure below, or mounted on the gantry. It is connected to the PC in the control room via an Ethernet cable, or via an existing LAN network. 2. The lasers in conjunction with the side cross makers of the MULTICube or on the I'mRT MatriXX can be used to position the device in the center of the beam.
3. Align I'mRT MatriXX, using a spirit level placed on the detector area.
4. At the accelerator, set the field size 20 × 20 cm, and turn on the light field.
5. Use the adjustment capabilities of the treatment couch, or the lifting table, to position I'mRT MatriXX so that the crosshairs at the sensor area and the light field crosshairs are superimposed.

USE THE SIDE MARKERS FOR POSITIONING
Due to the higher uncertainty when positioning the device in the light field (diffuse penumbras and cross-hair width), for precise positioning it is advisable to refer to the side markers which are engraved in the housing.
6. Ensure that the cables to the PC or the network are properly connected.
7. Plug the power cord into a mains power outlet, and switch on the MatriXX. Verify that only the green LED is illuminated.
Allow an appropriate warm-up time, and pre-irradiate the device during the warm-up (See 7.3.2 Pre-irradiation and Warm-up).  Table) so that the crosshairs at the sensor area of the MatriXX and the light field crosshairs are superimposed.

USE THE SIDE MARKERS FOR POSITIONING
Due to the higher uncertainty when positioning the device in the light field (diffuse penumbras and cross-hair width), for precise positioning it is advisable to refer to the side markers which are engraved in the housing.
6. Ensure that the cables to the PC or the network are properly connected.
7. Plug the power cord into a mains power outlet, and switch on the MatriXX. Verify that only the green LED is illuminated.

ALL ACCESSORIES MUST BE LOCKED TO THE SUPPORT FRAME
The total weight of the support frame with the MatriXX with 50 mm build up, backscatter holder with 100 mm backscatter plates, and the gantry holder, is 37.9 -39.6 kg (depending on the type of gantry holder).
Ensure that all knobs and safety clamps are firmly tightened before starting the measurement. Check: Try to pull the MatriXX out of the holder. It must not be possible to move it.

MATRIXX MUST STAY CLEAR OF SURROUNDING EQUIPMENT
Ensure that the mounted MatriXX stays clear of the patient couch or other equipment, when the gantry is rotated.

CAUTION ENTER GANTRY ADAPTER INFORMATION TO THE LINAC SOFTWARE
Ensure that the gantry adapter is accepted as an accessory by the Linac software; otherwise interlocks may occur.

START WITH THE BACKSCATTER HOLDER AND PLATES
If backscatter plates are going to be used, start by mounting the backscatter holder and plates.

Mounting the Backscatter Holder and Plates
Backscatter plates can be mounted from 10 to 100 mm, in steps of 1, 2, 5, and 10 mm.
The delivered backscatter plates are made of water equivalent polystyrene, RW3.

BACKSCATTER HOLDER
The plates must be positioned and locked in the backscatter holder.  . Lock the backscatter holder with the four knobs (b). These knobs will also lock the MatriXX to the frame.

CAUTION ENSURE THAT ALL KNOBS AND SAFETY CLAMPS ARE PROPERLY TIGHTENED.
The design of the holder is based on friction, therefore proper tightening of the screws is essential.

Mounting the MatriXX in the Support Frame
When inserting the MatriXX into the support frame, ensure that it will be positioned tightly to the wall of the frame. The openings in the frame allow the markings for laser adjustment to remain visible (c).
1. Move the MatriXX cautiously to the opposite wall of the frame, by turning the two knobs (d) on the side of the frame. Do not tighten the knobs.

Setup of MatriXX for measurements
| 76 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide 2. Use the four knobs (b) in the bottom of the frame to lift the MatriXX to the upper surface of the frame, so that the distance to the isocenter will be correct (100 or 76.2 cm). These knobs will also lock the MatriXX to the frame.

SURFACE OF THE DETECTOR AREA
The surface of the detector area is positioned 3 mm below the MatriXX housing surface. The water equivalent thickness is 3.2 mm.

CAUTION LOCK THE MATRIXX TO THE FRAME
Ensure that the MatriXX is locked with the four knobs in the bottom of the frame. The two knobs on the side of the frame will not lock the MatriXX. Check: Try to pull the MatriXX out of the holder. It must not be possible to move it.

Buildup Plates
Build up can be mounted up to 5 cm, in steps of 1 mm.
The delivered build up plates are made of water equivalent polystyrene, RW3.
The water equivalent depth of the MatriXX housing is 3.2 mm.

Remove the safety clamps (a).
Tip! Turn the clamps 180° and put them on the knob again, to keep them readily at hand. (a)

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 77 | 2. Position the plates on the MatriXX surface, in the frame. Lock the plates from above with the four clamps on the side of the frame (b).

CAUTION ENSURE THAT ALL CLAMPS (A) AND (B) ARE TIGHTENED
All clamps must be tightened, otherwise the plates may slide out. Table   IMPORTANT NOTICE

BACKSCATTER PLATES AND BUILD-UP PLATES
If backscatter plates and build up plates are going to be used, adjust the XY table after the backscatter holder and the build up plates have been mounted and locked.

MATRIXX MOUNTED ON THE GANTRY
If the MatriXX is going to be mounted on the gantry, adjust the XY-table after the complete equipment, the gantry adapter included, has been mounted on the gantry (see 7.1.1. 3

.5 Mounting of the Gantry Adapters).
XY

Setting up MatriXX Evolution
The diagram below shows the general placement of MatriXX Evolution , the power supply, the PC, and the connections between them.
It is connected to the PC in the control room via an Ethernet cable, or via an existing LAN network.

MatriXX
Evolution can be positioned on the treatment couch, or mounted in a MULTICube.

Setup with MULTICube
In the MULTICube the device can be positioned in steps of 5 cm vertically, thus raising the measurement plane up to 20 cm above the plane of the couch.

MatriXX
Evolution may also be positioned in a vertical position.

CAUTION SUPPORT THE ELECTRONICS PART OF THE MATRIXX
When backscatter plates are used, the center of mass is on the electronics side of the detector bed. Support the electronics part of the device to eliminate the risk that the MatriXX will tip over. (Sufficient build-up will offset the weight of the electronics and shielding).
If the MULTICube is not used place at least 5 cm solid water as backscatter and build-up material underneath and on top of the MatriXX.

Setup with Gantry Holder
For details about head mounting and alignment, see 7. Ensure that the cables to the PC or the network are properly connected.
Plug the power cord into a mains power outlet, and switch on the device. Verify that only the green LED is illuminated.

Pre-irradiation
Like other ion chambers, the MatriXX device needs a certain dose of preirradiation before the chamber signal reaches a stable value. Final profile

Examples of pre-irradiation profiles
Pre-irradiation can be performed during the warm-up phase.
Pre-irradiation has to be repeated every time the device is switched on.

Warm-up Time
For relative dosimetry, the stability of the MatriXX will be sufficient after 15 minutes' warm-up.
For absorbed dose measurements, the stability will be sufficient after 1 hour's warm-up.

Gantry Angle Sensor (available with MatriXX Evolution )
The Gantry Angle Sensor is an additional tool for the MatriXX E v o l u ti o n . Its purpose is online detection of the gantry angle while irradiating for treatment verification.
For the Gantry Angle Sensor, the use of MatriXX Evolution is mandatory, since only the MatriXX Evolution is intended to be used in rotational applications.
The sensor is equipped with 4 LEDs to facilitate alignment of the sensor in a vertical plane; a precondition for correct measurements (see 7. 3 The sensor shall be fixed on the gantry (e.g. using powerstrips or similar adhesive tapeobserve the instructions of use!). In order to provide correct results, the sensor must be aligned in a vertical plane within ± 5°.

MatriXX Evolution service port
Gantry angle sensor
2. Connect the sensor to the service port of the MatriXX Evolution .
3. Power on the MatriXX Evolution .
4. At the sensor, remove the tilt in direction Y.
6. Remove the tilt in direction X.
How to remove the tilt in each direction: 1. Turn the gantry to 0°, loosen the screw for Y direction and align the sensor until no LED for this direction lightens up. Fasten this screw. Repeat this procedure after turning the gantry to 90° for X direction.
2. The LEDs on the sensor will light up if the tilt is not within the permitted range (± 5°) in the respective direction. If no LEDs lighten up anymore, the sensor tilt is within the tolerance for both directions. The sensor can then be calibrated.
3. The correct alignment is checked in the software during calibration of the sensor (see 7. 3

MPORTANT NOTICE DISTANCE BETWEEN MATRIXX EVOLUTION AND GANTRY ANGLE SENSOR
Make sure the distance between MatriXX Evolution and Gantry Angle Sensor is such that the length of the cable (3 m) is sufficient even when turning the gantry.

GANTRY ANGLE AND ROTATIONAL DIRECTION
The gantry angle and the rotational direction of the sensor are defined in IEC 61217.

SENSOR READOUT
The sensor readout can be affected by outside influences (vibration, etc.).

Calibration of the Sensor
When the sensor is connected to the MatriXX Evolution , and the OmniPro I'mRT software is started, the software automatically detects the sensor. If a measurement is started without an existing sensor calibration, a warning message appears.

CALIBRATION OF SENSOR
The sensor calibration must be repeated every time that the MatriXX Evolution is switched on.
1. When the sensor is aligned, go to Measure/Calibrate Angle Sensor.
The Gantry Angle Calibration window opens.
The checkmark for Angle sensor is mounted on the collimator will for now only serve as information for the user. In later versions of the software there will be the possibility to mount the angle sensor at the collimator, and an algorithm will calculate the angle also when the collimator rotates.
Descriptions of the steps through the calibration process are displayed in the Gantry Angle Calibration window.
2. The first step after fixation of the sensor on the gantry is to move the gantry in an upright position (gantry head up) and press the Start button. The tilt of the sensor and the gantry angle will be displayed.
The tolerance to pass the calibration is ± 5°. If the tilt is within this range, a green checkmark is displayed. 3. Accumulate the corrected images to an integral.
4. Perform the QA in integral of set 4.
After performing a measurement with the gantry angle sensor, the angle will be stored. It is displayed in the dataset pane for each measurement.
The angle will also be displayed in the field list, for each measurement done with the sensor. For the automatically calculated integral no angle will be displayed.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 93 | The header information of a measurement done with the gantry angle sensor will contain the gantry angle value.

Function Check
To check the function of the sensor, measure two single shots and compare the measured gantry angle with the expected value.

CHECK FUNCTIONALITY
It is recommended to check the functionality of the sensor once a year.

Gantry Angle Correction
The MatriXX Evolution has a small angular dependence which can be corrected by a calculated matrix. These values are stored in look up tables and can be applied to already measured data dependent from the angle.

LUT CORRECTION
The values in the look up tables are only valid for the combination of MatriXX Evolution with MULTICube. If the MatriXX Evolution is not used with a MULTICube you can create and use your own angular correction tables (please see below).

IMPORTANT NOTICE
APPLYING ANGULAR CORRECTIONS Applying angular corrections to measurements is only possible if they were done with the gantry angle sensor.

