Varian SRS E2E Phantom

Instructions for Use

P1044659-001-A OCTOBER 2020

Legal Information
Publication ID
P1044659-001-A

Publication Title
Varian SRS E2E Phantom Instructions for Use

Abstract
This document provides reference information and procedures for Varian SRS E2E Phantom release version 1.0.
This publication is the English-language original.

Trademarks
Varian Medical Systems, Inc. or its affiliates own the names of our products and services referenced herein. These names
® ™
are either registered trademarks ( ) or trademarks ( ) in the United States and/or other countries. All trademarks are the
property of their respective owners. Any rights not expressly granted herein are reserved.

Copyright
© 2020 Varian Medical Systems, Inc. All rights reserved. Published in the United States of America.

No part of this publication may be reproduced, translated, or transmitted without the express written permission of Varian
Medical Systems, Inc.

Notice
Information in this publication is subject to change without notice and does not represent a commitment on the part of
Varian. Varian is not liable for errors contained in this publication or for incidental or consequential damages in connection
with furnishing or use of this material.

Electronic Labeling
This symbol on the label indicates that the Instructions for Use for the corresponding product are available at
www.MyVarian.com. Access the Instructions for Use in electronic form by logging in with your assigned MyVarian user
credentials.

In compliance with Anvisa and EU regulations, Varian will send Brazil and EU customers a free
printed copy of the Instructions for Use within 7 days. Use the “Paper Publication Request”
form provided on the Varian webpage to order your copy.

Legal Manufacturer
Varian Medical Systems, Inc.
3100 Hansen Way
Palo Alto, CA 94304
United States of America

Contact Customer Support

For customer support, go to www.MyVarian.com.

FDA 21 CFR 820 Quality System Regulations (cGMPs)

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within this federal regulation.

CAUTION: US Federal law restricts this device to sale by or on the order of a physician.

2 Varian SRS E2E Phantom Instructions for Use

 WHO
ICD-O codes and terms used by permission of WHO, from:
● International Classification of Diseases for Oncology, Third Edition.
ICD-10 codes and terms used by permission of WHO, from:
● International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).

International Organization for Standardization ISO 13485

Varian Medical Systems, Oncology Systems products are designed and manufactured in accordance with the
requirements specified within the ISO 13485 quality standard.

Legal Information 3
Table of Contents
Introduction ................................................................................................................... 5
About the Varian SRS E2E Phantom ................................................................................................ 5
Intended Use ............................................................................................................................ 6
Indications for Use .................................................................................................................... 6
Contraindications for Use ......................................................................................................... 6
About This Guide ............................................................................................................................... 6
Visual Cues .............................................................................................................................. 6
Contact Varian Customer Support ..................................................................................................... 7

Phantom Components and Description ..................................................................... 8

Phantom Components ....................................................................................................................... 8
Anthropomorphic Shell ...................................................................................................................... 9
Base Cylinder .................................................................................................................................. 10
Cassettes ......................................................................................................................................... 11
Multiple Modality CT & MRI Cassette ..................................................................................... 12
Ionization Chamber Cassette ................................................................................................. 12
Dual Plane Film Cassette ....................................................................................................... 13
Winston Lutz & Hidden Target Cassette ................................................................................. 14

Using the Phantom ..................................................................................................... 16

Change Cassette Insert ................................................................................................................... 16
Quality Activities .............................................................................................................................. 17
Check CT and MRI Image Registration ................................................................................. 17
Acquire Clinical CT Scan ........................................................................................................ 18
Measure Dose Using Ionization Chamber Cassette .............................................................. 18
Measure Dose Using Film Cassette Insert ............................................................................. 19
Perform Isocenter Size Test ................................................................................................... 19
Perform Hidden Target Test .................................................................................................... 20
Best Practices ................................................................................................................................. 20

Maintenance ................................................................................................................ 22
Cleaning .......................................................................................................................................... 22
Storage and Handling ...................................................................................................................... 22
Expected Service Life ...................................................................................................................... 22
Disposal ........................................................................................................................................... 22
Recognizing System Labels ............................................................................................................ 23

Index .......................................................................................................................... 24

4 Varian SRS E2E Phantom Instructions for Use

Introduction

About the Varian SRS E2E Phantom

The Varian SRS E2E Phantom enables end-to-end testing in stereotactic radiosurgery (SRS),
allowing a clinic to mimic a patient workflow and verify many of the steps involved. The phantom
is used as part of an effective QA process to evaluate machine performance as it relates to SRS
workflows.
The following tests can be performed using the phantom to simulate workflows:
● Check CT and MR imaging image registration to assess geometric accuracy.
● Acquire CT scan to create a treatment plan.
● Verify expected dose and delivered dose using film and ionization chamber.
● Determine the size of the linac isocenter (Winston-Lutz test).
● Evaluate couch shift accuracy (hidden target test).

