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59]

Original Article

Radiological safety features of indigenously

developed radiotherapy simulator
ABSTRACT Rajesh Kumar,
Objective:To study the radiological safety feature of indigenously developed radiotherapy simulator. Dayal Chand
Kar1, Sunil
Materials and Methods: A comprehensive study for radiological safety features of the unit were carried out as per the standard Dutt Sharma,
protocol/guidelines. NERO mAx X-ray test device was used for KVp, mA, mAs, and X-rays output related test of the units along with Ravi Ilpakurty2,
other required test device. Goteti Venkata
Results: All the measurement results indicate that all the tested parameters of this simulator are well within the prescribed tolerance limit. Subrahmanyam2
Conclusion:The simulator is safe for routine clinical use. Radiological Physics
and Advisory Division,
Bhabha Atomic
KEY WORDS: Quality assurance, radiological safety, radiotherapy simulator Research Centre,
Anushaktinagar,
Mumbai, 1Divison
of Remote Handling
INTRODUCTION time 1 s. Linearity of mA loading was estimated and Robotics,
using coefficient of linearity (COL). Linearity of Bhabha Atomic
Radiotherapy simulator is a device which has timer was tested for time setting from 280 to 1,000 Research Centre,
mechanical and radiation beam geometry identical ms by keeping constant value of kVp and mA at 50 Trombay, Mumbai,
to that of a teletherapy machine and imaging and 200, respectively. Maharashtra,
2
Panancea Medical
system similar to that of a diagnostic imaging Technologies Limited,
unit. It plays major role for accurate radiotherapy Accuracy of mA setting for set value ranges from Bangalore, Karnataka,
planning and dose delivery. It is used to determine 50 to 400 mA was evaluated. Output consistency India
patient positioning and beam parameters. Among for different kVp and mAs setting were evaluated.
For correspondence:
the medical centers with teletherapy facilities X‑ray beam output at 1 m in mR/mAs at 80 kV
Mr. Rajesh Kumar,
in our country, many do not have radiotherapy for field size of 20 × 20 cm2 were measured for Radiological Physics
simulator for accurate delivery of radiation different combination of current and time. The and Advisory Division,
therapy. There is wide gap between the demand output consistency was estimated by determining Bhabha Atomic
and availability of radiotherapy facilities in the the coefficient of variation (COV). Measurement of Research Centre,
CTCRS Building,
country. Considering the growing requirement for half‑value thickness for 70 kV X‑ray tube voltages
Anushaktinagar,
such machines, a digital radiotherapy simulator was measured. Attenuation curves were plotted Mumbai ‑ 400 085,
was developed by Bhabha Atomic Research Centre by varying the thickness of the aluminum filter, Maharashtra, India.
and its technical specifications are given in Table 1. and measuring the exposure. The thickness of E‑mail: rajeshr@barc.
This paper describes the radiological safety features aluminum was increased in 0.5 mm steps until gov.in
of this radiotherapy simulator. the measured exposure was well below half of
the reading corresponding to no added filter. The
MATERIALS AND METHODS total filtration was derived from the standard
data set from the measured half value layer (HVL)
A comprehensive study for radiological safety value. Aluminum equivalent of table top was also
features of the unit were carried out as per the measured. Radiation leakage from X‑ray tube
standard protocol/guidelines.[1‑6] NERO mAx X‑ray housing was measured using 40 cc cylindrical Access this article online
test device (Victoreen Inc) was used for KVp, ionization chamber with UnidoseE electrometer. Website: www.cancerjournal.net
mA, mAs, and X‑rays output related test of the Radiation levels at 5 cm from the surface of DOI: 10.4103/0973-1482.150412

units. Central beam alignment was evaluated high tension transformer were measured using PMID: ***

using a collimator and beam alignment test tools. a pressurized ion chamber‑based survey meter. Quick Response Code:

Accuracy of tube accelerating voltage was tested
for 45–150 kVp. Accuracy of timer was evaluated
for set time 0.1–1 sat 60 kVp and 100 mA. Linearity
of mA loading were studied for set mA ranges
from 20 to 320 mA with fixed kVp of 80 and
1056
Exposure rate at table top in fluoroscopy mode
was also measured using the above mentioned
survey meter. Image quality of simulator was
access using a high contrast resolution test tools
and Leeds tools.
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Kumar, et al.: Radiological safety features of simulator