Settings for Angular Correction
For applying a correction matrix to measurements go to Edit/Apply gantry angle correction.
Linac: In the drop down menu the given correction files are listed. Given by default is a matrix for 6 MV and a beam quality index of 0.666, and a matrix for 18 MV and a beam quality index of 0.783. These are common values for the beam quality index and representative for the 6 MV and 18 MV.
Energy: Select Set User-Defined to enable the fields for editing MV and Beam Quality Index values. Enter energy and a beam quality index.
The Beam Quality Index is specified by the tissue phantom ratio TPR20/10. If this value is not available, it can be obtained from the percentage depth dose curve for the given energy: where PDD 20/10 is the ratio of the percent depth dose at 20 cm and 10 cm depths for a field size of 10 cm × 10 cm defined at the phantoms surface with an SDD of 100 cm.
It is possible to select a customized beam quality index by ticking the box Select Beam Quality Index. Enter energy and a beam quality index. The software creates via linear interpolation the matrix for the given beam quality index and calculates the angular correction for the measured data. The entered energy is only a header information and does not influence the calculation.
Check the box Copy the original images if the original measurements shall be kept. In the field list the originals will be corrected, and a copy of the originals will be created. The integral is still the integration of the originals, even if the originals were replaced by the corrected data.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 95 | In the field LUTs it is possible to delete and export existing look up tables for correction of gantry angles, or to import new tables.

PATH TO ORIGINAL CSV FILES
If the LUTs were deleted by mistake, the original csv-files are stored under the path: C:\ProgramFiles IBADosimetry OmniPro-ImRT\ SampleData \ AngularCorrection.
To customize existing correction tables, export the LUT by pressing Export.
Save the csv-file under an individual name and open it with e.g. Microsoft Office Excel. To do this, in the Windows settings the decimal point must be "." and the list separator must be ",". Only csv-files can be imported.
In a similar way it is possible to customize the values as required (also without the MULTICube).

Setup of MatriXX for measurements
| 96 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide Create a customized angular correction factor tables It is possible to create a customized set of correction factor tables from MatriXX measurement and reference dose distributions. By doing so, it is possible to adjust the angular correction of MatriXX measurement to individual reference, e.g. heterogeneous or homogeneous TPS dose distributions or film measurements.
For the measurement of angular correction factors it is recommended to use a set of static fields with incident angles between 0° and 180° with an angular resolution of at least 10° for each photon beam energy (OmniPro ImRT 1.7 assumes symmetry between the angle range [0° -180°] and [180° -360°] so for example the correction factor for gantry angle 90° is used for gantry angle 270° as well). Correction factor tables are stored in a simple "comma separated value" (csv) file with following format:

MULTIPLE CORRECTION TABLES
One csv file can contain multiple correction tables, e.g. correction factor tables for different linacs or different beam energies.
Save the customized correction factor table and import the LUT by pressing Import under Edit/Apply gantry angle correction.
Correction of Measurements 1. Copy all data which shall be angular corrected to a field list, or choose the last done measurement.
2. Go to Edit/Apply gantry angle correction and select one of the listed correction files, and enter/mark the relevant options.
3. Press OK to apply the correction matrix to all measurements in the field list.

Example:
Below is an example of a measurement with 10 × 10 cm field size at a gantry angle of 90° and measured with 6 MV photons: In Dataset 1 is the original measurement is displayed. Dataset 2 displays the corrected measurement, for which a beam quality index of 0.67 was used.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 97 | When using the plan verification 2D tool and comparing the profiles, the result of the correction is displayed: The difference between the original and corrected data is displayed. The absolute measured values for 90° are approx. 4% lower than they shall be (red line). The corrected data (green line) adjust the measured points upwards by 4%.   N DW (60Co) • K uni ij is measured and calculated at the production site.
The k User factor can be created by the user (see Create the k User factor).

K off i,j can be created by the user (see User-defined off-axis calibration).
k pT is measured and calculated by the MatriXX system. The pressure factor can be corrected with the offset obtained when comparing the p value as measured by the system and by a reference meter (see 7.4.4.2 User-defined offset for the k pT factor).

Uniformity Correction Matrix for MatriXX
IMPORTANT NOTICE

UNIFORMITY CORRECTION MATRIX
The uniformity correction matrix is stored in the device itself, and shall be applied in all measurements.

WARNING UNIFORMITY CORRECTION MATRIXX FOR MATRIXX
The application of the Uniformity Correction Matrix file is mandatory. If the checkbox Activate device-internal calibration data is unmarked, the measurement will be performed without correction.
The uniformity correction matrix is individual for each MatriXX device, and will be used to remove inhomogeneities from the measured image. Data are stored in the device.

Add Correction Factors
A correction factor for the detector (k User ), and of the measured pressure and temperature (k pT ), can be added by the user.
The k User factor will be specific for the selected Linac, energy type, and energy value. Several factors, for different Linacs and energies, can be created. The new factor is persistent between sessions, and will be used until another factor is created.
If the Active checkbox in the Correction/Calibration dialog is not marked, the factor will be set as 1.

Dose Mode
1. Select Dose and enter the reference value. The value will be displayed as mGy, cGy, or Gy, depending on the settings in Options.

Click
Next to open the next wizard window.
3. Click the Measure button to start the measurement. The beam shall be turned on after the measurement has been started. Ensure that the beam time is long enough to cover the entire measuring time.
4. When the defined measurement time has elapsed, turn off the beam, and click the Stop button to stop the measurement.

Setup of MatriXX for measurements
| 104 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide The system will calculate k User , using the entered reference value and the average of the values of four central MatriXX chambers. The new factor will be displayed in the k User field.

Click
Save As to open the dialog Save Calibration Factor.
6. Enter a unique name. Optionally a comment in the Comment field can be added, and the number of monitor units can be edited. Click OK to save data and close the dialog. To overwrite the value for a previously calculated factor, select the name and click OK.
The new factor is persistent between sessions, and will be used until another factor is created.
If the Active checkbox in the Correction/Calibration dialog is not marked, the factor will be set as 1.

Selecting the K user Factor for a Measurement
Open the Correction/Calibration dialog from the MatriXX toolbar.
Expand the drop-down list in Select factor, and select a factor.
If the selected factor does not fit with the currently selected measurement parameters, a warning will be displayed in the MatriXX toolbar: To view data for the selected factor, click Details. The following information is displayed: The difference between the value measured by the device and the entered reference value is displayed in the User-defined Pressure Offset field, in the Correction/Calibration dialog.
The defined offset is persistent between sessions, and will be used in all measurements until another offset is defined.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 107 | If the Active checkbox in the Correction/Calibration dialog is not marked, the correction will not be used.

User-defined Off-axis Calibration
A user-defined calibration can be applied, to compensate for deviations that occur after the I'mRT MatriXX or MatriXX Evolution have been in use for some time. The calibration shall be applied as an add-on calibration.
The user calibration makes use of only three full-field measurements in order to calculate user calibration factors for 1020 pixels. Therefore inaccuracies and noise during the user calibration measurement will propagate from one pixel to the other over the full active area of the pixel array, adding a small amount of noise to the calibration data. Therefore it is recommended applying the user calibration only in cases where pixel deviations from uniformity are well above 1%.
The user calibration procedure has been proven to work well for typical cases of miscalibrated pixels, e.g. single or few pixels randomly distributed in the pixel array with arbitrary amount of miscalibration, or Gaussian noise on the entire active area. There might be rare cases however, when the user calibration leads to unsatisfying results. This can happen when miscalibrated pixels are unfavorably distributed in the pixel array, and one miscalibrated pixel is mapped to another one during the user calibration measurement (e.g. many adjacent miscalibrated pixels in one pixel column). In these cases we recommend to recalibrate the device in the factory.
It is recommended to use the gantry holder for the calibration. The recommended measurement time for each step in the calibration procedure is 100 MU. The recommended field size is 28 × 28 cm. All channels have to be covered, but the electronics must not be in the beam.

DEVICE-INTERNAL CALIBRATION DATA MUST BE ACTIVATED
Ensure that the check-box Activate device-internal calibration data is marked, before performing the measurements for the K off i,j factor.
A series of dialogs will guide you through the procedure.

First measurement
Position the MatriXX centered under the accelerator with an angle of 0 degrees. Select the number of monitor units that will be used for all measurements within the calibration process. Press the Measurement button to start the measurement first, and then turn on the beam.

Second measurement
Turn the MatriXX 90 degrees clockwise, and make a measurement with the same number of monitor units, and in the same way as described in First measurement.

Third measurement
Shift the MatriXX exactly one row of detectors in the right hand direction (looking at the gantry from the front), and repeat the measurement as in First and Second measurement.

ADDITIONAL MARKERS
On both sides of the MatriXX there are two smaller additional markers for aligning the MatriXX after shifting one pixel row to the right site.
Click Finish, and save the calibration in Save MatriXX User Calibration.
Click View to open the calibration file. Verify the result.

Apply the User-defined Calibration
Click the Correction button in the toolbar. Mark Activate device-internal calibration data and Activate user calibration matrix.

DEVICE-INTERNAL CALIBRATION DATA MUST BE ACTIVATED
Ensure that the check-box A ctivate device-internal calibration data is marked, when applying the K off i,j factor.
Click OK.

MatriXX Setup Tab
Open the MatriXX Setup tab.
Define how the device is mounted in Mounting. The options Table mounted and Head mounted are available.
Define the position in relation to the accelerator in Position.
Device data are found in the Device section in the dialog.

Single Shot Mode
In this mode, one single image is composed of a set of single frames (each one measured with the selected measuring time). The composed image contains the average of the selected number of samples.
If background compensation is activated, the background is subtracted from each individual frame.

Movie Mode
In this mode, a given number of movie pictures (single shots, as described above) are acquired. Each picture, as well as one integrated image, are saved.

NUMBER OF MOVIE IMAGES
If the No. of Movie Images is set to "0" the movie will not stop until the Stop Movie button is pressed. Firmware version 1.34 is required to use this option. Therefore please refer to chapter 5.

On-line Mode
In this mode, single shots, as described above, are measured continuously and displayed on-line. Only the last five images are saved.
3. Select scaling mode in the Mode drop down list: Relative to Maximum: All data is normalized to the maximum value which in turn is set to 100%.

RELATIVE TO MAXIMUM
It is not recommended to use Relative to Maximum during acquisition, as the original scaling cannot be retrieved later. It also may give the wrong impression that it looks like dose is building up without any beam present since the background will be scaled.
Relative to CAX: All data is normalized to the central axis value (4 central pixels) which set to 100%.

RELATIVE TO CAX
It is not recommended to use Relative to CAX during acquisition, as the original scaling cannot be retrieved later. I t also may give the wrong impression that it looks like dose is building up without any beam present since the background will be scaled.

SAMPLING TIME
The sampling time must be entered in multiples of 10.

Single Snap:
The measurement time is the product of the sampling time and the number of samples. The relative scaling is given by total integral, divided by the number of samples.
The dose is divided by the number of samples.

ABSORBED DOSE VALUE
Provided that No. of samples is set to 1, the absorbed dose value is not affected by renormalization, and always represents the total accumulated dose.