Introduction 5
 Intended Use
The Varian SRS E2E Phantom is intended to allow clinics to simulate clinical workflow of
stereotactic radiosurgery in the brain and measure dose delivered. The phantom can be used
when starting an SRS program or as a part of a continuing machine QA program.

Indications for Use

The Varian SRS E2E Phantom is intended to allow clinics to simulate clinical workflow of
stereotactic radiosurgery in the brain and measure dose delivered. The phantom can be used
when starting an SRS program or as a part of a continuing machine QA program.

Contraindications for Use

The Varian SRS E2E Phantom has no contraindications for use.

About This Guide

This publication contains the guidelines for the various tests and functions you can perform with
the Varian SRS E2E Phantom. The phantom is used with the linac that will be used for patient
treatment. You must be familiar with that device and its instructions before using the phantom.
This guide is organized based on the activities you perform. Focus on the content for performing
your activities safely and effectively. In some facilities, you might be responsible for more than
one set of activities.

Intended Users

Treatment As the treatment provider, you prepare the phantom for clinical treatment
Provider as you would an actual patient.

Quality Assurance As the quality assurance authority, you are responsible for ensuring that
Authority the treatment plan will deliver the expected dose and that it meets your
facility’s quality standards.

Using This Guide

Each chapter can contain different sections for the following:

Phantom Components This chapter contains descriptions of the phantom and its
and Description components.

Using the Phantom This chapter contains step-by-step instructions for your daily
activities.

Maintenance This chapter contains information on cleaning and storing the

Varian SRS E2E Phantom and technical specifications.

Visual Cues
This publication uses the following visual cues to help you find information:

6 Varian SRS E2E Phantom Instructions for Use

 WARNING: A warning describes actions or conditions that can result in serious
injury or death.

CAUTION: A caution describes hazardous actions or conditions that can result in

minor or moderate injury.

NOTICE: A notice describes actions or conditions that can result in damage to

equipment or loss of data.

Note: A note describes information that may pertain to only some conditions, readers, or
sites.

Tip: A tip describes useful but optional information such as a shortcut, reminder, or
suggestion, to help get optimal performance from the equipment or software.

Contact Varian Customer Support

Varian Customer Support is available on the internet, by e-mail, and by telephone. Support
services are available without charge during the initial warranty period.
The MyVarian website provides contact information, product documentation, and other resources
for all Varian products.
Use MyVarian to report incidents. Any serious incident that has occurred while using the device
should be reported to the manufacturer and the competent authority of the Member State in which
the user or patient is established.
1. Go to www.MyVarian.com.
2. Choose an option:
● If you have an account, enter your user login information (e-mail and password).
● If you do not have an account, use the on-screen prompts to create one. Establishing an
account may take up to two working days.
3. To get customer support:
● To display contact information, click Contact Us at the top of the page.
● To access product information and other support options, click Documentation at the top
of the page, or use the menu on the top right side of the screen.

Introduction 7
Phantom Components and Description

Phantom Components
The Varian SRS E2E Phantom consists of the following components:
● Anthropomorphic head phantom that includes typical facial features and a cylindrical inferior
cavity designed to accept interchangeable inserts.
● Base cylinder to hold the interchangeable cassette inserts.
● Four (4) interchangeable cassette inserts that mount to the base cylinder:
● Multiple Modality CT & MRI Cassette
● Ionization Chamber Cassette
Designed for one of the following: CC01, PinPoint 31014/31015, A16
● Dual Plane Film Cassette
● Winston Lutz & Hidden Target Cassette
● Insert assembly tray
● Four (4) retaining screws
● Assembly spider jig to hold film cassette
● Ionization chamber plug for ion chamber cassette
™
● Gafchromic film
● Dummy film
● Carrying case
The phantom has a simplified geometric bone skull. Use each of the four cassette inserts to
perform one or more specific tasks. Use the base cylinder with each insert.
The phantom and all its components, excluding the carry case, are MR compatible.

WARNING: Use only approved equipment with the phantom. Changing any part of
the phantom equipment with unapproved equipment may damage the
phantom and can lead to erroneous measurements.

