Phase 1. Control Room Setup

1.1 Initial Power-Up and System Checks

1. Power On Equipment

• Ensure the wall switch is set to HDR
• Turn on all cameras and scan the room to verify Video Monitor/Intercom are functional

2. Activate Safety Monitors

• Turn on the personal dose monitor by holding down the power button
• Turn on the radiation survey meter

3. Console System Check

• Locate the console key and switch the system on
• Note the following displayed information:
  • Date and time (verifies Date/Time on Console Correct)
  • Source activity/strength
  • Battery level (UPS Status should be > 90%)

1.2 Prepare Test Plan

4. Log In and Load Test Plan

• Log in with your clinic-approved credentials
• Click Test Plans > 4DailyQA and proceed

Phase 2. Treatment Room Setup

2.1 Enter Room and Initial Setup

5. Enter Treatment Room Safely

• Enter with the survey meter every time
• Verify the emergency container ("lead pig") is present in the room

6. Access Equipment

• Retrieve the lock key and Perma-Doc from the cabinet
• Unlock the two exterior locks on the cabinet using the current clinic-approved access process

7. Unlock Afterloader

• Use the key to unlock the afterloader's lock and remove the chain
• Verify the test plan information appears on the afterloader display (indicated by arrow)

2.2 Position Equipment

8. Position CamScale

• Roll out the CamScale and position it in line with the treatment bed facing the gantry

9. Position Afterloader

• Roll out the afterloader in front of the CamScale
• Position it parallel to the couch, on the side closer to the gantry

10. Connect CamScale Network

• Connect the CamScale ethernet cable to the wall port inside storage

11. Align CamScale

• Align the CamScale so the laser line remains within the tolerance region marked on the afterloader

2.3 Connect Transfer Guides

12. Connect Channel 1 (CamScale)

• Connect the transfer tube from CamScale storage (black tube) to the CamScale
• Connect the other end to channel 1 of the afterloader

13. Connect Channel 2 (Perma-Doc)

• Connect the transfer guide from the wall rack to the Perma-Doc
• Connect the other end to channel 2 of the afterloader

Phase 3. Safety Checks

3.1 Length Verification

14. Run Length Measurement

• With the plan loaded on the afterloader, run Length Measurement
• Tolerance: 132 cm ± 1 mm

15. Skip Push Test

• Press the skip button when prompted for Push Test

3.2 Obstruction Detection Test

16. Prepare for Obstruction Test

• Partially disconnect the transfer guide from the Perma-Doc (leave it loose)

17. Exit Room

• Start the Last Man Out sequence on the way out (press 1, then 2)

18. Complete Pre-Treatment Checklist

• Complete the Pre-treatment checklist at the console
• Click Done > Approve

19. Run QA Plan

• Run the QA plan from the control room
• The system should detect the obstruction in channel 2, confirming that obstruction detection is working

20. Reconnect Transfer Guide

• Return to the room
• Properly connect the transfer guide to the Perma-Doc
• Restart the Last Man Out sequence on exit

3.3 Dwell Time and PrimAlert Verification

21. Run QA Plan with Proper Connections

• Run the QA plan from the control room with the transfer guide properly connected

22. Time First Dwell Position

• Start both timers when the source (yellow indicator) reaches the first dwell position

• Expected dwell time: 30 seconds
• While timing, visually inspect that the PrimAlert monitor is blinking

23. Stop Timers

• Stop the timers when the source leaves the first dwell position
• Both timers should read 30 seconds

3.4 Interrupt Button Test

24. Test Console Interrupt

• Click the Interrupt button on the graphical interface after the source leaves the first dwell position
• This should:
  • Interrupt treatment
  • Park the source
  • Turn off the PrimAlert monitor lights

3.5 Key Interlock Test

25. Test Key Interlock

• Restart delivery of the QA plan
• Wait for the source to reach a dwell position
• Turn the key to the middle position to interrupt treatment

3.6 Door Interlock Test

26. Test Door Interlock

• Restart delivery of the QA plan
• Wait for the source to reach a dwell position
• Open the vault door while the source is out — treatment should interrupt
• Restart the Last Man Out sequence

3.7 Emergency Stop Test

27. Test Emergency Stop Button

• Restart delivery of the QA plan
• Wait for the source to reach a dwell position
• Press the Interrupt (red) button on the console to halt treatment

28. Clear Error and Complete

• Click Clear Error
• Move to the next screen to sign off on the tests

29. Abort Fraction

• Select Abort this fraction before clicking Done

3.8 Source Position Verification

30. Access Position Verification

• Click the dropdown menu (top right, to the left of Log Out)
• Select System Configuration > Cable and Source > Proceed

31. Run Position Verification

• Ensure the Position Verification tab is selected
• Proceed until reaching the verification window
• Click Prepare Verification and run the check

32. Verify Results

• Tolerance: ±1 mm (aim for ±0.5 mm or ±0.05 cm)
• Check the box All cables have been identified if within tolerance
• Click Ok > Close > Approve

3.9 Worklist Configuration Check

33. Verify Worklist Settings

• Select System Configuration > Console and Afterloader > System Setting
• Verify that the options for Worklist and Treatment appear on the bottom left

Phase 4. Creating a New Test Plan

34. Select Current Test Plan

• Click on the active test plan (e.g., 4DailyQA)

35. Copy Test Plan

• Click the Copy Test Plan button

36. Rename Copied Plan

• Rename the copy to the next sequential number
• Example: 4DailyQA becomes 5DailyQA

37. Save New Test Plan

• Save the plan
• The new test plan is now ready for use