TORABC

USER MANUAL

Radiography Image Quality Control

SAFETY

There are no special safety requirements associated with the use of this phantom.

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QUICK START

SET-UP

Position the phantom on the patient couch or vertical bucky, aligning the patient positioning
system to the centre and field markers on the phantom.

TEST

Obtain an image using standard settings of 70kV, or 100kv + 1mm Cu filtration.

RESULTS

Determine whether the beam centring disc breaks out of the ring to check for beam centring.

Determine the radiation field size by using the cross rulers.

Determine light to radiation field congruence by checking that the rulers on the x-ray image
show a field size in agreement with those set on the light field on the face fo the phantom
during setup.

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DESCRIPTION

Leeds Test Object TOR.ABC Alignment and Beam Centring phantom is designed such that system
performance can quickly be assessed against the established criteria given in IEC 61223-2-11:
Constancy tests – Equipment for general direct radiography. The phantom is designed for use
with both direct- and indirect- x-ray imaging systems, to enable the following constancy tests to be
made:

· Central beam angle deviation

· X-Ray- and visible light- field alignment
· Radiation field size

TOR.ABC comprises three main parts:

· High contrast grid sandwiched between two Perspex cover sheets, allowing for evaluation of
x-ray and light field coincidence as well as radiation field size.

· A central high contrast circular detail, above which is positioned the

centring tower. This setup permits evaluation of beam angle deviation.

· A vertical Bucky jig, for positioning of the phantom on a vertical Bucky

– not required for use on a horizontal Bucky table.

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ACCEPTANCE TESTING

Baseline values should be determined when:

· A new X-ray system is brought into use (acceptance testing)

· A new detector/CR reader is brought into use
· Any other factor which may affect image quality is altered

The image obtained at acceptance testing should be retained and marked ‘Reference
Image’ so that it can be compared with future images obtained during constancy testing.
The baseline values and X-ray system settings used at acceptance should be recorded
on the relevant test record sheet, and used in all subsequent tests.

CONSTANCY TESTING

Constancy tests should be carried out on a monthly basis, and when:

· Malfunction is suspected
· Immediately after maintenance on components which might affect the image
quality.
· The test leads to results outside the established criteria, in order to confirm
the test results.

The constancy values should be recorded on the relevant test record sheet.

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SET
BEAMUPCENTRING TUBE THEORY

TRIGONOMETRY KEY
Tan(θ) = opp/adj θ = angular deviation from
Tan(θ) = D/FFD = d/h normal
Tan(1.5) = 0.025 D = deviation of x-ray source
d = 0.025h (approx. linear at small angles)
FFD = Focus-Film Distance
Focal spot d = displacement of circular
D detail from centre of image
h = height (annulus detail-circle
detail)

Normals to imaging
plane

FFD

θ
θ

Beam centring tube

Figure 3: Diagram of an X-ray source tube positioned at an angle “q” from the normal to the
imaging plane. By corresponding angle analysis, the trigonometric equations (top left) hold true.
IEC standard 61223-2-11 states that the maximum angle of deviation should be 1.5°. As such,
the maximum acceptable difference between the inner diameter of the annulus detail and the
diameter of the circular detail is 0.05*h (allowing for deviations in any direction).

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 Annulus detail

Conical
section
of beam
Central
centring
circular
tube
detail

d max d max

Figure 4: Setup of phantom, showing how the theory applies to the beam centring tower. The
difference in diameters of the circle and inner annulus detail is 0.05*h, such that the maximum
angular beam deviation that can be imaged with the circle inside the ring is 1.5o.

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X-RAY AND LIGHT FIELD ALIGNMENT

The light field and collimators should be set such that the two fields are the same size and,
according to the settings, correspond spatially (as for patient imaging). Figure 5a illustrates where
these settings are accurate. However, over time, mechanical misalignment of the mirrors and/or
collimators can occur as shown in Figure 5b. The convention for measuring such misalignment is to
sum the moduli of the displacements (‘a’ + ‘c’) and (‘b’ + ‘d’) and compare the results with a
tolerance level:

|a| + |c| < 2% FFD; |b| + |d| < 2% FFD

KEY:

· Light grey area

represents light field
· Mid-grey area represents
effective radiation field
· Dark grey area
represents field overlap
Figure 5a: Illustration of the Figure 5b: Illustration of the
effective radiation field and light fields not aligned correctly:
fields aligned correctly. misalignments shown by
labelled arrows

RADIATION FIELD SIZE

The measured dimensions of the radiation field size should match those stated on the x-ray
equipment. Using the above convention for measuring this parameter, the tolerances remain at 2%
FFD for each axis. The user can employ the grid pattern on the image for measuring the field size
for convenience.
Horizontal

Vertical

Figure 6: Illustration of radiation field size measurement. This field size can be
easily measured to be approx. 242mm horizontally and 182mm vertically. The
dimensions are interchangeable as long as consistency is maintained.

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TEST PROCEDURE

Prior to use, the beam centring tower must be screwed into the central threaded hole in the upper
Perspex cover sheet. Do not over tighten the grub screw, as this will result in failure of central
alignment of the tower. The FFD (Focus-Film Distance) should be set at 1.00 ± 0.01m as required by
IEC 61223-2-11.

PHANTOM POSITIONING

The phantom should be positioned centrally to the light field, such that the edges of the light field
(centre of the semi-shadow area) are outlined by the white markings on the Perspex cover (Figure
7a). In the example shown, the test cassette holds an 18cm x 24cm film, so a 16cm x 22cm field
size is appropriate to ensure the entire radiation field is imaged. This is the size of the relevant
markings on the phantom.

The loaded test cassette should be positioned directly underneath the phantom with respect to the
radiation beam (if a vertical Bucky is used as in Figure 7b, the test cassette should be behind the
phantom). The phantom should be as close as possible to the image receptor for optimum beam
geometry.

The focus to film distance (FFD) must not vary from the value used at acceptance by more than
±1%. The lateral position of the phantom must not deviate from that used at acceptance by more
than ±10mm.

Figure 7a: Setup on a vertical Bucky with Suction Jig.

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 Push unit against
vertical Bucky
Support to hang
bracket from
Bucky table vertical Bucky
Knurled knob:
adjust height of
24 x 30cm (Cassette size)
phantom to centre
it in radiation beam
18 x 24cm (Cassette size)
13 x 18cm (Cassette size)
TEST

Push phantom over

hooks to hang
over vertical Bucky TOR.ABC
(side view,
cropped)
Figure 7b: Setup on a Bucky table. Figure 7c: Setup on vertical Bucky with Hanger.

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BEAM EXPOSURE SETTINGS

One exposure must be taken for each x-ray tube under manual control. One exposure must also be
taken for each X-ray tube per application device (image intensifier, Bucky table, etc.) under
automatic control. At least one of the exposures taken should be on each film- and cassette- size
combination used for patient imaging.

Example: For an X-ray exposure unit with one X-ray tube, a Bucky table and a vertical Bucky;
where a single film size of 18 x 24cm is used; three exposures in total are needed. One exposure
using manual settings on the Bucky table, and two automatic exposure settings: one on each of the
Bucky table and the vertical Bucky.

Note: Where a fluoroscopy unit is to be tested, the mAs setting should be as high as possible to
minimise quantum noise, but also ensuring that the lightest areas of the image are not over
exposed. Also the screen settings (brightness, contrast, etc.) should be set as standard for patient
imaging and recorded.

AUTOMATIC EXPOSURE MANUAL EXPOSURE

SETTINGS SETTINGS
100kV1, or closest available 70kV, or closest available
FOR ALL
setting, should be used. If 70kV setting. If 100kV is the closest
RADIOGRAPHY
is the closest available, use this available, use this setting in
SYSTEMS
setting in exception. exception1.
1
Where 100kV setting is used, a 1mm copper filter should be inserted to increase
contrast of the grid patterns. This should be positioned as close as possible to the focus
of the X-ray tube.

Table 1: Exposure settings for phantom imaging.

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ANALYSIS - BEAM ANGLE DEVIATION

This test is purely visual, and the threshold for acceptance is illustrated in Figure 8 (below). The
phantom has been designed such that if the circular detail appears to be just touching the annulus
detail, then the unit just passes this constancy test as per IEC 61223-2-11: this implies angular
deviation of 1.5o from normal.

Figure 8a: Central detail

imaged in centre of
annulus. PASS

Figure 8b: Central detail imaged

with horizontal displacement
from centre of annulus (~1mm).
This amounts to an angular
deviation of approx. 1.5° from
normal. The detail just touches
the annulus. PASS

Figure 8c: Central detail

imaged with displacement in
both x and y directions of
approx. 2mm (~3°) from
normal. Thus, the detail
image overlaps the annulus.
FAIL

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ANALYSIS - X-RAY AND LIGHT FIELD COINCIDENCE

The user should place the acetate sheet supplied such that the cross is oriented across the entire film
area, marking clearly the centre of the film. Using TOR.ABC, the user can determine if the unit is within
tolerance or not. A pass/fail by the 2% FFD tolerance level established in IEC 61223-2-11 can be
observed, if the cross passes through the central circle (20mm diameter), the unit passes the constancy
test, as shown in Figure 9 below, otherwise the unit fails.

Figure 9a: the phantom is Figure 9b: the central cross is Figure 9c: the cross is outside
imaged centrally so just touching the edge of the the circle, thus the
alignment is perfect. PASS circle, thus the misalignment is misalignment is outside
within the ±2% FFD tolerance in tolerance. FAIL
all directions. PASS

ANALYSIS - EFFECTIVE RADIATION FIELD SIZE

The user should measure the effective radiation field size using the phantom’s high contrast grid. The
size should correspond with that displayed on the machine settings, to within the tolerance given in
IEC 61223-2-11 of ± 0.02 * FFD (Focus-Film Distance). Figure 10 illustrates the procedure.

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RECOMMENDED PERFORMANCE STANDARDS

The phantom is manufactured in accordance with the IEC 61223-2-11 standard.

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Test Record Sheet

Phantom:
Leeds Test Objects TORABC serial number
________________________________________________

Machine Details:
Manufacturer_______________________________________________________________________

Model_____________________________________________________________________________

Serial Number______________________________________________________________________

Location___________________________________________________________________________

Image Quality Acceptance Constancy

Parameter Test Tests
Date Date Date Date Date Date Date Date
Beam angle
deviation
Light to Radiation
Field Alignment
Radiation Field Size

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MAINTENANCE

Storage
Always keep the phantom in its protective case when not in use to prevent accidental damage.

Care
Clean the components using a soft, dry, clean cloth, do not use solvents.

Maintenance
Observe the phantom for physical damage over time. Action is required only in the event that damage is
observed. In such a case, the phantom needs to be replaced/repaired.

Warranty
Any defects should be notified within three months of delivery and the defective product returned to
Leeds Test Objects Ltd at the purchaser’s expense. When Leeds Test Objects Ltd accepts that the defect is
due to faulty workmanship or materials Leeds Test Objects Ltd will have the option either to repair or
replace the defective product. The warranty given above will not apply to defects which are due to: fair
wear and tear, accidental damage or failure by the purchaser to adhere to Leeds Test Objects Ltd’s
recommendations.

Transport
Always transport the phantom in its protective case to prevent accidental damage.

Service
No service is required for this phantom.

Calibration
This tool does not require calibration.

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TROUBLE SHOOTING

PROBLEM CAUSE SOLUTION

I can’t see the test features on Incorrect positioning of the Re-position the phantom as per
my images phantom the set-up instructions

Incorrect exposure settings Check the correct exposure

settings, and patient equivalent
filtration are present

How do I know if my results are Results must be compared to the Consult the machine
acceptable? expected values manufacturer’s user manual

Consult the IPEM91 protocol

Results must be compared to the Consult the test record sheet

acceptance test values

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SOFTWARE

Currently, no automatic scoring software is available for this phantom from Leeds Test Objects Ltd.

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Man 120f 18/05/20

LEEDS TEST OBJECTS LTD

Unit 9 Phone +44(0)1423 320007
Becklands Close Email [email protected]
Boroughbridge Web www.leedstestobjects.com
North Yorkshire
YO51 9NR