South Carolina Code of Regulations
Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Subchapter 61-64 - X-Rays (Title B)
Part VI - USE OF THERAPEUTIC EQUIPMENT
Section 61-64.VI.RHB 6.6 - Operational Requirements for X-ray and Electron Therapy Systems with Energies of 1 MeV and Above

Universal Citation: SC Code Regs 61-64.VI.RHB 6.6

Current through Register Vol. 48, No. 9, September 27, 2024

6.6.1 Radiological Physics Support. The services of a radiological physicist shall be utilized in facilities having therapy systems with energies of one megaelectron volt (1 MeV) and above. The radiological physicist shall be responsible for:

6.6.1.1 Calibration;

6.6.1.2 Supervision and review of patient dosimetry;

6.6.1.3 Beam data acquisition and storage for computer dosimetry, and supervision of its use;

6.6.1.4 Quality assurance, including spot check review;

6.6.1.5 Consultation with the radiation therapist in treatment planning, as needed; and

6.6.1.6 Availability and responsiveness to immediate problems or emergencies.

6.6.2 Surveys.

6.6.2.1 All new facilities, and existing facilities not previously surveyed, shall have a survey made by, or under the direction of, the radiological physicist. In addition, such surveys shall be done after any change in the facility or equipment which might cause a significant increase in radiation hazard.

6.6.2.2 The registrant shall obtain a written report of the survey and a copy of the report shall be transmitted by the registrant to the Department within thirty (30) calendar days of the first patient treatment following the survey.

6.6.2.3 The survey and report shall indicate all instances where the installation, in the opinion of the radiological physicist, is in violation of applicable rules or regulations.

6.6.3 Calibrations.

6.6.3.1 The calibration of systems subject to RHB 6.5 shall be performed in accordance with an established calibration protocol acceptable to the Department before the system is first used for irradiation of a patient and thereafter at time intervals which do not exceed twelve (12) months and after any change which might significantly alter the calibration, spatial distribution, or other characteristics of the therapy beam. The protocol used shall be a nationally accepted standard, such as one established by the American Association of Physicists in Medicine.

6.6.3.2 The calibration shall be performed by or under the direct supervision of the radiological physicist who is physically present at the facility during the calibration.

6.6.3.3 Calibration radiation measurements required by RHB 6.6.3 shall meet the requirements of RHB 1.4.4.

6.6.3.4 Calibrations shall be in sufficient detail that the dose at a reference point in tissue equivalent phantom may be calculated to within an uncertainty of five percent (5%).

6.6.3.5 The calibration of the therapy unit shall include, but not be limited to, the following determinations:
6.6.3.5.1 Verification that the equipment is operating in compliance with the design specifications concerning the light localizer, all patient positioning lights, and back-pointer alignment with the isocenter when applicable, variation in the axis of rotation for the table, gantry, and collimator system, and beam flatness and symmetry at the specified depth.

6.6.3.5.2 The absorbed dose rate at various depths in a tissue equivalent phantom for the range of field sizes used, for each effective energy, that will verify the accuracy of the dosimetry of all therapy procedures utilized with that therapy beam.

6.6.3.5.3 The uniformity of the radiation field to include symmetry, flatness, and dependence on gantry angle.

6.6.3.5.4 Verification that existing isodose charts applicable to the specific machine continue to be valid or are updated to existing machine conditions.

6.6.3.5.5 Verification of transmission factors for all accessories such as wedges, shadow trays, and/or universal beam modifying devices.

6.6.3.6 Records of calibration measurements under RHB 6.6.3.1 and dosimetry system calibrations under RHB 6.6.3.3 shall be maintained for five (5) years after completion of the full calibration.

6.6.3.7 A copy of the latest calibrated absorbed dose rate measured pursuant to RHB 6.6.3.1 shall be available.

6.6.4 Spot Checks. Spot checks shall be performed on systems subject to RHB 6.5 during calibrations and at intervals established by the radiological physicist, not to exceed monthly, using a nationally accepted standard such as one established by the American College of Radiology, American Association of Physicists in Medicine, American College of Medical Physics, etc.

6.6.4.1 The spot check procedures shall be in writing and shall have been developed by the radiological physicist. A copy of the procedures shall be submitted to the Department upon request.

6.6.4.2 If a radiological physicist does not perform the spot check measurements, the results of the spot check measurements shall be reviewed by the radiological physicist within seven (7) treatment days.

6.6.4.3 The spot check procedures shall specify the frequency at which tests or measurements are to be performed and the acceptable tolerance for each parameter measured in the spot check when compared to the value for that parameter determined in the calibration.

6.6.4.4 Spot checks shall be made at a depth consistent with a nationally accepted standard, such as one established by the American Association of Physicists in Medicine.

6.6.4.5 Where a system has built-in devices which provide a measurement of any parameter during irradiation, such measurement shall not be utilized as a spot check measurement.

6.6.4.6 A parameter exceeding a tolerance set by the radiological physicist shall be corrected before the system is used for patient irradiation.

6.6.4.7 Whenever a spot check indicates a significant change in the operating characteristics of a system, as specified in the radiological physicist's spot check procedures, the system shall be recalibrated, as required in RHB 6.6.3.

6.6.4.8 Records of spot check measurements and any necessary corrective actions shall be maintained by the registrant for a period of three (3) years after completion of the spot check measurements.

6.6.4.9 Whenever a spot check requires a radiation measurement, such measurement shall be obtained using a system satisfying the requirements of RHB 6.6.3.3 or which has been intercompared with a system meeting those requirements within the previous year.

6.6.5 Prohibited Use. The system shall not be used in the administration of radiation therapy unless the requirements of RHB 6.6.1 through 6.6.4 have been met.

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