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M006 qa and qc in radiotherapy 2011

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Information about M006 qa and qc in radiotherapy 2011
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Published on March 9, 2014

Author: mtv243

Source: slideshare.net

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by Ossama Anjak
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‫א‬ ‫א‬ ‫א א‬ ‫‪Quality Control of Radiotherapy‬‬ ‫‪Equipments‬‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ‬ ‫هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫ﻣﺎﺟﺴﺘﻴﺮ اﻟﻮﻗﺎﻳﺔ اﻹﺷﻌﺎﻋﻴﺔ وﺁﻣﺎن اﻟﻤﺼﺎدر اﻟﻤﺸﻌﺔ‬ ‫ﻗﺴﻢ اﻟﻔﻴﺰﻳﺎء - آﻠﻴﺔ اﻟﻌﻠﻮم - ﺟﺎﻣﻌﺔ دﻣﺸﻖ‬ ‫1102-0102‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫א‬ ‫א‬ ‫ﺍﻟﻤﺘﺎﺒﻌﺔ‬ ‫ﺍﻟ‬ ‫ﻤﻌﺎ‬ ‫ﻟﺠﺔ‬ ‫ﺍﻟﺘﻭﺜﻴﻕ‬ ‫4‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫ﺍﻟﺘﺸﺨﻴﺹ‬ ‫ﺍﻟﺘﺨ‬ ‫ﻁﻴﻁ‬ ‫1102/22/3‬