NUMBER OF SAMPLES
It is not recommended to set the no. of samples other than 1.

Movie mode:
The measurement time is the product of the sampling time and the number of samples. The relative scaling for single frames is given by total integral, divided by the number of samples.
The total movie time is the product of the measurement time and the number of movie images.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 113 | An example of the relation between the measurement time and the total movie time.

SAMPLING TIME ≤40 MS
If the sampling time is ≤40 ms, the allowed number of images is limited, due to firmware limitations and limitations that might occur in the local network.
The movie acquisition can be stopped manually, without data loss.
At the end of a movie acquisition an integral frame is produced, containing the sum of all required frames. The relative scaling of this integral frame is divided by the number of frames in the movies (regardless if the movie has been aborted manually or completed).
The dose is divided by the number of samples.

ABSORBED DOSE VALUE
Provided that No. of samples is set to 1, the absorbed dose value is not affected by renormalization, and always represents the total accumulated dose.

NUMBER OF SAMPLES
It is not recommended to set the no. of samples other than 1.

TOTAL MOVIE TIME
In Movie Measurement mode (i.e. when checking dynamic or step and shoot fields), the total movie time must be longer than it takes to perform the treatment. Always add some margin for the startup of the accelerator. To remove all deactivations, click Activate All.

Select an algorithm (or
The four corner pixels are by default deactivated.

ADJACENT CHANNELS
Two perpendicular adjacent channels must not be selected.

View Deactivated Channels
Deactivated channels can be viewed in the info parameters for a MatriXX measurement.
Select Parameters in the View menu. Select the MatriXX Meas. tab.
When moving the mouse cursor to the Channel button, a tooltip will display how many channels that are deactivated. Click the button to view the deactivated channels.
If no channels are deactivated, the Channel button will be disabled. If the maximum signal is much higher than 100%, decrease the sampling time.
If the maximum signal is much less than 100%, increase the sampling time.
10. Repeat the measurement to check if the signal level is now about 100%.

TURN OFF THE ACCELERATOR
During background definition the accelerator must be turned off.
The background procedure performs a measurement of the signal level on a "dark" image. The defined value will be subtracted from all calculations and presentations.
Click the toolbar button Background. The measurement starts.
The button remains dimmed until the measurement is completed.
Background is always measured with one sample, for 20 seconds. To adapt the background level to the level of measured signals, the values are rescaled with the factor sampling time/background sampling time.

THE BACKGROUND VALUE IS VALID DURING ONE SESSION
The background value can be used for all subsequent measurements during a session. If the device or the software is turned off, a new background value must be defined before the next measurement. Select the radiation device, the wedge, the applicator, and the energy to be used.
Enter the SDD, and the gantry and collimator angle values.
Specify the field size used as reference field for the selected energy at SAD in inline and crossline.

Administration Tab
Select the Administration tab.
Since the information on this tab is already defined in the Clinic setup dialog, you only have to check if the information is correct.
If the information is correct, click OK. Depending on the measurement situation, different measurement modes are available for best results:

Single Shot Mode
In this mode, one single image is composed of a set of single frames (each one measured with the selected measuring time). The composed image contains the average of the selected number of samples.
If background compensation is activated, the background is subtracted from each individual frame.

Movie Mode
In this mode, a given number of movie pictures (single shots, as described above) are acquired. Each picture, as well as one integrated image, are saved.

NUMBER OF MOVIE IMAGES
If the No. of Movie Images is set to "0" the movie will not stop until the Stop Movie button is pressed.
If background compensation is activated, the background is subtracted from each individual frame.
If no interpolation is selected, the measured data is displayed on-line.
Use this measurement mode e.g. to analyze dynamic wedges, or MLC fields.

LOW COMPUTER PERFORMANCE
If the computer performance is low, display of movie data may be delayed.

SHORT SAMPLE TIMES
For low sample time values (<500 ms), an accumulated background rounding error of values may occur.

On-line Mode
In this mode, single shots, as described above, are measured continuously and displayed on-line. Only the last five images are saved.
If background compensation is activated, the background is subtracted from each individual frame.
Use this measurement mode e.g. to trim the field parameters of the accelerator. By looking at the inline and crossline profiles, it is easy to check symmetry and flatness parameters in both orientations simultaneously.

Single Shot Mode Measurements
Click the toolbar button Measure.
After measurement is completed the resulting image is displayed.

On-line Mode Measurements
Click the toolbar button Start On-line.
The images are displayed during the measurement.

When the treatment is completed, click S t o p O n -line t o s t o p t h e measurement.
Only the last five images are saved. To check these images open the Field list dialog by selecting View:Field list.

Movie Mode Measurements
Click the toolbar button Start Movie. Start the treatment as planned.
When the pre-defined time has elapsed, the measurement stops. If you want to stop the measurement before the total time has elapsed, use the Stop Movie button. The current image will be finished before the measurement stops.
When the measurement is completed the resulting image is displayed. If the Stop Movie button was used to stop the measurement, the images that were measured until the stop will be calculated and stored, and an integral image is calculated and stored.
To check single movie pictures, or to run the movie, open the Field list dialog by selecting View:Field list.

Manually Start and Stop Measurements using Movie Mode
If the No. of Movie Images in the Parameters is set to "0" the movie starts by clicking the Start Movie button. The software measures as long as the Stop Movie button is clicked.

Setup Measurement Parameters
Using the MULTICube please make sure to measure a correction factor for this constellation. Therefore please refer to 7.4.4 Add Correction Factor. For rotational measurements use the "Dose Mode" for measuring this factor.
For general software settings please refer to the chapter 7.4.5 Measurement Setup.

TAKE TREATMENT COUCH IN TPS INTO ACCOUNT
For a precise verification please make sure that the TPS takes the treatment couch into account for calculation the plans.

MatriXX
Evolution used together with the Gantry Angle Sensor (Gantry Angle Sensor), is required for the measurements.
The analysis can be made in OmniPro I'mRT, after import of DQA files from TomoTherapy (7.6.2.6 Export of DQA files to OmniPro I'mRT), or in TomoTherapy, after export of a MatriXX TIFF file from OmniPro I'mRT (7.6.2.5 Export of TIFF files to TomoTherapy).

EXPORT OF MATRIXX TIFF FILES RECOMMENDED
Export of a MatriXX TIFF file, to be analyzed in TomoTherapy, is recommended as a better alternative.
CT Scan of the MatriXX CT Setup and Configuration Use the same configuration for the MatriXX as the one that will be used in TomoTherapy.
The physical limitations of the TomoTherapy couch (i.e. it is impossible to raise the couch above a certain point) must be taken into consideration. The plan that will be administered must allow that the plane of the MatriXX will be within the physical limitations of the couch, once the plan is superimposed on the MatriXX.
As a general rule, 5 cm additional backscatter material will be sufficient for most plans, but not for all. If in doubt, choose using more backscatter material rather than less. 10 cm or more can be regarded as sufficient.
Using the MULTICube phantom in its full or "light" configuration will eliminate this problem for virtually all plans.

DIFFERENT CT SCANS FOR DIFFERENT MATRIXX'S
For every MatriXX a CT is necessary. Otherwise deviations in dose calculation and measurements are possible. Ensure that the correct CT scan is used.

Slice Width
The slice width is important, because the exported TomoTherapy DQA (Delivery Quality Assurance) files derive their resolution in the x-direction (parallel to the couch in the DQA) from it.
If the analysis is going to be made in OmniPro I'mRT, use 2 mm slice width, or less. A better resolution improves the landmark selection on the further procedure.

BANDING IN THE GAMMA ANALYSIS
If 3 mm slice width is used, it will work for analysis in OmniPro I'mRT, but the resolution of the DQA export will be non-isotropic, and "banding" will appear in the gamma analysis: 7.6.1.

Alignment
Align the MatriXX to the laser cross-hairs meticulously, to avoid obtaining skewed slices.
If a MULTICube phantom is not used, it is recommended that a couple of markers are placed right on the cross-hairs on the MatriXX housing. Thus the center of the device will easily be identified on the CT images.
If a MULTICube is used, it is not necessary to use markers, since the engraved crosshairs of the cube will be visible in the CT images.

Setup of MatriXX for measurements
| 124 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide CT DICOM Export Set TomoTherapy requires phantom CT sets to be named _phantom. In the phantom list in TomoTherapy, the name of the phantom will be the Patient ID that was assigned at the CT, not the patient name. The _phantom will not be displayed in the phantom list.
Thus the Patient ID at the CT should be e.g. MatriXX, and the patient name at the CT must be _phantom.

Pre-irradiation of the MatriXX
The MatriXX requires pre-irradiation prior to use. The most convenient way to do it is to use a C-Arm Linac, if available (I'mRT MatriXX -Setting up for Measurements / Pre-irradiation). Perform the pre-irradiation, un-plug the MatriXX, and move it to the TomoTherapy.
Pre-irradiation can also be performed in the TomoTherapy, either by using a static field, or a "cylindrical" helical plan from TomoTherapy. With these assumed values the pre-irradiation dose (D) will be 99 cGy, and the couch velocity (V) will be 0.144 cm/sec.

Pre-irradiation dose for a typical TomoTherapy dose rate:
In the

THE TOMO THERAPY MVCT CANNOT BE USED FOR PRE-IRRADIATION
The TomoTherapy MVCT cannot be used for pre-irradiation, since it does not deliver the sufficient quantity of MUs. The energy is only 3 MV.

USE ONLINE MODE IN OMNIPRO I'MRT
For pre-irradiation use the Online Mode in the OmniPro I'mRT software for better observing.

Background Subtraction and Energy Calibration
After pre-irradiation, the next step would normally be to do the background subtraction and to obtain the k User factor for energy calibration (see 7. 4

.4 Add correction factors).
The need for these procedures depends on which export method that will be used.

TOMO THERAPY DICOM PLANAR EXPORT METHOD TO BE RELEASED
This export method is not yet released at the time of publishing this manual.
The k user factor must be obtained in order to get the same information as with a C-arm Linac. A cylindrical plan to be delivered helically must be created. A known dose will be administered to the four central chambers of the MatriXX.

TIFF Export from OmniPro I'mRT
The k user factor must be obtained in order to get the correct dose information.

Creation of the Plan
Export the MatriXX CT images to the TomoTherapy planning station, and then select the plan that will administered to the MatriXX.
When the dose distribution is superimposed on the MatriXX phantom in the TomoTherapy, it is usually considered necessary that the distribution over the phantom is such that it includes the PTV, and other information, e.g. spine. To facilitate this, take into account the fact that the effective point of measurement, P eff , of the MatriXX is at a depth of 3 mm.
The air gaps of the ion chambers will be visible in the CT images rendered by the planning system. Thus it is possible to position the desired planar dose distribution at the MatriXX P eff , which is just slightly beneath the top electrodes of the chambers.

MVCT
Align the MatriXX 1. Align the MatriXX with the TomoTherapy lasers. There are two sets of lasers: red and green. The green laser defines the virtual isocenter in TomoTherapy, 70 cm offset from the real isocenter. The red lasers can be viewed and moved manually from the virtual isocenter, to match the patient/phantom fiducially. Usually it is suitable to align the MatriXX to the red patient laser/coordinate system.
2. Select the center axes of the device in order to define the origin of the phantom. This is done by moving the red laser around in the planning station. The BBs or the MULTICube c r o s s -hairs are useful in this procedure.

