IROC HOUSTON QA CENTER
DOSIMETRY INSTRUMENTATION
Institution:
Date:___/___/___
External Beam
Primary dosimeter system.
a.
Chamber
Model
Serial No.
Electrometer
Model
Serial No.
Electrometer settings
b.
System calibration factors: ND,w
ke
Last calibrated by:
Date___/___/____
Secondary dosimeter system.
a.
Chamber
Electrometer
Model
Serial No.
Model
Serial No.
Electrometer settings
b.
System calibration factors: ND,w
ke
Last calibrated by:_____________________
Date___/___/____
System intercomparison: How frequently intercompared with primary system?
Date of last intercomparison:
Constancy checks.
a.
How is the sensitivity of your dosimeter systems monitored?
? Co-60 Irradiator
? Sr-90
? Other
If “other”, please describe:
b.
How frequently is this check made?
Temperature and Pressure
Type of barometer: ? mercury ? aneroid ? digital ? other
If mercury, temperature correction applied: ? yes ? no; gravity correction applied: ? yes ? no
If not mercury, is barometer verified periodically? ? yes ? no Describe method
Type of thermometer: ? mercury ? alcohol ? thermocouple ? other
(OVER)
INSTRUMENTATION (cont'd)
External Beam Treatment Planning System
Manufacturer
Model
Date installed___/___/____
Current software version
Date installed___/___/____
Are software updates verified? ? yes ? no
If "yes", describe procedure:
Meter Set Calculations (monitor units or counts)
How is the clinical meter setting determined?
?
?
?
?
By above treatment planning system
By in-house software
By manual calculation
Other
Is a second calculation performed to check the clinical meter setting? Indicated which:
?
?
?
?
By above treatment planning system
By in-house software
By manual calculation
Other
What level of agreement is considered acceptable?