Cat PTW Supplementary

Technical Publication
Elekta Medical Linear Accelerator

Customer Acceptance Tests for: All models
Data verification with PTW Beamscan dosimetry after adjustment
Document ID: 1503568_12

Publication date: 2020-12
Language: English
Copyright statement
Copyright ©2020 Elekta Limited. All rights reserved. Do not copy or use this document, or parts of
it, without written agreement from Elekta Limited. All trademarks and registered trademarks of
Elekta products are the property of the Elekta Group.
Acknowledgement of other trademarks

Elekta acknowledges the trademarks and registered trademarks of other manufacturers that we
use in this document.
Referenced documents
Elekta does not supply all the documents that we refer to in this document with the equipment.
Elekta reserves the right to make the decision on which of the documents we supply with the
equipment.
Worldwide product manufacturing centers - Oncology

Elekta Limited
Linac House, Fleming Way,
Crawley, West Sussex. RH10 9RR.
United Kingdom
Tel: +44 (0)1293 544422, Fax: +44 (0)1293 654321
Elekta Beijing Medical Systems Co., Ltd.

No. 21, Chuang Xin Road,
Science and Technology Park,
Changping District,
Beijing. 102200
P.R. China
Tel: +86 10 8012 5400, Fax: +86 10 8012 5401
For technical help, contact your local Elekta representative

or Elekta product support - www.elekta.com/services
Document ID: 1503568_12 Elekta Medical Linear Accelerator

Customer Acceptance Tests
Page 2 © Elekta Group 2020. All rights reserved.
Table of Contents
Table of Contents
Chapter Title Page
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2 Description of customer acceptance tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3 Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
4 Appendix A - iCom Customer Acceptance program . . . . . . . . . . . . . . . . . . . . 43
5 Appendix B - Measuring the electron applicator average radiation leakage 47
Elekta Medical Linear Accelerator Document ID: 1503568_12

© Elekta Group 2020. All rights reserved. Page 3
Table of Contents
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Introduction
1 Introduction
Section Title Page
1.1 Document scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.2 Equipment registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Introduction
— Blank page —

Introduction
Document scope
1.1 Document scope

This document is applicable to all models of the Elekta Medical Linear Accelerator. These are:
• Elekta Harmony
• Elekta Harmony Pro
• Elekta Synergy® Platform
• Elekta Synergy®
• Elekta Infinity™
• Elekta Axesse™
• Versa HD™.
The tests in this document are the standard tests that Elekta do after the installation is
completed. The tests show that the Elekta Medical Linear Accelerator:
• Is installed correctly
• Operates satisfactorily
• Operates to the specifications agreed in the Contract of Sale.
Note: If Elekta has to do other tests that are not agreed as part of the Contract of Sale, there are added
costs.
Before you start the tests, make sure that the scale convention of the XVI system is the same as
the host linear accelerator. Refer to XVI Installation Information for more information.
To do the tests in a minimum of time, Elekta recommends that you do them in the sequence of
this document. But, it is possible to do the tests in different sequences.
After each test, record the result in this document in the space after the test procedure.
Use this document together with the applicable Instructions for Use.
1.2 Equipment registration

When the applicable customer acceptance tests are completed, the representatives from Elekta
and the customer must make sure that all copies of the document have:
• The results tables completed correctly
• All signatures and the date of approval on the Certificate of Acceptance.
When the Customer Acceptance Tests are completed, send the approved customer acceptance
test document to Elekta.
• If the Customer Acceptance Tests are completed using an electronic Customer
Acceptance Tests (CAT) document, upload the approved electronic document to the
Elekta Customer Lifecycle Management (CLM) system for equipment registration.
• For Customer Acceptance Tests using hardcopies, the BU or Distributor keeps two
copies, and the customer keeps one copy. A copy of the approved Certificate of
Acceptance is uploaded to the CLM for equipment registration.

Introduction
Equipment registration
— Blank page —

Description of customer acceptance tests
2 Description of customer acceptance tests

Section Title Page
2.1 Description of the available energies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.2 Tools and test equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.3 Description of the operating environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.4 Description of the standard gantry angles during the tests . . . . . . . . . . . . . . . . . . . . . 12
2.5 Description of the properties and position of the water phantom . . . . . . . . . . . . . . . . 12
2.6 Description of the depths of measurement for X-ray beams . . . . . . . . . . . . . . . . . . . . 12
2.7 Description of the depths of measurement for electron beams . . . . . . . . . . . . . . . . . . 12
2.8 Description of radiation detectors used in tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.9 Description of tests with X-ray films . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.10 Description of tests with AutoCAL™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.11 Adjustments during test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.12 Scaling conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

— Blank page —

Description of the available energies
2.1 Description of the available energies

The linear accelerator has a maximum of three levels of X-ray energy, two levels for high dose rate
(HDR) X-rays, and 10 possible levels of electron energy. The levels for X-ray and electron energies
are configured at the factory during the assembly and test of the linear accelerator.
X-ray Electron energy

energy
(MV)
Low Medium High HDR 1 HDR 2 MeV (4) HDRE
4 and 6 6, 8 or 10 10, 15, 18 or 6 or 10 6 or 10 4, 6, 8, 9(2), 10, 4, 6, 8, 9(2),
(25)(1) 12, 15, 18, 20 10
and 22(3)
1 25 MV is available as a non-standard optional configuration only.
2 A machine cannot be set up with 9 MeV and 10 MeV together, only 9 MeV or 10 MeV. This is
because 9 MeV does not have a Cal Block, therefore you must use 8 MeV or 10 MeV as these are
the energy settings near 9 MeV.
3 22 MeV is not available with Agility™.
4 The number of electron filters is reduced to two if you have a linear accelerator with HDR X-
rays. This will give possible energy ranges of 4, 6, 8, 10, 12, 15 MeV, or 4, 10, 12, 15, 18, 20 MeV,
or 6, 8, 18, 20 MeV.
2.2 Tools and test equipment
• A spirit level (≤0.30 mm/1m)

• An ion chamber
• A water phantom
• AutoCAL™ for MLCi2™
• X-ray film (for example EDR2)
• A Film processor and densitometer
• A 40 cm ruler
• Graph paper
• Buildup material to simulate tissue density. Minimum size: 30 cm × 30 cm, with a
thickness of 2 cm, 3 cm and 4 cm.
Note: Do not use AutoCAL™ to do the tests on machines with Agility™.
Note: A Film processor and densitometer are not used when you do the tests with AutoCAL or Ashland
GAFCHROMIC X-ray film.

Description of the operating environment
2.3 Description of the operating environment

The operational environment must be in compliance with the specification for the system
configuration. If the operational environment is not correct, Elekta does not accept the
responsibility if the equipment performance is less than the specifications agreed in the Contract
of Sale.
2.4 Description of the standard gantry angles during the tests

The default angle of rotation for the gantry and the BLD is 0°.
If a test tells you to use a gantry or BLD angle of 90° to make the measurements, you can equally
use an angle of 270° (-90°).
2.5 Description of the properties and position of the water

phantom
A water phantom is used for some of the tests during the customer acceptance tests. The surface
of the phantom is set up at a right angle to the radiation beam axis.
The dimensions of the water phantom area must be a minimum of 5 cm larger than the size of
the radiation field.
The depth of the phantom must be a minimum of 10 cm more than the depth of the point of
measurement.
2.6 Description of the depths of measurement for X-ray beams

The standard depth of measurement for a beam profile in compliance with IEC is:
• 5 cm for 4 MV energy
• 10 cm for 6 MV and higher
• 10 cm for HDR energies.
2.7 Description of the depths of measurement for electron

beams
The depth of measurement for a beam profile in an electron beam for 4 MeV and 6 MeV energies
is:
• The depth of the maximum absorbed dose.
The standard depth of measurement for a beam profile in an electron beam for 8 MeV and higher
energies is:
• IEC standard: Half the depth of the specified penetrative quality of 80% of the
maximum absorbed dose. (See Table 2.1).
• USA procedure: Half the depth of the specified penetrative quality of 85% of the
maximum absorbed dose.
For IEC standard, measurements in the electron beam are made at 95 cm SSD (Source Surface
Distance).

Description of radiation detectors used in tests
For USA procedure, measurements in the electron beam is at 100 cm SSD.
Note: There are alternative tests for electron flatness for Elekta linear accelerators installed to USA
procedure.
Table 2.1 Electron radiation penetrative quality (IEC standard)
Energy Level Depth of 80% dose

4 MeV 13.3 mm
6 MeV 20 mm
8 MeV 26.7 mm
9 MeV 30 mm
10 MeV 33.3 mm
12 MeV 40 mm
15 MeV 50 mm
18 MeV 60 mm
20 MeV 66.7 mm
22 MeV 1 73.3 mm
2.8 Description of radiation detectors used in tests

The radiation detector must:
• Be independent of the radiation spectrum
• Have sufficient spatial resolution in regions of high dose gradients, for example at the
edges of the radiation field.
2.9 Description of tests with X-ray films

For the tests in this document, use a type of film that has a flat response across the range of
energies used, for example EDR2. The films are exposed with an approximate buildup equal to the
depth of Dmax. Use a dose of between 40 and 70 MU to give an optical density of approximately
1.0.
2.10 Description of tests with AutoCAL™

If AutoCAL™ is available, you can use this tool and do the tests without films for MLCi2™. Do not
use AutoCAL™ with Agility™.
Make sure that you attach the test results from AutoCAL™ to this document. For more
information see AutoCAL™ v2.4 Instructions for Use.