IMPORTANT NOTICE ALIGNMENT
Do not align the red laser to the center of the chamber air cavities in the coronal plane. The P eff is on the top electrode.

MVCT AREA
It is not necessary to do an MVCT of the entire active area of the MatriXX. A few centimeters on either side of the transverse zero slice is sufficient to get the BBs in the MVCT and to make the center of the device visible.
4. Align the CT and MVCT images, using the TomoTherapy checkerboard. 2. Define the registration points in the TIFF image, by using the "General Coronal" procedure in TomoTherapy.

ONLY TWO REGISTRATION POINTS IN THE TIFF IMAGE
Since there are only two registration points in the TIFF image, the "Coronal plus 4 lasers" procedure cannot be used.
3. Select the plane that shall be exported. A plane that is near the center of the ion chamber air cavities shall be selected.

AIR CAVITIES MAY NOT BE VISIBLE
If a plane at the top electrode is selected, the air cavities will not be visible.
4. Two registration points will be requested by TomoTherapy. Use the hash marks. Mark the points on the dose plane, corresponding to the hash marks. The hash marks correspond to the chambers on the MatriXX diagonal to the blank spots on the top right corner and the bottom left corner of the device.

ENSURE THAT THE CORRECT SPOTS ARE MARKED
The MatriXX may be displayed sideways in the DQA workspace. Ensure that the correct spots are marked.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 129 | 7.6.2.6. Export of DQA Files to OmniPro I'mRT Creation of the DQA Export If the analysis will be made in OmniPro I'mRT, prepare the DQA export from TomoTherapy as follows: Use the "Text DQA Header and Image Files" for export to OmniPro I'mRT. These files are created by TomoTherapy for export.

CUBIC DICOM EXPORT
The cubic DICOM export method is not recommended.
Select a random film in the TomoTherapy film panel, and mock register it. The film can be of any size. This action will enable the dose plane export button.
7.6.2.7. Import of DQA Files to OmniPro I'mRT Select File/TomoTherapy/Import ASCII File i n t h e O m n i P r o I ' m R T software.

SAVING DQA FILES
It is not recommended to save the DQA files in sub-folders, since certain sub-folder names or characters will disrupt the function. Copy the files to the desktop, and work from there.
The imported file will look similar to the example below: Take notes of the isodose lines and the coordinates corresponding to the import. The position to the import relative to measured data is arbitrary, since there is no coordinate system in the DQA export file. Data must be registered manually, using the Turn Array, Flip Horizontal, and Move data functions. Turn the array 90degrees clockwise, select Flip Horizontal, and use the Move Data f u n c t i o n t o r e g i s t e r t h e i m a g e s m a n u a l l y . T h e s e functions can be pre-defined in Macros, under the Edit menu.

Setup of MatriXX for measurements
| 130 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide The following macro is recommended: ■ Turn array 90 degrees in the positive X direction ■ Flip horizontal ■ Convert grid to 0.762 cm -optional ■ Convert grid to 1 mm in order to frequency match the data with the interpolated MatriXX data -optional

CHANGE THE STEP SIZE
It is recommended to change the step size to 1 cm, instead of 1mm, for the initial alignment.
Use the isodose lines to align data, and then use the profiles for fine-tuning. If appropriate isodose lines are picked, it will be possible to hone in on the ideal registration point without the use of profiles. 2. Use a marker in the I'mRT Phantom origin that can be clearly seen on the CT image, and that can be used for later positioning of the I'mRT Phantom, e.g. a small piece of metal, or a characteristic structure of the phantom.
3. Set the isocenter in such a way that it will be easy to position the I'mRT Phantom under the gantry.
4. Note down the distance from the phantom origin to the isocenter, and the distance from the phantom origin to the origin for the dose calculation (in case the origin for dose calculation is not at isocenter position). 2. Tip! One possibility is to align the I'mRT Phantom in such a way that the I'mRT Phantom is parallel to the couch and the lasers (room coordinate system), and the phantom origin is in isocenter position.
3. Move the treatment couch by the distance between marker and isocenter (as noted when calculating the dose plan). ■ It must be possible to mark the films. The distance between the film marking and the phantom origin must be known.

Insert an ionization chamber into
■ The composition of the material shall be water or tissue equivalent.
The picture above shows the default orientation of the I'mRT Phantom. If you look in the direction towards the gantry, the origin marker for each film slice is on the right side of the center. If the phantom is rotated, you have to adapt the marker position in the equipment setup.

HEAD AND NECK TREATMENT
If you want to verify a head and neck treatment, perform a CT-scan and calculate the treatment plan for the cube only.

An example of a dose plan calculated for a patient:
The marker in the origin of the I'mRT Phantom coordinate system is clearly visible. Note that this marker can be in any CT-slice, as long as the distance to the isocenter and to the origin for dose calculation is known.

WARNING FILM GETS SATURATED
Depending on the choice of film, the saturation dose of the film may be lower than the maximum dose to be verified. Scale down the treatment plan or select an appropriate film.

. I'mRT Phantom Setup
Tip! To avoid mixing up the films, mark each film in a corner far outside the beam.

MARKERS ON FILM
Markers for identification, orientation, or positioning may overlap or interfere with optical density, due to radiation. Mark your films outside the region where you want to determine the dose.
1. Mount the films into the phantom.
2. Mark the films (for later alignment and positioning).

IMPORTANT NOTICE ALIGNMENT
The film may be misaligned either in its envelope, or tilted inside the phantom. To correct this misalignment after scanning, use two markers, or a line (e.g. the border of the phantom), to align the film to the body phantom coordinate system. The alignment markers must be parallel to the main axes of the phantom coordinate system.

ABSOLUTE POSITION
It is important to know the absolute position of the film with respect to the phantom origin. Mark the film, at a precisely defined position in relation to the phantom origin. The absolute position of this marker is entered in the Body Phantom setup dialog in Equipment.

Position the I'mRT
Phantom onto the treatment couch, and align it according to the treatment plan.
Tip! One possibility is to align the I'mRT Phantom in such a way that the I'mRT Phantom is parallel to the couch and the lasers (room coordinate system), and the phantom origin is in isocenter position. Then move the treatment couch by the distance between marker and isocenter (as noted when calculating the dose plan).

Measurement
Perform the treatment according to the treatment plan.

VERIFYING ONE PART OF THE TREATMENT ONLY
If you want to verify only one part of the treatment (e.g. one field), insert new films for this field, take them out after irradiation and insert new films for the next field. Remember to mark the films.

I'MRT QA/BIS CORRECTION IMAGE
The specification of the correction image file and the CCD area are mandatory. If you specify an incorrect or non-existing file and/or path, the measured image will not be corrected. If you specify an incorrect CCD area, the measured image will be incorrect. It will be very noisy and shifted, and may not appear fully on the screen. Before performing an I'mRT QA/BIS measurement, the Correction image file, found on the installation disk delivered with the I'mRT QA/BIS, must be copied to your computer.
The Correction image is individual for each I'mRT QA/BIS and will be used to remove inhomogeneities of the scintillator from the measured image. Before performing any analysis tasks the Correction image must be applied to the measured image.

FRAME GRABBER BOARD
The Frame grabber board must be installed in the computer that will be used for the measurements. Refer to the I'mRT QA/BIS Manual for further instructions.

WARNING I'MRT QA/BIS CORRECTION IMAGE
The specification of the correction image file and the CCD area are mandatory. If you specify an incorrect or non-existing file and/or path, the measured image will not be corrected. If you specify an incorrect CCD area, the measured image will be shifted and may not appear fully on the screen.

LIGHT FIELD MEASUREMENT
If you want to measure the light field (for comparison of light field with radiation field), insert the light field scintillator instead.

Measurement scintillator
The white side shall be located downwards; th e b l a ck s id e s h a ll b e located towards the radiation source.

Light field scintillator
The label I'mRT QA/BIS Light S/N xxx shall be located downwards.
6. Connect the data cable to the frame grabber board in the PC.
7. Plug the power cord of the power supply into a mains power outlet. Verify that the green and yellow LEDs ("Power" and "Image on Demand") are illuminated.
8. Continue by defining the I'mRT QA/BIS parameters.

Define the image device position in relation to the accelerator, in
Position.
The icon shows the relationship between the IEC and the I'mRT QA coordinate systems. 2. Specify information about the scaling mode to be used, in Mode.

Setup of MatriXX for measurements
3. In the Timing section, enter the sampling time (i.e. the integration time for one measurement) to be used, and the number of samples and movie images to be used.

TOTAL MOVIE TIME
In Movie Measurement mode (i.e. when checking dynamic or step and shoot fields), the total movie time must be longer than it takes to perform the treatment. Always add some margin for the startup of the accelerator.

An example of the relation between the measurement time and the total movie time.
The measurement time is the product of sampling time and the number of samples. The total movie time is the product of measurement time and the number of movie images.

Correction:
The path for the Correction Image and the CCD Region will be displayed as previously defined.
Date/Time: The date and time for the measurement will be automatically entered.

BIS 710
If BIS 710 is selected, the Meas. tab will be displayed as below.
Enter data in Scaling and Timing as in the I'mRT QA Meas. tab.

SAMPLING TIME
The minimum sampling time is 240 ms.

IMPORTANT NOTICE AMPLIFICATION
The Amplification option is not available for BIS 710.

I'mRT QA/BIS 710 Field Tab
1. Click the Field tab. The options available in this dialog are dependent upon the specifications setup in the Radiation Device Setup dialog.

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 141 | 2. Select the radiation device, the wedge, the applicator, and the energy to be used.

Enter the SSD and the gantry and the collimator angle values.
4. Specify the field size used as reference field for the selected energy at SAD in inline and crossline.

I'mRT QA/BIS 710 Administration Tab
Click the Administration tab.
Since the information on this tab is already defined in the Clinic setup dialog, you only have to check if the information is correct.
If the information is correct, click OK.

TURN OFF THE ACCELERATOR
During background definition the accelerator must be turned off.
The background procedure performs a measurement of the signal level on a "dark" image. The defined value will be subtracted from all calculations and presentations.
1. Ensure that the measurement scintillator is inserted. No light may enter the image device! 2. Click the toolbar button Background. The measurement starts.
The button remains dimmed until the measurement is completed.

SAMPLING TIME AND NUMBER OF SAMPLES
Background becomes invalid if the sampling time is changed, or if the number of samples used for background compensation is less than the number of samples used for the measurement.

Measurement
When I'mRT QA/BIS has been selected as measurement equipment, the toolbar and menu options will be expanded. If background compensation is activated, the background is subtracted from each individual frame.

Movie Mode
In this mode, a given number of movie pictures (single shots, as described above) are acquired. Each picture, as well as one integrated image, are saved. To ensure acquisition without gaps, the measured data is not displayed on-line.
If background compensation is activated, the background is subtracted from each individual frame.
Use this measurement mode e.g. to analyze dynamic wedges, or MLC fields.

