Modus QA QUASAR User manual

User’s Guide
Version 2.0.0

Legal & Copyright Notice
Information in this manual is subject to change without notice. No part of this manual may
be reproduced in any form without the written permission of Modus Medical Devices Inc
(Modus QA).
Copyright ©2020 Modus Medical Devices Inc. All rights reserved. QUASAR™and the QUASAR™
logo are trademarks of Modus Medical Devices Inc.
Modus QA reserves the right to make any changes without further notice to any products
herein. Modus QA makes no representation, warranty or guarantee regarding the suitability
of its products for any particular purpose, nor does Modus QA assume any liability arising out
of the application or use of any product, and specifically disclaims any and all liability,
including without limitation consequential or incidental damages. “Typical” parameters can
and do vary in different applications. All operating parameters and default values, including
“Typicals” must be validated for each customer application by customer’s technical experts.
Modus QA does not convey in this user’s guide any license under its patent rights nor the
rights of others.

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Contents
Verify Image-Guided Shifts for 6º of Freedom Couches.....................................................5
Daily 6DoF QA..............................................................................................................................................5
Specifications ...............................................................................................................................................5
Instructions..........................................................................................................................................................5
Daily 6DoF CBCT/Couch QA ..............................................................................................................5
Standard Daily CBCT/Couch QA .....................................................................................................6
Additional Points .......................................................................................................................................7
Appendix - Penta-Guide Tilt-Plate Dimensional References ......................................... 8
Anterior View ......................................................................................................................................... 8
Lateral View............................................................................................................................................ 8
Axial View ..................................................................................................................................................9
Vertical Pillar...........................................................................................................................................9
Warranty..............................................................................................................................................................10
Modus Medical Devices Inc. Limited Warranty .................................................................10
Technical Support.........................................................................................................................................10

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Verify Image-Guided Shifts for 6º of Freedom Couches
Introducing QUASAR™ Penta-Guide Tilt Plate, an easy and efficient way to verify couch
corrections for six degrees of freedom (6DoF) couches. The QUASAR™ Penta-Guide Tilt
Plate positions the QUASAR™ Penta-Guide Phantom at known rotation angles and
displacements relative to the isocenter. With this device, users test rotation corrections and
combined translation and rotation corrections on a 6DoF couch.
Daily 6DoF QA
The central lines on the tilt plate, in each group of three, align the centre of the phantom
with the laser isocenter for rotation only corrections. Other lines require translation and
rotation corrections.
Specifications
•Tilt angles are: 0.75º, 1.25º, and 1.0º (see appendix for further dimensional references)
•Turning the tilt plate in 90º increments varies the direction of the rotation
corrections
•Compatible with all new and existing QUASAR™ Penta-Guide Phantoms
•Compatible with most localization bars for faster, simpler test setup
Instructions
Daily QA of a linear accelerator includes testing of the treatment couch motion, as well as
the on-board cone beam CT (CBCT) imaging system. Typically, this procedure is performed
with the QUASAR™ Penta-Guide Phantom, which enables simultaneous testing of the
couch motion (in 3 directions) and imaging systems. However, some treatment couches
(eg. Hexapod Couch), are capable of 6 degree of freedom motion (3 translations and 3
rotations). Therefore, the QUASAR™ Penta-Guide Tilt Plate was designed as an accessory
to the QUASAR™ Penta-Guide Phantom to facilitate the daily QA of linear accelerators
equipped with these 6 degree of freedom couches.
Daily 6DoF CBCT/Couch QA
(Phantom with Tilt Plate for rotation only or rotation plus translation corrections)
1. Place the QUASAR™ Penta-Guide Phantom in the Tilt Plate
2. Align the Tilt Plate markings with the room lasers. The level indicators show that the
Tilt Plate is level, but the phantom is not level.
3. Acquire CBCT of the QUASAR™ Penta-Guide Phantom and Tilt Plate