Adjustments during test
2.11 Adjustments during test

Only make the adjustments that you can complete with the controls that the user can access
during usual operation. If you make other adjustments, you can cause a change to the results of
earlier tests. Therefore, you must do these tests again.
2.12 Scaling conventions

The scale convention used for the tests in this document is IEC 61217. All applicable equipment
must use this scale convention.
Diaphragm Y2
+Y2
+Y1
Diaphragm - X1 + X2 Diaphragm
X1 - X2 + X1 X2
- Y1
- Y2
Leaf X1:1 Leaf X2:1
Diaphragm Y1
005123 ©2013 Elekta Limited
Figure 2.1 IEC 61217 scale convention (projected at isocenter)

Tests
3 Tests
Section Title Page
3.1 Position of the crosswire at isocenter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

3.1.1 Doing a check of the position of the crosswires during rotation of the beam limiting
device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.1.2 Doing a test to check the position of the mechanical isocenter during gantry rotation . . . 17
3.2 X-ray field size and field size display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.2.1 Specification for X-ray field size and field size display . . . . . . . . . . . . . . . . . . . . . . . . . . 19
3.2.2 Doing a test of the X-ray field size and field size display . . . . . . . . . . . . . . . . . . . . . . . . 19
3.3 X-ray depth dose characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.3.1 Specification for data match set up (X-rays) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.3.2 Specification for penetrative quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.3.3 Doing a test of the penetrative quality of the X-rays of a non-matched linear accelerator 22
3.3.4 Description of the test of X-ray penetrative quality on a machine set up for Factory Data
Match . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.3.5 Doing a test of the penetrative quality of the X-rays for Factory Data Match . . . . . . . . . . 23
3.3.6 Description of the test of X-ray penetrative quality on a machine set up for Customer
Data Match . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.3.7 Doing a test of the penetrative quality of the X-rays for Customer Data Match . . . . . . . . 25
3.4 Electron depth dose characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3.4.1 Specification for data match set up (electrons) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3.4.2 Specification for penetrative quality (IEC Standard) . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3.4.3 Specification for penetrative quality (USA procedure) . . . . . . . . . . . . . . . . . . . . . . . . . . 27
3.5 Examining the penetrative quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
3.5.1 Specifications for the depth dose measurements for MLCi2™ and Agility™ . . . . . . . . . . . 28
3.5.2 Doing a test of the penetrative quality of electron radiation (IEC standard) . . . . . . . . . . . 28
3.5.3 Doing a test of the penetrative quality of electron radiation (USA procedure) . . . . . . . . . 28
3.5.4 Results table for the penetrative quality of electron radiation . . . . . . . . . . . . . . . . . . . . 29
3.6 Uniformity of X-ray radiation fields (non-FFF beams) . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.6.1 Specification for the flatness of X-ray radiation fields . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.6.2 Specification for the symmetry of X-ray radiation fields . . . . . . . . . . . . . . . . . . . . . . . . 30
3.6.3 Definition of the flattened area in the uniformity test of X-ray fields . . . . . . . . . . . . . . . 30
3.6.4 Test conditions for the uniformity test of X-ray radiation fields . . . . . . . . . . . . . . . . . . . 31
3.6.5 Doing the uniformity test of X-ray radiation fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
3.7 Uniformity of X-ray radiation fields (FFF beams) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.7.1 Specification for the symmetry of the FFF beams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.7.2 Specification for the beam profile for the FFF beams . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.7.3 Definition of the beam points of measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3.7.4 Doing the uniformity test of the FFF beams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Tests
3.8 High dose rate electron treatment (HDRE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

3.8.1 Test procedure for high dose rate electron treatment (HDRE) . . . . . . . . . . . . . . . . . . . . 37
3.9 Uniformity of electron radiation fields (IEC standard) . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.9.1 Specification for the flatness of electron radiation fields (IEC standard) . . . . . . . . . . . . . 38
3.9.2 Specification for the symmetry of electron radiation fields (IEC standard) . . . . . . . . . . . . 38
3.9.3 Specification of the conditions for the uniformity test of electron radiation fields (IEC
uniformity standard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.9.4 Doing the uniformity test of electron radiation fields (IEC standard) . . . . . . . . . . . . . . . . 39
3.10 Uniformity of electron radiation field (USA procedure) . . . . . . . . . . . . . . . . . . . . . . . . 40
3.10.1 Specification for the flatness and symmetry of electron radiation fields (USA procedure) 40
3.10.2 Specification for the uniformity test of electron radiation fields (USA procedure) . . . . . . 40
3.10.3 Doing the uniformity test of electron radiation fields for MLCi2™ and Agility™ (USA
procedure) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3.11 Certificate of Acceptance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Tests
Position of the crosswire at isocenter
3.1 Position of the crosswire at isocenter

3.1.1 Doing a check of the position of the crosswires during rotation of
the beam limiting device
With full rotation of the beam limiting device, the position of the crosswires must be contained in
a circle with a diameter of:
• 1 mm at 100 cm SSD
• 2 mm at the level of the floor.
1 Use a spirit level and adjust the gantry angle accurately to 0°.
2 Set up the treatment table with the surface of the table top at 100 cm SSD.
3 Attach a sheet of graph paper to the surface of the table top.
4 Rotate the BLD 360° and make a plot on the sheet of graph paper of the position of the
crosswire image.
5 Rotate the treatment table to get a projection of the crosswire image on the floor.
6 Attach a sheet of graph paper to the floor.
7 Rotate the BLD 360° and make a plot on the sheet of graph paper of the position of the
crosswire image.
8 Record the results of the two plots in Table 3.1.
Table 3.1 Position of crosswires during BLD rotation
Crosswire position Limit Measured deviation of the

crosswires
Position of crosswire at 1 mm diameter circle
100 cm SSD 20.00
Position of crosswire at 2 mm diameter circle
floor level
Accepted by:
3.1.2 Doing a test to check the position of the mechanical isocenter

during gantry rotation
At all angles of the gantry, the intersection of the crosswires at 100 cm SSD must stay on the inner
side of a circle with a diameter of 2 mm or less.
1 Set up an external fixed pointer at 100 cm SSD.

2 Align the pointer with the crosswire image to the midpoint at the four cardinal angles.
3 Rotate the gantry 360°.
4 Make a note of the deviation of the crosswire image in relation to the fixed pointer in the A-
B plane and G-T plane at:
– 90°
– 180°

Tests
Position of the crosswire at isocenter
– 270°
– 0°.
5 Record the results in the Table 3.2.
To calculate the vector use the formula that follows:
Vector = (AB) 2 + (GT) 2
Table 3.2 Crosswire deviation during gantry rotation
Deviation at
Limit Deviation A-B Deviation G-T Vector
gantry angle
90° Vector ≤ 2
mm
180°
270°
0°
Accepted by:

Tests
X-ray field size and field size display
3.2 X-ray field size and field size display

3.2.1 Specification for X-ray field size and field size display
The X-ray field edges must align with the displayed diaphragm or leaf position to:
• ±1 mm for field sizes of maximum 20 cm × 20 cm.
• ±1% for larger fields.
The light field edges must align with the X-ray field edges to:
• ±1.0 mm for field sizes from 5 cm × 5 cm to 20 cm × 20 cm.
• ±1% for larger fields.
For film, measurement of the X-ray field edges is from the 50% density point, to the image of the
crosswires at isocenter.
If you use AutoCAL™, AutoCAL™ will control these settings.
3.2.2 Doing a test of the X-ray field size and field size display
1 Set up the prescriptions with applicable field sizes, see Table 3.3.
Note: If you have the AutoCAL™ tool, you can use this to do the tests for MLCi2™ without films. Do not
use AutoCAL™ with Agility™. Make sure that you attach a copy of the test results from AutoCAL™
to each copy of this document.
2 Record the values of the fields in Table 3.4.

