Brilliance CT: Therapy Top Kit Installation Instructions
Brilliance CT: Therapy Top Kit Installation Instructions
Brilliance CT
Therapy Top Kit Installation
Instructions
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Philips Legal Department. This document must be returned to Philips when the user is no longer licensed and in any event upon Philips’ first
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BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Symbol Descriptions
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BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Safety Information
To the User of This Manual
The user of this manual is directed to read and carefully review the instructions, warnings and cautions contained herein prior to beginning installation
or service activities. While you may have previously installed or serviced equipment similar to that described in this manual, changes in design,
manufacture or procedure may have occurred which significantly affect the present installation or service.
!
WARNING In addition to the warnings listed above, make sure to follow all safety guidelines as
described in the Safety Manual. Failure to do so can result in severe personal injury.
Installation and Environment
Except for installations requiring certification by the manufacturer per federal standards, see that a radiation protection survey is made by a qualified
expert in accordance with NCRP 102, section 7, as revised or replaced in the future. Perform a survey after every change in equipment, workload, or
operating conditions which might significantly increase the probability of persons receiving more than the maximum permissible dose equivalent.
Only properly trained and qualified personnel should be permitted access to any internal parts. Live electrical terminals are deadly; be sure line
disconnects are opened and other appropriate precautions are taken before opening access doors, removing enclosure panels, or attaching
accessories.
Do not under any circumstances, remove the flexible high tension cables from the x-ray tube housing or high tension generator and/or the access
covers from the generator until the main and auxiliary power supplies have been disconnected. Failure to comply with the above may result in serious
or fatal bodily injuries to the operator or those in the area.
Switch off the system at the main power supply (using the on-site On-Off switch), and the internal/external uninterruptible power supply (UPS).
Make sure that no other person can switch on power or switch off the security measures, when installation, maintenance or service work on the
system is performed.
Always use an ESD protection wrist strap when servicing any component in the system.
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BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Electrical-grounding Instructions
The equipment must be grounded to an earth ground by a separate conductor. The neutral side of the line is not to be considered the earth ground.
On equipment provided with a line cord, the equipment must be connected to properly grounded, three-pin receptacle. Do not use a three-to-two pin
adapter.
Those authorized to operate, participate in or supervise the operation of the equipment must be thoroughly familiar and comply completely with the
current established safe exposure factors and procedures described in publications, such as: Subchapter J of Title 21 of the Code of Federal
Regulations, "Diagnostic X-ray Systems and Their Major Components", and the national council on radiation protection (NCRP) no. 102, "Medical X-
ray And Gamma-ray Protection For Energies Up To 10 Mev-equipment Design and Use", as revised or replaced in the future.
Those responsible for planning of x-ray and gamma-ray equipment installations must be thoroughly familiar and comply completely with NCRP no.
49, "Structural Shielding Design and Evaluation For Medical Of X-rays and Gamma-rays of Energies Up to 10 Mev", as revised and replaced in the
future. Failure to observe these warnings may cause serious or fatal bodily injuries to the operator or those in the area.
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Revision History
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Revision History
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Brilliance CT Therapy Top Kit Installation Instructions
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Introduction
The Brilliance CT Therapy Top is a carbon fiber couch top that may be installed on any Philips Brilliance CT scanner
patient support. This therapy top provides radiation oncologists with a patient positioning system that is identical to the
Clinac family of linear accelerators, ensuring identical patient setup between CT scanning and treatment.
There are three major sections to installing the therapy top:
• Aligning the patient support and positioning the therapy top
• Taking deflection measurements
• Verification
This document will provide detail on each section.
NOTE The approximate time required for this installation is 2 - 4 hours. If the therapy top is being installed on an
existing couch, it might take much longer, depending on the cleanup that would be required on the base.
Prerequisites
Philips Brilliance CT Scanner with patient support.
Patient support must have the bayonet style mount for head rests. If not, order the patient support carbon top upgrade
kit, p/n 4535 671 15431.
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Materials and Tools Required
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
.
Table 1: Contents of Therapy Top Kit, p/n 4535 673 43661
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Materials and Tools Required
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
1. Before attempting to install the Therapy Top, the patient support must be checked for levelness and that the
horizontal travel is orthogonal to the scan plane.
2. Remove the patient support covers. Refer to the Brilliance CT Patient Support Repair / Replacement Manual.
3. Place a bubble level on the front and rear edges of the patient support base, and on the right and left side rails.
Level front to rear (longitudinal) and left to right (transverse). See Figure 1 and Figure 2. Verify patient support is
level.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
4. If patient support is not level, loosen the five patient support mounting bolts and install the proper shims under the
patient support base to bring patient support to level. Tighten the mounting bolts once levelness is verified.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
5. Place the therapy top on top of the patient support. Loosen the five #10 mounting screws securing the adjustable
end plate at the foot end and three #10 mounting screws securing the adjustable wedge at the head end of the
therapy top to allow for adjustment. See Figure 3 for location of mounting screws.
Adjustment
Figure 3: Mounting screws at Foot End and Head End of Therapy Top
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
6. Back out the thumbscrews on the foot end of the therapy top to allow it to rest on the top edge of the patient support
carbon top. There should be a gap between the inside of the Adjustment End Plate and the couch carbon top. The
head end of the therapy top has a “male” wedge feature to consistently locate the recess in the center of the front
edge of the carbon top (see Figure 4). Insert wedge of therapy top into recess in patient support carbon top.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
7. Ensure the therapy top is laying flat on the carbon top. At the foot end of the therapy top, engage the two fluted
thumbscrews into the recessed holes in the carbon top (see Figure 5).