‫511‪IAEA BSS‬‬ ‫• ﺍﻟﻔﻘﺭﺓ 22.2 ﻤﻥ ‪ BSS‬ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﻌﺭﻀﺎﺕ‬ ‫ﺍﻟﻁﺒﻴﺔ:‬ ‫– ﻴﻘﻭﻡ ﺍﻟﻤﺴﺠﻠﻭﻥ ﻭﺍﻟﻤﺭﺨﺹ ﻟﻬﻡ ﺒﺎﻹﻀﺎﻓﺔ ﺇﻟﻰ ﺘﻁﺒﻴﻕ ﻤﺘﻁﻠﺒﺎﺕ ﻀﺒﻁ‬ ‫ﺍﻟﺠﻭﺩﺓ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﻋﻠﻰ ﺍﻟﻨﺤﻭ ﺍﻟﻤﺤﺩﺩ ﻓﻲ ﻤﻭﺍﻀﻴﻊ ﺍﺨﺭﻯ ﻤﻥ ﻫﺫﻩ‬ ‫ﺍﻟﻤﻌﺎﻴﻴﺭ ﺒﻭﻀﻊ ﺒﺭﻨﺎﻤﺞ ﺸﺎﻤل ﻟﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﻌﺭﻀﺎﺕ‬ ‫ﺍﻟﻁﺒﻴﺔ ﺒﻤﺸﺎﺭﻜﺔ ﺨﺒﺭﺍﺀ ﻤﺅﻫﻠﻴﻥ ﺘﺄﻫﻴﻼ ﻜﺎﻓﻴﺎ ﻓﻲ ﺍﻟﻤﺠﺎﻻﺕ ﺫﺍﺕ ﺍﻟﺼﻠﺔ.‬ ‫ﹰ ﹰ‬ ‫ً‬ ‫ﻜﺎﻟﻔﻴﺯﻴﺎﺀ ﺍﻹﺸﻌﺎﻋﻴﺔ ﺃﻭ ﺍﻟﺼﻴﺩﻟﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﻤﻊ ﻤﺭﺍﻋﺎﺓ ﺍﻟﻤﺒﺎﺩﺉ ﺍﻟﺘﻲ‬ ‫ﺤﺩﺩﺘﻬﺎ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ‪ WHO‬ﻭﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﻟﻠﺒﻠﺩﺍﻥ‬ ‫ﺍﻷﻤﺭﻴﻜﻴﺔ ‪.PAHO‬‬ ‫5‬ ‫1102/22/3‬ ‫‪BSS‬‬ ‫• ﺍﻟﻔﻘﺭﺓ 32.2 ﻤﻥ ‪ : BSS‬ﺘﺸﺘﻤل ﺒﺭﺍﻤﺞ ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻓﻲ‬ ‫ﻤﺠﺎل ﺍﻟﺘﻌﺭﻀﺎﺕ ﺍﻟﻁﺒﻴﺔ ﻋﻠﻰ ﻤﺎ ﻴﻠﻲ:‬ ‫‪(a‬‬ ‫‪(b‬‬ ‫‪(c‬‬ ‫‪(d‬‬ ‫‪(e‬‬ ‫ﺍﻟﻘﻴﺎﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺒﺎﺭﻤﺘﺭﺍﺕ ﺍﻟﻔﻴﺯﻴﺎﺌﻴﺔ ﻟﻤﻭﻟﺩﺍﺕ ﺍﻹﺸﻌﺎﻉ‬ ‫ﻭﺃﺠﻬﺯﺓ ﺍﻟﺘﺼﻭﻴﺭ ﺒﺎﻷﺸﻌﺔ ﻭﻤﻨﺸﺂﺕ ﺍﻟﺘﺸﻌﻴﻊ ﻭﻗﺕ ﺍﻹﻋﺩﺍﺩ‬ ‫ﻟﻠﺘﺸﻐﻴل ﻭﺒﺼﻔﺔ ﺩﻭﺭﻴﺔ.‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻌﻭﺍﻤل ﺍﻟﻤﺎﺩﻴﺔ ﻭﺍﻟﺴﺭﻴﺭﻴﺔ ﺍﻟﻤﻼﺌﻤﺔ ﺍﻟﺘﻲ ﺘﺴﺘﺨﺩﻡ‬ ‫ﻓﻲ ﺘﺸﺨﻴﺹ ﺃﻭ ﻋﻼﺝ ﺍﻟﻤﺭﻀﻰ.‬ ‫ﻭﺴﺠﻼﺕ ﻤﻜﺘﻭﺒﺔ ﻟﻺﺠﺭﺍﺀﺍﺕ ﻭﺍﻟﻨﺘﺎﺌﺞ ﺫﺍﺕ ﺍﻟﺼﻠﺔ.‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻤﻌﺎﻴﺭﺓ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻭﻅﺭﻭﻑ ﺍﻟﺘﺸﻐﻴل ﺍﻟﺨﺎﺼﺔ‬ ‫ﺒﻤﻌﺩﺍﺕ ﻗﻴﺎﺱ ﺍﻟﺠﺭﻋﺎﺕ ﻭﺍﻟﻤﺴﺢ ﺍﻹﺸﻌﺎﻋﻲ.‬ ‫ﺍﻟﻘﻴﺎﻡ، ﻜﻠﻤﺎ ﺃﻤﻜﻥ، ﺒﻌﻤﻠﻴﺎﺕ ﻤﺭﺍﺠﻌﺔ ﻤﻨﺘﻅﻤﺔ ﻭﻤﺴﺘﻘﻠﺔ ﻟﺒﺭﻨﺎﻤﺞ‬ ‫ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﺍﻟﺨﺎﺹ ﺒﺈﺠﺭﺍﺀﺍﺕ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺒﺎﻹﺸﻌﺎﻉ.‬ ‫6‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫؟‬ ‫א‬ ‫• ﺘﻌﺭﻑ ﺍﻟﺠﻭﺩﺓ ﺒﺄﻨﻬﺎ ﻤﺠﻭﻋﺔ ﻤﻴﺯﺍﺕ ﺍﻟﻤﻨﺘﺞ ﺃﻭ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺘﻲ‬ ‫ﻴﺅﺩﻴﻬﺎ ﻟﺘﻠﺒﻴﺔ ﺍﻟﺤﺎﺠﺎﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ.‬ ‫• ﺘﺘﻌﻠﻕ ﺍﻟﺠﻭﺩﺓ ﺒـ:‬ ‫– ﻟﻴﺎﻗﺔ ﺍﻻﺴﺘﻌﻤﺎل ‪.Fitness for use‬‬ ‫– ﻟﻴﺎﻗﺔ ﺍﻟﻐﺭﺽ ‪.Fitness for purpose‬‬ ‫• ﺘﺸﻴﺭ ﺍﻟﺠﻭﺩﺓ ﺇﻟﻰ ﺍﻟﻤﻁﺎﺒﻘﺔ ﻤﻊ ﺍﻟﻤﻌﺎﻴﻴﺭ ﻭﺍﻟﻁﺭﻴﻘﺔ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺃﻥ‬ ‫ﻨﺤﺎﻓﻅ ﺒﻬﺎ ﻋﻠﻰ ﺘﻠﻙ ﺍﻟﻤﻌﺎﻴﻴﺭ ﻭﺘﺤﺴﻴﻨﻬﺎ ﻟﻠﻭﺼﻭل ﺇﻟﻰ ﻤﺎ ﻫﻭ‬ ‫ﻤﻁﻠﻭﺏ.‬ ‫7‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫•‬ ‫א‬ ‫‪QA‬‬ ‫‪QA‬؟‬ ‫: ﻤﺠﻤﻭﻋﺔ ﺍﻷﻋﻤﺎل ﺍﻟﻤﺨ ﱠﻁﺔ‬ ‫ِ ‪ ‬ﹶﻁ ِ‬ ‫ﻭﺍﻟﻤﻨ ﹼﻤﺔ ﺍﻟﻀﺭﻭﺭﻴﺔ ﻟﻠﺸﻌﻭﺭ ﺒﺎﻟﺜﻘﺔ ﺍﻟﻜﺎﻓﻴﺔ ﻤﻥ ﺃﻥ ﺍﻟﻤﻨﺘﺞ ﺃﻭ‬ ‫َ‬ ‫ِ‬ ‫ﻅ ِ‬ ‫ﺍﻟﺨﺩﻤﺔ ﺴ ﹶﺴﺘﻭﻓﻰ ﻤﺘﻁﻠﺒﺎﺕ ﻤﺤﺩﺩﺓ ﻟﻠﺠﻭﺩﺓ.‬ ‫ﹶ‬ ‫‪‬ﺘ‬ ‫• ﺍﻟﻐﺎﻴﺔ: ﺘﺯﻭﻴﺩ ﺍﻹﺩﺍﺭﺓ ﺒﻜل ﺍﻟﻨﺸﺎﻁﺎﺕ ﺍﻟﺘﻲ ﺘﺅ ﹼﺭ ﻋﻠﻰ ﺠﻭﺩﺓ‬ ‫ﺜ‬ ‫ﺍﻟﺨﺩﻤﺔ ﺍﻟﻤﻘﺩﻤﺔ‬ ‫8‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫•‬ ‫ﺍﻟﺘﻲ ﺘﻀﻤﻥ ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺃﻥ:‬ ‫א‬ ‫א‬ ‫: ﻫﻭ ﺘﻠﻙ ﺍﻹﺠﺭﺍﺀﺍﺕ‬ ‫– ﺍﻟﻭﺼﻔﺔ ﺍﻟﻁﺒﻴﺔ ﻭﺘﻁﺒﻴﻘﻬﺎ ﺘﺘﻡ ﺒﺸﻜل ﺴﻠﻴﻡ ﻭﺁﻤﻥ ﻜﻤﺎ ﻫﻭ‬ ‫ﻤﺤﺩﺩ ﺒﺎﻟﻨﺴﺒﺔ ﻟﺤﺠﻡ ﺍﻟﻬﺩﻑ ﻤﻊ ﺍﻟﻤﺤﺎﻓﻅﺔ ﻋﻠﻰ ﺠﺭﻋﺔ‬ ‫ﺃﺼﻐﺭﻴﺔ ﻟﻠﻨﺴﺞ ﺍﻟﺴﻠﻴﻤﺔ‬ ‫– ﻭﺃﻥ ﺘﻌﺭﺽ ﺍﻟﻌﺎﻤﻠﻭﻥ ﻭﻋﻤﻭﻡ ﺍﻟﻨﺎﺱ ﻀﻤﻥ ﺍﻟﺤﺩﻭﺩ‬ ‫ﺍﻟﻤﻘﺒﻭﻟﺔ.‬ ‫– ﻭﺃﺨﻴﺭﺍ ﻤﺭﺍﻗﺒﺔ ﺍﻟﻤﺭﻴﺽ ﺒﺸﻜل ﺠﻴﺩ ﺒﻬﺩﻑ ﺘﺤﺩﻴﺩ ﺍﻟﻨﺘﻴﺠﺔ‬ ‫ﹰ‬ ‫ﺍﻟﻨﻬﺎﺌﻴﺔ ﻟﻠﻤﻌﺎﻟﺠﺔ.‬ ‫ِ‬ ‫9‬ ‫1102/22/3‬ ‫א‬ ‫‪Quality Control‬؟‬ ‫• ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ‪ :QC‬ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﻤﻨﻅﻤﺔ ﺨﻼل ﺘﻘﻴﻡ ﺍﻷﺩﺍﺀ ﺍﻟﻔﻌﻠﻲ‬ ‫ﻤﻥ ﺨﻼل ﻤﻘﺎﺭﻨﺔ ﺍﻟﻘﻴﺎﺴﺎﺕ ﻤﻊ ﺍﻟﻤﻌﺎﻴﻴﺭ ﺍﻟﻤﺘﺎﺤﺔ ﻭﺍﻟﻘﻴﺎﻡ‬ ‫ﺒﺎﻷﻋﻤﺎل ﺍﻟﻀﺭﻭﺭﻴﺔ ﻟﻠﻤﺤﺎﻓﻅﺔ ﻋﻠﻰ ﺘﻠﻙ ﺍﻟﻤﻌﺎﻴﻴﺭ ﺃﻭ‬ ‫ﺍﺴﺘﺭﺠﺎﻋﻬﺎ.‬ ‫01‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫‪QA‬‬ ‫‪QC‬‬ ‫• ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ‪ َQA‬ﻫﻭ ﻜﺎﻓﺔ ﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻤﺩﻋﻭﻤﺔ‬ ‫ﺒﺎﺨﺘﺒﺎﺭﺍﺕ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ‪.QC‬‬ ‫• ﺘﺼﻑ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ‪ QC‬ﺍﻵﻟﻴﺎﺕ ﻭﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﻔﻌﻠﻴﺔ ﺍﻟﺘﻲ‬ ‫ﹶ‬ ‫ﹶ‬ ‫ﹶ‬ ‫ﹸ‬ ‫ِ ﹸ‬ ‫ﻴﻤﻜﻥ ﻤﻥ ﺨﻼﻟﻬﺎ ﺍﻻﻁﻤﺌﻨﺎﻥ ﻋﻠﻰ ﺠﻭﺩﺓ ﺍﻷﺩﺍﺀ.‬ ‫ﺿﺒﻂ‬ ‫ﺿﺒﻂ‬ ‫اﻟﺠﻮدة‬ ‫اﻟﺠﻮدة‬ ‫‪QC‬‬ ‫‪QC‬‬ ‫ﺿﻤﺎن‬ ‫ﺿﻤﺎن‬ ‫اﻟﺠﻮدة‬ ‫اﻟﺠﻮدة‬ ‫‪QA‬‬ ‫‪QA‬‬ ‫ﺿﺒﻂ‬ ‫اﻟﺠﻮدة‬ ‫‪QC‬‬ ‫11‬ ‫1102/22/3‬ ‫ﺿﺒﻂ ﺍﳉﻮﺩﺓ ﰲ ﺍﳌﻌﺎﳉﺔ ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫‪Quality Control in‬‬ ‫‪Radiotherapy‬‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫א‬ ‫א‬ ‫א‬ Quality Control in radiotherapy ‫• ﻴﻭﺠﺩ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻜﺘﺏ ﻭﺍﻟﻤﻨﺸﻭﺭﺍﺕ ﺍﻟﺘﻲ ﺘﺼﻑ ﻤﺎﻫﻴﺔ ﺇﺠﺭﺍﺀﺍﺕ‬ .‫ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ﺍﻟﺘﻲ ﻴﺠﺏ ﺍﻟﻘﻴﺎﻡ ﺒﻬﺎ ﻓﻲ ﻤﺠﺎل ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ 13 3/22/2011 ‫א‬ • • • • ‫א‬ ‫א‬ ‫א‬ AAPM 1994. “Report of Task Group 40: Comprehensive QA for Radiation Oncology,” Medical Physics 21, 581-619. Fraass et al.: American Association of Physicists in Medicine Radiation Therapy Committee Task Group 53: Quality assurance for clinical radiotherapy treatment planning. Med. Phys. 25 (10), October 1998. IPEM (1999). Physics Aspects of Quality Control in Radiotherapy, IPEM Report 81, edited by Mayles, W.P.M. et al. IPEM, York, United Kingdom. Venencia et al.: Commissioning and quality assurance for intensity modulated radiotherapy with dynamic multileaf collimator. Journal of Applied Clinical Medical Physics, Vol. 5, No. 3 Summer 2004. 3/22/2011 14 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫ﺇﺠﺭﺍﺀﺍﺕ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ‬ ‫• ﺴﻠﺴﻠﺔ ﻤﻥ ﺍﻟﻘﻴﺎﺴﺎﺕ ﻭﺍﻹﺨﺘﺒﺎﺭﺍﺕ ﻭﻤﻘﺎﺭﻨﺔ ﺍﻟﻨﺘﺎﺌﺞ ﻤﻊ‬ ‫ﺍﻟﻘﻴﻡ ﺍﻟﻨﻅﺎﻤﻴﺔ ﺒﻬﺩﻑ:‬ ‫– ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺴﻼﻤﺔ ﻋﻤل ﺍﻟﺘﺠﻬﻴﺯﺍﺕ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫– ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﻋﺩﻡ ﻭﺠﻭﺩ ﺃﻱ ﺨﻠل ﻓﻲ ﺍﻷﺠﻬﺯﺓ ﻴﻤﻜﻥ ﺃﻥ ﻴﺅﺩﻱ‬ ‫ﺇﻟﻰ ﺘﻌﺭﺽ ﺇﺸﻌﺎﻋﻲ ﻏﻴﺭ ﻤﺒﺭﺭ.‬ ‫– ﺍﻟﻘﻴﺎﻡ ﺒﺼﻴﺎﻨﺔ ﺍﻷﺠﻬﺯﺓ.‬ ‫51‬ ‫1102/22/3‬ ‫ﺒﺭﻨﺎﻤﺞ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ‬ ‫• ﻳﺠﺐ أن ﻳﻜﻮن ﺑﺮﻧﺎﻣﺞ ﺿﺒﻂ اﻟﺠﻮدة ﻗﺎﺑﻞ ﻟﻠﺘﻄﺒﻴﻖ ﺑﻜﺎﻓﺔ اﻟﺘﺠﻬﻴﺰات‬ ‫واﻷدوات اﻟﻤﻮﺟﻮدة ﻓﻲ ﻗﺴﻢ اﻟﻤﻌﺎﻟﺠﺔ ﺑﺤﻴﺚ ﻳﺘﻀﻤﻦ ﺑﺮﻧﺎﻣﺞ ﺿﺒﻂ‬ ‫اﻟﺠﻮدة:‬ ‫اﻹﺟﺮاءات اﻟﻤﺘﺒﻌﺔ ﻓﻲ آﻞ اﺧﺘﺒﺎر.‬ ‫اﻟﺘﺠﻬﻴﺰات اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ آﻞ إﺟﺮاء ﻋﻠﻰ ﺣﺪة.‬ ‫ﺗﻮاﺗﺮ إﺟﺮاء اﻻﺧﺘﺒﺎر )ﻳﻮﻣﻲ، أﺳﺒﻮﻋﻲ، ……………(.‬ ‫اﻟﻘﻴﻢ اﻟﻤﺴﻤﻮﺣﺔ .‬ ‫اﻟﻤﺴﺆول ﻋﻦ اﻹﺟﺮاء )ﻓﻴﺰﻳﺎﺋﻲ، ﻓﻨﻲ اﻷﺷﻌﺔ، ﻣﻬﻨﺪس اﻟﺼﻴﺎﻧﺔ، ...( .‬ ‫61‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺍﻟﺘﻮﺛﻴﻖ:‬ ‫• ﻴﺠﺏ ﺍﻻﺤﺘﻔﺎﻅ ﺒﻜﺎﻓﺔ ﻨﺘﺎﺌﺞ ﺍﺨﺘﺒﺎﺭﺍﺕ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ﻓﻲ‬ ‫ﺴﺠل ﺨﺎﺹ ﻴﺘﻀﻤﻥ:‬ ‫– ﺍﺴﻡ ﺍﻟﺠﻬﺎﺯ ﻤﻭﻀﻭﻉ ﺍﻻﺨﺘﺒﺎﺭ ﻭﺘﺎﺭﻴﺦ ﺍﻹﺠﺭﺍﺀ.‬ ‫– ﺍﻟﺘﺠﻬﻴﺯﺍﺕ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓﻲ ﺍﻟﻘﻴﺎﺱ.‬ ‫– ﺍﻟﻁﺭﻴﻘﺔ )ﺍﻹﺠﺭﺍﺀ(.‬ ‫– ﺘﺤﻠﻴل ﺍﻟﻨﺘﺎﺌﺞ ﻭﺍﻟﻤﻼﺤﻅﺎﺕ.‬ ‫71‬ ‫1102/22/3‬ ‫‪CAPCA Quality Control Standards: Medical Linear Accelerators‬‬ ‫81‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