3 Set up the films in position at the isocenter.
4 Expose the films, see Table 3.3.
5 Make sure that there is a mark on the films to show the:
– Crosswires
– Light field edges
– A-B and G-T planes.
6 Develop the films and check:
– The X-ray field size
– That the light fields align.
7 In Table 3.4 record the differences between the:
– X-ray to displayed field
– X-ray to light field.
Table 3.3 Field sizes and field size displays for this test
Buildup
Field size Angle of
Beam limiting device Film No. Energy (MV) material
(cm) (X × Y) BLD
(cm)
MLCi2™ and Agility™ 1 10 × 10 0° 4 and 6 2 cm
2 10 × 10 0° 8, 10 and 15 3 cm
3 10 × 10 0° 18 and 25 4 cm

Tests
X-ray field size and field size display
Table 3.4 Results from X-ray field size and field size display tests
X-ray to
Total X-ray
Displayed Measured X- Measured light field
Energy Total field Total light to light
field size Diaphragm ray field edge light field edge
(MV) size (cm) field (cm) difference
(cm) (cm) edge (cm) difference
(cm)
(cm)
X1
X2
Y1
Y2
X1
X2
Y1
Y2
X1
X2
Y1
Y2
Accepted by:

Tests
X-ray depth dose characteristics
3.3 X-ray depth dose characteristics

3.3.1 Specification for data match set up (X-rays)
It is not possible to do a match of linear accelerators that have different BLDs.
Table 3.5 Specification for the set up of X-rays
The percentage depth dose ratio on the radiation beam axis of D10 to Dmax is the nominal energy,
(±1%), to which the group of machines are matched.
Depth dose SSD = 100 cm
Field size:
10 cm × 10 cm for MLCi2™ and Agility™
SSD = 95 cm for 4 MV
SSD = 90 cm for 6 MV and higher energy
Gantry and BLD angles = 0°
Flatness Field size
Depth of probe = 5 cm for 4 MV
10 cm × 10 cm and 30 cm × 30 cm for MLCi2™ and Agility™
Depth of probe = 10 cm for 6 MV and higher energies
Inplane: G-T
Measurement
Crossplane: A-B
direction
Diagonal: TA-GB and GA-TB
Note: Elekta can only match digital accelerators with flattening filter free (FFF) beams at D10 nominal
energy.
3.3.2 Specification for penetrative quality
For X-rays, the penetrative quality is the percentage dose at a depth of 10 cm (D10), measured in
relation to the maximum absorbed dose on the radiation beam axis.

Tests
3.3.3 Doing a test of the penetrative quality of the X-rays of a non-

matched linear accelerator
Is this test applicable to this machine?
Yes, this test is applicable
No, this test is not applicable, and will not be completed.
1 Set up a water phantom with the surface at 100 cm SSD.

2 Set the field size:
– For MLCi2™ and Agility™, the field size is 10 cm × 10 cm.
3 Use a traveling ionization chamber and measure the percentage dose on the radiation beam
axis.
4 Record the results in Table 3.6.
Note: The maximum permitted difference between the actual value and the declared value of
penetrative quality is ±1%.
Table 3.6 Results of depth dose test
Penetrative quality
Radiation Energy Difference (%)
Declared 1 Measured
X-ray X-low 67.5% 67.57 -0.10 %
X-mid %
X-high 73.0% 72.91% 0.10 %
6 MV HDR 67.5% 67.47% 0.04 %
10 MV HDR %
1 See Table 3.7 for the list of declared values.
Table 3.7 Declared values for penetrative quality
Energy level 4 MV 6MV / HDR 8 MV 10 MV / HDR 15 MV 18 MV 25 MV

Depth (D10) 63% 67.5% 71% 73% 76.5% 78.5% 82%
Accepted by: AHMAD SYAFI'I 14th Sept 2023
3.3.4 Description of the test of X-ray penetrative quality on a machine set

up for Factory Data Match
The linear accelerator can be set up to have the same specification and mode of operation as one
or more other Elekta linear accelerators. These can be new or previously installed machines.

Tests
To set up a new machine to operate with a previously installed machine or machines, Elekta uses
the archived factory data from the installed machine or machines.
To set up a new machine, or group of new machines, Elekta uses the current factory data.
Note: Elekta can only match linear accelerators from serial no. 105520.
Note: The type of machine and the type of BLD must be correct for a match. For example, a flattened
profile match is not possible with a MLCi2, but a D10 match is possible.
Note: The maximum permitted difference of penetrative quality of the machine, or group of machines, is
±1% between the measured value and the factory data value.
Note: Elekta can only match linear accelerators with FFF beams at D10 nominal energy.
3.3.5 Doing a test of the penetrative quality of the X-rays for Factory Data
Match
1 Record the serial numbers of the linear accelerators to be matched in Table 3.8.
Table 3.8 Serial no of linear accelerators to be matched
Machine no. Serial no.

1
2
3
4
5
3 Set the field size.
axis.
6 Do steps 2 to 5 again for each of the linear accelerators.

Tests
Table 3.9 Results of X-ray depth dose test
Penetrative quality (D10)

Radiation Energy Measured data of Difference (%)
Factory data of machines to be matched
new machine
1 2 3 4 5
X-ray X-low %
X-mid %
X-high %
6 MV HDR %
10 MV HDR %
Accepted by:
3.3.6 Description of the test of X-ray penetrative quality on a machine set

up for Customer Data Match
The Customer Data Match is the same as the Factory Data Match, but uses new data from
previous installed machines.
To set up a new machine to operate with a previous installed machine or machines, Elekta uses
the factory standards to get the data from the machine to be matched, and then make sure that
the data is in the correct format. The new machine is then set up to match the installed machine
or machines.
The new data from the customer must:
• Give continued compliance to IEC standards.
• Be approved by Elekta.
• Agreed as part of the Contract of Sale.
Note: Elekta can only match linear accelerators from serial no. 105520.
Note: The type of machine and the type of BLD must be correct for a match. For example, a flattened
profile match is not possible between MLCi2™ and Agility™, but a D10 match is possible.
Note: The maximum permitted difference of penetrative quality of the machine, or group of machines, is
±1% between the measured value and the factory data value.
Note: Elekta can only match linear accelerators with FFF beams at D10 nominal energy.

Tests
3.3.7 Doing a test of the penetrative quality of the X-rays for Customer
Data Match
1 Record the serial numbers of the linear accelerators to be matched in Table 3.10.
3 Set the field size.
axis.
6 Do steps 2 to 5 again for each of the linear accelerators.
Table 3.10 Serial no of linear accelerators to be matched
Machine no. Serial no.

1
2
3
4
5
Table 3.11 Results of X-ray depth dose test
Penetrative quality (D10)

Radiation Energy Customer data of machines to be matched Measured data of Difference (%)
1 2 3 4 5 new machine
X-ray X-low %
X-mid %
X-high %
6 MV HDR %
10 MV HDR %
Accepted by:

Tests
Electron depth dose characteristics
3.4 Electron depth dose characteristics

3.4.1 Specification for data match set up (electrons)
It is not possible to do a match of digital accelerators that have different BLDs.
Table 3.12 Specification for the set up of electrons (IEC Standard)
The distal 80% isodose on the radiation beam axis is less than or equal to 1 mm of the average of
the group of machines that are matched. There is no match of electron flatness.
Depth dose SSD = 95 cm
Gantry and BLD angles = 0°
Electron applicator field size = 10 cm × 10 cm
3.4.2 Specification for penetrative quality (IEC Standard)
The specified penetrative quality is the depth where 80% of the maximum absorbed dose on the
radiation beam axis (R80) is obtained.
The energy is specified as E (MeV) = 0.3 × R80 (mm), where R80 is the depth of the 80% relative
dose.
The maximum difference between the actual value and the declared value of penetrative quality,
(see Table 3.13), must not be more than ±1 mm for:
MLCi2™ and Agility™:
• SSD = 95 cm
• Electron applicator with field size = 10 cm × 10 cm.
Table 3.13 Electron radiation penetrative quality

4 MeV 13.3 mm
6 MeV 20 mm
8 MeV 26.7 mm
9 MeV 30 mm
10 MeV 33.3 mm
12 MeV 40 mm
15 MeV 50 mm
18 MeV 60 mm
20 MeV 66.7 mm
22 MeV 1 73.3 mm
Note: The ionization data must be changed to absorbed dose in relation to depth.

Tests
Electron depth dose characteristics
3.4.3 Specification for penetrative quality (USA procedure)
The specified penetrative quality is the depth where you have 80% of the maximum absorbed
dose on the radiation beam axis (R80).
The energy is specified as MeV = 0.3 × R80 (mm), where R80 is the depth of the 80% relative dose.
The maximum difference between the actual value and the declared value of penetrative quality,
see Table 3.14, must not be more than ±1 mm for:
MLCi2™ and Agility™:
• SSD = 100 cm
• Electron applicator with field size = 14 cm × 14 cm.
The TG21/TG25 standards for beam definition cannot be used with the energies in Table 3.14,
because the parts that follow are made for compliance with IEC standards:
• Electron filters
• Primary foils
• Related electron applicators.
Therefore, it is only possible to do the analysis of beam profiles to IEC standards.
Note: In relation to the formulae to calculate the energy, R50 × 2.33 gives a lower value than R80 × 3.0. If
you increase the energy to adjust the difference, this can have an effect on the flatness of the
profile. This is because the filters are designed for compliance with the IEC standard.
Table 3.14 Electron radiation penetrative quality (USA procedure)

4 MeV 13.3 mm
6 MeV 20 mm
8 MeV 26.7 mm
9 MeV 30 mm
10 MeV 33.3 mm
12 MeV 40 mm
15 MeV 50 mm
18 MeV 60 mm
20 MeV 66.7 mm
22 MeV 1 73.3 mm
Note: The ionization data must be changed to absorbed dose in relation to depth.