On-line Mode
In this mode, single shots, as described above, are measured continuously and displayed on-line. Only the last five images are saved.
If background compensation is activated, the background is subtracted from each individual frame.
Use this measurement mode e.g. to trim the field parameters of the accelerator. By looking at the inline and crossline profiles, it is easy to check symmetry and flatness parameters in both orientations simultaneously.

Single Shot Mode
Click the toolbar button Measure.
After measurement is completed, the resulting image is displayed.

On-line Mode
Click the toolbar button Start On-line.
The images are displayed during the measurement.
When the treatment is finished, press Stop On-line t o s t o p t h e measurement.
The images are not saved.

Movie Mode
Click the toolbar button Start Movie. Start the treatment as planned.
When the pre-defined time has elapsed, the measurement stops. If you want to stop the measurement before the total time has elapsed, use the Stop Movie button After measurement is completed, the resulting image is displayed.

FILM OFFSET
Film and film-envelope produce an offset. When inserting films in a body phantom, other film planes or slices are shifted, due to the thickness of the films and their envelopes. When defining the offset information in the film setup, take into account the additional offset produced by the other films.
6. Edit the field information under the Field tab.

Click OK.
It is possible to save the measurement setup. Data for the selected scanner will be displayed in the Info Panel.
The resolution and bit depth options available for the connected scanner type are displayed.
3. Define Resolution, Bit depth, and Number of films.

RESOLUTION
In most cases the lowest resolution is sufficient, and should be used to minimize the amount of data.

Options for Vidar Scanners:
Use feeder: Option for Vidar scanners with multi film feeder. Mark the checkbox, and enter the number of films to be scanned, if you want to scan more than one film.

Autodetect film width:
Option for all Vidar scanners. If this option is selected, the scanner will detect the width of the inserted film before it starts to scan, and will stop the scanning process when the last line is reached.

AUTODETECT FILM WIDTH
The displayed progress bar will not be accurate if Autodetect film width is selected, since the height of the film cannot be estimated before the start of the scan.

AUTODETECT FILM WIDTH
Do not select Autodetect film width if part of the film is not irradiated.
The selection is persistent between sessions.
If the Autodetect film width option is not selected, the entire scan area will be scanned.
Eject film after scanning: If selected, the film will be ejected after the scan.
If not selected, the film will be automatically re-positioned for scanning.
Eject: Click to eject the film.

Light calibration:
Option for all Vidar scanners. Click this option to perform a light calibration. It takes 1 -2 minutes to perform the calibration. A progress bar is displayed.

Option for LumiScan Scanners:
Use film present sensor: Mark the checkbox to activate the function that handles information from the scanner's film detector.

FILM PRESENCE DETECTOR
If the scanner model used does not have a film presence detector, the I'mRT film present sensor will not receive the information that the film is inserted, and the message Film Not Inserted will appear. This applies for a few LumiScan scanner models. If this happens, uncheck the Use film present sensor checkbox.
7. Apply the scanner artifacts correction to that film using for the scanner and film calibration.

IMPORTANT NOTICE
Apply the calculated correction matrix always before performing the scanner/film calibration.
8. Perform the calibration as described in 7.9.5 Scanner Calibration and 7.9.6 Film Calibration.

ALWAYS USE THE CALCULATED CORRECTION FOR THE CALIBRATION FILM
Apply the calculated correction matrix always to the films used for the calibration procedure. The steps should be the follows: -Scan film.
-Correct the film with the correction matrix.
-Calibrate the film.
9. For applying the correction matrix open an image (or scan a film), and select it in the Film List by checkmarking. 10. Click Apply correction. The background data will be subtracted from the image. The name of the image will appear in green in the Film List.
11. Save the corrected image.

CAUTION DO NOT APPLY CORRECTION TO A SAVED FILE
The information that the image is corrected is not saved. To prevent that an image will be corrected more than once, do not apply this function to a saved file. 2. Insert the calibration film in the film magazine of the scanner. Orient the film so that the step with the lowest density is scanned first.

Setup of MatriXX for measurements
3. Select the Scan t a b , a n d p r e p a r e t h e s c a n i n t h e Task Panel (see 7.9.3.3 Prepare Scanning).

Define Resolution (the lowest resolution is sufficient for calibration) and
Bit depth. The default value for Number of films is 1.

Select scanner options. Click
Scan to perform the scanning.

OLDER TYPES OF VIDAR SCANNERS
For older types of Vidar scanners it is important that the film guides are closed as much as possible in order to avoid ambient light disturbing the calibration process. If the step film is narrower than the film guide opening, it needs to be attached to a larger sheet of film, or similar, which is not transparent to the light from the scanner. The scanned (Vidar and LumiScan scanners) or imported (external scanner) image will be displayed in the Display Panel.

SCANNER ARTIFACTS CORRECTION
If a correction for scanner artifacts will be appliedthis needs to be done before the calibration. Therefore please refer to chapter 7.9.4 S c a n n e r Artifacts Correction.

Select New calibration in the Task Panel:
Current date is automatically displayed in Calibration Info.
2. Enter the serial number of the step film, and the name of the operator.
Option: Enter additional information in the Comments field.

Define the step film properties in Options:
4. Enter the side length of the square to be used for ADC mean value calculation, in Measure area square side. 8. Position the cursor in the area with the lowest OD value in the step film image. Ensure that the cursor is positioned at half the step length from the border to next step (i.e. if the step length is 10 mm, position the cursor 5 mm below the border).

Setup of MatriXX for measurements
9. Select Load steps. All steps are automatically entered in the ADC column in the Calibration Data table.
If the step length in the step film varies, enter one step at a time. Position the cursor in a field, and select Add new step. Repeat for each step. Hold the <Shift> key to display the measuring area.  It is strongly recommended to calibrate both the scanner and the film.

Save Calibration Data
Data is automatically saved in the OmniPro I'mRT main application when the dialog is closed. It is also possible to save data to the main application manually, by clicking the Send button in the Film List.

Load Template
The Load template function is similar to the Load steps function.

APPLY SIMILAR CONDITIONS
The calibration films, on which the template is applied, must be scanned under approximately the same conditions (orientation and size), otherwise the values will be read from the wrong positions. 11. Define the step film properties in Options i n t h e Task Panel (7.9.5.3 Calibration Procedure).
12. Right-click in the image, and select Show cursor in the context menu.
13. Position the cursor in the area with the lowest OD value in the step film image. The cursor must be positioned at half the step length form the border to the next step.
14. Click Load steps. All steps are automatically entered in the Calibration Data 19. Calibration data is automatically saved in the OmniPro I'mRT database when the Film Control Panel is closed. Data can also be saved by clicking the Send button in the Film List.

Scanner Calibration Workflow, External Scanners
Below is a summary of the workflow for external scanner calibration. For details, please refer to 7.9.5.2 Prepare Calibration and 7.9.5.3 Calibration Procedure.
1. Scan the calibration film according to the instructions for the external scanner 2. Save the image in .tif format.
3. Open the file in the Film Control Panel. The scanned image will be displayed in the Display Panel.

Select New calibration.
5. The current date is automatically displayed in Calibration Info. Enter the serial number of the scanner and the step film, and the name of the operator. Option: Enter additional comments in the Comments field. 11. Enter the density values, delivered with the step film, in the OD column in Calibration data.
12. Option: Click Find maximum to find the point with the highest ADC value. Enter the value with Add new step.
13. Option: Save the calibration te mp la te in th e Film Control Panel b y clicking Save template.
14. Option: Save calibration data in the Film Control Panel by clicking Save calibration (7.9.5.5 Save Calibration data).
15. Calibration data is automatically saved in the OmniPro I'mRT database when the Film Control Panel is closed. Data can also be saved by clicking the Send button in the Film List.

Setup of MatriXX for measurements
| 160 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide 7.9.6. Film Calibration Film calibration defines the conversion factor between the Optical Density (OD) and absorbed dose. The calibration is dependent upon the type of film in use and how it was developed. The calibration is stored with the selected film type in the measurement setup. It is required that each film type has an individual calibration. For greater accuracy every film batch should be calibrated individually.

SENSITIVITY MAY VARY FROM FILM TO FILM
The sensitivity of radiographic films is strongly dependent on parameters like type, age, batch, or storage conditions. Perform a film calibration when using films where one or more of the above parameters differ from the film used for the current film calibration.
To perform the calibration, you can choose to use multiple films exposed to various dose levels or a single film exposed to multiple various dose levels, covering the range of interest (e.g. 0.0 to 3 Gy). 7.9.6.1.

Fog Determination
For fog determination, you can choose to scan an unexposed film, or use an unexposed part of a film with multiple exposed dose levels. Enter the dose value 0 to the corresponding optical density in the calibration table.

WARNING OD VALUES OUTSIDE FILM SCANNER CALIBRATION RANGE
If a film is calibrated or measured outside the film scanner calibration range, the measurement values can be incorrect. Never calibrate or measure a film outside the OD range for which the film scanner has been calibrated.

WARNING OD VALUES OUTSIDE FILM SCANNER CALIBRATION RANGE
If a film is measured outside the film calibration range, the measurement values can be incorrect. Never measure a film outside the dose range for which the film has been calibrated.
Mark the points on the scanned film, where you know the dose. The points will be added in the film calibration table with the optical density value. 7.9.6.3. Prepare Calibration 1. Place a single or multiple exposed developed film into the film magazine of the scanner.
2. Open the Scan tab in the Film Control Panel.
3. Define Resolution (the lowest resolution is sufficient), Bit depth, and Number of films, and select scanner options (see 7.9.3.3 Prepare Scanning).

Click
Scan to perform the scanning.

SCANNER ARTIFACTS CORRECTION
If a correction for scanner artifacts will be appliedthis needs to be done before the calibration. Therefore please refer to chapter 7.9.4 S c a n n e r Artifacts Correction.
1. Open the Calibration tab. The scanned image will be displayed in the Display Panel.

Select New calibration in the Task Panel:
3. Select Film in the Task Panel.
The current date will be displayed automatically.
4. Enter the film type, the batch ID, and the name of the operator. The points can be deleted or modified. Select Delete step or Modify step.
11. Data will also be graphically displayed in Calibration Graph. Doubleclick in the graph to enlarge the view. Double-click again to restore the original scale.
12. Option: Save calibration data in the Film Control Panel by clicking Save calibration. See 7.9.6.8 Save Film Calibration Data.
13. Calibration data is automatically saved in the OmniPro I'mRT database when the Film Control Panel is closed. Data can also be saved by clicking the Send button in the Film List. Select Overwrite in the dialog to save the calibration for the current film.
14. Select Print calibration to print the calibration table and graph.

MEASUREMENT POINTS
For a valid calibration you need at least three measurement points.

RECALIBRATION
Recalibration on a regular basis is recommended, due to variation in film quality, and especially due to variation when developing the film.

PREVIOUSLY SAVED FILMS
Recalibration will not change the measurement values on previously scanned and saved films. 7.9.6.5.

Film Calibration Templates
A film calibration can be saved as a template. The positions of the calibration points and the entered OD values are saved in the template, and will be used when the template is loaded for a new calibration.