CAPCA Quality Control Standards: Medical Linear Accelerators 19 3/22/2011 CAPCA Quality Control Standards: Medical Linear Accelerators 3/22/2011 20 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫ﺍﻟﺘﺠﻬﻴﺰﺍﺕ ﺍﳌﺴﺘﺨﺪﻣﺔ ﰲ ﺇﺟﺮﺍءﺍﺕ ﺿﺒﻂ ﺍﳉﻮﺩﺓ:‬ ‫• ﻤﻘﻴﺎﺱ ﺠﺭﻋﺔ ﺇﺸﻌﺎﻋﻴﺔ:‬ ‫– ﻤﻘﻴﺎﺱ ﺍﻟﺠﺭﻋﺔ + ﺤﺠﻴﺭﺍﺕ ﺍﻟﺘﺄﻴﻥ.‬ ‫– ﻓﺎﻨﺘﻭﻡ ﻤﺎﺌﻲ ‪.Water Phantom‬‬ ‫• ﺘﺠﻬﻴﺯﺍﺕ ﻻﺨﺘﺒﺎﺭ ﺘﺠﺎﻨﺱ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ.‬ ‫• ﺃﻓﻼﻡ ﺘﺼﻭﻴﺭ.‬ ‫• ﻤﻘﻴﺎﺱ ﻤﺴﺎﻓﺔ، ﻤﻘﻴﺎﺱ ﺤﺭﺍﺭﺓ، ﻤﻘﻴﺎﺱ ﻀﻐﻁ ﺠﻭﻱ.‬ ‫12‬ ‫1102/22/3‬ ‫א‬ ‫)א‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫−06 + א‬ ‫א‬ ‫א‬ ‫(‬