Tests
Examining the penetrative quality
3.5 Examining the penetrative quality

3.5.1 Specifications for the depth dose measurements for MLCi2™ and
Agility™
Table 3.15 Depth dose measurements MCLi2™ and Agility™
Angular rotation Applicator Nominal dose Nominal energy SSD

(cm) rate
Gantry BLD
0° or 90° 0° 10 × 10 200 or 600 All energies 95
0° or 90° 0° 14 × 14 1 200 or 600 All energies 100
1USA procedure only
3.5.2 Doing a test of the penetrative quality of electron radiation (IEC

standard)
1 Set up a water phantom with its surface at 95 cm SSD.

2 Attach an electron applicator with a field size of 10 cm × 10 cm.
3 Use a traveling ionization chamber, or a semiconductor detector, and measure the relative
dose of ionization in relation to the depth along the radiation beam axis.
4 Do step 2 and step 3 for all available energies.
5 Change the ionization data to absorbed dose in relation to depth.
6 Record the results in the Electron depth dose results table.
Accepted by:
3.5.3 Doing a test of the penetrative quality of electron radiation (USA

procedure)

2 For MLCi2™ and Agility™, attach an electron applicator with a field size of 14 cm × 14 cm.
3 Use a traveling ionization chamber and measure the relative dose of ionization in relation to
the depth along the radiation beam axis.
4 Do step 2 and step 3 for all available energies.
5 Change the ionization data to absorbed dose in relation to depth.
6 Record the results in the Electron depth dose results table.
Accepted by: AHMAD SYAFI'I

13th Sept 2023
Related Links:
Results table for the penetrative quality of electron radiation on page 29
Specifications for the depth dose measurements for MLCi2™ and Agility™ on page 28

Tests
Uniformity of X-ray radiation fields (non-FFF beams)
3.5.4 Results table for the penetrative quality of electron radiation
Table 3.16 Results of electron depth dose
Penetrative quality
(R80) Difference (maximum
Nominal energy
±1 mm)
Declared Measured
4 MeV 13.3 mm NA NA mm
6 MeV 20 mm 19.8 0.20 mm
8 MeV 26.7 mm 26.67 0.03 mm
9 MeV 30 mm NA NA mm
10 MeV 33.3 mm 33.18 0.12 mm
12 MeV 40 mm 39.89 0.11 mm
15 MeV 50 mm 49.87 0.13 mm
18 MeV 60 mm NA NA mm
20 MeV 66.7 mm NA NA mm
22 MeV1 73.3 mm NA NA mm
122 MeV is not available with Agility™.
3.6 Uniformity of X-ray radiation fields (non-FFF beams)

3.6.1 Specification for the flatness of X-ray radiation fields
The flatness of the X-ray fields is the ratio of the maximum absorbed dose in the flattened area, to
the minimum absorbed dose in the flattened area at the standard depth of measurement.
The standard depth of measurement is:
• 5 cm for the 4 MV energy
• 10 cm for all other energies.
Each measured point can be an average of not more than 1 cm2. The ratio must not be more
than:
• MLCi2™ and Agility™:
– 106% for field sizes between 10 cm × 10 cm and 30 cm × 30 cm
– 110% for field sizes greater than 30 cm × 30 cm.
Where:

Tests
3.6.2 Specification for the symmetry of X-ray radiation fields
This is the maximum ratio of the absorbed dose at two points in a flattened area, equidistant
from the center axes measured at the standard depth of measurement.
The depth of measurement is calculated as an average over an area not greater than 1 cm2. The
ratio must not be more than 103%.
Where:
Dleft and Dright are points equidistant from the center axis on the left and right side.
3.6.3 Definition of the flattened area in the uniformity test of X-ray fields
The definition of the flattened area is the area inside a straight line that connect at points on the
major axes and diagonal axes of square fields. (See Table 3.17 and Figure 3.1).
Table 3.17 Definition of flattened area of an X-ray field
Field size F (cm) Dimensions defining the flattened area

Dm (major axes) Dd (diagonal axis)
5 to 10 1 cm 2 cm
10 to 30 0.1 × F 0.2 × F
30 to 35 3 cm 6 cm

Tests
(Dm) 1
3
(Dd)
2
5 1
NOT TO SCALE 000503 ©2012 Elekta Limited
Figure 3.1 X-ray field uniformity measurements
(1) Major axes (4) Flattened area

(2) Contour of 50% absorbed dose on the (5) Field dimensions F
radiation beam axis
(3) Radiation beam axis (6) Nominal edge of the radiation field
3.6.4 Test conditions for the uniformity test of X-ray radiation fields
Table 3.18 Flatness and symmetry test conditions
Type of beam limiting Angular rotation Radiation Absorbed Radiation

device field dose rate type
Gantry BLD
(cm × cm)
MLCi2™ and Agility™ 0° 0° 10 × 10 200 or 600 X-rays
30 × 30

Tests
The maximum size of a square field is 35 cm × 35 cm. Larger fields have round corners. This is
caused by the aperture of the primary collimator, which makes the primary beam the shape of a
circle with a maximum diameter of 50 cm at 100 cm SSD.
3.6.5 Doing the uniformity test of X-ray radiation fields
1 Rotate the gantry to 0° (±0.1°).

2 Rotate the beam limiting device to 0° (±0.1°).
3 Set up a water phantom with SSD:
– 95 cm for 4 MV energy
– 90 cm for 6 MV and higher energies.
4 Set up a field probe ion chamber to a depth of:
– 5 cm (±0.5 mm) for 4 MV energy
– 10 cm (±0.5 mm) for 6 MV and higher energies.
5 Do a scan or step measurement along the major axes of the field.
6 From the results of the dose profiles, calculate the flatness and the symmetry for each test
condition.
7 Record the flatness and symmetry results in Table 3.19 for MLCi2™ and Agility™.
Table 3.19 Results for X-ray flatness and symmetry tests for MLCi2™ and Agility™
Plot type X-low X-mid X-high

(cm × cm) Flatness % Symmetry % Flatness % Symmetry % Flatness % Symmetry %
10 × 10 G-T axis 104.22 100.57 NA NA 104.36 101.71
10 × 10 A-B axis 104.79 100.8 NA NA 104.14 100.5
10 × 10 TA-GB axis 102.59 100.69 NA NA 102.95 102.28
10 × 10 GA-TB axis 103.01 101.06 NA NA 101.89 101.09
30 × 30 G-T axis 103.01 100.58 NA NA 104.35 101.79
30 × 30 A-B axis 103.12 100.75 NA NA 103.43 100.64
30 × 30 TA-GB axis 104.07 100..71 NA NA 103.97 100.99
30 × 30 GA-TB axis 104.35 100.8 NA NA 104.16 101.5
Accepted by: AHMAD SYAFI'I 18th Sept 2023

Tests
Uniformity of X-ray radiation fields (FFF beams)
3.7 Uniformity of X-ray radiation fields (FFF beams)

3.7.1 Specification for the symmetry of the FFF beams
This is the maximum ratio of the absorbed dose measured at points equidistant from the
radiation beam axis up to 80% of the field size.
The ratio must not be more than 103%.
Where:
Dleft and Dright are points equidistant from the center axis on the left and right side.
3.7.2 Specification for the beam profile for the FFF beams
The beam profile is a set of relative dose measurements made at the beam points of
measurement. The relative dose is the ratio of the dose at a given point (Dx) to the dose at the
radiation beam axis (Dcax). The relative dose is shown as a percentage. The relative dose is
measured at points in the radiation field with the photon diode in the isocenter plane at a depth
of 10 cm of water.
100 × Dx
Relative_dose =
Dcax
Table 3.20 Nominal relative dose and tolerances at each field measurement point for the major axes
(6 MV HDR)
Measurement point (distance from CAX as Nominal relative dose Nominal relative dose
a % of the half field width) (%) for a 10 cm × 10 cm (%) for a 30 cm × 30 cm
field size field size
20% 99.0 94.8
50% 94.8 79.4
80% 87.2 64.2
Absolute tolerance (±%) 3 3
Table 3.21 Nominal relative dose and tolerances at each field measurement point for the major axes
(10 MV HDR)
Measurement point (distance from CAX as Nominal relative dose Nominal relative dose
a % of the half field width) (%) for a 10 cm × 10 cm (%) for a 30 cm × 30 cm
field size field size
20% 98.4 90.5
50% 91.7 69.2
80% 81.3 53.1
Absolute tolerance (±%) 3 3

Tests
3.7.3 Definition of the beam points of measurement
For field sizes of 5 cm × 5 cm and larger, examine points along the major axes at 20%, 50% and
80% from the center of the beam axis to the set field edge.
The gray points in Figure 3.2 show the beam points of measurement on the major, and the black
points show the beam points of measurement on the diagonal axis.
H
al
fD
ia
go
na
F
lF
D E
ie
ld
w
id
th
(H
D
FW
)
A = 20% HFW
B = 50% HFW
C = 80% HFW
D = 20% HDFW
A
G E = 50% HDFW
B F = 60% HDFW
C
G = Vertex
Half Field width (HFW)
Figure 3.2 Points of measurement for beam profile shape and symmetry
3.7.4 Doing the uniformity test of the FFF beams
1 Rotate the gantry to 0° (±0.1°).