8 Varian SRS E2E Phantom Instructions for Use

 Figure 1 Phantom Components

Anthropomorphic Shell
The phantom shell is a semi-anthropomorphic design that mimics the basic anatomy of a patient.
It also contains a simplified skull structure to mimic real patients. The shell contains an inferior
cavity to accept the base cylinder and cassettes. This design allows the user to exchange
cassettes even with immobilization devices in place. As well, this minimizes air gaps in the
regions the beams are likely to pass through.

Phantom Components and Description 9

 Figure 2 Anthropomorphic Shell

1. Top
2. Perspective
3. Front
4. Right

Base Cylinder
The base cylinder is a component common to all uses of the phantom. It is a shim between the
lock plate and smaller inner cassette. It contains a lock plate that is uniquely designed to interface
with the phantom shell to lock in place with minimal air gap. It has a central channel to allow ion
chambers to be inserted when using the ion chamber cassette. It also has four (4) retaining
screws that go the length of the cylinder and attach to individual cassettes.

WARNING: The insertion cylinder fits in the phantom cavity snugly. To change the
insert without dropping it, lay the phantom on a flat surface and
remove one retaining screw to release the airlock. Then pull the base
cylinder out from the cavity.

10 Varian SRS E2E Phantom Instructions for Use

 Figure 3 Base Cylinder

1. Top
2. Perspective
3. Front
4. Right

Cassettes
There are four cassettes that can be used with the phantom. Each one is meant to be used for a
specific use case.
● Multiple Modality CT & MRI Cassette
● Ionization Chamber Cassette
● Dual Plane Film Cassette
● Winston Lutz & Hidden Target Cassette
Each cassette must be used with the base cylinder and secured with the retaining screws before
use.

Phantom Components and Description 11

 Multiple Modality CT & MRI Cassette
The Multiple Modality CT & MRI Cassette is designed to measure the geometric fidelity of an MR
system and the registration accuracy of the two datasets, as is common for SRS patient
workflows. The cassette has a centrally located 2 cm target as well as six additional 1 cm targets
around the edge of the phantom. The targets provide contrast in both CT and MR, so they can be
registered. One of the outer targets has a different contrast than the rest of the targets, so that
orientation is unambiguous.

Figure 4 Multiple Modality CT & MRI Cassette

1. Top
2. Perspective
3. Front
4. Right

Ionization Chamber Cassette

The Ionization Chamber Cassette is designed to house one of four chambers. The center of the
active volume of the chamber is at the center of the cassette. The cassette also contains a
centrally located 2 cm target volume. This target has a slight HU contrast for easy delineation
when contouring and localizing the cassette. Additionally, a plug is provided to insert if no ion
chamber is in place.

12 Varian SRS E2E Phantom Instructions for Use

 Figure 5 Ionization Chamber Cassette

1. Top
2. Perspective
3. Front
4. Right

Dual Plane Film Cassette

The Dual Plane Film Cassette is composed of four quadrants. Gafchromic EBT3 film is provided
and is specially cut to fit the cassette. The cassette can be oriented one of two ways to capture a
sagittal dose plane or coronal dose plane. The cassette contains a centrally located 2 cm target
and an offset 1 cm target. Both targets are placed along film axes so as to capture dose through
the center planes of each target. Dummy film is also provided for assembly when real film is not
desired. A “spider” tool is included which helps assemble and disassemble the film cassette.

Phantom Components and Description 13

 Figure 6 Dual Plane Film Cassette

1. Top
2. Perspective
3. Front
4. Right

Winston Lutz & Hidden Target Cassette

The Winston Lutz & Hidden Target Cassette contains two 8 mm diameter brass BBs. One is
located at the center of the phantom and the other is offset. The central BB can be used to
perform Winston-Lutz isocenter size measurements. The offset BB can be used to make image-
guided shifts on the treatment couch and compare to the nominal offset. The offset BB is located
2.5 cm left, 3.5 cm posterior, and 1.5 cm superior using patient coordinate convention.

14 Varian SRS E2E Phantom Instructions for Use

 Figure 7 Winston Lutz & Hidden Target Cassette

1. Top
2. Perspective
3. Front
4. Right

Phantom Components and Description 15

Using the Phantom

Change Cassette Insert

To change the cassette insert, you must first remove the base cylinder from the phantom.

WARNING: The insertion cylinder fits in the phantom cavity snugly. To change the
insert without dropping it, lay the phantom on a flat surface and
remove one retaining screw to release the airlock. Then pull the base
cylinder out from the cavity.