‫א‬ ‫)א‬ ‫−06 + א‬ ‫א‬ ‫א‬ ‫(‬ ‫• ﺍﻟﺤﺭﻜﺎﺕ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻴﺔ.‬ ‫• ﺍﻟﺴﺎﺤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ ‫• ﺍﻟﻤﺅﺸﺭﺍﺕ ﺍﻟﺩﺍﻟﺔ ﻋﻠﻰ ﺇﺼﺩﺍﺭ‬ ‫ﺍﻷﺸﻌﺔ ‪Radiation ON‬‬ ‫• ﺁﻟﻴﺔ ﺘﺤﺭﻴﻙ ﻤﻨﺒﻊ ﺍﻟﻜﻭﺒﺎﻟﺕ-06‬ ‫‪Source ON/OFF‬‬ ‫• ﺘﺸﺎﺒﻙ ﺍﻷﻤﺎﻥ ‪Safety interlocks‬‬ ‫32‬ ‫1102/22/3‬ ‫א‬ ‫א א‬ ‫א‬ ‫• ﺍﻟﺤﺭﻜﺎﺕ ﺍﻟﺩﻭﺭﺍﻨﻴﺔ.‬ ‫– ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺘﻁﺎﺒﻕ ﺍﻟﻤﺅﺸﺭﺍﺕ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻴﺔ ﻤﻊ ﺍﻟﺭﻗﻤﻴﺔ.‬ ‫• ﻤﺅﺸﺭﺍﺕ ﺯﺍﻭﻴﺔ ﺩﻭﺭﺍﻥ ﺍﻟﺫﺭﺍﻉ‬ ‫• ﻤﺅﺸﺭﺍﺕ ﻤﻭﻀﻊ ﺍﻟﻁﺎﻭﻟﺔ‬ ‫• ﻤﺅﺸﺭﺍﺕ ﺯﺍﻭﻴﺔ ﺩﻭﺭﺍﻥ ﺍﻟﻤﺤﺩﺩﺍﺕ.‬ ‫• ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺃﺒﻌﺎﺩ ﺍﻟﺴﺎﺤﺔ‬ ‫• ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺭﻜﺯ ‪Isocentre check‬‬ ‫42‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫• ﺍﻟﻤﻁﺎﺒﻘﺔ ﺒﻴﻥ ﺃﺒﻌﺎﺩ ﺍﻟﺴﺎﺤﺔ ﺍﻟﻀﻭﺌﻴﺔ ﻤﻊ ﻤﺅﺸﺭﺍﺕ ﺃﺒﻌﺎﺩ ﺍﻟﺴﺎﺤﺔ )ﺍﻟﺨﻁﺄ ﺍﻷﻋﻅﻤﻲ‬ ‫ﺍﻟﻤﺴﻤﻭﺡ ﺒﻪ ‪ 1mm‬ﻤﻥ ﻜﺎﻓﺔ ﺠﺎﻨﺏ (.‬ ‫• ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺃﺒﻌﺎﺩ ﺍﻟﺴﺎﺤﺔ ﻤﻥ ﺃﺠل ﻋﺩﺩ ﻤﻥ ﺯﻭﺍﻴﺎ ﺩﻭﺭﺍﻥ ﺍﻟﺫﺭﺍﻉ.‬ ‫‪Field size verification plates‬‬ ‫52‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫• ﺘﺴﺘﻌﻤل ﺍﻟﺴﺎﺤﺔ ﺍﻟﻀﻭﺌﻴﺔ ﻤﻥ ﺃﺠل ﺇﻋﺩﺍﺩ ﺍﻟﻤﺭﻴﺽ‬ ‫ﻭﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺍﻟﺴﺎﺤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﻤﻁﺎﺒﻘﺔ ﻟﻬﺎ.‬ ‫• ﺇﻥ ﺤﺩﻭﺙ ﺨﻁﺄ ﻓﻲ ﺍﻟﺘﻁﺎﺒﻕ ﺒﻴﻥ ﺍﻟﺴﺎﺤﺘﻴﻥ ﺍﻟﻀﻭﺌﻴﺔ‬ ‫ﻭﺍﻹﺸﻌﺎﻋﻴﺔ ﻴﻤﻜﻥ ﺃﻥ ﻴﺅﺩﻱ ﺇﻟﻰ ﻓﻘﺩﺍﻥ ﺠﺯﺀ ﻤﻥ‬ ‫ﺍﻟﻭﺭﻡ ﺨﺎﺭﺝ ﻤﺠﺎل ﺍﻷﺸﻌﺔ.‬ ‫.‬ ‫• ﻴﺠﺏ ﺇﺠﺭﺍﺀ ﻫﺫﺍ ﺍﻻﺨﺘﺒﺎﺭ‬ ‫62‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫اﺧﺘﺒﺎر ﺗﻄﺎﺑﻖ ﺑﻴﻦ اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ واﻹﺷﻌﺎﻋﻴﺔ‬ ‫1102/22/3‬ ‫72‬ ‫اﺧﺘﺒﺎر ﺗﻄﺎﺑﻖ ﺑﻴﻦ اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ واﻹﺷﻌﺎﻋﻴﺔ‬ ‫82‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫اﺧﺘﺒﺎر ﺗﻄﺎﺑﻖ ﺑﻴﻦ اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ واﻹﺷﻌﺎﻋﻴﺔ‬ ‫1102/22/3‬ ‫92‬ ‫اﺧﺘﺒﺎر ﺗﻄﺎﺑﻖ ﺑﻴﻦ اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ واﻹﺷﻌﺎﻋﻴﺔ‬ ‫03‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫‪Osama Anjak‬‬ ‫1102/22/3‬

‫اﺧﺘﺒﺎر ﺗﻄﺎﺑﻖ ﺑﻴﻦ اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ واﻹﺷﻌﺎﻋﻴﺔ‬ ‫اﻟﺴﺎﺣﺔ اﻟﻀﻮﺋﻴﺔ‬ ‫اﻟﺴﺎﺣﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ ‫1102/22/3‬ ‫13‬ ‫א‬ ‫א‬ ‫‪Isocentre check‬‬ ‫• ﻴﺠﺭﻱ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﻤﺭﻜﺯ ﻜل ﻤﻥ:‬ ‫– ﺩﻭﺭﺍﻥ ﺍﻟﺫﺭﺍﻉ.‬ ‫– ﻁﺎﻭﻟﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫– ﺍﻟﻤﺤﺩﺩﺍﺕ‬ ‫• ﺘﺠﺭﻱ ﻤﺭﺍﻗﺒﺔ ﻤﺭﻜﺯ ﺍﻟﺘﺼﺎﻟﺏ ‪ Crosswire‬ﻤﻥ ﺃﺠل ﺩﻭﺭﺍﻥ ‪.360o‬‬ ‫23‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫•‬ ‫•‬ ‫א‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻤﺭﻜﺯ ﺒﺩﻭﺭﺍﻥ ﺍﻟﺫﺭﺍﻉ.‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻤﺭﻜﺯ ﺒﺩﻭﺭﺍﻥ ﺍﻟﻤﺤﺩﺩ.‬ ‫33‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫‪SSD indicator‬‬ ‫א‬ ‫• ﻴﺠﺏ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﻤﺅﺸﺭ ﺍﻟﻤﺴﺎﻓﺔ ‪ SSD indicator‬ﺍﻟﻀﻭﺌﻲ ﺒﺎﻟﻤﻘﺎﺭﻨﺔ ﻤﻊ‬ ‫ﺍﻟﻤﺅﺸﺭ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻲ ‪ Mechanical front pointers‬ﻭﻟﻌﺩﺓ ﻤﺴﺎﻓﺎﺕ.‬ ‫‪Front pointer‬‬ ‫‪Front pointers for Different‬‬ ‫‪SSDs‬‬ ‫43‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺯﺍﻭﻴﺔ ﺩﻭﺭﺍﻥ ﺍﻟﻤﺤﺩﺩﺍﺕ ‪Pointer rotation‬‬ ‫53‬ ‫1102/22/3‬ ‫א‬ ‫63‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫א‬ ‫א‬ ‫א‬ ‫‪Radiation and light field coincidence‬‬ ‫א‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫א‬ Radiation and light field coincidence ‫א‬ 37 3/22/2011 Gantry rotation 3/22/2011 ‫א‬ ‫א‬ ‫א א‬ ‫א‬ ‫א‬ 38 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫א‬ ‫א‬ ‫• ﻴﺠﺏ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺘﻘﺎﻁﻊ ﺍﻟﺨﻁﻭﻁ ﻓﻲ ﺍﻟﻤﺭﻜﺯ.‬ ‫• ﺇﺸﺎﺭﺓ ﺨﺎﻁﺌﺔ ﻟﻠﻤﺭﻜﺯ ﺒﻭﺍﺴﻁﺔ ﺨﻁﻭﻁ ﺍﻟﻠﻴﺯﺭ ﺴﻭﻑ ﻴﻨﺘﺞ ﻋﻨﻬﺎ ﻓﻘﺩﺍﻥ ﻓﻲ‬ ‫ﺍﻟﺤﻴﺯ ﺍﻟﺠﻐﺭﺍﻓﻲ ﻟﻠﻭﺭﻡ.‬ ‫93‬ ‫1102/22/3‬ ‫א‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫א‬ ‫א‬ ‫א‬ ‫‪QA of Telecobalt Safety features‬‬ ‫− 06‬ ‫ﺍﻟﻤﺅﺸﺭﺍﺕ ﺍﻟﻀﻭﺌﻴﺔ ﺍﻟﺩﺍﻟﺔ ﻋﻠﻰ ﻭﻀﻌﻴﺔ ﺍﻟﺘﺸﻌﻴﻊ‬ ‫ﺠﻬﺎﺯ ﺍﻟﻤﺭﺍﻗﺒﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ - ﺼﻭﺘﻲ ﻭﻀﻭﺌﻲ )ﻴﻌﻤل/ﻻ ﻴﻌﻤل(.‬ ‫ﺍﻟﻤﺅﺸﺭ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻲ ﺍﻟﺩﺍل ﻋﻠﻰ ﻭﻀﻌﻴﺔ ﺍﻟﻤﻨﺒﻊ ﻋﻠﻰ ﺠﻬﺎﺯ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﺍﻟﻤﺼﺒﺎﺡ ﺍﻟﻀﻭﺌﻲ ﻋﻠﻰ ﺒﺎﺏ ﻏﺭﻓﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﺩﺍل ﻋﻠﻰ ﻭﻀﻌﻴﺔ ﺍﻟﺘﺸﻌﻴﻊ.‬ ‫ﺍﺨﺘﺒﺎﺭ ﺃﺩﺍﺀ ﻜﺒﺴﺎﺕ ﺍﻹﻴﻘﺎﻑ ﺍﻟﻁﺎﺭﺉ ‪Emergency OFF‬‬ ‫‪Radiation area monitor‬‬ ‫04‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫‪QA of Telecobalt Safety features‬‬ ‫− 06‬ ‫اﻟﻤﺆﺷﺮ اﻟﻤﻴﻜﺎﻧﻴﻜﻲ اﻟﺪال‬ ‫ﻋﻠﻰ وﺿﻌﻴﺔ اﻟﻤﻨﺒﻊ ﻋﻠﻰ‬ ‫ﺟﻬﺎز اﻟﻤﻌﺎﻟﺠﺔ‬ ‫‪Radiation area monitor‬‬ ‫14‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫• א‬ ‫ﺒﺎﻟﺸﻬﺭ.‬ ‫א‬ ‫• א‬ ‫א‬ ‫• א‬ ‫א‬ ‫24‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫א‬ ‫א‬ ‫–‬ ‫א‬ ‫א‬ ‫−06‬ ‫−06: ﻴﺠﺏ ﺇﺠﺭﺍﺀ ﺍﻻﺨﺘﺒﺎﺭ ﻤﺭﺓ ﻭﺍﺤﺩﺓ‬ ‫: ﻻ ﺤﺎﺠﺔ ﻟﻬﺫﺍ ﺍﻹﺠﺭﺍﺀ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﻜﻭﺒﺎﻟﺕ-06‬ ‫: ﻴﺠﺏ ﺇﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭ ﻴﻭﻤﻲ ﻟﻠﻤﺅﻗﺕ ﺍﻟﺯﻤﻨﻲ.‬ ‫1102/22/3‬

‫‪QC‬‬ ‫‪work‬‬ ‫‪sheet‬‬ ‫34‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫&א‬ ‫• ﻴﺠﺏ ﺍﺨﺘﺒﺎﺭ ﺍﻟﺨﺭﺝ ﺍﻹﺸﻌﺎﻋﻲ ﻟﻠﻤﺴﺭﻉ‬ ‫ﻴﻭﻤﻴﺎ ﻟﻜل ﻤﻥ ﺤﺯﻡ ﺍﻟﻔﻭﺘﻭﻨﺎﺕ‬ ‫ﹰ‬ ‫ﻭﺍﻻﻟﻜﺘﺭﻭﻨﺎﺕ.‬ ‫• ﺍﺨﺘﺒﺎﺭ ﺍﻟﻁﺎﻗﺔ: ﻴﺠﺏ ﺇﺠﺭﺍﺀﻩ ﻴﻭﻤﻴﺎ/ﺃﺴﺒﻭﻋﻴﺎ‬ ‫ﹰ‬ ‫ﹰ‬ ‫– ﺩﻟﻴل ﺍﻟﻁﺎﻗﺔ: 01/02‪ ) TMR‬ﺍﻟﺠﺭﻋﺔ ﻋﻠﻰ ﻋﻤﻕ‬ ‫02 ﺴﻡ ﺇﻟﻰ ﺍﻟﺠﺭﻋﺔ ﻋﻠﻰ ﻋﻤﻕ 01 ﺴﻡ ﻀﻤﻥ ﺸﺭﻭﻁ‬ ‫ﺍﻟﻘﻴﺎﺱ (‬ ‫44‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫01/02‪TMR‬‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫א‬ ‫–א‬ ‫• ﺘﺴﻁﺢ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ‪Beam flatness‬‬ ‫• ﺘﻨﺎﻅﺭ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ‪Beam symmetry‬‬ ‫• ﺍﻟﻅﻠﻴل ‪.Penumbra‬‬ ‫• ﻴﺠﺏ ﺍﻟﻘﻴﺎﻡ ﺒﺎﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺴﺎﺒﻘﺔ ﻤﺭﺓ ﻜل 6‬ ‫ﺃﺸﻬﺭ.‬ ‫‪Beam profile - flatness‬‬ ‫54‬ ‫1102/22/3‬ ‫א‬ ‫64‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫א‬ ‫–א‬ ‫א‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫–א‬ ‫א‬ ‫74‬ ‫1102/22/3‬ ‫א‬ ‫84‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫א‬ ‫–א‬ ‫א‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫א‬ ‫• ‪QC work sheet‬‬ ‫94‬ ‫1102/22/3‬ ‫ﺍﺧﺘﺒﺎﺭﺍﺕ ﺍﳌﻴﻜﺎﻧﻴﻜﻴﺔ ﻟﺘﺠﻬﻴﺰﺍﺕ ﺍﳌﻌﺎﳉﺔ‬ ‫א‬ ‫‪Simulator‬‬ ‫א‬ ‫‪Treatment Unit‬‬ ‫05‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺍﺧﺘﺒﺎﺭ ﻣﻴﺰﺍﺕ ﺍﳊﺰﻣﺔ ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﻓﺎﻨﺘﻭﻡ ﻤﺎﺌﻲ ﻟﻤﺴﺢ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ ‫‪Water Phantom‬‬ ‫25‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫–א‬ ‫א‬ ‫35‬ ‫1102/22/3‬ ‫א‬ ‫45‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫א‬ ‫–א‬ ‫א‬ ‫1102/22/3‬