2 Rotate the beam limiting device to 0° (±0.1°).
3 Set up a water phantom with 90 cm SSD for 6 MV and higher energies.
4 Set up a field probe photon diode to a depth of 10 cm (±0.5 mm) for 6 MV and higher
energies.
5 Do a scan or step measurement along the major axes of the field.
6 From the results of the dose profiles, calculate the beam profile for each test condition.
The figure below Figure 3.3 shows the parameters measured for a 40 cm × 40 cm field.

Tests
In-field evaluation points
Field edge
Penumbra
Figure 3.3 Example of a beam profile for an FFF beam

7 Record the results of the beam profiles in Table 3.22 and Table 3.23.
Table 3.22 Results for uniformity test (6 MV HDR)
Measurement point Nominal relative dose (%) for each test field size
distance from CAX as a %
10 cm × 10 cm 30 cm × 30 cm
of the half field width
L R Avg L R Avg
20% G-T axis 99.2 99.2 99.2 94.71 95 94.86
A-B axis 99.32 99.05 99.19 95.25 95.04 95.15
50% G-T axis 94.92 95.46 95.19 79.35 80.01 79.68
A-B axis 95.16 95.01 95.09 79.43 79.6 79.52
80% G-T axis 87.29 87.71 87.50 64.27 64.76 64.52
A-B axis 87.01 86.99 87.00 64.32 64.54 64.43
Symmetry G-T axis 100.80 101.63
Symmetry A-B axis 100.62 101.05

Tests
Table 3.23 Results for uniformity test (10 MV HDR)
Measurement point Nominal relative dose (%) for each test field size
distance from CAX as a %
10 cm × 10 cm 30 cm × 30 cm
of the half field width
L R Avg L R Avg
20% G-T axis NA NA NA NA NA NA
A-B axis NA NA NA NA NA NA
Symmetry G-T axis NA NA
Symmetry A-B axis NA NA
Accepted by: NA

Tests
High dose rate electron treatment (HDRE)
3.8 High dose rate electron treatment (HDRE)

3.8.1 Test procedure for high dose rate electron treatment (HDRE)
1 Log on to the control system.

2 Select Clinical Mode.
3 Use the iCom test harness or MOSAIQ™ sequencer and send an HDRE beam to the Receive
External Prescription (REP) window.
4 Go in to the treatment room and install the HDRE dedicated electron applicator.
5 Come out of the treatment room, and complete the treatment interlocks.
6 Inhibit 572 appears on the screen.
7 Use the special HDRE key switch, and select HDRE Authorize.
8 Inhibit 572 is replaced with a door inhibit.
9 Use the special HDRE key switch, and select HDRE Enable.
You continue to hear a warning until the attenuator is in position and complete the last
interlock.
10 If you use the iCom test harness, click the Confirm Settings button.
11 Deliver radiation to normal termination.
12 Confirm that the maximum dose rate does not exceed 300 MU/min for each HDRE energy.
13 Deliver a radiation beam at the maximum dose rate of 300 MU/min and record the actual
does rate for each applicable HDRE energy.
14 Record the configured energy and dose rate for each HDRE energy in Table 3.24.
Table 3.24 Maximum dose rate
HDRE energy Dose rate

HDRE 1 MU/min
HDRE 2 MU/min
Accepted by:

Tests
Uniformity of electron radiation fields (IEC standard)
3.9 Uniformity of electron radiation fields (IEC standard)

3.9.1 Specification for the flatness of electron radiation fields (IEC
standard)
The maximum distance between the 90% isodose profiles and the edges of the geometrical field
(defined by the 50% isodose) at 95 cm SSD at the standard depth of measurement. This distance
must not be more than 10 mm along the major axes.
The ratio of the maximum absorbed dose at two points in a radiation field related to the
absorbed dose on the axis of the beam, must not be more than 103%.
Where:
3.9.2 Specification for the symmetry of electron radiation fields (IEC

standard)
This is the ratio of the absorbed dose, at two points in a symmetrical position, in relation to the
beam axis more than 1 cm on the inner side of the 90% isodose profile.
At the standard depth of measurement and the calculated average for an area not greater than
1 cm2, the ratio must not be more than 103%.
Where:
3.9.3 Specification of the conditions for the uniformity test of electron

radiation fields (IEC uniformity standard)
Table 3.25 Conditions for the electron radiation uniformity test
Angular rotation Nominal dose

Radiation type Nominal energy MeV
Gantry BLD rate
0° 0° 200 or 600 Electrons Highest available

Lowest available

Tests
Uniformity of electron radiation fields (IEC standard)
3.9.4 Doing the uniformity test of electron radiation fields (IEC standard)
In this test, make measurements with:

• The highest and lowest available levels of energy
• The smallest and largest available size of electron applicator.
Note: If you adjust the Autotracking values from the default settings during installation, you must
measure the electron applicator average radiation leakage. See Appendix B - Measuring the
electron applicator average radiation leakage.

2 Use an electron diode and do a scan or step measurement along the major axes of the field.
3 On each plot, identify the 50% points with relation to the beam axis point (see Figure 3.4).
The 50% point is the definition of the geometrical edges of the radiation field.
4 On each plot on the major axes, make sure that the 90% points are <10 mm from the
geometric edges.
5 On each plot, make sure that no point in the radiation field is greater than 103% of the beam
axis point.
6 On each plot, examine the pairs of symmetrical points in the area 1 cm on the inner side of
the 90% points (dimension a on Figure 3.4) to make sure that the symmetry ratio is not more
than 103%.
a 90%
Distance a = (d1-1 cm) + (d2-1 cm)
Distance b = geometric field size
50%
d1 d2
b
Figure 3.4 Electron flatness and symmetry points of measurement (IEC standard)
7 Record the results of the flatness and symmetry tests in Table 3.26 and Table 3.27.
Table 3.26 Results for electron flatness and symmetry test (energy level high)
Energy level Applicator size Flatness

Plot direction Symmetry %
(E-High) (cm × cm) Dmax% -(50%- 90%) +(50%-90%)
A-B axis
G-T axis
A-B axis
G-T axis

Tests
Uniformity of electron radiation field (USA procedure)
Table 3.27 Results for electron flatness and symmetry test (energy level low)
Energy level Applicator size Flatness Symmetry %

Plot direction
(E-Low) (cm × cm) Dmax% -(50%- 90%) +(50%-90%)
A-B axis
G-T axis
A-B axis
G-T axis
Accepted by:
3.10 Uniformity of electron radiation field (USA procedure)

3.10.1 Specification for the flatness and symmetry of electron radiation
fields (USA procedure)
The ratio of the maximum absorbed dose, or the minimum absorbed dose to the average
absorbed dose, must not be more than ±5%. This measurement is made across the middle 80% of
the geometrical field size (defined by 50% isodose).
Where:
Field size = 10 cm × 10 cm to 25 cm × 25 cm
(MaxDose + MinDose)
Average =
2
The average percentage difference between the absorbed dose of each half of the radiation field
must not be different by more than 2%. This measurement is made across distances d1 and d2.
3.10.2 Specification for the uniformity test of electron radiation fields (USA
procedure)
Table 3.28 Conditions for the electron radiation uniformity test
Angular rotation Nominal dose

Radiation type Nominal energy MeV
Gantry BLD rate
0° 0° 200 or 600 Electrons Highest available

Lowest available

Tests
Uniformity of electron radiation field (USA procedure)
3.10.3 Doing the uniformity test of electron radiation fields for MLCi2™
and Agility™ (USA procedure)
Make two measurements on the major axes, with different levels of energy and the largest
available electron applicator.
Note: If you adjust the Autotracking values from the default settings during installation, you must
measure the electron applicator average radiation leakage. See Appendix B - Measuring the
electron applicator average radiation leakage.

2 Use an ionization chamber, and do a scan or step measurement along the major axes of the
field.
Where the:
Scan depth = R85/2 (measurement from radiation axis depth dose plot)
3 Do the field symmetry check across the distance a. See Figure 3.5.
a 90%
Distance a = 80% of distance b
Distance b = geometric field size
Distance d1 = d2 = ½ distance a
50%
d1 d2
b
Figure 3.5 Electron flatness and symmetry points of measurement

4 Record the results of the flatness and symmetry in Table 3.29.
Table 3.29 Results of the uniformity of electron radiation field test
Applicator size
Energy level Plot direction Flatness % Symmetry %
(cm × cm)
6 MeV 20 x 20 A-B 105.11 100.11
6 MeV 20 x 20 G-T 104.77 100.77
8 MeV 20 x 20 A-B 105.47 100.26
8 MeV 20 x 20 G-T 105.59 101.61
Accepted by: AHMAD SYAFI'I

19th Sept 2023
10 MeV 20 x 20 A-B 104.92 100.28

10 MeV 20 x 20 G-T 104.97 100.97
12 MeV 20 x 20 A-B 104.81 100.42
12 MeV 20 x 20 G-T 104.53 100.91
15 MeV 20 x 20 A-B 104.36 100.21
15 MeV 20 x 20 G-T 104.78 101.12

Tests
Certificate of Acceptance
3.11 Certificate of Acceptance
The installation and commissioning of the Elekta products were completed. The applicable tests in the customer
acceptance test (CAT) plan were completed in compliance with the specification. A user manual (Instructions for
Use) was supplied.
Elekta Harmony ✔ Elekta Infinity™

Elekta Harmony Pro Elekta Axesse™
Elekta Synergy® Platform Versa HD™
Elekta Synergy®
Serial No. of the linear accelerator:
156788
Hospital: (block capitals)

RSPAL DR. RAMELAN NAVY HOSPITAL
Address: (block capitals in full)

JL. GADUNG NO. 1-2 SURABAYA
Country: (block capitals in full)
INDONESIA
Name: AHMAD SYAFI'I Signature:

Date: 20 SEPT 2023 Hospital Representative
Name: PRIHASDI ADHITYA

Date: 20 SEPT 2023 Signature: Elekta Representative
If the Customer Acceptance Tests are completed using an electronic Customer Acceptance Tests
(CAT) document, upload the approved electronic document to the Elekta Customer Lifecycle
Management (CLM) system for equipment registration.
For Customer Acceptance Tests using hardcopies, the BU or Distributor keeps two copies, and the
customer keeps one copy. A copy of the approved Certificate of Acceptance is uploaded to the
CLM for equipment registration.