RESULTS AND DISCUSSION It can be inferred that they are in well agreement with
each other. Figure 3 shows the image of Leeds phantom
Figure 1 shows the image acquired for beam alignment test. acquired from the simulator. The 13th circle for low contrast
It can be inferred from the image that both ball are exactly resolution which is corresponding to the contrast value of
coinciding with each other and beam alignment found to be 0.022 and 10th line pattern for high contrast resolution which
well below the acceptable values of 1.5°. Figure 2 presents the is corresponding to the 1.4 lp/mm are visible in the image.
congruence between set and observed values of delineating Table 2 shows the test result of set and measured kVP values.
wire for field size ranges from 5 × 5 cm2 to 15 × 15 cm2. It can be observed that the variation between measured and
set kVP  values are ranges from  −0.1 to 1.1 kVp, which is
Table 1: Technical specification of indigenously developed well within the tolerance limit value of ± 5kVp. Table 3
radiotherapy simulator represents the variation between measured and set value
Gantry rotation at focus to axis ±185 degree of the timer. The tolerance values for the variation between
distance 100 cm
Isocenter height above the floor 128
measured and set timing is ± 10%, while the evaluated
Maximumgantry rotation speed 1RPMs variation was not detectable. Table 4 shows the test result
Anticollision logic Yes
FAD 80-120 cm Table 4: Test result for linearity of mA loading station
Collimator rotation ±95 degree
Field size (delineators) 45×45 cm2 Set Measured mR mR/mAs Coefficient Remarks
Independent delineators motions Yes mA (average) of linearity
Field size (shielding jaws) 0.5×0.5 to 50×50 cm2 20.0 74.1 3.703 0.004 Tolerance: Coefficient
Independent jaw motion Yes 50.0 186. 3.727 of linearity <0.1
Image intensifier arm motions ±20 cm (longitudinal), ±20 cm 100.0 373.2 3.732
(lateral), 0-60 cm (radial) 160.0 595.4 3.721 0.0064
Image intensifier auto recenter Yes 320.0 1,175.4 3.673
KV peak 40-125 KVp (radiography mode), Exposure parameters: kVp=80, s=1
40-150 KVp (fluoroscopy mode)
Milliampere 1-20 mA (radiography mode),
Table 5: Test result for linearity of timer
1-800 mA (fluoroscopy mode)
Focal spot size 0.4 mm, 0.8 mm Set time Measured mR/ Coefficient Remarks
Image intensifier size 290 mm (ms) mR (average) mAs of linearity
Couch motions 68-135 cm (vertical), 90cm 280 71.7 1.2807 0.006 Tolerance: Coefficient
(longitudinal), ±20 cm (lateral) 500 129.2 1.2924 of linearity <0.1
Table top Carbon fiber 800 204.4 1.2778
Software control Yes 1,000 255.4 1.2771
DICOM compatibility Yes Exposure parameters: kVp=50, mA=200
DICOM=Digital imaging and communications in medicine, FAD=Focus to axis
distance, KV=Kilo voltage
Table 6: Variation of set and measured mA values
Table 2: Accuracy of tube accelerating voltage (kVp) Set mA Measured mA % error
50.0 49.5 1
Set kVp Measured kVp Difference (kVp) 100.0 99.5 0.480
45 44.2 0.8
160.0 159.7 0.158
50 49 1
200 199.2 0.385
55 53.9 1.1
320 319.9 0.038
60 59.9 0.1
Exposure parameters: kVp=60, s=1
65 64.9 0.1
70 69.6 0.4
80 79.6 0.4
90 89 1
100 100.1 −0.1
110 109.4 0.6
120 119 1
130 129.7 0.3
140 139.3 0.7
150 148.9 1.1
kVp=Kilo voltage

Table 3: Accuracy of timer setting

Set time (s) Measured time (s) % error Remarks
0.1 0.1 0 Tolerance±10%
0.2 0.20 0.0
0.32 0.32 0
0.4 0.40 0
0.63 0.63 0
1.0 1.0 0
Exposure parameters: kVp=60; mA=100 Figure 1: Image showing the results of beam alignment test of simulator

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Kumar, et al.: Radiological safety features of simulator