.1. Save Template
Define the calibration points, and enter the corresponding OD values. Click Save template to save the calibration template as a .tem file.

Load Template
The Load template function is similar to the Load steps function.

APPLY SIMILAR CONDITIONS
The calibration films, on which the template is applied, must be scanned under approximately the same conditions (orientation and size), otherwise the values will be read from the wrong positions.
Open (or scan) the calibration film. Adjust it in the same way as the film in the calibration template that is going to be used.
Click Load Template, and select a template file (.tem).
When the template file is loaded, the position and dose value for each point is loaded, and the OD value is read from the image. A new calibration table is created.

Film Calibration Workflow, Vidar and LumiScan Scanners
Below is summary of the workflow for film calibration, with Vidar or LumiScan scanners.  5. Insert an unexposed film into the scanner, to make the fog determination (7.9.6.1 Fog Determination).
6. Select the Scan tab, and click the Scan button to perform the scanning.
7. Insert a single or multiple exposed developed film into the scanner (7.9.6.4 C a l i b r a t i o n P rocedure a n d 7.9.6.2 Optical Density to Dose Determination).
8. Click the Scan button to perform the scanning. The scanned images will be displayed in the Display Panel and in the Film List.
9. Select the Calibration tab, and expand Film in the Task Panel.

Select New calibration. For recalibration select Edit calibration.
11. The current date is automatically displayed in Calibration Info. Enter the serial number of the step film, and the name of the operator. Option: Enter additional comments in the Comments field.
12. Select the image of the unexposed film. Right-click in the image, and select Show cursor in the context menu.
13. Position the cursor at the point where you want to define the fog value (no dose).

Setup of MatriXX for measurements
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 165 | 14. Option: If a calibration template will be used, click Load template, and continue by saving the calibration data.
15. If no calibration template is used: Select the image of the exposed film. 21. Calibration data is automatically saved in the OmniPro I'mRT database when the Film Control Panel is closed. Data can also be saved by clicking the Send button in the Film List.

Select
Overwrite in the dialog to save the calibration for the current film. 7.9.6.7.

Film Calibration Workflow, External Scanners
Below is a summary of the workflow for film calibration, with an external scanner.
2. Save the image as a .tif file.
3. Scan a single or multiple exposed developed film into the scanner 12. Option: If a calibration template (7.9.6.5 Film Calibration Templates) will be used, click Load template, and continue by saving the calibration data.
13. Select the image of the exposed film.
14. Position the cursor at the point where you want to define the dose, and click Add new step.
15. Repeat for each point. 19. Calibration data is automatically saved in the OmniPro I'mRT database when the Film Control Panel is closed. Data can also be saved by clicking the Send button in the Film List (7.9.6.8 Save Film Calibration Data).

Select
Overwrite in the dialog to save the calibration is the current film.

Save Calibration Data in the Film Control Panel
Click Save calibration to save data in the Film Control Panel. The data will not be saved in the OmniPro I'mRT database. Data is saved as a .cal file.

Save calibration data in the OmniPro I'mRT database
Data is automatically saved in the database of the main application when the Film Control Panel is closed.

SAVE ADC TO DOSE IN THE FILM CONTROL PANEL
ADC to dose calibration must be saved in the Film Control Panel (Save calibration), and loaded (Load calibration) before use.
It is also possible to save data by sending it to the I'mRT Workspace: 1. Select the calibration image and click Send i n t h e Film List. The Importing data… dialog opens.

Apply Current Calibration to All Films in the Film List
The current calibration can be applied simultaneously to all films, calibrated as well as un-calibrated, that are displayed in the Film List.

CHECK LOADED CALIBRATION
When the Film Control Panel is opened, the calibrations for the selected scanner and film will be displayed in the Task Panel. Ensure that the correct calibration is loaded before applying it to the film.
1. Load the calibration that shall be used.
2. Click the button Apply the current scanner and film calibration to all films in the list in the Task Panel: The current calibration data will be applied, and displayed in the Info Panel.

RISK OF UNPREDICTABLE RESULTS
Applying a different calibration table on an already calibrated film can produce unpredicted results. 7.9.6.11.

Replace Calibration Data in a Calibrated Film
The calibration data embedded in a film can be replaced with the current calibration. Select the Calibration tab.
Select the film to which the current calibration data shall be applied, by marking the checkbox in the Film List. Click the Scanner or/and the Film Calibration button in the Info Panel. The embedded calibration data is displayed. Click the button Apply selected global calibration.
The current calibration data will be applied, and displayed in the Info Panel.

RISK OF UNPREDICTABLE RESULTS
Applying a different calibration table on an already calibrated film can produce unpredicted results.

Display and Modification of Images
To modify an image, and to change the display, select the Registration tab. 7.9.7.1.

Phantom Orientation
Expand Orientation in the Task Panel.
Film orientation: The orientation is displayed relative to the phantom, as defined in Equipment:Body Phantom Setup.

Phantom position (Rotation angle):
Select the rotation angle. The IEC coordinate system is used.

CAUTION CHANGE THE POSITION OF THE MARKER IF THE P H ANTOM IS ROTATED
The default orientation of the body phantom is as shown in the screen-shot above. If the phantom is rotated, the position of the marker should also be changed.
Distance from phantom origin to film markers: Define the offsets for origin and alignment points (the distance from the phantom origin to these markers). If the offsets are defined in Equipment:Body Phantom Setup, they will be displayed as read-only. The modification can be applied simultaneously on all films in the film list. Mark all checkboxes, and apply the modification. The Restore/Undo/Redo commands will be applied on the currently displayed film.

Crop
Select Crop. A square appears in the image. Define the cropping area by dragging the corners of the square. Select Apply.
To return to a previously cropped area, select Undo Crop.
To return to the original image, select Restore Original Film.
The modification can be applied simultaneously on all films in the film list. Mark all checkboxes, and apply the modification. The Restore/Undo/Redo commands will be applied on the currently displayed film.

Dose Unit:
The selected unit will be applied in all views and files.
Extract Channel: Select channel for import of RGB files.
Film Label: Define a name that will be used as film label in the Film List.
The default label is Film.
Length Unit: The selected unit will be applied in all views and files.
Measure Area Square Side: Define the area used for ADC mean value calculation (average value area).

MEASURE AREA IN CALIBRATIONS
The measure area used in calibrations is defined in the Options box in the Task Panel in the Calibration tab:

CORRUPT FILES
There are file types that are not secured via a check sum. If such a file has been corrupt by editing and manipulating the file, it will in most cases not be possible to import or open the file. However, in a few cases it may be possible to import or open a file that contains incorrect information. Never manipulate or edit files in a way not intended by the manufacturer! Always check the consistency of data!

LARGE FILES
Depending of the RAM capacity of the computer used, it may be impossible, or take very long time, to import very large files.

DICOM CONFORMANCE
OmniPro I'mRT is a co mmo n p la t fo r m fo r d ig i ta l , fi l m, a n d EP ID IMR T verification. To support these functions some of the radiotherapy objects (RT Plan, RT Image, and RT Dose), and the CR Image modality defined by the DICOM standard are supported for import. Please refer to the DICOM Conformance Statement [2] for details. See References. The document is available on the OmniPro I'mRT installation disk.

IMPORT OF DATA IN GRAPHIC FORMAT
Import of graphic files is restricted to 16 bit grey scale images, and any attempt to open an image with another bit depth will result in an error.
Since the files do not contain any calibration information, the current scanner and film calibration will be applied.

ORIENTATION OF ISOCENTER
The transformation of the coordinate system where the dose is stored to the gantry coordinate system is not possible from the dose information. Therefore a movement of the orientation might be done manually.

Import of Dose Planes and Dose Cubes
Select the menu command File:Import Data to import dose planes or dose cubes in the following formats:

Dose Planes
Dose plane is calculated 2D data. Select the menu command File:Import Data:TPS Dose Planes, or click the button in the toolbar.

Dose cubes
Dose cube is calculated 3D data. Select the menu command File:Import Data:TPS Dose Cube.
A window for TPS data import will open. In the left panel patient and data information, embedded in the imported image, will be displayed.
The panel to the right contains three tabs, Imported Data, Data Transformation, and Options, containing the functions and information needed for import and data transformation.

DICOM Import
Select the DICOM RTDOSE tab. The Import dose distributions in DICOM RTDOSE format dialog opens.

Data Import
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 179 | The orientation of the imported slice will be visualized in the coordinate system in the upper right corner of the dialog. The orientation of the coordinate system will be changed corresponding to the attributes from the imported DICOM data. It is not possible to import dose planes with different orientation at the same time.
The images will be displayed in the Image Preview box, with the original TPS orientation.
The images can be imported from file, via DICOMDIR, o r v i a T C P / I P (StorageSCP Service).
Select the Options tab and define the TCP parameters, and the logging directory (optional): Port number: 0 -65535.
Application Entity: Application entity title.

SPACES IN TITLE
Do not use spaces in the application entity title.
8.1.1.1. Import from a Local Data Source Select the Imported Data tab.
Click File to import files from your local data source.
A standard Open dialog opens. Browse for and select the required file. Click Open.
The file will be imported and displayed.
To continue, see 8. The StorageSCPService is a Windows service, which collects DICOM data via TCP/IP and saves it on the disk. The service is started at system start, so files can be collected even if the OmniPro I'mRT software is not running.
The TCP settings are changed in the Options dialog.
The collected data is displayed in the Collect list. Only RT Dose data is displayed.
Select the data to import. If Preview is selected, the data is displayed in the image list.
The imported data is automatically removed from the list. 3. Click Add, and select the requested CMS files.

Data Import
| 182 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide The images will be displayed in the Image Preview box, with the original TPS orientation.
The orientation of the imported slice will be visualized in the coordinate system in the upper right corner of the dialog.
4. Select the Data Transformation t a b . C l i c k Change a n d e n t e r t h e distance from TPS origin to phantom origin. The changed data is reflected in Extensions.
Different offsets can be named and selected in Select previous or store existing offset. The selection of offsets will be persistent.

RTOG Import
Binary and ASCII RTOG files can be imported.