Appendix A - iCom Customer Acceptance program
4 Appendix A - iCom Customer Acceptance

program
Section Title Page
4.1 Using the iCom Customer Acceptance program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

— Blank page —

Using the iCom Customer Acceptance program
4.1 Using the iCom Customer Acceptance program

This is a test to show that the connection between the external R&V system and the linear
accelerator operates correctly.
Refer to the iCom Interface Information manual for information on how to use the iCom Customer
Acceptance Test program.
Note: Do not use this procedure for the treatment of patients.
1 Log on in Clinical Mode.

2 Make sure that the linear accelerator is set up in Receive External Prescriptions mode.
3 Log on to the iCom CAT program.
4 Select a standard prescription.
5 If necessary, change the text in the prescription file.
6 Click Send Field.
7 Make sure that the linear accelerator is set up correctly.
8 Click Confirm Settings.
The linear accelerator goes in to the Ready to Start machine state.
9 On the console, press the START button.
10 Make sure that the treatment continues on the Vx display in the iCom CAT window.
11 At the end of the treatment, click Clear Field to remove the treatment settings from the
linear accelerator.
12 Make sure that the prescription transfers correctly.
Accepted by:

Using the iCom Customer Acceptance program
— Blank page —

Appendix B - Measuring the electron applicator average radiation leakage
5 Appendix B - Measuring the electron applicator

average radiation leakage
Section Title Page
5.1 Description of measuring the electron applicator average radiation leakage . . . . . . . . . 49

5.2 Measuring the electron applicator average radiation leakage . . . . . . . . . . . . . . . . . . . 50
5.3 Auto tracking leakage tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
5.3.1 Measurement points for a 6 cm x 6 cm square applicator . . . . . . . . . . . . . . . . . . . . . . . 54
5.3.2 Measurement points for a 10 cm x 10 cm square applicator . . . . . . . . . . . . . . . . . . . . . 55
5.3.6 Measurement points for a 20 cm x 10 cm rectangular applicator . . . . . . . . . . . . . . . . . . 59
5.3.7 Measurement points for a 16 cm x 8 cm rectangular applicator . . . . . . . . . . . . . . . . . . . 60

— Blank page —

Description of measuring the electron applicator average radiation leakage
5.1 Description of measuring the electron applicator average

radiation leakage
This site test is in compliance with IEC 60601-2-1 safety standard requirement for average leakage
in
• Area M/M10 Clause 201.10.1.2.103.2.2 (IEC 60601-2-1:2009+Amd1:2014), “Leakage
Radiation through beam limiting devices - Electron radiation”.
Do this site test for all electron energies and electron applicators where the values of the
autotracking settings are greater than the default values that Elekta supplies (see IFSN
20001103073).
For the applicable IEC limits for average leakage in the patient plane see Table 5.1. The average
limits are for energies that are available for Elekta digital accelerators (see Figure 5.1).
Table 5.1 Limits of average leakage radiation inside the patient plane
Nominal Energy (MeV) Average Leakage Limit (%)

4.0 1.00
6.0 1.00
8.0 1.00
9.0 1.00
10.0 1.00
12.0 1.06
15.0 1.16
18.0 1.26
20.0 1.32
22.0 1.38

Measuring the electron applicator average radiation leakage
2,0
1,5
Average %
LEAKAGE
RADIATION
1,0
0,5
0
0 5 10 15 20 25 30 35 40 45 50 55
ELECTRON ENERGY MeV
IEC 817/98
000249_001
Figure 5.1 Limits of leakage radiation through the beam limiting devices during electron radiation
(reported from IEC 60601-2-1:1:2009 + Amd1:2014)
Note: Do the measurements in air with a 1 cm buildup cap, in compliance with the IEC standard. This
prevents the effects of scattered radiation from the phantom on the measured radiation leakage.
Note: If no applicable buildup cap is available, do the measurements in water at a depth of one cm.
Note that the IEC limits do not include the scattered radiation from the phantom.
5.2 Measuring the electron applicator average radiation

leakage
1 Log on to Service Mode.

2 Click Deliver Quick Beam.
3 Select Interlock Group 7.
4 Set the gantry to 0°.
5 Set the BLD to 0°.
6 Attach the electron applicator for which the Autotracking settings are changed.
7 Set-up a water phantom that is correct for 3D dose measurements (with a scanning volume
of approximately 500 mm x 500 mm x 400 mm) with an electron diode.
8 Put the phantom surface at the normal treatment distance of 95 cm.
9 Make sure that the electron applicator is immediately out of contact with the water surface.
Note: The 20 cm × 6 mm applicator is a short applicator and measured with SSD 95 cm, and is not close
to the water surface.
10 Select the electron energy that agrees with the changed settings.

11 Start the radiation.

12 Do a depth dose scan and find the position of dose maximum (Dmax) on the center axis.
13 Measure the maximum absorbed dose at the depth of dose maximum (Dmax) on the center
axis.
Use this value as the 100% normalization point for the subsequent measurements of leakage
dose.
14 Terminate the radiation.
15 Empty the water from the phantom.
16 Install the electron diode with a 1 cm tissue equivalent buildup cap.
17 Put the diode on the center axis, with the top surface of the buildup at the usual treatment
distance of 95 cm.
18 Make sure that there is a sufficient clearance between the buildup cap and the electron
applicator.
This prevents the collision of the diode and the electron applicator during a scan.
19 Start the radiation.
20 Do the diode measurements in air (with one cm buildup) in the horizontal plane along four
directions that follow.
– in-line
– cross-line
– two diagonal lines at 45°
21 Do these measurements at two cm intervals along eight line segments. This is from points
five cm out of the peripheral of the geometric radiation field (5 × √2 cm on the diagonals) to
the boundary defined by the IEC standard (see Figure 5.2).

000248_001
Figure 5.2 Measurement points for averaging leakage radiation during electron irradiation
(reported from IEC 60601-2-1:1998 + A1:2002 and :2009 editions)
22 The specified measurement positions are in the Autotracking leakage tests for each electron
applicator.
23 Terminate the radiation.
24 Calculate the average value DLE of all the diode measurements (sum of all measured values
divided by the total number of measurements).
25 Calculate the DLE as a percentage of the maximum absorbed dose on the center axis
(measured in water at step 13 ) and record it in Table 5.2.
Table 5.2 Electron radiation Average Leakage inside the patient plane as a percentage of Dmax
Applicator Size (cm x cm) Electron Energy (MeV) Average Leakage (% wrt
Dmax)

Auto tracking leakage tests
Applicator Size (cm x cm) Electron Energy (MeV) Average Leakage (% wrt
Dmax)
5.3 Auto tracking leakage tests

5.3.1 Measurement points for a 6 cm x 6 cm square applicator
Page 54
Table 5.3 Measurement points for a 6 cm x 6 cm square applicator
Inline (GT) Crossline (AB) D1 (AGBT) D2 (GBAT)

6 cm × 6 cm
X (mm) Y (mm) X (mm) Y (mm) X (mm) Y (mm) Vector X (mm) Y (mm) Vector

L1 240.0 0.0 0.0 240.0

L2 220.0 0.0 0.0 220.0
L3 200.0 0.0 0.0 200.0 164.9 164.9 233.1 164.9 -164.9 233.1
L4 180.0 0.0 0.0 180.0 150.7 150.7 213.1 150.7 -150.7 213.1
L5 160.0 0.0 0.0 160.0 136.6 136.6 193.1 136.6 -136.6 193.1
L6 140.0 0.0 0.0 140.0 122.4 122.4 173.1 122.4 -122.4 173.1
L7 120.0 0.0 0.0 120.0 108.3 108.3 153.1 108.3 -108.3 153.1
L8 100.0 0.0 0.0 100.0 94.1 94.1 133.1 94.1 -94.1 133.1
L9 80.0 0.0 0.0 80.0 80.0 80.0 113.1 80.0 -80.0 113.1
L10 -80.0 0.0 0.0 -80.0 -80.0 -80.0 -113.1 -80.0 80.0 -113.1
L11 -100.0 0.0 0.0 -100.0 -94.1 -94.1 -133.1 -94.1 94.1 -133.1
L12 -120.0 0.0 0.0 -120.0 -108.3 -108.3 -153.1 -108.3 108.3 -153.1
L13 -140.0 0.0 0.0 -140.0 -122.4 -122.4 -173.1 -122.4 122.4 -173.1
L14 -160.0 0.0 0.0 -160.0 -136.6 -136.6 -193.1 -136.6 136.6 -193.1
L15 -180.0 0.0 0.0 -180.0 -150.7 -150.7 -213.1 -150.7 150.7 -213.1
L16 -200.0 0.0 0.0 -200.0 -164.9 -164.9 -233.1 -164.9 164.9 -233.1
L17 -220.0 0.0 0.0 -220.0
L18 -240.0 0.0 0.0 -240.0