CAUTION: Do not over tighten the retaining screws and cam lock. They are
breakable. Failure of the lock or screws can lead to erroneous results.

1. Remove one retaining screw completely from the phantom.

Tip: Remove one of the two screws at the bottom of the phantom as it lays flat. This
makes it easier to work with the phantom in the insert assembly tray.

2. Turn the cam lock so that the arrow points away from the phantom.
3. Pull the base cylinder from the cavity.
4. Put the base cylinder into the insert assembly tray.
Align the ridge in the tray with the notch in the base cylinder.
5. Remove the three (3) remaining retaining screws.
6. Remove the cassette insert at the top of the base cylinder.
7. Place the new cassette insert on top of the base.
Make sure that the etched words on the insert face the base cylinder.

CAUTION: Use the insert assembly tray when manipulating or changing the
inserts. If the insert assembly tray is not used, inserts may roll and
fall to the ground, which can lead to personal injury or equipment
damage.

8. Insert, then tighten three (3) of the retaining screws.

9. Slide the base insert cylinder completely into the phantom cavity.
10. Insert, and then tighten the last retaining screw.

WARNING: Make sure that the phantom is properly assembled before each
use. Inserts that are not tightened may result in air gaps that could
cause deviations in dose measurements.

11. Turn the cam lock so that the arrow points toward the phantom.

16 Varian SRS E2E Phantom Instructions for Use

 Quality Activities
This section contains the guidelines for the various tests you can run with the Varian SRS E2E
Phantom. The phantom is used with the linac that will be used for patient treatment. You should
be familiar with that device and its instructions before using the phantom.

WARNING: When doing an SRS end-to-end test, use the same settings and steps
that are used in practice for SRS head treatments according to your
hospital’s SRS treatment protocol. Using different settings could lead
to undetected deviations.

NOTICE: The phantom is not designed as a calibration tool. Make sure that your
machine is in a good operating condition when performing an end-to-
end test. If a test shows a deviation from previous results, investigate
the problem with other QA tools.

CAUTION: Make sure that the phantom and its accessories are placed stably on
the couch before moving the couch.

Make sure that you have the appropriate cassette insert for the test being performed. The proper
cassette insert is referenced at the beginning of a specific task.
● Multiple Modality CT & MRI Cassette is used to test image quality.
● Ionization Chamber Cassette is used to measure dose with an ion chamber.
● Dual Plane Film Cassette is used to measure planar dose using film.
● Winston Lutz & Hidden Target Cassette is used to perform Winston Lutz test and geometric
tests.
Perform all routine QA according to your institutional guidelines.
Within each task, the steps for the treatment provider are indicated, unless the steps are for the
quality assurance authority only.

Note: The phantom is designed for SRS workflow end-to-end testing using institutional
workflows. When performing a workflow, follow your institutional guidelines if they differ
from the guidelines in this publication.

Check CT and MRI Image Registration

Use this test to acquire both a CT and an MR imaging scan to assess the geometric fidelity and
accuracy of the two scanning systems. Both the treatment provider and the quality assurance
authority do this test.
1. Load the clear cassette insert marked Multiple Modality CT & MRI Cassette in the
phantom.
2. Treatment Provider:
a. Place the phantom on the CT scanner couch, in head-first supine position.
b. Acquire a scan of the entire phantom with a slice thickness <1.25 mm.
c. Remove the phantom from the CT scanner.

Using the Phantom 17

 d. Place the phantom on the MR imaging scanner couch, in head-first supine position.
e. Acquire either a T1 or T2 scan of the entire phantom with a slice thickness <1.25 mm.
f. Remove the phantom from the MR imaging couch.
3. Quality Assurance Authority:
a. Import the CT scan and the MR imaging scan into the treatment planning system.
b. Perform an image registration on the two scans to evaluate registration accuracy.

Acquire Clinical CT Scan

Use this test to acquire a CT scan of the phantom, so that you can create a treatment plan from it.
1. Load the cassette that will be used when delivering the plan to the phantom on the linac.
2. Place the phantom on the CT scanner couch, in head-first supine position.
3. If applicable, place a clinically acceptable immobilization system (for example, Qfix
Encompass) on the phantom to simulate what will be used during treatment with the patient.
4. Acquire a scan of the entire phantom with a slice thickness <1.25 mm, or use your clinic’s
guidelines for SRS treatment.
5. Push the CT scan DICOM dataset to the PACS/treatment planning system.
6. If applicable, remove the immobilization system from the phantom.
7. Remove the phantom from the CT scanner couch.
A CT scan, adequate to use for treatment planning, has been acquired and pushed to the
treatment planning system.