FILE NAMING
The directory file must end with zeros. The number of zeros determine the format of image files reference by their image number in the reference file. E.g. directory file name: aapm0000. If an image number in this is 12, the corresponding image file name has to be 'aapm0012'.
Select the Imported Data tab.
Click Directory File. A standard Open dialog opens.
The orientation of the imported slice will be visualized in the coordinate system in the upper right corner of the dialog.
Browse for, and select the directory file. All dose distributions in the file are displayed. Select a dose distribution in the list view.
The images will be displayed in the Image Preview box, with the original TPS orientation.
Select the Data Transformation tab. Click Change and enter the distance from TPS origin to phantom origin. The changed data is reflected in Extensions.
Different offsets can be named and selected in Select previous or store existing offset. The selection of offsets will be persistent. Select the Imported Data tab.
Click Add, and select the requested CadPlan files. Click Open.
Select the Options t a b . D e fi n e a c o o r d i n a t e s y s t e m fo r t h e T P S , a n d (optional) name the labels of the axes.
Click Change and enter the distance from TPS origin to phantom origin. The changed data is reflected in Extensions.
Different offsets can be named and selected in Select previous or store existing offset. The selection of offsets will be persistent. Enter the dose at 100%.
To continue, see 8.1.6 Send to I'mRT Workspace.
Select the Imported Data tab.
The icon in the upper right corner displays the TPS coordinate system.
Click File, and select the requested files. The images will be displayed in the Image Preview box, with the original TPS orientation.
Select the Data Transformation tab. Click Change and enter the distance from TPS origin to phantom origin.
The changed data is reflected in Extensions.
Different offsets can be named and selected in Select previous or store existing offset. The selection of offsets will be persistent. Choose if data shall be saved as Data set 1 or Data set 2.
Define the normalization value.
Tip! By default the Normalization is selected in such a way that 1 Gy becomes 100% in the OmniPro I'mRT main program. This means that the values displayed in OmniPro I'mRT can be interpreted as cGy (or rad). Film data may also be imported with a rescaling factor of 1 Gy = 100%. By this, the planned data and measured data can be compared without further rescaling.
Click OK. The imported data is displayed in the OmniPro I'mRT Workspace. A window for TPS fluence map import will open. In the left panel patient and data information, embedded in the imported image, will be displayed.
The panel to the right contains three tabs, Imported Data, Fluence Planes, and Options, containing the functions and information needed for import and data transformation. Select the Fluence Planes tab to edit SSD (Source to Surface Distance) and Depth (build-up).
Distance, i.e. the distance from the source to the fluence plane, will be calculated automatically.
If required, enter the value for the collimator Rotation and the Gantry angle.

IMAGE ROTATION
The imported fluence will be rotated in the same direction as the collimator is rotated (according to the definition in IEC 61217). The image will therefore appear to be rotated in the direction opposite to the specified angle. The definition of the direction of angles in I'mRT is in the other direction. Therefore the angle displayed in the Field tab and Modification tabs of the Parameter window will have the opposite sign. Select the compensator type. The selection is persistent between sessions.
Define the TCP port, and the logging directory (optional): Port number: 0 -65535.
Application Entity: Application entity title. These files shall be in the same folder or in a folder below the DICOMDIR file. Filenames must be 8 characters without extension.
Click the DICOMDIR… button.
Select the folder where the DICOMDIR file is. A list of data is displayed.
Only RTPlan data is displayed.
Select the data to import and click OK. The images are displayed in the image list.
To continue, see 8.2.5 Enter location.

TCP/IP Import (StorageSCP Service)
The StorageSCPService is a Windows service, which collects DICOM data via TCP/IP and saves it on the disk. The service is started at system start, so files can be collected even if the OmniPro I'mRT software is not running.
The TCP settings are changed in the Options tab.

Data Import
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 191 | The collected data is displayed in the Collect list in the Imported data tab. Only RT Plan with Compensator data is displayed.
Select the data to import. If Preview is selected the data is displayed in the image list.
The imported data is automatically removed from the list .
To continue, see 8.2.5 Enter location.

KonRad Fluence Import
Select the KonRad button. The Import fluence distributions in KonRad format dialog opens.
Click Add and select the requested files. The imported fluence map data is displayed.

TCP/IP Import (StorageSCP Service)
The StorageSCPService is a Windows service, which collects DICOM data via TCP/IP and saves it on the disk. The service is started at system start, so files can be collected even if the OmniPro I'mRT software is not running.
The TCP settings are changed in Options tab.
The collected data is displayed in the Collect list in the Import Data tab.
Only RT Image data is displayed.
Select the data to import. If Preview is selected, the data is displayed in the image list.
The imported data is automatically removed from the list.
To continue, see 8.2.5 Enter location.

Enter Location
Select the Image Planes tab to enter SSD and Depth (build-up).
Distance, i.e. the distance from the source to the fluence plane, will be calculated automatically.
If required, enter the value for the collimator Rotation and the Gantry angle.

IMAGE ROTATION
The imported fluence will be rotated in the same direction as the collimator is rotated (according to the definition in IEC 61217). The image will therefore appear to be rotated in the direction opposite to the specified angle. The definition of the direction of angles in I'mRT is in the other direction. Therefore the angle displayed in the Field tab and Modification tabs of the Parameter window will have the opposite sign.
To continue, see 8.1.6 Send to I'mRT Workspace. The coordinate system used is fixed to the collimator, with the x-direction in leaf movement direction (a row in the file is parallel to the x-axis), and the y-direction perpendicular to the leafs (a column in the file is parallel to the yaxis). The first row gives the x-coordinate of each column running from -x to +x. The first column gives the y-coordinate of each row running from -y to +y. The isocenter is at position (x = 0, y = 0). X Collimator (leaf movement direction) and Y Collimator (perpendicular to the leaves) are mapped one-to-one to X IEC and Y IEC .

IMPORTANT NOTICE COORDINATES
If the file is viewed without using the coordinates given in the first row and column, you have to keep in mind the following fact: the y-coordinates are increasing with increasing row number, with the consequence that the rows have to be mirrored to get the correct coordinate system layout (x pointing to the right, y pointing upward).

Error Messages
Error messages are displayed as follows: 1st row: Name and path of the erroneous file.
2nd row: The number of the line where the error occurred, and the error number.
3rd row and forward: Descriptive text.
The following error messages may occur during the import of BrainLAB files: Error # Text Description / Possible cause 1 Unexpected symbol: "symbol 1" Expected: "symbol 2" The format of the file is not correct as symbol 1 was found, whereas symbol 2 was expected in the given line.

"Token" expected
The format of the file is not correct as the Token was expected but not found in the given line.

Error when reading Object
A general error occurred when reading the named Object. Either the error cannot be specified in more detail, or the error is displayed in addition to a previous error.

8
"Type" not supported The file has a valid format, but contains objects that are not supported by the import component.  Direction and length unit of horizontal values inside the plane. The direction must be the first direction of the plane type defined in the header.

FLUENCE MAP IS SET TO ABSOLUTE DOSE
The length unit must equal the one defined in the header.
Optional. If set, the next line below must also be entered. Positions in the first direction All positions in the first direction in the defined length unit.
Optional. If not set, the "Spacing" value from the header is used, and the data is centered horizontally. n: Numbers separated by the Separator defined in the header, where n must be the number of columns as defined above. Positions in the second direction + data values The first value in each row is the position in the second direction in the defined length unit.
The subsequent numbers are the data values in the unit defined in the header.
1 Number (optional), followed by n numbers, separated by the Separator defined in the header each.
n must be the number of columns as defined above.

*)
*) The line above is repeated x times, where x must be the number of rows as defined in the header. The user interfaces of the ASCII and the BrainLAB Import look exactly the same. They only differ in the header information that is displayed.

Identifier
File Name and Path display the file name and folder location of the files selected for import.
In the pane to the right of the File Selection pane, header information on the selected file is displayed. If more than one file is selected, the pane displays the text Multiple Selection. If a file that has not the appropriate format is selected, the text File has an invalid format is displayed.
The preview of the selected file can be switched on or off, by marking or unmarking the Preview checkbox. The loading time of large files can be reduced by switching the preview off.
The preview pane displays a preview image of the currently selected file and the coordinate axes. If the Preview checkbox is unchecked, or more than one file or a file containing more than one plane is selected, the preview pane is empty.
Select import as a 3d cube or as single planes with the radio-buttons Import as Cube and Import as Planes.
This image shows the target coordinate system in OmniPro I'mRT, which is always according to IEC-61217.
The Add File(s) button opens a standard Open dialog.
The Remove button removes the selected files from the list. The format of the file is not correct, as symbol 1 was found whereas symbol 2 was expected in the given line.

"Token" expected
The format of the file is not correct as the Token was expected but not found in the given line.

Macros
Several operations for data modification can be combined in a macro. The macro may be applied to one field or to a whole field list.
The parameters displayed below can be combined in a macro. To display the flatness marker, select the right-click command Show markers. Two horizontal lines are displayed at the chosen dose levels.

Function
To display symmetry and flatness values, select the right-click command Profile analysis.

PARAMETERS MEASURED UNDER NON-REFERENCE CONDITIONS
Dosimetry protocols define the reference conditions for the determination of symmetry or flatness. Definition of water as medium, a certain depth, and a certain field is required, and also the type of detector to be used may be specified. If measuring under different conditions (e.g. when using I'mRT QA/BIS in air), these parameters may differ from those measured under reference conditions.
To edit or change the protocol for penumbra and field width parameterization, select Tools:Options and choose the 1D-Options tab in the dialog.
To edit or change the protocol for flatness or symmetry parameterization, select the Tools:Options command and choose the 1D-Options tab in the dialog.

Build a 3D Cube
Film data is 2D data. If this 2D data shall be compared with calculated 3D Dose distributions the measured 2D data must first be converted into 3D data.
To create a 3D cube of measured or imported data you need several images of the same measuring type with different offset values. These images then are "piled on each other" to build the 3D cube.

SINGLE 2D SET
It is also possible to convert just one single 2D set (e.g. one film) into 3D dose format. Select the order of calculation (dataset 1 vs. dataset 2, or vice versa).

DISSIMILAR RESOLUTIONS
When the two datasets have dissimilar resolutions, the results may also be slightly dissimilar.
Use the Export Results command to export the Result data as an opd file (OmniPro I'mRT data).

COMPARING HIGH AND LOW RESOLUTION DATA
When comparing two matrices with different resolution, the high resolution data (this is typically the scanned film data) should be in data set 2, the lower resolution data (typically the imported data from treatment planning system) in data set 1. This speeds up the calculation and prevents interference-like patterns in the gamma matrix.

GAMMA CALCLULATION
To evaluate the result of a gamma calculation, the palette should be switched to Gamma. (Use the right-click command Change Palette). The palette range should be 0% to 125% (set the range in the Palette Range dialog). The color turns to red at the selected upper threshold value. 100% is equal to the gamma value 1.
The delta dose and delta distance values are displayed in the caption of the result view. 9.5.6.1.

Practical usage of the Gamma Method
The most common method to verify calculations vs. measurements is the Gamma method. Therefore a workflow for using the Gamma method in a correct way is described: 1.) Import the plan, perform the measurements.

Data Analysis
| 246 | P-07-002-510-001 06 OmniPro-ImRT System User's Guide The screenshot shows the measured field in data set 1 and the imported dose plane in data set 2.
2.) Convert the grid of the imported TPS dose plane to the resolution of the MatriXX. With this step it is simulated what the MatriXX should "see". This step is required as the MatriXX has a resolution of 7.62 mm while TPS calculates with a resolution of 1 mm (in this case).
If the used linac has an even number of leaf pairs, the use of the centre adaption Align edges (2 centre lines) is recommended. For an odd number the Centre A daption " A l i g n c e n t r e ( o n e c e n t r e l i n e ) " i s r e c o m me n d e d . Centre Adaption is required especially when the grid resolution is reduced. Please check the effect on a square field (plan import). A shift of the field can be seen for grid conversion to lower resolution with no centre alignment.
3.) Convert the grid of the TPS data and the measurements to a higher resolution (1mm for example).