© Elekta Group 2020. All rights reserved.
10 cm × Inline (GT) Crossline (AB) D1 (AGBT) D2 (GBAT)

10 cm X (mm) Y (mm) X (mm) Y (mm) X (mm) Y (mm) Vector X (mm) Y (mm) Vector

L1 240.0 0.0 0.0 240.0

L2 220.0 0.0 0.0 220.0
L3 200.0 0.0 0.0 200.0 170.7 170.7 241.4 170.7 -170.7 241.4

L4 180.0 0.0 0.0 180.0 156.6 156.6 221.4 156.6 -156.6 221.4
L5 160.0 0.0 0.0 160.0 142.4 142.4 201.4 142.4 -142.4 201.4
L6 140.0 0.0 0.0 140.0 128.3 128.3 181.4 128.3 -128.3 181.4
L7 120.0 0.0 0.0 120.0 114.1 114.1 161.4 114.1 -114.1 161.4
L8 100.0 0.0 0.0 100.0 100.0 100.0 141.4 100.0 -100.0 141.4
L9 -100.0 0.0 0.0 -100.0 -100.0 -100.0 -141.4 -100.0 100.0 -141.4
L10 -120.0 0.0 0.0 -120.0 -114.1 -114.1 -161.4 -114.1 114.1 -161.4
L11 -140.0 0.0 0.0 -140.0 -128.3 -128.3 -181.4 -128.3 128.3 -181.4
L12 -160.0 0.0 0.0 -160.0 -142.4 -142.4 -201.4 -142.4 142.4 -201.4
L13 -180.0 0.0 0.0 -180.0 -156.6 -156.6 -221.4 -156.6 156.6 -221.4
L14 -200.0 0.0 0.0 -200.0 -170.7 -170.7 -241.4 -170.7 170.7 -241.4
L15 -220.0 0.0 0.0 -220.0
L16 -240.0 0.0 0.0 -240.0
Page 55
Page 56

14 cm
X (mm) Y (mm) X (mm) Y (mm) X(mm) Y(mm) Vector X (mm) Y(mm) Vector

L1 240.0 0.0 0.0 240.0

L2 220.0 0.0 0.0 220.0
L3 200.0 0.0 0.0 200.0 176.6 176.6 249.7 176.6 -176.6 249.7
L4 180.0 0.0 0.0 180.0 162.4 162.4 229.7 162.4 -162.4 229.7
L5 160.0 0.0 0.0 160.0 148.3 148.3 209.7 148.3 -148.3 209.7
L6 140.0 0.0 0.0 140.0 134.1 134.1 189.7 134.1 -134.1 189.7
L7 120.0 0.0 0.0 120.0 120.0 120.0 169.7 120.0 -120.0 169.7
L8 -120.0 0.0 0.0 -120.0 -120.0 -120.0 -169.7 -120.0 120.0 -169.7
L9 -140.0 0.0 0.0 -140.0 -134.1 -134.1 -189.7 -134.1 134.1 -189.7
L10 -160.0 0.0 0.0 -160.0 -148.3 -148.3 -209.7 -148.3 148.3 -209.7
L11 -180.0 0.0 0.0 -180.0 -162.4 -162.4 -229.7 -162.4 162.4 -229.7
L12 -200.0 0.0 0.0 -200.0 -176.6 -176.6 -249.7 -176.6 176.6 -249.7
L13 -220.0 0.0 0.0 -220.0
L14 -240.0 0.0 0.0 -240.0


20 cm

L1 250.0 0.0 0.0 250.0

L2 230.0 0.0 0.0 230.0
L3 210.0 0.0 0.0 210.0 192.4 192.4 272.1 192.4 -192.4 272.1

L4 190.0 0.0 0.0 190.0 178.3 178.3 252.1 178.3 -178.3 252.1
L5 170.0 0.0 0.0 170.0 164.1 164.1 232.1 164.1 -164.1 232.1
L6 150.0 0.0 0.0 150.0 150.0 150.0 212.1 150.0 -150.0 212.1
L7 -150.0 0.0 0.0 -150.0 -150.0 -150.0 -212.1 -150.0 150.0 -212.1
L8 -170.0 0.0 0.0 -170.0 -164.1 -164.1 -232.1 -164.1 164.1 -232.1
L9 -190.0 0.0 0.0 -190.0 -178.3 -178.3 -252.1 -178.3 178.3 -252.1
L10 -210.0 0.0 0.0 -210.0 -192.4 -192.4 -272.1 -192.4 192.4 -272.1
L11 -230.0 0.0 0.0 -230.0
L12 -250.0 0.0 0.0 -250.0
Page 57
Page 58

25 cm

L1 235.0 0.0 0.0 235.0 217.4 217.4 307.5 217.4 -217.4 307.5
L2 215.0 0.0 0.0 215.0 203.3 203.3 287.5 203.3 -203.3 287.5
L3 195.0 0.0 0.0 195.0 189.1 189.1 267.5 189.1 -189.1 267.5
L4 175.0 0.0 0.0 175.0 175.0 175.0 247.5 175.0 -175.0 247.5
L5 -175.0 0.0 0.0 -175.0 -175.0 -175.0 -247.5 -175.0 175.0 -247.5
L6 -195.0 0.0 0.0 -195.0 -189.1 -189.1 -267.5 -189.1 189.1 -267.5
L7 -215.0 0.0 0.0 -215.0 -203.3 -203.3 -287.5 -203.3 203.3 -287.5
L8 -235.0 0.0 0.0 -235.0 -217.4 -217.4 -307.5 -217.4 217.4 -307.5

5.3.6 Measurement points for a 20 cm x 10 cm rectangular applicator
Table 5.8 Measurement points for a 20 cm x 10 cm rectangular applicator

10 cm
X (mm) Y (mm) X (mm) Y (mm) X(mm) Y(mm) Vector X (mm) Y(mm) Vector

L1 240.0 0.0 0.0 250.0

L2 220.0 0.0 0.0 230.0
L3 200.0 0.0 0.0 210.0 170.7 170.7 241.4 170.7 -170.7 241.4

L4 180.0 0.0 0.0 190.0 156.6 156.6 221.4 156.6 -156.6 221.4
L5 160.0 0.0 0.0 170.0 142.4 142.4 201.4 142.4 -142.4 201.4
L6 140.0 0.0 0.0 150.0 128.3 128.3 181.4 128.3 -128.3 181.4
L7 120.0 0.0 0.0 -150.0 114.1 114.1 161.4 114.1 -114.1 161.4
L8 100.0 0.0 0.0 -170.0 100.0 100.0 141.4 100.0 -100.0 141.4
L9 -100.0 0.0 0.0 -190.0 -100.0 -100.0 -141.4 -100.0 100.0 -141.4
L10 -120.0 0.0 0.0 -210.0 -114.1 -114.1 -161.4 -114.1 114.1 -161.4
L11 -140.0 0.0 0.0 -230.0 -128.3 -128.3 -181.4 -128.3 128.3 -181.4
L12 -160.0 0.0 0.0 -250.0 -142.4 -142.4 -201.4 -142.4 142.4 -201.4
L13 -180.0 0.0 0.0 -156.6 -156.6 -221.4 -156.6 156.6 -221.4
L14 -200.0 0.0 0.0 -170.7 -170.7 -241.4 -170.7 170.7 -241.4
L15 -220.0 0.0 0.0
L16 -240.0 0.0 0.0
Page 59
Page 60

8 cm

L1 250.0 0.0 0.0 250.0

L2 230.0 0.0 0.0 230.0
L3 210.0 0.0 0.0 210.0 174.9 174.9 247.3 174.9 -174.9 247.3
L4 190.0 0.0 0.0 190.0 160.7 160.7 227.3 160.7 -160.7 227.3
L5 170.0 0.0 0.0 170.0 146.6 146.6 207.3 146.6 -146.6 207.3
L6 150.0 0.0 0.0 150.0 132.4 132.4 187.3 132.4 -132.4 187.3
L7 130.0 0.0 0.0 130.0 118.3 118.3 167.3 118.3 -118.3 167.3
L8 110.0 0.0 0.0 -130.0 104.1 104.1 147.3 104.1 -104.1 147.3
L9 90.0 0.0 0.0 -150.0 90.0 90.0 127.3 90.0 -90.0 127.3
L10 -90.0 0.0 0.0 -170.0 -90.0 -90.0 -127.3 -90.0 90.0 -127.3
L11 -110.0 0.0 0.0 -190.0 -104.1 -104.1 -147.3 -104.1 104.1 -147.3
L12 -130.0 0.0 0.0 -210.0 -118.3 -118.3 -167.3 -118.3 118.3 -167.3
L13 -150.0 0.0 0.0 -230.0 -132.4 -132.4 -187.3 -132.4 132.4 -187.3
L14 -170.0 0.0 0.0 -250.0 -146.6 -146.6 -207.3 -146.6 146.6 -207.3
L15 -190.0 0.0 -160.7 -160.7 -227.3 -160.7 160.7 -227.3
L16 -210.0 0.0 -174.9 -174.9 -247.3 -174.9 174.9 -247.3
L17 -230.0 0.0
L18 -250.0 0.0