Measure Dose Using Ionization Chamber Cassette

Before performing this test, create a deliverable treatment plan from the phantom CT scan. See
Acquire Clinical CT Scan on page 18.
Use this test to make sure that the treatment plan can be delivered accurately to the phantom.
Both the treatment provider and the quality assurance authority do this test.
1. Load the Ionization Chamber Cassette insert in the phantom.

CAUTION: Use the correct, compatible ionization chamber with the phantom.
The ionization chamber cassette lists the compatible chamber on
the front. A different ionization chamber may become stuck in the
insert or break during assembly. Using an incorrect ion chamber
may lead to erroneous measurements.

2. Treatment Provider:
a. Place the phantom on the treatment couch in head-first supine position.
The treatment provider sets up the phantom as they would a real patient.
b. If applicable, place the same immobilization system used in Acquire CT Scan on the
phantom to simulate what will be used during treatment with the patient.
c. Place the ion chamber into position in the insert.
d. Move the couch to align the external marks per the treatment plan.
e. (Optional) Perform image guidance to register the acquired image with the treatment
planning CT image.

18 Varian SRS E2E Phantom Instructions for Use

 f. Deliver the treatment plan to the phantom.
3. Quality Assurance Authority: Record the ionization chamber reading.
The treatment plan is delivered to the phantom and the dose can be recorded with the ion
chamber.

Measure Dose Using Film Cassette Insert

Before performing this test, create a deliverable treatment plan from the phantom CT scan. See
Acquire Clinical CT Scan on page 18.
Use this test as an alternate method to make sure that the treatment plan can be delivered
accurately to the phantom. Both the treatment provider and the quality assurance authority do this
test.
1. Load the Dual Plane Film Cassette insert in the phantom using the provided specially cut
film.

CAUTION: Use the film cassette spider tool to aid film cassette loading and
assembly. If the film cassette spider tool is not used, inserts may
roll and fall to the ground, which can lead to personal injury or
equipment damage.

2. Treatment Provider:
a. Place the phantom on the treatment couch in head-first supine position.
The treatment provider sets up the phantom as they would a real patient.
b. If applicable, place the same immobilization system used in Acquire CT Scan on the
phantom to simulate what will be used during treatment with the patient.
c. Move the couch to align the external marks per the treatment plan.
d. (Optional) Perform image guidance to register the acquired image with the treatment
planning CT image.
e. Deliver the treatment plan to the phantom.
3. Quality Assurance Authority: Scan the film to measure dose distribution.
The treatment plan is delivered to the phantom with the dose recorded on the film.

Perform Isocenter Size Test

Use the isocenter size test (also known as the Winston-Lutz test) to determine the size of the
linac isocenter using a phantom surrogate.
1. Load the Winston Lutz & Hidden Target Cassette insert in the phantom.
2. Place the phantom on the treatment couch.
3. Use image guidance as used for an SRS treatment to localize the phantom so that the
radiopaque marker is centered about the isocenter.
4. Acquire images formed by the multileaf collimator, jaws, or cone at several angles for the
gantry, collimator, and couch.
When loaded into an image analysis program, the acquired images can determine the isocenter
size.

Using the Phantom 19

 Perform Hidden Target Test
Use this test to measure and evaluate couch shift accuracy using image guidance.
1. Load the Winston Lutz & Hidden Target Cassette insert in the phantom.
2. Place the phantom on the treatment couch in head-first supine position.
3. Use image guidance as used for an SRS treatment to localize the patient, and then place the
phantom isocenter at the treatment isocenter.
4. Use image guidance to plan a couch movement that shifts the phantom’s position to the
offset target location.
5. Execute the planned couch movement.
6. Use image guidance to verify the couch movement.
The quality assurance authority can evaluate the positional accuracy of the planned shift, and the
positional accuracy of the couch after the actual shift.

Best Practices
This section identifies some of the best practices when using the phantom.

Use the assembly tray when assembling and disassembling phantoms

The assembly tray is specifically designed to hold the base cylinder and a cassette in place so
that removing or inserting the retaining screws is not overly difficult.

Use the spider tool when assembling, disassembling, or storing the film cassette
The black 4-pronged “spider” tool is meant to hold the quadrants of the film cassette in place
when placing film as the quadrants are loose and can be easily shifted when assembling.

