SECTION 252:410-11-75. Treatment planning simulators and other imaging equipment used in the therapeutic process.

(a)   Policies and procedures for imaging equipment. Therapeutic system permittees shall develop policies and procedures to ensure the proper operation of all imaging equipment used in the treatment planning or treatment process.

(b)   Calibration of imaging equipment. Imaging equipment used for treatment planning and delivery must be calibrated annually by a qualified expert. This calibration must include:

(1)   For conventional simulators:

(A)   Collimator, gantry, and couch isocenter determination, and coincidence;

(B)   verification of table positioning under typical patient load;

(C)   high and low contrast resolution;

(D)   imaging dose and

(E)   all monthly and daily spot checks required by OAC 252:410-11-75(c).

(2)   For CT simulators:

(A)   Indexing and positioning accuracy under scanner control;

(B)   gantry tilt indication accuracy and reproducibility;

(C)   spatial and contrast resolution;

(D)   imaging dose and

(E)   all monthly and daily spot checks required by OAC 252:410-11-75(c).

(3)   For other x-ray imaging equipment used in treatment planning or delivery:

(A)   Beam quality and energy if applicable;

(B)   imaging dose and

(C)   all monthly and daily spot checks required by OAC 252:410-11-75(c).

(c)   Periodic Spot Checks. Periodic spot checks are required to ensure that the previous calibration is still valid. Daily and Monthly Spot checks of imaging equipment may be performed by radiation therapy technologists, x-ray technologist or other similarly qualified personnel. Spot checks shall be reviewed by a qualified expert at least annually. These spot checks must include:

(1)   Monthly checks for conventional simulators:

(A)   Accuracy verification for field size, gantry and collimator angle, cross hair centering, and focal spot indicator;

(B)   light field, radiation field coincidence and

(C)   image quality.

(2)   Daily checks for conventional simulators:

(A)   Localizing laser alignment and

(B)   distance indicator.

(3)   Monthly checks for CT simulators:

(A)   Orientation of gantry, wall and ceiling lasers with respect to imaging plane;

(B)   orientation of CT table top with respect to imaging plane;

(C)   table position indicator accuracy, reproducibility;

(D)   x-ray field uniformity and

(E)   CT number verification for 4 or more materials.

(4)   Daily checks for CT simulators:

(A)   Alignment of gantry lasers with imaging plane;

(B)   CT number verification for water;

(C)   image noise and

(D)   in plane spatial integrity.

(5)   Monthly checks for other x-ray imaging equipment used in treatment planning or delivery:

(A)   Imaging and treatment coordinate system coincidence (four cardinal angles for planar imaging);

(B)   scaling or geometric distortion and

(C)   image quality.

(6)   Daily checks for other x-ray imaging equipment used in treatment planning or delivery: Imaging and treatment coordinate system coincidence.

[Source: Added at 17 Ok Reg 1136, eff 6-1-00; Amended at 29 Ok Reg 672, eff 7-1-12]