6 cm

L1 240.0 0.0 0.0 240.0

L2 220.0 0.0 0.0 220.0
L3 200.0 0.0 0.0 200.0 164.9 164.9 233.1 164.9 -164.9 233.1

L4 180.0 0.0 0.0 180.0 150.7 150.7 213.1 150.7 -150.7 213.1
L5 160.0 0.0 0.0 160.0 136.6 136.6 193.1 136.6 -136.6 193.1
L6 140.0 0.0 0.0 140.0 122.4 122.4 173.1 122.4 -122.4 173.1
L7 120.0 0.0 0.0 120.0 108.3 108.3 153.1 108.3 -108.3 153.1
L8 100.0 0.0 0.0 100.0 94.1 94.1 133.1 94.1 -94.1 133.1
L9 80.0 0.0 0.0 -100.0 80.0 80.0 113.1 80.0 -80.0 113.1
L10 -80.0 0.0 0.0 -120.0 -80.0 -80.0 -113.1 -80.0 80.0 -113.1
L11 -100.0 0.0 0.0 -140.0 -94.1 -94.1 -133.1 -94.1 94.1 -133.1
L12 -120.0 0.0 0.0 -160.0 -108.3 -108.3 -153.1 -108.3 108.3 -153.1
L13 -140.0 0.0 0.0 -180.0 -122.4 -122.4 -173.1 -122.4 122.4 -173.1
L14 -160.0 0.0 0.0 -200.0 -136.6 -136.6 -193.1 -136.6 136.6 -193.1
L15 -180.0 0.0 0.0 -220.0 -150.7 -150.7 -213.1 -150.7 150.7 -213.1
L16 -200.0 0.0 0.0 -240.0 -164.9 -164.9 -233.1 -164.9 164.9 -233.1
L17 -220.0 0.0
L18 -240.0 0.0
Page 61
Page 62

6 cm

L1 240.0 0.0 0.0 240.0

L2 220.0 0.0 0.0 220.0
L3 200.0 0.0 0.0 200.0 164.9 164.9 233.1 164.9 -164.9 233.1
L4 180.0 0.0 0.0 180.0 150.7 150.7 213.1 150.7 -150.7 213.1
L5 160.0 0.0 0.0 160.0 136.6 136.6 193.1 136.6 -136.6 193.1
L6 140.0 0.0 0.0 140.0 122.4 122.4 173.1 122.4 -122.4 173.1
L7 120.0 0.0 0.0 120.0 108.3 108.3 153.1 108.3 -108.3 153.1
L8 100.0 0.0 0.0 -120.0 94.1 94.1 133.1 94.1 -94.1 133.1
L9 80.0 0.0 0.0 -140.0 80.0 80.0 113.1 80.0 -80.0 113.1
L10 -80.0 0.0 0.0 -160.0 -80.0 -80.0 -113.1 -80.0 80.0 -113.1
L11 -100.0 0.0 0.0 -180.0 -94.1 -94.1 -133.1 -94.1 94.1 -133.1
L12 -120.0 0.0 0.0 -200.0 -108.3 -108.3 -153.1 -108.3 108.3 -153.1
L13 -140.0 0.0 0.0 -220.0 -122.4 -122.4 -173.1 -122.4 122.4 -173.1
L14 -160.0 0.0 0.0 -240.0 -136.6 -136.6 -193.1 -136.6 136.6 -193.1
L15 -180.0 0.0 -150.7 -150.7 -213.1 -150.7 150.7 -213.1
L16 -200.0 0.0 -164.9 -164.9 -233.1 -164.9 164.9 -233.1
L17 -220.0 0.0
L18 -240.0 0.0


6 cm

L1 244.8 0.0

L2 224.8 0.0 0.0 246.0 169.6 169.6 239.9 169.6 -169.6 239.9
L3 204.8 0.0 0.0 226.0 155.5 155.5 219.9 155.5 -155.5 219.9

L4 184.8 0.0 0.0 206.0 141.3 141.3 199.8 141.3 -141.3 199.9
L5 164.8 0.0 0.0 186.0 127.2 127.2 179.8 127.2 -127.2 179.9
L6 144.8 0.0 0.0 166.0 113.0 113.0 159.8 113.0 -113.0 159.9
L7 124.8 0.0 0.0 -166.0 98.9 98.9 139.8 98.9 -98.9 139.9
L8 104.8 0.0 0.0 -186.0 84.8 84.8 119.9 84.8 -84.8 119.9
L9 84.8 0.0 0.0 -206.0 -84.8 -84.8 -119.9 -84.8 84.8 -119.9
L10 -84.8 0.0 0.0 -226.0 -98.9 -98.9 -139.8 -98.9 98.9 -139.9
L11 -104.8 0.0 0.0 -246.0 -113.0 -113.0 -159.8 -113.0 113.0 -159.9
L12 -124.8 0.0 -127.2 -127.2 -179.8 -127.2 127.2 -179.9
L13 -144.8 0.0 -141.3 -141.3 -199.8 -141.3 141.3 -199.9
L14 -164.8 0.0 -155.5 -155.5 -219.9 -155.5 155.5 -219.9
L15 -184.8 0.0 -169.6 -169.6 -239.9 -169.6 169.6 -239.9
L16 -204.8 0.0
L17 -224.8 0.0
L18 -244.8 0.0
Page 63
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Technical Publication

Elekta Medical Linear Accelerator

Document ID: 1503568_12

Acknowledgement of other trademarks

Worldwide product manufacturing centers - Oncology

Elekta Beijing Medical Systems Co., Ltd.

For technical help, contact your local Elekta representative

Document ID: 1503568_12 Elekta Medical Linear Accelerator

2 Description of customer acceptance tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

4 Appendix A - iCom Customer Acceptance program . . . . . . . . . . . . . . . . . . . . 43

5 Appendix B - Measuring the electron applicator average radiation leakage 47

Elekta Medical Linear Accelerator Document ID: 1503568_12

Document ID: 1503568_12 Elekta Medical Linear Accelerator

1.1 Document scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Elekta Medical Linear Accelerator Document ID: 1503568_12

Document ID: 1503568_12 Elekta Medical Linear Accelerator

1.1 Document scope

1.2 Equipment registration

Elekta Medical Linear Accelerator Document ID: 1503568_12

Document ID: 1503568_12 Elekta Medical Linear Accelerator

2 Description of customer acceptance tests

2.1 Description of the available energies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Elekta Medical Linear Accelerator Document ID: 1503568_12

Document ID: 1503568_12 Elekta Medical Linear Accelerator

2.1 Description of the available energies

X-ray Electron energy

2.2 Tools and test equipment

• A spirit level (≤0.30 mm/1m)

Note: Do not use AutoCAL™ to do the tests on machines with Agility™.

Elekta Medical Linear Accelerator Document ID: 1503568_12

2.3 Description of the operating environment

2.4 Description of the standard gantry angles during the tests

2.5 Description of the properties and position of the water

2.6 Description of the depths of measurement for X-ray beams

2.7 Description of the depths of measurement for electron

Document ID: 1503568_12 Elekta Medical Linear Accelerator

For USA procedure, measurements in the electron beam is at 100 cm SSD.

Table 2.1 Electron radiation penetrative quality (IEC standard)

Energy Level Depth of 80% dose

2.8 Description of radiation detectors used in tests

2.9 Description of tests with X-ray films

2.10 Description of tests with AutoCAL™

Elekta Medical Linear Accelerator Document ID: 1503568_12

2.11 Adjustments during test

2.12 Scaling conventions

Figure 2.1 IEC 61217 scale convention (projected at isocenter)

Document ID: 1503568_12 Elekta Medical Linear Accelerator

3.1 Position of the crosswire at isocenter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Elekta Medical Linear Accelerator Document ID: 1503568_12

3.8 High dose rate electron treatment (HDRE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Document ID: 1503568_12 Elekta Medical Linear Accelerator

3.1 Position of the crosswire at isocenter

Table 3.1 Position of crosswires during BLD rotation

Crosswire position Limit Measured deviation of the

3.1.2 Doing a test to check the position of the mechanical isocenter

1 Set up an external fixed pointer at 100 cm SSD.

Elekta Medical Linear Accelerator Document ID: 1503568_12

Table 3.2 Crosswire deviation during gantry rotation

Document ID: 1503568_12 Elekta Medical Linear Accelerator

3.2 X-ray field size and field size display

2 Record the values of the fields in Table 3.4.

Elekta Medical Linear Accelerator Document ID: 1503568_12

Document ID: 1503568_12 Elekta Medical Linear Accelerator