Table 7: Measurements of output consistency

Set parameters Exposure (mR) Coefficient of variation Remarks
kVp mAs I II III IV V
45 40 43.9 43.9 43.9 44.2 43.9 0.0030 Tolerance <0.05
50 40 61 61 60.8 61.1 61 0.0018
60 40 97.9 97.9 97.4 97.6 97.7 0.0034
70 32 110.9 110.3 110. 110.4 110.4 0.0052
80 32 146.7 146.6 146.7 146.6 146.6 0.0004
90 20 118.1 118.4 118.2 118.4 118.2 0.0020
100 16 148.5 148.8 148.9 149.2 149.2 0.0020
120 10 174.6 175. 174.7 174.7 174.7 0.0009
130 6 127 127 126.9 127.2 127 0.0009
150 5 123.6 123.8 123.8 123.6 123.4 0.0014

Table 8: X‑ray beam output at 1m in mR/mAs at 80 kV for

field of 20×20 cm2
Set Set Mean mR/ Coefficient Remarks
current time exposure mAs of linearity
(mA) (ms) (mR)
12.5 500 27.32 4.3712 0.002 Tolerance:
20 500 43.98 4.398 Coefficient of
50 500 109.78 4.3912 linearity <0.005
a b 100 500 220.84 4.4168
200 500 458.66 4.5866
320 500 720.28 4.50175

the results of output consistency. It can infer from the table

c d
Figure 2: Image showing the results of congruence test for set
and observed values of delineating wire for field size (a) 5 × 5 cm2
(b) 10 × 10 cm2 (c) 12 × 12 cm2 (d) 15 × 15 cm2
that a COV value varies from 0.001 to 0.005 in respect to the
tolerance limit of 0.05. X‑rays output in term of mR/mAs at
80 kV for field size of 20 × 20 cm2 at different mA setting
is given in the Table 8. It can be seen from the table that
measured values have COV of about 0.02, which is less than
the tolerance limit value of 0.05. The measured values of
HVL for 70 kV was found to be 4.08 mm of aluminum (Al).
The corresponding total filtration was estimated from the
standards result and found to be 7.6 mm Al. The Al equivalent
of table top was measured and found to be 0.5 mm. Radiation
leakage level at 1 m from focus was measured and found to
122 mR in 1 h for 320 mA‑min and 73.44 mR in 1 h for 180
mA‑min. This value is well within the tolerance limit of 115
mR in 1 h for 180 mA‑min. The radiation level at 5 cm from
the surface of high tension transformer was 0.1 mR in 1 h
for 5mA and 60 min setting.

CONCLUSIONS

Radiological safety features of this simulator were studied to

Figure 3: Image of Leeds phantom acquire by simulator
for mA loading linearity. The estimated COL was found to be
0.004 up to 100 mA and 0.006 for 160‑320 mA setting. Results
of linearity of timer can be seen in the Table 5. The evaluated
values of COL were found to be 0.006, which is well within
the tolerance limit values of 0.1. Variation between measured
and set value of mA is listed in Table 6. Evaluated percentage
error was found to be in range of 0.38‑1%. Table 7 shows
evaluate its performance for comparison with the standards.
Measurement results indicate that all the tested parameters
of this simulator arewell within the prescribed tolerance limit.
The simulator is safe for routine clinical use.
REFERENCES
1. Type approval tests for simulator, BARC/RP and AD/MPSS/QA/SIM,
Radiological Physics and Advisory DivisionBhabha Atomic Research
Centre, Mumbai.
2. Type approval tests for Diagnostic X‑ray Machine, BARC/RP and
AD/MPSS/TA/XD‑4, Radiological Physics and Advisory Division

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Kumar, et al.: Radiological safety features of simulator

Bhabha Atomic Research Centre, Mumbai.
3. European Commission. European guidelines on quality criteria for
diagnostic radiographic images. EUR 16260ISBN 92‑827‑7284‑5,
Brussels; 1996.
4. Quality assurance handbook. Middleton (WI): RMI; 1992.
5. American Association of Physicists in Medicine Medical Physics
Monograph 4; 1977.
6. International Electrotechnical Commission, Particular
requirements for the safety of radiotherapy simulators,
IEC‑ 60601‑2‑29 (1991).
Cite this article as: Kumar R, Kar DC, Sharma SD, Ilpakurty R,
Subrahmanyam GV. Radiological safety features of indigenously
developed radiotherapy simulator. J Can Res Ther 2016;12:1056-9.
Source of Support: Nil, Conflict of Interest: None declared.

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