‫اﻟﻤﻌﺎﻳﺮة‬ ‫‪Calibration‬‬ ‫ﻣﻌﺎﻳﺮة اﻟﻤﺼﺎدر اﻟﻤﺸﻌﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ:‬ ‫ﺗﻌﻴﻴﻦ اﻟﺠﺮﻋﺔ اﻟﻤﻤﺘﺼﺔ ﺑﺎﻟﻐﺮي ‪ Gy‬ﻋﻨﺪ ﻧﻘﻄﺔ ﻣﺮﺟﻌﻴﺔ ﺿﻤﻦ اﻟﺤﺰﻣﺔ‬ ‫اﻹﺷﻌﺎﻋﻴﺔ.‬ ‫ﺗﻌﻴﻴﻦ زﻣﻦ ﺗﺸﻐﻴﻞ اﻟﺤﺰﻣﺔ أو ﻋﺪد وﺣﺪات اﻟﻤﺮاﻗﺒﺔ ‪monitor units‬‬ ‫)‪ (MU‬اﻟﺘﻲ ﻳﺠﺐ ﺗﻄﺒﻴﻘﻬﺎ ﻟﻠﻮﺻﻮل إﻟﻰ اﻟﺠﺮﻋﺔ اﻟﻤﻄﻠﻮﺑﺔ.‬ ‫هﺬا اﻹﺟﺮاء هﺎم ﺟﺪا )إذا ﺣﺪث ﺧﻄﺄ ﻓﻲ ذﻟﻚ ﻓﺈن آﻞ ﺷﻲء ﻳﻠﻴﻪ ﺳﻴﻜﻮن ﺧﺎﻃﺊ(.‬ ‫ً‬ ‫ﻓﻲ ﺳﻠﺴﻠﺔ ﻣﻌﺎﻳﻴﺮ اﻵﻣﺎن ‪ BSS‬ﺗﻌﺪ اﻟﻤﻌﺎﻳﺮة ﺟﺰء ﻣﻦ ﺗﻘﻨﻴﻦ اﻟﺘﻌﺮض اﻟﻄﺒﻲ.‬ ‫ً‬ ‫55‬ ‫1102/22/3‬ ‫ﺍﻟﻤﻠﺤﻕ .91.‪ II‬ﻤﻥ ‪BSS‬‬ ‫:‬ ‫א‬ ‫ﺛﺎﻧﻴﺎ-91: ﻳﺘﺤﻘﻖ اﻟﻤﺴﺠﻠﻮن واﻟﻤﺮﺧﺺ ﻟﻬﻢ ﻣﻤﺎ ﻳﻠﻲ:‬ ‫ً‬ ‫)أ( إﻣﻜﺎﻧﻴﺔ اﺳﻨﺎد ﻣﻌﺎﻳﺮة اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﺘﻌﺮﺿﺎت اﻟﻄﺒﻴﺔ إﻟﻰ اﻟﻤﺨﺘﺒﺮ‬ ‫اﻟﻤﻌﻴﺎري ﻟﻘﻴﺎس اﻟﺠﺮﻋﺎت ‪.Standards dosimetry laboratory‬‬ ‫65‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫‪Traceability of calibration‬‬ ‫‪PSDLs‬‬ ‫‪BIPM‬‬ ‫‪PSDLs‬‬ ‫‪SSDLs‬‬ ‫‪IAEA‬‬ ‫‪SSDLs‬‬ ‫‪SSDLs‬‬ ‫‪Users‬‬ ‫‪Users‬‬ ‫‪Users‬‬ ‫‪Users‬‬ ‫75‬ ‫‪Users‬‬ ‫1102/22/3‬ ‫ﺍﻟﻤﻠﺤﻕ .91.‪ II‬ﻤﻥ ‪:BSS‬‬ ‫:‬ ‫א‬ ‫ﺛﺎﻧﻴﺎ-91: ﻳﺘﺤﻘﻖ اﻟﻤﺴﺠﻠﻮن واﻟﻤﺮﺧﺺ ﻟﻬﻢ ﻣﻤﺎ ﻳﻠﻲ:‬ ‫ً‬ ‫)ب( ﻣﻌﺎﻳﺮة ﺗﺠﻬﻴﺰات اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ اﻟﻤﺘﻌﻠﻘﺔ‬ ‫ﺑﻨﻮﻋﻴﺔ اﻹﺷﻌﺎع أو ﻃﺎﻗﺘﻪ واﻟﺠﺮﻋﺔ اﻟﻤﻤﺘﺼﺔ أو ﻣﻌﺪل‬ ‫اﻟﺠﺮﻋﺔ اﻟﻤﻤﺘﺼﺔ ﻋﻠﻰ ﻣﺴﺎﻓﺔ ﻣﺤﺪدة ﺳﻠﻔﺎ ﻓﻲ ﻇﻞ‬ ‫ً‬ ‫ﻇﺮوف ﻣﻌﻴﻨﺔ، ﺑﺈﺗﺒﺎع اﻟﺘﻮﺻﻴﺎت اﻟﻮاردة ﻓﻲ اﻟﺘﻘﺮﻳﺮ‬ ‫رﻗﻢ 772 ﻣﻦ ﺳﻠﺴﻠﺔ اﻟﺘﻘﺎرﻳﺮ اﻟﺘﻘﻨﻴﺔ اﻟﺘﻲ ﺗﺼﺪرهﺎ‬ ‫اﻟﻮآﺎﻟﺔ اﻟﺪوﻟﻴﺔ ﻟﻠﻄﺎﻗﺔ اﻟﺬرﻳﺔ ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل، .....‬ ‫85‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺑﺮوﺗﻮآﻮﻻت اﻟﻤﻌﺎﻳﺮة‬ ‫‪:Calibration protocols‬‬ ‫ﺗﻌﺪ اﻟﻤﻌﺎﻳﺮة ﻣﻦ اﻹﺟﺮاءات اﻟﻤﻌﻘﺪة ﻳﺘﻄﻠﺐ إﺟﺮاءهﺎ ﻣﻦ‬ ‫ﻗﺒﻞ ﺧﺒﻴﺮ ﻓﻲ ﻓﻴﺰﻳﺎء اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ.‬ ‫ﻳﻮﺟﺪ ﻋﺪد ﻣﻦ ﺑﺮوﺗﻮآﻮﻻت ﻟﻘﻴﺎس اﻟﺠﺮع اﻟﺘﻲ ﺗﺰودﻧﺎ‬ ‫ﺑﻄﺮاﺋﻖ اﻟﻤﻌﺎﻳﺮة:‬ ‫دوﻟﻴﺔ: )893 ‪(eg IAEA TRS 277 or TRS‬‬ ‫وﻃﻨﻴﺔ: )ﻋﺎدة ﺗﻜﻮن ﻣﻮﺿﻮﻋﺔ ﻣﻦ ﻗﺒﻞ اﻟﻬﻴﺌﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻠﻔﻴﺰﻳﺎء‬ ‫اﻹﺷﻌﺎﻋﻴﺔ ... ,86 ‪(AAPM TG 21, AAPM TG 51, DIN‬‬ ‫95‬ ‫1102/22/3‬ ‫أي ﺑﺮوﺗﻮآﻮل ﻧﺴﺘﺨﺪم؟‬ ‫ﻳﻌﺘﻤﺪ ذﻟﻚ ﻋﻠﻰ آﻴﻔﻴﺔ ﻣﻌﺎﻳﺮة ﺣﺠﻴﺮة اﻟﺘﺄﻳﻦ ﻓﻲ ﻣﺨﺒﺮ اﻟﻤﻌﺎﻳﺮة. أي إذا زودت‬ ‫اﻟﺤﺠﻴﺮة ﺑﻤﻌﺎﻣﻞ ﻣﻌﻴﺮة آﻴﺮﻣﺎ اﻟﻬﻮاء )‪ (NK‬أو ﻣﻌﺎﻣﻞ اﻟﺘﻌﺮض )‪ (NX‬ﻓﺈن‬ ‫اﻟﺒﺮوﺗﻮآﻮل 893-‪ IAEA’s TRS‬ﻻ ﻳﻤﻜﻦ اﺳﺘﻌﻤﺎﻟﻪ.‬ ‫‪IAEA’ TRS‬‬‫وإذا زودت اﻟﺤﺠﻴﺮة ﺑﻤﻌﺎﻣﻞ ﻣﻌﻴﺮة ﺟﺮﻋﺔ ﻣﻤﺘﺼﺔ ﺑﺎﻟﻤﺎء )‪ (NDW‬ﻓﺈﻧﻪ ﻳﻤﻜﻦ‬ ‫ﺗﻄﺒﻴﻖ اﻟﺒﺮوﺗﻮآﻮل 893-‪IAEA’s TRS‬‬ ‫-‪IAEA’ TRS‬‬ ‫06‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺑﺮﻧﺎﻣﺞ ﺗﺪﻗﻴﻖ ﻗﻴﺎس اﻟﺠﺮع ﺑﺈﺷﺮاف‬ ‫‪WHO/IAEA‬‬ ‫16‬ ‫1102/22/3‬ ‫א‬ ‫اﻟﻬﺪف ﻣﻦ‬ ‫ﻳﺠﺐ أن ﺗﻜﻮن اﻟﺠﺮﻋﺔ اﻹﺷﻌﺎﻋﻴﺔ ﺿﻤﻦ اﻟﺸﺮوط اﻟﻤﺮﺟﻌﻴﺔ ﻟﻠﻘﻴﺎس واﺣﺪة‬ ‫ﻓﻲ أﻧﺤﺎء اﻟﻌﺎﻟﻢ ﻣﺨﺘﻠﻒ اﻷﻣﺎآﻦ‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫26‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫‪1Gy‬‬ ‫1102/22/3‬

‫ﺗﺪﻗﻴﻖ ﻗﻴﺎس اﻟﺠﺮﻋﺔ ‪Dosimetric audits‬‬ ‫ﻻ أﺣﺪ ﻣﻌﺼﻮم ﻣﻦ اﻟﺨﻄﺄ .....!!!.‬ ‫ﻗﻴﺎس اﻟﺠﺮﻋﺎت ﻋﻤﻞ ﺷﺎق وﻣﻌﻘﺪ.‬ ‫ﻳﺘﻄﻠﺐ اﻟﺪﻓﺎع ﻓﻲ اﻟﻌﻤﻖ إﺟﺮاء اﻟﻌﺪﻳﺪ ﻣﻦ اﻻﺧﺘﺒﺎرات.‬ ‫أﻳﻀﺎ ﻳﺘﻄﻠﺐ ﺗﺪﻗﻴﻖ ﻗﻴﺎس اﻟﺠﺮﻋﺔ ﻧﻈﺮة ﻓﺎﺣﺼﺔ ﻣﻦ‬ ‫ً‬ ‫ﺧﺒﻴﺮ ﺧﺎرﺟﻲ ﻟﻠﺘﺤﻘﻖ ﻣﻦ دﻗﺔ اﻟﻘﻴﺎﺳﺎت.‬ ‫36‬ ‫1102/22/3‬ ‫ﺑﺮﻧﺎﻣﺞ اﻟﺘﺪﻗﻴﻖ ﻋﻠﻰ ﻗﻴﺎس اﻟﺠﺮع ﺑﺈﺷﺮاف ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ واﻟﻮآﺎﻟﺔ‬ ‫اﻟﺪوﻟﻴﺔ ﻟﻠﻄﺎﻗﺔ اﻟﺬرﻳﺔ ‪WHO/IAEA‬‬ ‫‪TLD capsules‬‬ ‫‪water‬‬ ‫46‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫ﺘﺩﻗﻴﻕ ﻗﻴﺎﺱ ﺍﻟﺠﺭﻋﺔ ﻀﻤﻥ ﺍﻟﺸﺭﻭﻁ ﺍﻟﻤﺭﺠﻌﻴﺔ‬ ‫‪FS: 10x10cm, d=5cm‬‬ ‫1102/22/3‬

‫ﺑﺮﻧﺎﻣﺞ ﺗﺪﻗﻴﻖ ﻗﻴﺎس اﻟﺠﺮع‬ ‫‪TLD Quality Audit‬‬ ‫ﺗﺤﺪﻳﺪ إﻣﻜﺎﻧﻴﺔ اﻟﻤﺸﺎرآﺔ ﺑﺎﻟﺒﺮﻧﺎﻣﺞ ﺑﺎﻟﻔﺘﺮة اﻟﻤﺤﺪد’ ﻣﻦ اﻟﻮآﺎﻟﺔ.‬ ‫اﺳﺘﻼم آﺒﺴﻮﻻت اﻟـ ‪ TLD‬ﻣﻊ اﻻﺳﺘﻤﺎرات وإﺟﺮاءات اﻟﺘﺸﻌﻴﻊ‬ ‫ﺗﻌﻴﻦ ﻣﻌﺪل اﻟﺠﺮﻋﺔ اﻹﺷﻌﺎﻋﻴﺔ )ﺿﻤﻦ اﻟﻔﺘﺮة اﻟﻤﺤﺪدة( ﺑﺎﺳﺘﺨﺪام‬ ‫أدوات اﻟﻘﻴﺎس اﻟﻤﺘﻮﻓﺮة ﻓﻲ اﻟﻤﺨﺒﺮ/ﻗﺴﻢ اﻟﻤﻌﺎﻟﺠﺔ اﻹﺷﻌﺎﻋﻴﺔ. ﺿﻤﻦ‬ ‫اﻟﺸﺮوط اﻟﻤﺮﺟﻌﻴﺔ ﻟﻠﻘﻴﺎس.‬ ‫اﻟﺤﺰﻣﺔ اﻹﺷﻌﺎﻋﻴﺔ آﻮﺑﺎﻟﺖ-06/ﻓﻮﺗﻮﻧﺎت ﻋﺎﻟﻴﺔ اﻟﻄﺎﻗﺔ.‬ ‫اﻟﺴﺎﺣﺔ اﻹﺷﻌﺎﻋﻴﺔ ‪.10x10cm2 at SSD/SAD=100cm‬‬ ‫اﻟﻌﻤﻖ ﺿﻤﻦ اﻟﻔﺎﻧﺘﻮم ‪d=5 or 10cm‬‬ ‫56‬ ‫1102/22/3‬ ‫‪TLD Quality Audit‬‬ ‫‪Ion‬‬ ‫‪Chamber‬‬ ‫‪Water‬‬ ‫‪Phantom‬‬ ‫06-‪Co‬‬ ‫-‪Co‬‬ ‫& ‪TLD‬‬ ‫‪Holder‬‬ ‫66‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫‪TLD Quality Audit‬‬ ‫‪Water‬‬ ‫‪Phantom‬‬ ‫06-‪Co‬‬ ‫-‪Co‬‬ ‫& ‪TLD‬‬ ‫‪Holder‬‬ ‫76‬ ‫1102/22/3‬ ‫ﺑﺮﻧﺎﻣﺞ ﺗﺪﻗﻴﻖ ﻗﻴﺎس اﻟﺠﺮع‬ ‫‪TLD Quality Audit‬‬ ‫ﺗﻌﻴﻦ اﻟﺰﻣﻦ اﻟﻼزم ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﺟﺮﻋﺔ إﺷﻌﺎﻋﻴﺔ ﻣﻘﺪارهﺎ ‪.2Gy‬‬ ‫ﺗﻌﺮﻳﺾ آﺒﺴﻮﻻت اﻟـ ‪.TLD‬‬ ‫ﺗﺪوﻳﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﻄﻠﻮﺑﺔ ﻓﻲ اﻻﺳﺘﻤﺎرة اﻟﺨﺎﺻﺔ.‬ ‫إﻋﺎدة ﻣﻘﺎﻳﻴﺲ اﻟـ ‪ TLD‬ﻣﻊ اﻻﺳﺘﻤﺎرة إﻟﻰ اﻟﻮآﺎﻟﺔ.‬ ‫86‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

IAEA mean dose = 1.00 User stated dose 69 3/22/2011 ‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫א‬ IAEA/WHO TLD POSTAL DOSE QUALITY AUDIT for SSDLs 60− ‫א‬ ‫א‬ IAEA/WHO TLD Postal Dose Quality Audit Co-60 (1992-2007) IA E A m e a n d o se /U se r s te te d d o s e 1.06 1.03 1 1992 1994 1996 1998 2000 2002 2004 2006 2008 0.94 0.91 0.88 0.85 3/22/2011 1990 0.97 Year of Audit 70 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

(Absolute Dosimetry) ‫ﺗﻌﻴﻴﻦ اﻟﺠﺮﻋﺔ اﻟﻤﻤﺘﺼﺔ ﻓﻲ اﻟﻤﺎء‬ TECHNICAL REPORTS SERIES No. 398 Absorbed Dose Determination in External Beam Radiotherapy An International Code of Practice for Dosimetry Based on Standards of Absorbed Dose to Water Sponsored by the IAEA, WHO, PAHO and ESTRO INTERNATIONAL ATOMIC ENERGY AGENCY, VIENNA, 2000 71 3/22/2011 ‫؟ ؟؟‬ ‫؟‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫ﺿﺒﻂ ﺍﳉﻮﺩﺓ ﳉﻬﺎﺯ ﺍﶈﺎﻛﻲ‬ ‫‪Simulator‬‬ ‫א‬ ‫א‬ ‫‪Simulator‬‬ ‫• ﺇﻥ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ ﻻ ﻴﻘﺘﺼﺭ ﻋﻠﻰ ﺃﺠﻬﺯﺓ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻓﻘﻁ !!‬ ‫• ﻴﺠﺏ ﺇﺠﺭﺍﺀ ﻀﺒﻁ ﺠﻭﺩﺓ ﻟﺠﻬﺎﺯ ﺍﻟﻤﺤﺎﻜﻲ ﺃﻴﻀﺄ.‬ ‫ً‬ ‫47‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫א‬ ‫א‬ ‫‪Simulator‬‬ ‫• ﺇﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭﺍﺕ ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻟﻠﺒﺎﺭﺍﻤﺘﺭﺍﺕ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﻤﻊ‬ ‫ﺠﻬﺎﺯ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫– ﺍﻟﺤﺭﻜﺎﺕ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻴﺔ ﻭﺯﻭﺍﻴﺎ ﺍﻟﺩﻭﺭﺍﻥ.‬ ‫– ﺤﺭﻜﺎﺕ ﺍﻟﻁﺎﻭﻟﺔ.‬ ‫• ﻤﻌﺎﻴﺭﺓ ﺍﻟﺠﻬﺩ ‪ kVp‬ﻭﺍﻟﻤﺎﺱ ‪mAs‬‬ ‫• ﺍﺨﺘﺒﺎﺭ ﺠﻭﺩﺓ ﻤﺴﺘﻘﺒل ﺍﻟﺼﻭﺭﺓ ‪ Image intensifier‬ﺍﻟﺘﺤﻜﻡ‬ ‫ﺍﻵﻟﻲ ﺒﺎﻟﺘﻌﺭﻴﺽ ‪)AEC‬ﺇﻥ ﻭﺠﺩ(.‬ ‫• ﺁﻟﻴﺔ ﺘﺤﻤﻴﺽ ﺍﻷﻓﻼﻡ ‪Film processor‬‬ ‫57‬ ‫1102/22/3‬ ‫א‬ ‫א‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺃﺒﻌﺎﺩ ﺍﻟﺴﺎﺤﺔ ‪.Field Size‬‬ ‫ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺭﻜﺯ ‪Isocenter check‬‬ ‫ﺍﺨﺘﺒﺎﺭ ﺍﻟﺘﻁﺎﺒﻕ ﺒﻴﻥ ﺍﻟﺴﺎﺤﺘﻴﻥ ﺍﻹﺸﻌﺎﻋﻴﺔ ﻭﺍﻟﻀﻭﺌﻴﺔ.‬ ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﻤﺅﺸﺭ ﺍﻟﻤﺴﺎﻓﺔ ﺍﻟﻀﻭﺌﻲ‬ ‫ﺍﺨﺘﺒﺎﺭ ﻋﻤﻭﺩﻴﺔ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ.‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫‪Optical – Radiation Field alignment‬‬ ‫67‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫‪Star shot – isocentre check‬‬ ‫1102/22/3‬