Data Analysis
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 247 | The reason for the convert grid to a higher resolution is the discrete Gamma calculation in OP I'mRT (the number of measurement points are evaluated).
Please use the settings like in the screenshot above.
The reason for this normalization step is the fact that OmniPro I'mRT is using the normalization v a l u e t o c a l c u l a t e t h e Δ G a m m a v a l u e .

5.) Analyzing
For analyzing the profile cursor as well as the histogram is available. Please refer to chapter 9.4.2 Profile and 9.5.4 Histogram.

OPEN TWO DATA SET FILES
To perform the operations described below, it is necessary to open two data set files. Normally this will be the measured data in one data set, and an imported dose cube from TPS in the other data set.

2D DATA SET AND 3D CUBE
It is not possible to compare a 2D data set with a 3D dose cube. The 2D data must first be converted to a 3D cube. See 9.4.3 Build a 3D cube.
Click the toolbar button to switch to 3D Plan verification view. 9.6.1. Difference to 2D In Plan 3D Verification you can perform the same operations as in 2D. The difference is that you can choose which plane to view, and that it is possible to move through the different planes, step by step.
To select a plane with another orientation, click XY, XZ, or YZ.
To select a plane with another offset, drag the slider.
If you want to synchronize the views, click . The profile cursors, the plane orientation, and the offset of the selected plane will be synchronized. P-07-002-510-001 06 | 267 | 2. After selecting a patient, step through the buttons in the iViewGT Browser to make your selection of images.
Patients: Activates a search for the Search for patients dialog.
Treatments: Shows the active treatments associated with a patient.
Fields: Shows the fields belonging to a treatment.
Images: Shows the images belonging to a field. Observe that an image can consist of several frames.
The image pixels are renormalized before they are saved in the database. The scaling factor is displayed in the column Pixel factor.

Example:
If 100 image frames were integrated at acquisition time during delivery of an I'mRT segment, a typical maximum brightness in this raw accumulated image might be 2 500 000 pixel units. Before saving into the database, the pixel values are renormalized in this accumulated image to give maximum brightness of, typically, 40 000, so all pixel values would be multiplied by 0.016. This is the value of the pixel factor.

COMPOSED IMAGE
In the case of a composed image, the pixel factor is not available until the user wants to visualize this image.
A checkbox is placed in the table associated to the images. This checkbox is used for marking images to be composed or to be sent to the I'mRT application.
View selected images: Click this button to display the selected images in the pane beside the button. To remove an image, right-click in it and select Remove image i n t h e c o n t e x t m e n u t h a t a p p e a r s . T h e corresponding checkbox will become unmarked. You can also remove an image by unmarking the corresponding checkbox.
You can add images from other patients, treatments, and fields, and send them simultaneously.
If an image is composed of several frames, an arrow (expand/collapse) button will be shown at the left side of the image. Each individual frame can be previewed. If you click on a frame in the preview window, the frame will be displayed in the right side of the browser (image holder). If you left click with the mouse on any image in the image holder, a new image dialog will be displayed. The left mouse button gives you a zoom function.

. Compose Images
Compose images: This button allows you to compose images. All images with a marked checkbox will be composed to a single image.
In image composition, a max internal scale factor is used. Observe that an image does not hold an absolute dose.
During image composition, all images/frames are calculated with a renormalization factor and scaled relative to each other.

Send Images to the Main Application
Send: All images with a marked checkbox will be transferred to the OmniPro I'mRT application for further analysis. It is possible to select images from different treatments, fields, or patients, and send them simultaneously. If an image consists of frames, a dialog will be shown, asking if the frames shall be transferred to the I'mRT application.
The image data is normalized before it is sent to the main application. The pixel value, read from the image, is divided with pixel factor, resulting in a 32 bit pixel value. A median filter is applied so that the bad pixels are not taken into account for the calculation of the maximum value. Thus they have no influence on the rescaling factor, but they are not removed from the image.

Set origin:
If the origin of the image was not set in the database, the Set origin dialog will open when you click the Send button. This dialog gives you the option to set the origin in the centre of the image, before it is sent.

Close and Log Out
Close: The iViewGT Browser dialog will be closed, but the username and password are remembered for the next dialog usage.
Logout: The iViewGT Browser dialog will be closed and you will be logged out. You need to enter the username and password the next time you open the dialog.

CORRECT ELEKTA IVIEWGT SOFTWARE VERSION
You must ensure that you use the correct version of Elekta's iViewGT software. The version must contain an image renormalization factor.

CONNECT TO THE CORRECT DATABASE
You must ensure that you connect to the correct database. It is possible to set up/configure multiple ODBC drivers.

VERIFY PATIENT SELECTION iViewGT Browser
OmniPro-ImRT System User's Guide P-07-002-510-001 06 | 269 | You must ensure that you select the correct patient, treatment, fields, and images. The current selection is displayed in the upper part of the iViewGT Browser dialog.

DOSIMETRY LIMITATIONS
You must be aware of the dosimetry limitations of the image information given from the iViewGT.

CORRECT IMAGE TYPE
For I'mRT verifications you must ensure that you are using the correct image 12.1.1.2. Moving the Database

REINSTALLATION REQUIRED
Change of the location of the database requires reinstallation of the program. The existing database can be copied over the newly created database after installation, or copied there before installation (will not be overwritten).
To move the database to another location (after the initial installation), follow the steps below:

Cleaning
To clean the housing of the device, use a soft, dry duster, moistened with a cleaning agent. Do not use organic solvents.
Use dry compressed air to clean the connectors on the rear side of the device, and the cable connectors.

Repair
Extremely low-current devices, like ion chamber detectors, require special knowledge and tools. Do not try to repair MatriXX yourself, but return it to IBA Dosimetry.

Recalibration
MatriXX needs recalibration, please return it to IBA Dosimetry. Cross-over cable not used for direct connection to the computer.
Use cross-over cable.
Adapter is used for connection. Do not use adapters (e.g. USB-Ethernet converter) for connection.
Ethernet cable / pins are broken or defect.
Network socket is defect.
Network (cable) defect or is not compatible with CAT-6.

Ethernet port blocked by other application
Check if the Ethernet port is available.
Recommended cable length exceeded.
Use an Ethernet minihub and ping the device.
The Ethernet port can be deactivated if a battery-powered laptop is used.
Check power administration.
Firewall is active and blocks communication.
Deactivate the firewall.
Device cannot be found by the computer / is not communicating The laptop has a WiFi interface. Verify that the wireless internet connection is turned off. Impossible to install / modify / set up the device on the computer.
Operator does not have administrator rights.
Log-on with administrator rights before the program is started.
XX Setup tool not accepted by the local network Network firewall settings.
Add the XX Setup tool to the list of applications that are allowed access to the network. Problems with the isscript-file installation.
Right click the isscript.msi from the OmniPro I'mRT installation disk, and select Install. A wizard will guide you through the installation.
The administrator on the local computer has no access to the network location where the database shall be located.
Log in as local administrator, and install the program and the database locally on the computer.
Log in as user with network access.
Create a folder on the network. Map the folder to a driver letter (same letter for all users) Move the database to the new location.
Configure the ODBC data source, see 12. Measured film data are 2D distributions, 3D dose cubes are 3D data. 2D Data must be converted to a 3D cube first.
Select the film data.
Set the Offset for each film.
The result of a gamma-calculation shows an interference pattern Data with high resolution (typically filmdata) in Dataset 1, data with low resolution (typically planned data) in Dataset 2.
Open the low resolution data in Dataset 1, and the high resolution data in Dataset 2.
or Use data with similar resolution.
Lost "old" data set? If a new measurement /import is performed while another data set is already open, the "old" data set disappears from the pane.
All fields are found in the in the Field list. No data is lost.
Open the Field list dialog.
Select requested field from the list. This field is displayed in the data set pane(s).
If saving the data set the new data will be saved as new fields in the same field list as the old ones.   Max quotient in dose between two points on equal distance from central axis, within flattened area defined as in item  The profiles are internally and individually normalized to 100%. The fit works on left and right penumbra zones (e.g. 10% -90% area). The width shall be equal on both sides.
14. x: x-distance between C1 and C2 (equals x-distance between C3 and C4) x1: x-distance between C1 and Si (equals x-distance between C3 and Si) x2: x-distance between Si and C2 (equals x-distance between Si and C4) y: y-distance between C1 and C3 (equals y-distance between C2 and C4) y1: y-distance between C1 and Si (equals y-distance between C2 and Si) y2: y-distance between Si and C3 (equals y-distance between Si and C4) The interpolation is done in three steps:

Applicator
Extended collimator used for electron fields, also called Cone or Tube.

Array
Presents the Data set pane in a 2D array view.

ASCII American Standard Code for Information
Interchange; a code for information exchange between computers made by different companies.

Background
The signal of a measurement device without any beam.

BIS
Beam Imaging System. IBA Dosimetry provides three beam imaging systems: I'mRT QA, BIS 710, and MatriXX.

BIS2G
A 2D detector array by IBA Dosimetry, sold until 2nd quarter 2003 under the product name BIS2G. The new product name is I'mRT QA.
Its predecessor was the BIS 710.
In this manual the term I'mRT QA/BIS is used in information that applies to both I'mRT QA and BIS 710.

BIS 710
A 2D detector array by IBA Dosimetry.
In this manual the term I'mRT QA/BIS is used in information that applies to both I'mRT QA and BIS 710. DTA Distance To Agreement. The DTA is the distance between a dose point in the calculated distribution and the nearest point containing the same dose value in the measured distribution.
dpi Dots per Inch. A unit used to describe the resolution of scanners.

Field
Radiation Field. One single dose distribution. One or more fields can be saved in one Data set.

Film calibration
With the help of a number of films, irradiated with known doses, the optical density can be calibrated to dose.

Fixture
Attachment in-between the BIS and the treatment head, allowing the servo to rotate with the gantry.

Fog
The optical density of an unexposed but developed film.

Frame grabber
A PCI card mounted in the computer: It acts as an interface between the BIS and the OmniPro I'mRT software.

FW
Field Width.

Head mounted
Fixed to the gantry (head).

I'mRT QA
A 2D detector array by IBA Dosimetry, sold until 2nd quarter 2003 under the product name BIS2G. The new product name is I'mRT QA.
In this manual the term I'mRT QA/BIS is used in information that applies to both I'mRT QA and BIS 710.

I'mRT MatriXX
A 2D detector array by IBA Dosimetry.

Isocenter
Rotation centre for the gantry.

Isodose
Points with the same dose value.

MatriXX Evolution
A 2D detector array by IBA Dosimetry, especially intended for rotational techniques.

MeV
MegaelectronVolt, a unit used for the nominal or real energy of a beam consisting of charged particles (electrons, protons).

Complaint Reports
This section contains three copies of Complaint Report, OmniPro I'mRT, and three copies of Complaint Report, MatriXX.
Always keep one copy of the form. If needed, make more photocopies of the form. If there is no form, make a written report describing the fault with as much detail as possible. Please always include your name, address, email, phone, and the license number (found in the About box of OmniPro I'mRT).
The user shall report all complaints about the system to any representative of IBA Dosimetry, or directly to: