SARRP

Training Manual
Table of Contents

1) SARRP Basics – Safety and Functions of the machine

2) Imaging Concepts and Functions
3) Treatment Planning Concepts
4) Imaging and Treatment Planning
5) QA Procedures
6) Housekeeping
7) Troubleshooting
8) SARRP Dose Planning System
9) Glossary
10) Anatomical Directions
SARRP Basics- Safety and Functions of machine
1) MP1- controls X-rays for imaging and treatment
2) PC-drives SARRP and controls all parts
3) SARRP- Imaging system with fine beam irradiation
a. On, Off, Emergency Off buttons
b. Laser switch
4) Gantry- allows tube head to rotate around the stage
5) Stage- X, Y, Z and Theta
a. This is where the mouse beds attach (3 types): Immobilization bed, fat mouse bed, and flat top
stand.
b. Start position is 0 for all coordinates; this can be changed by use of the PC.
6) CT Flat Panel – allows for imaging that can be constructed into a 3D image. Lead shield must be covering
the flat panel during treatment to protect panel from high energy X-rays.

Try This!

Using the plunger and lead panel handle, pull the lead shield up and into place for imaging and then pull
the lead shield down and place it back against the frame for irradiation.

7) Portal Camera - the camera sits opposite the gantry and allows the user to capture of a moving image of
the subject internal anatomy. It can also be used to take still pictures from the Beam’s Eye View
direction.
8) Collimator and Nozzles – This allows for precision during imaging and treatment delivery.

Try This!

Place nozzles in and out of the collimator. Place collimator off and on Gantry.

9) Filters- 2 types: Copper for treatment and Aluminum for Imaging.

10) Webcam – This allows the user to view the Gantry, Stage and subject during imaging and treatment
delivery.
11) Generator – This creates the current needed to produce X-rays and is controlled by the MP1.
12) Cooler - The tube head creates x-rays by getting very hot. The cooler flows air or water around the tube
head to get rid of the excess heat.

 At the end of the day, the lead panel shield should be left down, mouse beds and nozzle should be
removed.
Imaging concepts and functions
CT Flat Panel- Refer to SARRP Manual Section5.1.4

Detector Calibration

CBCT Image

CT Image Confirmation – Refer to SARRP Manual Section 5.1.6

Capture Single Image

Create Double Exposure

Portal Camera – Refer to SARRP Manual Section

Create Movie

Capture Single Image

Try This!

Try creating CBCT images, creating double exposures and capturing movies using the Portal Camera.

 Hint: No spaces are allowed in the names of the Experiments or scans.

Treatment Planning Concepts

X-rays: History and Application

What are X-rays and how are they produced?

When the filament is heated, it releases electrons that collide with a Tungsten target. This produces X-rays.

When the x-rays enter the subject they can either attenuate. This is the loss of x-rays through the matter. This
can happen through two different ways. Some x-rays will be absorbed. This means that the energy in the x-ray
is absorbed in the matter. This is delivery of the dose. Another interaction is called scatter. The x-ray will
interact with the atom and cause an electron in the atom to scatter. This can be absorbed in a different place in
the subject.
Several x-rays emitted from an x-ray tube in a beam interacting with the tissues gives a certain dose to an area.
This area is defined by the beam opening and kV applied. The dose is the amount of time in a given area.

In tissues with differing densities (tissue, air, bone), attenuation will happen differently in each tissue. In air
attenuation is minimal. Contrastly, in bone attenuation is very strong. This means that you will get a larger dose
buildup in bone than air.

Delivering Parallel Opposed Beams

In this image we have a mouse head and we want to deliver 2Gy to the Isocenter located in the middle of the
head.

Let’s try this with 1 beam.

In this example we have used 1 Lateral beam pointed towards the Isocenter. When radiation hits the patient
tissue, it undergoes attenuation. This means that the intensity of the beam decreases the deeper it goes into
the tissue. If the tissue is uniform (such as a brain), the intensity would decrease exponentially. We would have
to pump a lot of dose at the surface of the subject to get a decrease in dose to 2 Gy in the center. This creates a
non-uniform dose distribution throughout the subject’s head.

Now let’s try this with 2 beams.

In this example we have spread the dose between 2 different beams. Since they are exactly opposed beams, we
can split the dose between the beams. Each beam will deliver 1Gy (50%). The beam path will head straight on
to the Isocenter and when it meets in the middle and the doses will add up to 2 Gy. This allows for better, more
uniform coverage than using a single beam and decreases the amount of dose to the surrounding tissue.
Field Setup

The SID or Source to Isocenter Distance is always 350mm. The subject is moved to where the Isocenter meets
this point. The Dose calculator is looking for the SSD or Source to Skin Distance. The user must find the distance
from the defined Isocenter to the skin of the subject.
Imaging and Treatment Planning
When a CBCT is created, an isocenter must be placed in the treatment area using the MuriSlice
software. Refer to SARRP Manual Section 5.1.5.1. Using this 3D image, the user must decide on beam
placement. Once an isocenter is defined, the user will draw a line from the skin to the isocenter in the direction
of the beam. This will give the depth in mm. It would also be advised to take a screenshot of the isocenter and
measurement line for future reference.

Dose Calculator

SARRP defines a dose by the amount of time the beam is left on at the MP1. The time is defined in the Dose
Calculator. This is found in the SARRP Interface under the Dose Delivery menu. To define the time you must
decide first which collimator to use. The SSD is the source to skin distance. This is the distance from the head of
the x-ray tube to the skin of the subject. The depth is defined in the CBCT. Once an Isocenter is chosen, the user
must use the measurement tool and draw a path from the Isocenter to the surface in the direction of the beam.
The Isocenter is ALWAYS defined at 350mm from the source; therefore, the user must take the depth (mm) and
subtract from 350mm to find the SSD. For example:

In this example an Isocenter is 6mm from the surface if I choose a beam from the gantry at 0° position. If the
source to Isocenter distance is 350mm then I will subtract 6mm to find the source to skin distance.

350 −6 = 344

Therefore, 344mm is my SSD. If use a 5x5mm collimator and want to deliver 200cGy to the Isocenter, I would
set up my dose calculator in this way:
If the user wanted to use 2 beams and the depth were the same, the dose would be split in half. Review section
(delivering parallel opposed beams in Treatment Planning Concepts) to remember that beams add up in the
center so the dose must be cut in half to add up to 200cGy. For each beam the dose calculator would be setup
in this way:

QA Procedures
BB Test Refer to SARRP Manual Section 5

Housekeeping
Review SARRP Software options

1. Robot
This section refers to the robotic stage. The robotic stage is in a different coordinate system than CT.
 To keep the robotic stage always rotating around the Isocenter with submilimetric accuracy, the stage
applies correction factors as it rotates. If you use this menu to move the stage it will not apply the
correction factors. The speed of movement can also be changed in this menu, it is not advised to do so.
This section allows the user to unhome the robot. This is also not advised to use.
2. CBCT
Re-reconstruction allows a user to take the CBCT raw data and use another protocol for reconstruction
so the user would not have to take the image again.
Detector Calibrate is the button to calibrate the panel each time a different value for imaging is used.
CT Calibration is used to calibrate the panel placement and account for rotation or movement. This is
performed by a Technician.
3. XIS Detector
This is the name for the flat panel. It enables the user to turn off the detector and reinitialize. It is not
advised to be used.
4. Image J
This software will open any type of image including raw CT images.
5. Delivery
This is where you will find the Dose calculator. Also you can set up a Continuous Arc Motion. This is a
conical arc where the Gantry is static and the mouse will rotate around an Isocenter.
6. Help
This menu shows you which version of SARRP software is running. Calibration software is used by the
engineers. The GPU commissioning tab is used once to obtain the fluence values from your
commissioning data for the SARRP Dose Planning System

You have a CBCT data folder found under C:/CBCT_data. Monitor this folder periodically to keep the folder from
taking up too much space on the hard drive. For instance, if a reconstruction is completed, the raw data can be
deleted without losing the reconstruction image.

When evaluating an image to define an Isocenter, it is advised to take a screenshot when the measurement tool
is used to save the depth parameters.

Troubleshooting
As needed.

SARRP Dose Planning System

Refer to SARRP Dose Planning System Manual Section 5
Glossary of Terms
SSD: Source to Skin(surface) Distance. The source of the x-rays lies in the tube head.

Depth: In the path length of the beam, it will enter the subject skin and be directed to a user defined isocenter.
The length the path must travel to reach the isocenter is the depth.

Collimator: This is the object attached to the gantry head used to cone the beam down to the shape necessary
for a user defined treatment.

Gantry: This is the mechanical arm that rotates around the stage. It also houses the tube head.

Couch: This is the apparatus in which to place the subject for imaging and treatment delivery.

Stage: This tower moves in X, Y, Z and Theta directions to give the user many options in isocenter placement
and treatment delivery.

SARRP: Small Animal Radiation Research Platform- This is an Image Guided Micro Irradiator for small animals.

MP1: This controls the x-rays

PC: This controls all of the parts of the machine except the x-rays.

SARRP Software: This software connects to the motors, portal camera and flat panel detector for imaging and
treatment delivery setup.

Lasers: 3 lasers that generate a point at the mechanical and imaging isocenter.

Filter: There are 2 types: Copper and Aluminum. These are used to “harden” the beam. By hardening the
beam, the lower energy x-rays are absorbed so that the spectrum of energy entering the subject is uniform.

Nozzle: This is a small piece that attaches on to the collimator to give a specific shape. In the standard package
there is available:10x10mm, 5x5mm, 3x9mm, 3x3mm, 1mm and 0.5mm diameter.

Attenuation: The loss of x-rays through matter.

Absorption: This is a way that an x-ray can be attenuated. The energy in the x-ray will be taken up by the atom
it interacts with.

Dose Gradient: Due to attenuation through matter, dose is not uniform through a subject. At the surface of
the subject is the largest amount of dose and it decreases the further it travels. This is a gradient of dose.

Hot Spot: Depending on the beam setup, dose can combine at a certain point and create a spot where there is a
large amount of dose.
The hot spot can also develop at the surface of the tissue due to the dose gradient, there must be enough dose
going in to achieve the desired dose at the isocenter.
Anatomical Directions