‫اﺨﺘﺒﺎﺭ ﺨﺼﺎﺌﺹ ﺍﻟﺤﺯﻤﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ X-ray beam parameters (Image forming system) (Image .mA ‫ ﻭﺍﻟﺘﻴﺎﺭ‬kV ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﺠﻬﺩ‬ .x-ray output ‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺜﺒﺎﺘﻴﺔ ﺍﻟﺨﺭﺝ ﺍﻹﺸﻌﺎﻋﻲ‬ .‫ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻤﺅﻗﺕ ﺍﻟﺯﻤﻨﻲ‬ .Focal spot size ‫ﻗﻴﺎﺱ ﺃﺒﻌﺎﺩ ﺍﻟﺒﺅﺭﺓ ﺍﻟﻤﺤﺭﻗﻴﺔ‬ ‫ﺍﺨﺘﺒﺎﺭ ﺍﻟﺘﺴﺭﻴﺏ ﻤﻥ ﺍﻷﻨﺒﻭﺏ‬ • • • • • X-ray output meter mAs & KVp meter Verification of focal spot size 77 3/22/2011 ‫؟؟‬ ‫א‬ Test 1. Door Interlock 2. Motion enable/disable switches 3. Warning Lights 4. Emergency off 5. Collision avoidance 3/22/2011 ‫א א‬ ‫א‬ Frequency of Tests Daily Daily Daily Daily Daily 78 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫؟‬ ‫א‬ Test 1. Optical checks Localizing lasers Distance indicator (SAD) 2. Mechanical checks Cross hair centering Block tray centering Field size indicator 3. Safety checks Door interlock Motion & Warning lights 3/22/2011 ‫א א‬ ‫א‬ Tolerance 2mm 2mm 2mm 2mm 1mm per edge Operating 79 Listing of Simulator QC 3/22/2011 80 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫א‬ ‫א‬ ‫א‬ ‫‪Simulation‬‬ ‫‪CT‬‬ ‫• ﺠﻭﺩﺓ ﺍﻟﺼﻭﺭﺓ ‪Image quality‬‬ ‫• ﺍﻟﻤﻘﺎﻁﻊ ﻭﺍﻟﺘﺸﻭﻩ ﻓﻲ ﺍﻟﺼﻭﺭﺓ ‪Scaling‬‬ ‫• ﺁﻟﻴﺔ ﻨﻘل ﺍﻟﺼﻭﺭ ‪Transfer DICOM‬‬ ‫‪of data‬‬ ‫‪Gammex RMI CT test tool‬‬ ‫• ﻨﻘل ﺍﻟﻤﺭﻴﺽ )ﻭﻀﻌﻴﺔ ﺍﻟﻤﺭﻴﺽ ﻭﺘﻁﺎﺒﻕ‬ ‫ﻁﺎﻭﻟﺔ ﺠﻬﺎﺯ ﺍﻟـ ‪ CT‬ﻤﻊ ﻁﺎﻭﻟﺔ ﺠﻬﺎﺯ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫18‬ ‫1102/22/3‬ ‫‪Quality assurance of‬‬ ‫‪Treatment planning‬‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

Quality assurance of Treatment planning Components of Quality assurance for treatment planning • Training of staff – Understanding the algorithm – Understanding the input requirements – Verification of beam data • Reproducibility tests • In vitro/vivo dosimetry 83 3/22/2011 Quality control checks for planning system • Hardware Digitizer Plotter Frequency of check weekly check weekly check System turn on CT interface for image transfer • External beam data Data set Reference Field size plan Monitor Units 3/22/2011 semi-annually semi-annually Each patient 84 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

In Vitro / in vivo dosimetry checks • In vitro dosimetry with Anthropomorphic phantom (Rando) • This phantom could be CT scanned and planned like patient • Phantom could be loaded with TLD and treatemnt plan could be verified Rando Phantom 85 3/22/2011 In vivo dosimetry • Verification of dose delivered • Dose to Critical organs – eyes, gonads or fetus • Exit dosimetry • Detectors – Diode, MOS-FET, – TLD 3/22/2011 TLD reader MOSFET detectors 86 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

Specification and Acceptance Testing of Radiotherapy Treatment Planning Systems 87 3/22/2011 Acceptance Testing and QC of Radiotherapy Treatment Planning Systems 3/22/2011 88 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

‫ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﻭﻗﺎﻴﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ ‫‪QA and radiation protection‬‬ ‫• ﻴﻔﻴﺩ ﺒﺭﻨﺎﻤﺞ ﻀﻤﺎﻥ ﻓﻲ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ.‬ ‫• ﺘﺒﻌﺎ ﻟﻤﻌﺎﻴﻴﺭ ﺍﻵﻤﺎﻥ ‪ BSS‬ﺠﺭﻯ ﺘﺼﻨﻴﻑ ﺇﻟﻰ ﻋﺩﺩ ﻤﻥ ﺍﻷﺠﺯﺍﺀ‬ ‫ﹰ‬ ‫ﺒﺤﻴﺙ ﻴﻜﻭﻥ ﻜل ﻤﻨﻬﺎ ﻤﺴﺘﻘل ﻋﻥ ﺍﻵﺨﺭ:‬ ‫– ﻤﺘﻁﻠﺒﺎﺕ ﺍﻟﺘﺸﻐﻴل ‪Requirements for Practices‬‬ ‫– ﺁﻤﺎﻥ ﺍﻟﻤﻨﺎﺒﻊ ‪Safety of Sources‬‬ ‫– ﺍﻟﺘﻌﺭﺽ ﺍﻟﻁﺒﻲ ‪Medical Exposure‬‬ ‫– ﺍﻟﺘﻌﺭﺽ ﺍﻟﻤﻬﻨﻲ ‪Occupational Exposures‬‬ ‫98‬ ‫1102/22/3‬ ‫ﺍﻟﻨﺘﺎﺋﺞ ؟؟؟؟؟‬ ‫09‬ ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬ ‫1102/22/3‬

‫ﺍﳋــﺎﲤــــﺔ‬ ‫• ﻴﺠﺏ ﺍﻟﻘﻴﺎﻡ ﺒﺎﺨﺘﺒﺎﺭﺍﺕ ﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ‬ .‫ﺩﻭﺭﻴﺎ‬ ‫ﹰ‬ ً ‫• ﻴﺠﺏ ﺘﻭﺜﻴﻕ ﻨﺘﺎﺌﺞ ﺍﻟﻘﻴﺎﺴﺎﺕ‬ .‫ﻭﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻀﻤﻥ ﺴﺠﻼﺕ ﺨﺎﺼﺔ‬ 91 3/22/2011 References(1) 1. Accuracy Requirements and Quality Assurance of External Beam Therapy with Photon and Electrons, Ed. by Anders Brahae, Acta Oncologica Supplement 1 . 1988. 2. International Electrotechnical Commission (IEC): Medical Electrical Equipment, Medical Electron Accelerators in the Range 1 MeV to 50 MeV. Guidelines for Functional performance characteristic, IEC Technical Report 977, 1989. Hospital Physicists Association Report 54, Commissioning and Quality Assurance of Linear Accelerators. IPSM, Publication York UK 1988. 3. 3/22/2011 92 ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

References(2) 4. Sunthartingam N. Quality Assurance of Radiotherapy Locizer / simulators, Proceeding of an American College of Medical Physics Sysmosium, 1991- Quality Assurance in Radiotherapy Edited by G. Starksehall and J.L.Horton. 5. Griffiths E.Sue ET al:” Radiotherapy: Principles to Practice. a manual for quality in treatment delivery”. Longman Group UK Limited. 1994. 93 3/22/2011 ‫מ‬ ‫א‬ ‫א‬ Ossama Anjak AECS, Department of Protection &Safety PO Box 6091 Damascus Syria E-mail: oanjak@gmail.com ‫أﺳﺎﻣﺔ أﻧﺠﻖ - هﻴﺌﺔ اﻟﻄﺎﻗﺔ اﻟﺬرﻳﺔ اﻟﺴﻮرﻳﺔ‬

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