Remove one retaining screw when inserting or removing the cylinder from the shell
The tight manufacturing tolerances between the shell and insert are designed to give minimal air
gaps and smooth operation. A side effect of this is that an air vacuum and pressure forms when
inserting or removing the insert. Rather than fighting the vacuum (possibly with immobilization in
place), remove one retaining screw to let air travel along the channel.

Use the built-in lettering to identify orientation on the CT scan

Each cassette has engraved lettering identifying the cassette type as well as orientation. This
lettering is designed so it can be easily read on a CT scan. This gives reassurance of the correct
cassette as well as orientation. The film, both dummy and real, also has lettering that can be used
with the cassette for unambiguous assembly.

Use the slits and small hole in the film for TPS registration
When comparing the measured dose film to a treatment planning system dose, the film itself
should be registered using geometric landmarks. These landmarks have been included in the film
to be used with the registration software. The slits can be used to correct the rotation of the scan.
The slits and hole can all be used as landmarks between isocenter and the geometric landmark.

20 Varian SRS E2E Phantom Instructions for Use

 The phantom can be used with optical surface tracking
The phantom surface is compatible with the IDENTIFY optical tracking system and can be used
with radiation image guidance, if desired.

Using the Phantom 21

Maintenance

Cleaning
To clean, wipe the phantom and its components with a soft cloth using only mild detergent and
warm water.

NOTICE: Do not soak the phantom or any of its components in water. The
materials are hygroscopic, and soaking them in water could alter their
shape and their MR imaging signal.

NOTICE: Do not use germicidal wipes or abrasive cleaners of any kind.

Germicidal wipes and abrasive cleaners may lead to degradation of
the phantom surface.

Storage and Handling

CAUTION: Keep the phantom and its accessories in the carrying case during
transportation. Dropping the phantom may lead to its functional loss or
fracture, and can cause personal injury. If you notice any deviation in
the phantom’s state from the specification, contact Varian Customer
Support.

Expected Service Life

The Varian SRS E2E Phantom has an expected service life of 10 years. This time period is based
on product reliability and resulting safety and effectiveness.

Disposal
The Varian SRS E2E Phantom does not contain any materials that would require special disposal
instructions. If the phantom requires disposal, follow your facility’s guidelines.

22 Varian SRS E2E Phantom Instructions for Use

 Recognizing System Labels
Observe caution.
ISO 7010-M002

This symbol on the label indicates that the instructions for use for the
corresponding product is available at www.MyVarian.com.
ISO 7000-1641

Date of manufacture

Catalog or model
ISO 7000-2493

Serial number
ISO 7000-2498

This symbol on the label indicates that the device has been demon-
strated to pose no known hazards in the specified MR imaging environ-
ment with the specified conditions of use.

Maintenance 23
Index
A indications for use 6
intended use 6
anthropomorphic shell 9 intended users 6
introduction 5
Ionization Chamber Cassette 12, 17, 18
B
isocenter size test 19
base cylinder 10
best practices 20
L
labels 23
C
capabilities 5
cassettes 11
M
change insert 16 measure dose 18, 19
Dual Plane Film Cassette 13, 19 MRI image registration 17
Ionization Chamber Cassette 12, 18 Multiple Modality CT & MRI Cassette 12, 17
Multiple Modality CT & MRI Cassette 12, 17 MyVarian 7
Winston Lutz & Hidden Target Cassette 14,
19, 20
change insert 16 O
cleaning 22
online customer support 7
components 8
ordering product documents by phone 7
contraindications 6
CT image registration 17
CT Scan 18 Q
customer support 7
quality assurance authority 6, 17–20

D
R
description 5
disposal 22 registration
Dual Plane Film Cassette 13, 17, 19 image 17
remove base cylinder 16

E
S
emailing Varian customer support 7
expected service life 22 storage 22
support e-mail addresses 7
symbols 23
H system labels 23
hidden target test 20
T
I technical support 7
image registration 17

24 Varian SRS E2E Phantom Instructions for Use

tests
CT image registration 17
CT Scan 18
hidden target 20
isocenter size 19
measure dose 18, 19
MRI image registration 17
Winston-Lutz 19
treatment provider 6, 17–19

V
Varian customer support 7
visual cues 6

W
Winston Lutz & Hidden Target Cassette 14, 17,
19, 20
Winston-Lutz test 19

Index 25