Fluted
Thumbscrew Recessed Hole
Fluted
Thumbscrew
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
8. Place bubble level on therapy top in both X and Y positions to verify levelness. (see Figure 6) If therapy top is not
level, use neoprene tape as needed to shim therapy top.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
NOTE Three different varieties (.015 in., .030 in., and .060 in. thickness) of neoprene shim tape are available to
achieve alignment in the Y direction. The shim tape may be carefully placed along the .060 neoprene strips
where the therapy top rests on the patient support. Refer to Figure 7 for shim tape placement.
NOTE To compensate for the deflection of the couch top, it may be necessary to shim the patient support. The
suggested shim thickness is 0.070 inches in the front and 0.035 inches in the center. These values are based
on experimentation. In some cases, there may be a need to add or remove shims to achieve the required
deflection. Make sure that final vertical couch travel is plumb.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
9. Place the Therapy Top Calibration Phantom (p/n 4535 673 43771) onto the head end (H5/H4) of the therapy top.
Secure in place using the two lockbars supplied with the phantom. See Figure 8.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
15. Retract the top 500 mm backwards. This is the marking plane for the prostrate position (MP-P).
16. Record these values in the table below:
Table 3:
SP-H
MP-H
SP-P
MP-P
Setup a surview 180 and an abdominal axial body (see Figure 9).
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
19. Adjust the scanable range to include the entire range of the phantom (see Figure 11).
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
21. Scan the phantom and verify that you can observe the cross marks on the phantom. See Figure 12. Repeat scan
at the prostate position.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
34. Move laser behind the weights to the prostate position (37 in. (93.9 cm) from front end). (see Figure 15)
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
Verification
NOTE The following steps are verification steps that have to be performed after the lap lasers or any third party
lasers are installed.
39. Perform the following steps to verify the deflection measurements.
40. The head and prostate positions can be simulated by placing the phantom in the H5 / H4 and
F1 / F2 notches respectively. The Head position is shown in Figure 16.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
41. Make sure to keep the head and prostate areas clear for installation of the phantom (see Figure 17).
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
c. Loosen, do not remove, 16 hex-head screws connecting table top to the four j-brackets. Refer to Figure 18.
Figure 18: J-Bracket Screws Location (Left-hand side shown, right-hand side similar)
d. Tilt carbon top up or down as required (the intent is to preload the carbon top so that when the weight is re-
applied, the top will be level).
e. Use supports between subframe and carbon top until top is secure.
f. Tighten 16 fasteners to 11 lb-ft (132 lb-in / 14.9 Nm) torque.
g. Repeat Step 41 thru Step 45 above.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
46. If additional adjustment is necessary, add shims between the carbon top and therapy top. Refer to Figure 7 on
page 10.
NOTE Ensure therapy top is level along scan length. Add shim where needed to correct irregularities of top.
Check with laser assembly and combination square or ruler as required.
NOTE The LAP lasers are usually placed 500 mm from the gantry isocenter. This actual distance has to be
verified at each site. The marking plane for head and prostrate locations has to be changed for the
following verification test section only.
47. Install the phantom at head location (H4/H5) and align with external third party marking plane lasers (MP-H).
48. Write down the X and Y values from the laser as XL-head and YL-head.
49. Move the top 500 mm (or the external laser distance from the isocenter) forward to scan position.
50. Perform an axial scan with the parameters defined in Step 18. DO NOT do a surview scan.
51. Verify if all the crosshairs are visible. Ideally the crosshairs should be visible on the center (8th or 9th slide). But
they could be off by a slide or two depending on how the laser is aligned to the phantom in the marking plane.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
52. Mark the center point on the center phantom as shown in . Write down the center values from the scan as X1-head
and Y1-head. Refer to Figure 19.
Figure 19:
53. Install the phantom at the prostate location (F1/F2) and align with the external third party marking lasers, marking
the centerpoint of the phantom (MP_P).
54. Write down the X and Y values from the laser as XL-prostate and YL-prostate.
55. Repeat Step 49 through Step 51.
56. Mark the centerpoint and write down the center values from the scan as X1-prostate and Y1-prostate.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
57. Calculate the delta values for head and prostate position according to the tables below.
58. Verify that the difference in values from head and prostate location X and Y coordinates are within 1.0 mm and
2.0 mm respectively.
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
59. Carefully drill and pin the steel plate to the foot end of the therapy top using the two pilot holes in the plate. Drill into
the therapy top with a 1/8 in. diameter bit. Insert the provided 1/8 in. diameter dowel pins using Loctite #401 to
retain the pins (see Figure 20).
Figure 20: Drill and pin the End Plate at Foot End
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
60. Secure the steel plate at the head end of the therapy top by tightening the three #10 screws. Be careful not to strip
the threads by over tightening.
61. Carefully drill and pin the steel plate at the head end of the therapy top using the two pilot holes to pin the Wedge to
the therapy top (see Figure 21).
Pilot Holes
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Therapy Top Kit Installation
BrillianceTM CT Therapy Top Kit Installation Instructions Rev C
62. Locate and install two (2) Alignment Labels (4535 673 20581) on the couch carbon top foot end near the handles
for easy location of the therapy top by the technician during clinical usage. Place labels on each side of the carbon
top so that when facing the top surface of the therapy top, you can see all of the arrows but not the line (see
Figure 22).
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