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4. Use the image registration tools to align the CBCT with a reference CT of the
QUASAR™ Penta-Guide Phantom (reference CT should not contain Tilt Plate)
Ensure the calculated shifts are within 1mm of the expected shifts (magnitude of
shifts depends on markings used), and that rotations are <0.5 degrees from
expected rotation (0.75º, 1.25º, and 1.0º)
5. Apply the correction and move the couch. Check that the lasers now coincide with
the central markings on the QUASAR™ Penta-Guide Phantom. The level indicators
show that the phantom is level, but the Tilt Plate is not level.
Figure 1 –Before correction: Lasers aligned with
Tilt Plate
Figure 2 –After correction: Lasers aligned with
Phantom
Standard Daily CBCT/Couch QA
(Phantom alone without the Tilt Plate for translation only corrections)
1. Align the off-centre markings on the QUASAR™ Penta-Guide Phantom with the
lasers
2. Acquire CBCT of the QUASAR™ Penta-Guide Phantom
3. Use the image registration tools to align the CBCT with a reference CT of the
QUASAR™ Penta-Guide Phantom (isocentre at the centre of the phantom on the
reference CT)
4. Ensure the calculated shifts are within 1mm of the expected shifts (1cm, 1.2cm, and
1.4cm), and that rotations are <0.5 degrees (since there should be no rotations of the
phantom
5. Apply the correction and move the couch. Check that the lasers now coincide with
the central markings on the QUASAR™ Penta-Guide Phantom

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Additional Points
•Daily Couch/CBCT QA of a 6 degree of freedom couch with the tilt plate is simple.
Only 1 extra step from the standard QUASAR™ Penta-Guide Phantom.
•When aligning the CBCT to the reference CT, it is best to perform an automatic
match. However, the clipbox must be selected such that it does not contain the tilt
plate. (Since there is no tilt plate in the reference scan).
•There are other vendor specific QC tests that need to be performed daily for the
6DoF couches - this does not replace those tests.
•There is a channel in the base of the Tilt Plate that is compatible with most
localization bars
•Placing the Tilt Plate on a localization bar may simplify setup and improve
repeatability of these tests

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Appendix - Penta-Guide Tilt-Plate Dimensional References
Anterior View
Dimensions are in millimeters. Demonstrates
that the central markings on the tilt-plate
correspond to the center sphere location
within the Penta-Guide phantom as it rests in
the Tilt-Plate. The additional markings
indicate a 10 mm displacement from that
origin location. The yaw is indicated as a 1°
counter-clockwise displacement.
Figure 3 –Anterior View
Lateral View
Indicating a 1.25° inclination (pitch) built into
the Tilt-Plate surface, raising the superior
aspect of the Penta-Guide anteriorly.
Figure 4 –Lateral View

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Axial View
From the inferior end of the
Tilt-Plate indicating a 0.75°
inclination (roll) raising the
Left (90° side) of the Penta-
Guide phantom.
Figure 5 –Axial View
Vertical Pillar
The vertical pillar contains 3
reference lines. The central
line aligns with the central
sphere of the Penta-Guide
phantom. The anterior and
posterior lines indicate a
10mm displacement from
the center line or center of
the central Penta-Guide
sphere.
Figure 6 –Vertical Pillar
Please note, these measurements are provided for reference only. As part of the
recommended QA process, the residual error in alignment is the metric that should
determine pass/fail criteria. I.e., after alignment images and corrections are applied, a
verification image set (CBCT) should be performed to verify that the overall 6DoF
alignment accuracy is within your expected tolerances (1-2mm).

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Warranty
Modus Medical Devices Inc. Limited Warranty
Modus Medical Devices Inc. warrants to the original purchaser that the products sold will
be free from defects in material and workmanship for a period of one year from the date of
delivery. If the product is found to be defective during the warranty period, the part(s) and
labor required to repair the product will be provided free of charge. This warranty is subject
to the following exceptions and limitations:
•The customer shall be responsible for proper maintenance and handling of the
product.
•No warranty is extended to any equipment that has been altered or modified in any
way.
•No warranty is extended to any equipment that has been misused, or damaged.
This warranty is in lieu of all other warranties, express or implied, including warranties of
merchantability or fitness for a particular purpose and is the sole and exclusive remedy for
any claim of damages arising from defects in the Modus product. Modus shall have no
liability for consequential damages or personal injury or for the loss, damage or expense,
directly or indirectly arising from the use of this product. No distributor, dealer or other
party is authorized to make any warranty on behalf of Modus, or to assume for Modus any
other liability with respect to its products.
Technical Support
If you require service or support for this product, please contact Modus Medical Devices Inc. at:
Modus Medical Devices Inc.
1570 North Routledge Park
London, Ontario N6H 5L6
CANADA
Toll Free (North America): [phone]
Tel: [phone] x111
[e-mail]
www.modusQA.com