Chapter DHS 157

DHS 157.67(5)(g)2. 2. A source inadvertently lodged within the patient following completion of the treatment.

DHS 157.67(6) (6) Dosimetry equipment.

DHS 157.67(6)(a) (a) Except for low dose-rate remote afterloader sources where the source output or activity is determined by the manufacturer, a licensee shall have a calibrated dosimetry system available for use. To satisfy this requirement, one of the following conditions shall be met:

DHS 157.67(6)(a)1. 1. The system shall have been calibrated using a system or source traceable to the national institute of standards and technology and published protocols accepted by nationally recognized bodies, or by a calibration laboratory accredited by the American association of physicists in medicine. The calibration shall have been performed within the previous 2 years and after any servicing that may have affected system calibration.

DHS 157.67 Note Note: An example of a nationally recognized body is the American Association of Physicists in Medicine.

DHS 157.67(6)(a)2. 2. The system shall have been calibrated within the previous 4 years. Eighteen to 30 months after that calibration, the system shall have been compared to another dosimetry system that was calibrated within the past 24 months by the national institute of standards and technology or by a calibration laboratory accredited by the American association of physicists in medicine. The results of the comparison shall have indicated that the calibration factor of the licensee’s system had not changed by more than 2%. A licensee may not use the intercomparison result to change the calibration factor. When comparing dosimetry systems to be used for calibrating sealed sources for therapeutic units, a licensee shall use a comparable unit with beam attenuators or collimators, as applicable, and sources of the same radionuclide as the source used at the licensee’s facility.

DHS 157.67(6)(b) (b) A licensee shall have available for use a dosimetry system for spot-check output measurements to periodically measure the radiation output of the device for consistency, if applicable. To satisfy this requirement, the system may be compared with a system that has been calibrated under par. (a). The comparison shall have been performed within the previous 12 months and after each servicing that may have affected system calibration. The spot-check system may be the same system used to meet the requirement in par. (a).

DHS 157.67(6)(c) (c) A licensee shall retain a record of each calibration and comparison under s. DHS 157.71 (20).

DHS 157.67(7) (7) Full calibration measurements on teletherapy units.

DHS 157.67(7)(a) (a) A licensee authorized to use a teletherapy unit for medical use shall perform full calibration measurements on each teletherapy unit under any of the following circumstances:

DHS 157.67(7)(a)1. 1. Before the first medical use of the unit.

DHS 157.67(7)(a)2. 2. Before medical use under all of the following conditions:

DHS 157.67(7)(a)2.a. a. Whenever spot-check measurements indicate that the output differs by more than 5% from the output obtained at the last full calibration corrected mathematically for radioactive decay.

DHS 157.67(7)(a)2.b. b. Following replacement of the source or following reinstallation of the teletherapy unit in a new location.

DHS 157.67(7)(a)2.c. c. Following any repair of the teletherapy unit that includes removal of the source or major repair of the components associated with the source exposure assembly.

DHS 157.67(7)(a)3. 3. At intervals not exceeding one year.

DHS 157.67(7)(b) (b) To satisfy the requirements of par. (a), full calibration measurements shall include determination of all of the following:

DHS 157.67(7)(b)1. 1. The output within plus or minus 3% for the range of field sizes and for the distance or range of distances used for medical use.

DHS 157.67(7)(b)2. 2. The coincidence of the radiation field and the field indicated by the light beam localizing device.

DHS 157.67(7)(b)3. 3. The uniformity of the radiation field and its dependence on the orientation of the useful beam.

DHS 157.67(7)(b)4. 4. Timer accuracy and linearity over the range of use.

DHS 157.67(7)(b)5. 5. On-off error.

DHS 157.67(7)(b)6. 6. The accuracy of all distance measuring and localization devices in medical use.

DHS 157.67(7)(c) (c) A licensee shall use the dosimetry system described in sub. (6) (a) to measure the output for one set of exposure conditions. The remaining radiation measurements required in par. (b) may be made using a dosimetry system that indicates relative dose rates.

DHS 157.67(7)(d) (d) A licensee shall perform a full calibration required by par. (a) under published protocols accepted by nationally recognized bodies.

DHS 157.67 Note Note: An example of such a nationally recognized body is the American Association of Physicists in Medicine.

DHS 157.67(7)(e) (e) A licensee shall mathematically correct the outputs determined in par. (b) 1. for physical decay for intervals not exceeding one month for cobalt-60, 6 months for cesium-137 or at intervals consistent with one percent decay for all other nuclides.

DHS 157.67(7)(f) (f) Full calibration measurements required by par. (a) and physical decay corrections required by par. (e) shall be performed by an authorized medical physicist.

DHS 157.67(7)(g) (g) A licensee shall retain a record of each calibration under s. DHS 157.71 (21).

DHS 157.67(8) (8) Full calibration measurements on remote afterloader units.

DHS 157.67(8)(a) (a) A licensee authorized to use a remote afterloader unit for medical use shall perform a full calibration measurement on each unit under any of the following circumstances:

DHS 157.67(8)(a)1. 1. Before the first medical use of the unit.

DHS 157.67(8)(a)2. 2. Before medical use under all the following conditions:

DHS 157.67(8)(a)2.a. a. Following replacement of any source or following reinstallation of the unit in a new location outside the facility.

DHS 157.67(8)(a)2.b. b. Following any repair of the unit that includes removal of the source or major repair of the components associated with the source exposure assembly.

DHS 157.67(8)(a)3. 3. Each calendar quarter, at intervals not exceeding 100 days for high dose-rate, medium dose-rate and pulsed dose-rate remote afterloader units with sources whose half-life exceeds 75 days.

DHS 157.67(8)(a)4. 4. At intervals not exceeding one year for low dose-rate remote afterloader units.

DHS 157.67(8)(b) (b) To satisfy the requirement of par. (a), a full calibration measurement shall include, as applicable, determination of all the following:

DHS 157.67(8)(b)1. 1. The output within 5%.

DHS 157.67(8)(b)2. 2. Source positioning accuracy to within plus or minus one millimeter.

DHS 157.67(8)(b)3. 3. Source retraction with backup battery upon power failure.

DHS 157.67(8)(b)4. 4. Length of the source transfer tubes.

DHS 157.67(8)(b)5. 5. Timer accuracy and linearity over the typical range of use.

DHS 157.67(8)(b)6. 6. Length of the applicators.

DHS 157.67(8)(b)7. 7. Function of the source transfer tubes, applicators and transfer tube-applicator interfaces.

DHS 157.67(8)(c) (c) In addition to the requirement for full calibration for low dose-rate remote afterloader units in par. (b), a licensee shall perform an autoradiograph of the source to verify inventory and source arrangement at intervals not exceeding one calendar quarter.

DHS 157.67(8)(d) (d) A licensee shall use the dosimetry system described in sub. (6) (a) to measure the output.

DHS 157.67(8)(e) (e) A licensee shall make a full calibration measurement required by par. (a) under published protocols accepted by nationally recognized bodies.

DHS 157.67(8)(f) (f) For low dose-rate remote afterloader units, a licensee may use measurements provided by the source manufacturer that are made under pars. (a) to (e).

DHS 157.67(8)(g) (g) A licensee shall mathematically correct the outputs determined in par. (b) 1. for physical decay at intervals consistent with one percent physical decay.

DHS 157.67(8)(h) (h) A full calibration measurement required by par. (a) and physical decay correction required by par. (g) shall be performed by the authorized medical physicist.

DHS 157.67(8)(i) (i) A licensee shall retain a record of each calibration under s. DHS 157.71 (21).

DHS 157.67(8)(j) (j) In addition to the requirements for full calibration for low dose rate remote afterloaders, as specified in par. (b), a licensee shall perform an autoradiograph of the source or sources to verify inventory and source arrangement at intervals not to exceed 3 months.

DHS 157.67(9) (9) Full calibration measurements on gamma stereotactic radiosurgery units.

DHS 157.67(9)(a) (a) A licensee authorized to use a gamma stereotactic radiosurgery unit for medical use shall perform full calibration measurements on each unit under any of the following circumstances:

DHS 157.67(9)(a)1. 1. Before the first medical use of the unit.

DHS 157.67(9)(a)2. 2. Before medical use under all of the following conditions:

DHS 157.67(9)(a)2.a. a. Whenever spot-check measurements indicate that the output differs by more than 5% from the output obtained at the last full calibration corrected mathematically for radioactive decay.

DHS 157.67(9)(a)2.b. b. Following replacement of the sources or following reinstallation of the gamma stereotactic radiosurgery unit in a new location.

DHS 157.67(9)(a)2.c. c. Following any repair of the gamma stereotactic radiosurgery unit that includes removal of the sources or major repair of the components associated with the source assembly.

DHS 157.67(9)(a)3. 3. At intervals not exceeding one year, with the exception that relative helmet factors need only be determined before the first medical use of a helmet and following any damage to the helmet.

DHS 157.67(9)(b) (b) To satisfy the requirement of par. (a), a full calibration measurement shall include determination of all the following:

DHS 157.67(9)(b)1. 1. The output within plus or minus 3%.

DHS 157.67(9)(b)2. 2. Relative helmet factors to verify that the helmet material provides the required shielding to the patient.

DHS 157.67(9)(b)3. 3. Isocenter coincidence to confirm the centering accuracy of the radiation beam relative to the helmet openings.

DHS 157.67(9)(b)4. 4. Timer accuracy and linearity over the range of use.

DHS 157.67(9)(b)5. 5. On-off error.

DHS 157.67(9)(b)6. 6. Trunnion centricity to determine the rotational center of the source relative to the helmet openings.

DHS 157.67(9)(b)7. 7. Treatment table retraction mechanism, using backup battery power or hydraulic backups with the main power to the unit off.

DHS 157.67(9)(b)8. 8. Helmet microswitches to determine if the switches terminate the radiation beam when tripped by unintended movement of the helmet.

DHS 157.67(9)(b)9. 9. Emergency timing circuits.

DHS 157.67(9)(b)10. 10. Stereotactic frames and localizing devices (trunnions).

DHS 157.67(9)(c) (c) A licensee shall use the dosimetry system described in sub. (6) (a) to measure the output for one set of exposure conditions. The remaining radiation measurements required in par. (b) 1. may be made using a dosimetry system that indicates relative dose rates.

DHS 157.67(9)(d) (d) A licensee shall make a full calibration measurement required by par. (a) under published protocols accepted by nationally recognized bodies.

DHS 157.67 Note Note: An example of such a nationally recognized body is the American Association of Physicists in Medicine.

DHS 157.67(9)(e) (e) A licensee shall mathematically correct the outputs determined in par. (b) 1. at intervals not exceeding one month for cobalt-60 and at intervals consistent with one percent physical decay for all other radionuclides.

DHS 157.67(9)(f) (f) A full calibration measurement required by par. (a) and physical decay correction required by par. (e) shall be performed by an authorized medical physicist.

DHS 157.67(9)(g) (g) A licensee shall retain a record of each calibration under s. DHS 157.71 (21).

DHS 157.67(10) (10) Periodic spot-checks for teletherapy units.

DHS 157.67(10)(a) (a) A licensee authorized to use teletherapy units for medical use shall perform output spot-checks on each teletherapy unit once in each calendar month that include determination of all of the following:

DHS 157.67(10)(a)1. 1. Timer constancy and timer linearity over the range of use.

DHS 157.67(10)(a)2. 2. On-off error.

DHS 157.67(10)(a)3. 3. The coincidence of the radiation field and the field indicated by the light beam localizing device.

DHS 157.67(10)(a)4. 4. The accuracy of all distance measuring and localization devices used for medical use.

DHS 157.67(10)(a)5. 5. The output for one typical set of operating conditions measured with the dosimetry system described in sub. (6) (b).

DHS 157.67(10)(a)6. 6. The difference between the measurement made in this subd. 5. and the anticipated output expressed as a percentage of the anticipated output, which is the value obtained at last full calibration corrected mathematically for physical decay.

DHS 157.67(10)(b) (b) A licensee shall perform measurements required by par. (a) under procedures established by the authorized medical physicist. The authorized medical physicist need not actually perform the spot check measurements.

DHS 157.67(10)(c) (c) A licensee shall have the authorized medical physicist review the results of each spot-check within 15 working days. The authorized medical physicist shall notify the licensee in writing of the results of each spot-check within 10 working days.

DHS 157.67(10)(d) (d) A licensee authorized to use a teletherapy unit for medical use shall perform safety spot-checks of each teletherapy facility once in each calendar month and after each source installation to assure proper operation of all of the following: