Dosimetrist/Physicist Training Guide - UCSF Radiation Oncology

MOSAIQ 

Dosimetrist/Physicist 

Training Guide 

Version 1.60 

Module II: Treatment Plans, Dose Tracking, and 

Manual Treatments

Dosimetrist/Physicist 

Training Guide 

MOSAIQ 

Oncology Management System 

Version 1.60 

Module II: Treatment Plans, Dose Tracking, and Manual Treatments 

Copyright 2009 

All Rights Reserved 

IMPAC Medical Systems

PUBLISHED BY: 

IMPAC Medical Systems, Inc. 

100 Mathilda Place, Fifth Floor 

Sunnyvale, CA 94086 

COPYRIGHT 2009 by IMPAC Medical Systems 

All Rights Reserved 

Instructional Designer/Writer: Robin Bonke 

LTGRAD0005B – 1.0 – 2/20/2009 

This manual contains proprietary information to be used exclusively 

by customers of IMPAC Medical Systems. All rights reserved. 

No part of the contents of this book may be reproduced or transmitted 

in any form or by any means without the written permission 

of IMPAC Medical Systems.

Table of Contents 


Table of Contents...........................................................................................................................................................................................i 

Introduction ................................................................................................................................................................. 1 

What’s In This Course ................................................................................................................................................................................ 1 

SupportPlus Online ...................................................................................................................................................................................... 2 

Document Conventions.............................................................................................................................................................................. 3 

Text Conventions...............................................................................................................................................................................................................3 

Mouse Conventions...........................................................................................................................................................................................................4 

Keyboard Conventions .....................................................................................................................................................................................................5 

Lesson 4 Multi-Leaf Collimator (MLC) Plans....................................................................................................... 7 

Objectives....................................................................................................................................................................................................... 7 

Viewing MLC Leaf Plans .............................................................................................................................................................................. 8 

Changing MLC Leaf Plans.......................................................................................................................................................................... 10 

What's Next ................................................................................................................................................................................................ 17 

Quick Version.............................................................................................................................................................................................. 18 

Viewing MLC Leaf Plans............................................................................................................................................................................................... 18 

Changing MLC Leaf Plans............................................................................................................................................................................................ 18 

Lesson 5 Radiotherapy Treatment Plans ........................................................................................................... 19 

Objectives..................................................................................................................................................................................................... 19 

Importing/Exporting Radiotherapy Treatment Plans .......................................................................................................................... 21 

Setting RTP Import Defaults ....................................................................................................................................................................................... 21 

Changing Data in the Edit Data Import Window................................................................................................................................................. 24 

Changing File Data to Ignore Status......................................................................................................................................................................... 29 

Changing the Tolerance Table and Site Name...................................................................................................................................................... 31 

Importing RTP Files........................................................................................................................................................................................................ 32 

Viewing IMRT Control Point Data.............................................................................................................................................................................. 34 

Exporting RTP Files........................................................................................................................................................................................................ 36 

Viewing Options in Treatment Field Definition................................................................................................................................... 39 

Importing and Changing Treatment Plan Documents ........................................................................................................................ 43 

Configuring Multiple Approvals for Treatment Plan Documents ...................................................................................................................... 43 

Importing Files for the Treatment Plan Document............................................................................................................................................... 45 

Viewing/Changing Treatment Plan Documents...................................................................................................................................................... 51 

What's Next ................................................................................................................................................................................................ 55 

Quick Version.............................................................................................................................................................................................. 56 

Setting RTP Import Defaults ....................................................................................................................................................................................... 56 

Changing Data in the Edit Import Data Window................................................................................................................................................. 56 

Changing File Data to Ignore Status......................................................................................................................................................................... 57 

Changing the Tolerance Table and Site Name...................................................................................................................................................... 57 

Importing the RTP File .................................................................................................................................................................................................. 57 

Viewing IMRT Control Point Data.............................................................................................................................................................................. 58 

Exporting RTP Files........................................................................................................................................................................................................ 58 

Copyright 2009, IMPAC Medical Systems i 

LTGRAD0005B/1.0/20-Feb-2009

MOSAIQ Dosimetrist/Physicist Training Guide Module II 

Reviewing IMRT Options in Treatment Field Definition ...................................................................................................................................... 58 

Configuring Multiple Approvals for Treatment Plan Documents ...................................................................................................................... 59 

Importing Files for the Treatment Plan Document ............................................................................................................................................... 60 

Viewing/Changing Treatment Plan Documents...................................................................................................................................................... 60 

Lesson 6 Setting Up Dose Tracking ....................................................................................................................61 

Objectives..................................................................................................................................................................................................... 61 

Defining Dose Tracking for Prescription Sites ..................................................................................................................................... 62 

Reviewing Primary Dose Tracking Sites ................................................................................................................................................................... 62 

Adding Cumulative Secondary Dose Tracking Sites.............................................................................................................................................. 64 

Adding and Changing Dose Coefficients .................................................................................................................................................................. 65 

Adding Secondary Dose Tracking Sites .................................................................................................................................................................... 68 

Adding Prior Dose........................................................................................................................................................................................................... 69 

Adding Dose Action Points ...................................................................................................................................................................... 71 

Configuring Treatment Charts ................................................................................................................................................................ 75 

What's Next ................................................................................................................................................................................................ 77 

Quick Version.............................................................................................................................................................................................. 78 

Adding Primary Dose Tracking Sites ......................................................................................................................................................................... 78 

Adding Cumulative Secondary Dose Tracking Sites.............................................................................................................................................. 78 

Adding Secondary Dose Tracking Sites .................................................................................................................................................................... 78 

Adding and Changing Dose Coefficients .................................................................................................................................................................. 78 

Adding Prior Dose........................................................................................................................................................................................................... 79 

Adding Dose Action Points ........................................................................................................................................................................................... 79 

Configuring Treatment Charts .................................................................................................................................................................................... 80 

Lesson 7 Manually Recording Treatments..........................................................................................................81 

Objective ...................................................................................................................................................................................................... 81 

Recording Manual Treatments................................................................................................................................................................. 82 

Opening Dose and Fractions Review Window.................................................................................................................................... 86 

What's Next ................................................................................................................................................................................................ 88 

Quick Version.............................................................................................................................................................................................. 89 

Recording Manual Treatments................................................................................................................................................................................... 89 

Opening Dose and Fractions Review Window ....................................................................................................................................................... 89 

Lesson 8 Changing Dose .......................................................................................................................................91 

Objectives..................................................................................................................................................................................................... 91 

Changing Prescribed Doses...................................................................................................................................................................... 92 

Changing Fractional Dose ......................................................................................................................................................................... 93 

Changing MU/Dose Coefficients ............................................................................................................................................................. 94 

What's Next ................................................................................................................................................................................................ 96 

Quick Version.............................................................................................................................................................................................. 97 

Changing Prescribed Doses and Fractionation Doses........................................................................................................................................... 97 

Changing MU/Dose Coefficients ................................................................................................................................................................................ 97 

Appendix A – MLC Fit Import/Export.....................................................................................................................99 

Importing MLC Leaf Plans......................................................................................................................................................................... 99 

Exporting an MLC Leaf Plan ...................................................................................................................................................................103 

ii Copyright 2009, IMPAC Medical Systems 

LTGRAD0005B/1.0/20-Feb-2009


Course Evaluation: Dosimetrist/Physicist Module II ........................................................................................... 105 

Copyright 2009, IMPAC Medical Systems iii 

LTGRAD0005B/1.0/20-Feb-2009


iv Copyright 2009, IMPAC Medical Systems 

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Notes 


Copyright 2009, IMPAC Medical Systems 1 

LTGRAD0005B /1.0/20-Feb-2009 

Introduction 

Welcome to MOSAIQ Dosimetrist/Physicist Training Module II. This book is your 

guide to unlocking the possibilities of MOSAIQ 1.60 application software, hereafter 

referred to as MOSAIQ. It is designed to be used during your instructor-led training, 

and as a handy desk reference any time you need a quick reminder how to do 

something in MOSAIQ. We recommend that you keep this book near your 

workstation so you can find it easily when needed. 

This training guide is not intended to replace the MOSAIQ radiation oncology 

documentation, which is contained in the MOSAIQ Help system. The MOSAIQ Help 

system provides in-depth information on all available MOSAIQ features. 

Dosimetrist/Physicist Training Module II is an Intermediate course that, with 

Dosimetrist/Physicist Training Modules I and III, covers how to use MOSAIQ to review 

and add treatment information that your facility will use to safely treat the patient. This 

course assumes that you have basic Windows skills and have taken, and are familiar 

with, the concepts presented in MOSAIQ General Introduction training. Topics 

presented in this course build upon the concepts learned in the General Introduction. 

What’s In This Course 

In this course, you will review treatment information, define prescriptions, define 

treatment fields, change MLC files, import and export RTP files, review IMRT 

options, and set up dose tracking. You will also manually record treatments, change 

dose, use the Treatment Calendar, and run the eCHART Chart Check. 

In this module, you will view and change MLC files, export and import RTP files, set 

up dose tracking, record manual treatments, and change dose. 

This course will not teach you basics on using MOSAIQ, which are covered in the 

General Introduction. 

Note that when you are working in the practice database, all activities are enabled for 

the practice ID. In your clinical database, you may or may not have security rights to 

do all the activities that you will do in this course.


Notes 

SupportPlus Online 

SupportPlus is IMPAC’s dedicated online support system, which gives you the most 

from your IMPAC oncology management system. SupportPlus contains valuable 

support information including installation and troubleshooting documents, training 

manuals, upgrade checklists, downloadable software tools, and much more. 

Access may be restricted based on your IMPAC service 

agreement. 

You can find this document under the Oncology Management tab in the Training 

Resources folder. 

Turn to SupportPlus for resources on implementation, training, support, and upgrades 

for all IMPAC products. 

For more information, contact support@impac.com, or call 800.488.4672. 

Log in to SupportPlus every week or two to check for new 

announcements, new document postings, and new training 

events. Please take a moment to send us a Product 

Suggestion. 

2 Copyright 2009, IMPAC Medical Systems 

LTGRAD0005B /1.0/20-Feb-2009

Notes 

Introduction 


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Document Conventions 

This document uses specific conventions, or rules, in the instructions to help you 

perform the exercises correctly. This section explains the text, mouse, and keyboard 

conventions used in this document. 

Text Conventions 

The instructions in this guide are formatted to make them easy to read and to 

recognize when you should perform a particular task. The following text conventions 

are used in the instructions: 

Bold Print Indicates menu or list items that you select. 

Example: Click File | Register New Patient…. 

Example: In the Select Patient window, click Lamb, Mary. 

Italics Indicates words or phrases that appear on the computer 

screen, references to text or a number as itself, or new terms 

that are being defined. 

Highlighted 

Print 

Example: Position the insertion point to the left of p in 

patient. 

Example: Annotation is the process of adding customized 

notes to a Help topic. 

Indicates something you type. 

Example: Type 3000. 

Explanations Located directly below the step. 

Menus Menu commands that are executed one directly after the other 

are separated by a vertical line. 

Buttons and 

Icons 

Example: Click File | System Utilities | Supplies… 

means from the menu bar, click File, from the File 

menu, point to the System Utilities command, 

and from the System Utilities menu, click the 

Supplies… command. 

Indicate items on which you click. 

Example: Click . 

Example: Click .


Notes 

Notes, Hints, 

and Warnings 

Note example: 

Hint example: 

Warning example: 

Mouse Conventions 

Notes, hints and warnings are preceded by unique symbols 

and are presented in a box. Notes provide ancillary 

information, hints provide tips to help you use the system, 

and warnings provide important information on the 

consequences of performing a particular action. 

You can also display the eCHART Navigator window by 

pressing F5. 

You may find it helpful to print out illustrations from the 

Help reference tools to include with patient education 

materials. 

Once you change the status of an order to Voided, you 

cannot change the status again. 

The following terms are used to describe actions you perform with the mouse: 

Click Press and release the left mouse button. 

Double-click Click the left mouse button twice in rapid succession. 

Right-click Press and release the right mouse button. 

Drag Move the mouse while holding down the left mouse button. 

Highlight Drag the mouse pointer across data, causing the information 

to appear in reverse video. 


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Introduction 


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Notes Keyboard Conventions 

Keys that do not produce a character appear in all upper case bold print. These keys 

include: 

Function Keys F1, F2, F3, F4, F5, F6, F7, F8, F9, F10, F11, and F12. 

Booster Keys ALT, CTRL, and SHIFT. 

Pointer 

Movement 

Keys 

HOME, PAGE UP, PAGE DOWN, END, TAB, and the 

arrow keys. 

Other Keys BACKSPACE, DELETE, INSERT, CAPS LOCK, ESC, 

ENTER, SPACEBAR, PRINT SCRN, SCROLL LOCK, 

PAUSE, and NUM LOCK. 

Two or more keys that should be pressed simultaneously are separated by a plus sign. 

Example: Press CTRL+F4. 

Example: Press ALT+N.


Notes 


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Notes 



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Lesson 4 Multi-Leaf 

Collimator (MLC) 

Plans 

Objectives 

You will learn how to: 

• View an MLC leaf plan 

• Change an MLC leaf plan 

The MLC Fit feature lets you add, view, and change geometric information that you 

can use to make treatment field shapes. To do so, MLC Fit lets you digitize treatment 

field shapes, get Multi-leaf Collimator (MLC) leaf plans from these digitized shapes, 

and change those shapes within MOSAIQ. 

In this lesson, you will view and change MLC leaf plans. Refer to Appendix A in this 

Module for information on how to import and export MLC leaf plans. 

To open the Diagnoses and Interventions window, you must 

have Clinical | General | View security rights. 

To open the Treatment Field Definition and Beam’s Eye View 

dialog boxes, you must have Clinical | Field Defs | View 

security rights. 

To open MLC leaf plans, you must have Clinical | Field Defs | 

View rights. 

To change an MLC leaf plan, you must have Clinical | Field 

Defs | Modify security rights.


Notes 

Viewing MLC Leaf Plans 

You can view MLC leaf plans added in MOSAIQ, as well as MLC leaf plans added 

elsewhere and imported. In this exercise, you will view an MLC leaf plan. 

1. From the Diagnoses and Interventions window, double-click a treatment field 

with an MLC leaf plan. 

Opens the Treatment Field Definition dialog box. 

2. Click . 

Opens the Beam’s Eye View dialog box, shown in Figure 1. 

Figure 1: Beam’s Eye View Dialog Box 

is the only button available and there are no buttons that let you change 

the MLC shape. You can change the position of the leaves and jaws, but not the 

MLC shape itself. Use , , , and to change 

the shape of the MLC so that the leaves are better positioned. For example, 

automatically finds the best fit for the leaves around the MLC shape. 

3. Click . 

Closes the Beam’s Eye View dialog box. 


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Lesson 4: Multi-Leaf Collimator (MLC) Plans 


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Notes 4. Right-click in the dialog box or press F4, then click Preferences. 

Opens the Treatment Field Definition Options menu, then opens the Preferences 

Options menu, shown in Figure 2. 

Figure 2: Preferences Options Menu 

The default view (View MLC Edge) shows the MLC edge only and gives the 

clearest view of surrounding anatomy. The aperture view (View MLC Aperture) 

shows the MLC interleaf lines within the jaw boundaries. The third option (View 

MLC All) shows all the MLC leaves. 

5. Click View MLC All. 

Specifies to show all the MLC leaves. 

6. Click . 

Opens the Beam’s Eye View dialog box, shown in Figure 3. 

Figure 3: Beam’s Eye View Dialog Box with All Leaves Showing


Notes 7. Click . 


8. Right-click in the dialog box or press F4, click Preferences, then click View 

MLC Edge. 

Sets the Beam’s Eye View to the default view. 

9. Click . 

Closes the Treatment Field Definition dialog box. 

Changing MLC Leaf Plans 

If you have an MLC leaf plan for a treatment field, whether you added it in MOSAIQ, 

you imported it from an MLC workstation, or through RTP import, you may have to 

make changes to it. How you change an MLC leaf plan is a simple process. Click the 

leaf you want to move and drag it to the desired position. Keep in mind that the 

machine characterization limits any changes that you can make. In this exercise, you 

will change an MLC leaf plan. 

You cannot use MLC Fit to change IMRT treatment fields. 

If you must make major changes to an MLC shape, IMPAC 

recommends that you change it first in the shaping 

software. We recommend you then import the revised shape 

so that the information in both systems is the same. 

1. In the Diagnoses and Interventions window, double-click a treatment field with an 

MLC leaf plan. 

Opens the Treatment Field Definition dialog box. 

2. Click . 

Opens the Beam’s Eye View dialog box. 

, , and are enabled. 

3. Right-click in the dialog box or press F4. 

Opens the Beam’s Eye View Options menu, shown in Figure 4. 


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Notes 



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4. Click Unlock Shape. 

Figure 4: Beam’s Eye View Options Menu 

Unlocks the shape as shown in Figure 5. 

Figure 5: Beam’s Eye View with Unlocked Shape 

If you open the Beam’s Eye View Options menu again, all items on the Options 

menu except Unlock Shape, Zoom In, and Zoom Out are disabled, and Unlock Shape 

has a checkmark adjacent to it.


Notes 5. Click the MLC shape. 

Shows the MLC shape points as shown in Figure 6. 

Figure 6: Beam’s Eye View with MLC Shape Points Visible 

6. To change the MLC shape, click and move the MLC shape points. 

7. Right-click or press F4, then click Unlock Shape. 

Locks the MLC shape again as shown in Figure 7. 


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Notes 



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Figure 7: Beam’s Eye View with Changes to the MLC Shape 

The outline in green is the original MLC shape. The outline in yellow is the new 

MLC shape. 

8. In the Fit Method group, click Intrusive. 

Specifies an MLC Fit method. and are now available. 

9. Click . 

Automatically changes the leaf positions, shown in Figure 8.


Notes 

Figure 8: Beam’s Eye View with AutoFit to the New MLC Shape 

The angle of the collimator has changed so that more of the shape is covered. 

Also, the leaves intrude into the MLC shape. This occurred because you clicked 

Intrusive as the Fit Method. 

10. In the Fit Method group, click Non-Intrusive. 

Changes the position of the leaves so that they do not intrude into the MLC 

shape, shown in Figure 9. 


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Notes 



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Figure 9: Beam’s Eye View with Non-Intrusive Fit 

11. Click Intrusive again in the Fit Method group, then click a leaf in the viewer. 

Selects a leaf, which changes the outline from green to blue, shown in Figure 10.


Notes 

Figure 10: Beam's Eye View with Leaf Information 

The collimator angle changes again when you select Intrusive as the Fit Method. 

The side, number, and position of the selected leaf appears in the Leaf group. 

12. To change the size of the leaf, click it and drag it downward. 

The Rx Position changes in the Leaf group and appears, which moves 

leaves to the digitized shape with the constraint specified in the Fit Method group. 

13. Click . 

Moves the leaves back to the position set by the Intrusive Fit Method. 

14. Click . 

Saves the changes, then closes the Beam’s Eye View dialog box. The new MLC 

shape appears in the Treatment Field Definition dialog box. 

15. Click , then . 

Saves the changes, then closes the Diagnoses and Interventions window. 


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Notes What's Next 

In this lesson, you learned how to view and change MLC leaf plans. Use the Quick 

Version as a concise, step-by-step guide when you must quickly apply any of the skills 

you have learned in this lesson or if you simply want to reinforce what you have 

learned. 

In the next lesson, you will learn how to set RTP import defaults, change import data, 

import an RTP file, view IMRT control point data, and export an RTP file. You also 

will learn how to review IMRT treatment options, configure multiple approvals of 

treatment plan documents, import treatment plan documents, and associate treatment 

plans with courses and/or prescriptions.


Notes 

Quick Version 

Viewing MLC Leaf Plans 

1. From the Diagnoses and Interventions window, double-click a treatment field 

with an MLC shape to open the Treatment Field Definition dialog box. 

2. Click to open the Beam’s Eye View dialog box. 

Changing MLC Leaf Plans 

1. In the Beam’s Eye View dialog box, right-click in the dialog box or press F4. 

2. Click Unlock Shape. 

3. Click the MLC shape. 

4. To change the MLC shape, click and move the MLC shape points. 

5. When finished, right-click in the dialog box or press F4, then click Unlock 

Shape. 

6. Click Intrusive in the Fit Method group. 

7. Click . 


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Notes 



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Lesson 5 Radiotherapy 

Treatment Plans 

Objectives 


• Set RTP import defaults 

• Change import data 

• Import RTP files 

• Export RTP files 

• View IMRT control point data 

• Review IMRT options 

• Configure multiple treatment plan document approvals 

• Import treatment plan documents 

• Review treatment plan documents 

• Associate treatment plan documents with courses and/or prescriptions 

Use the RTP import and export feature to import and export radiotherapy treatment 

plans (RTP) and DICOM RT (Digital Imaging and Communications in Medicine) 

plans, such as IMRT (Intensity Modulated Radiation Therapy). 

In this lesson, you will set RTP import/export defaults, change import data, import an 

RTP file, and export an RTP file. You will view IMRT control point data in RTP 

Import and view IMRT treatment options. You will also configure multiple approvals 

and import files for treatment plan documents, review treatment plan documents, and 

associate treatment plan documents with courses and/or prescriptions.


Notes 



To change a machine characterization, you must have 

Admin | Administrative | General | Admin security rights. 

To import and export RTP files, you must have Clinical | 

Dosimetry Gen | Modify and Clinical | Action Points | Approve 

security rights. 

To open an MLC shape from the Treatment Field Definition 

dialog box, you must have Clinical | Field Defs | View and 

Modify security rights. 

To open the Import Tx Plan window, you must have Clinical | 

Tx Plans | View security rights. 

To configure multiple approvals for treatment plan 

documents, you must have Admin | System Utilities | Clinical 

| Modify rights. 

To import or change a treatment plan, you must also have 

Clinical | Tx Plans | Modify rights. 


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Notes 

Lesson 5: Radiotherapy Treatment Plans 


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Importing/Exporting Radiotherapy Treatment 

Plans 

RTP import/export lets you use data files to transfer the treatment-related patient 

information between your treatment planning system and the treatment management 

system. Before you import the RTP file, you can change the file and configure default 

settings for the treatment field(s) in the file. In the following exercises, you will set 

RTP Import defaults, change an RTP file, import an RTP file, view IMRT control 

point data, and export an RTP file. 

For these exercises, ask your system administrator or the 

instructor for the location of test RTP files to import. 

Setting RTP Import Defaults 

Before you import the RTP file, you can set RTP defaults to save yourself some steps 

later, particularly in the Treatment Field Definition dialog box. Your system 

administrator sets these defaults during treatment machine characterization in the 

system. In this exercise, you will set up RTP import defaults. 

1. Click File | System Utilities | Machine Characterization…. 

DO NOT try to change machine characterizations in your 

clinical database. 

Opens the Machine Characterization dialog box, shown in Figure 11. 

Figure 11: Machine Characterization Dialog Box


Notes 2. Double-click a machine location. 

Opens the Machine Characterization Editor dialog box, shown in Figure 12. 

Figure 12: Machine Characterization Editor Dialog Box 

3. In the Reference group, click RTP Import Defaults from the Section field. 

Opens the RTP defaults in the window pane on the lower left side of the Machine 

Characterization Editor dialog box. 

The machine characterization can change blank data in the 

RTP file to default machine characterization data, but it 

does not overwrite any actual file data. 

4. Click IMRT Doserate from the Key field, then click . 

Copies IMRT Doserate to the machine characterization. The IMRT Doserate appears 

in the Key fields of the Reference and Characterization groups. 

5. In the Characterization group, click IMRT Doserate from the Key field, then type 

300 in the Value field. 

Changes the default IMRT doserate so that you do not have to type this data in 

the system. The IMRT doserate is typically between 300 and 600. 

6. In the Reference group, click No Wedge Label from the Key field, then click 

. 

Copies the No Wedge Label to the machine characterization. The No Wedge Label 

appears in the Key fields of the Reference and Characterization groups. 


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Notes 7. In the Characterization group, click No Wedge Label from the Key field, then type 

NONE in the Value field. 

Changes the default for No Wedge Label to NONE. 

8. Click . 

Saves the changes, then closes the Machine Characterization Editor dialog box. 

The machine location has a status of Unapproved as shown in Figure 13. 

Figure 13: Machine Characterization with Unapproved Machine Location 

9. Click the unapproved machine location, then click . 

Opens the Approve dialog box. 

10. Type your password, then click . 

Approves the changes to the machine location. Approved appears in the Status 

column for the machine location. 

11. Close the Machine Characterization dialog box.


Notes Changing Data in the Edit Data Import Window 

If there is file data that conflicts with the patient data in the system, the conflicting 

data appears as errors in the Import Treatment Plan window. You cannot import an 

RTP file with errors. You can change the file data in the Import Treatment Plan 

window to correct errors or change specific data before you import the file. In this 

exercise, you will make the necessary changes to import the RTP file. 

1. Click File | Import/Export | RTP Import.... 

Opens the RTP Import window, shown in Figure 14. 

Search for RTP files outside the RTP import areas. 

Polling status message and 

the number of files found. 

Figure 14: RTP Import Window 

If the import path does not appear in the Look in field, click , then select the 

path. 

IMPAC configures the RTP Import Areas during installation. 

If no RTP Import Areas appear when you click adjacent 

to the Look in field, contact your system administrator. 

2. Click an RTP import file, then click . 

RTP import areas. 

Opens the Import Treatment Plan window, shown in Figure 15. 


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Notes 



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Shows system data. 

Indicates errors in the course 

and prescription file data. 

Indicates that the file data on the right under the Import 

Data column does not already exist in the system. 

Figure 15: Import Treatment Plan Window 

If « appears in the Action column, the data is ready for import and contains no 

errors, though it can contain warnings. If XX appears, the data is ignored when 

MOSAIQ imports the file. If ?? appears, an error exists and you cannot import the 

file. The color codes in the Import Treatment Plan window are shown below: 

Red The import data contains errors. You cannot import the plan 

if errors are highlighted. 

Yellow The import data contains warnings, but you can still import 

the plan. The warning message appears in the Edit Import 

Data window. 

Green You can import the data. 

Shows the action that will take 

place for the import data. 

Shows file data. 

Blue The import data does not contain any errors, but MOSAIQ 

will not import it. 

3. Click a prescription with an error in the Import Data column, then click . 

Opens the Edit Import Data window for the course data in the system and RTP 

file, shown in Figure 16.


Notes 

Type of data in this window. The error message. 

Figure 16: Edit Import Data Window – Prescription Site 

The title bar of the window shows Prescription Site, and the error message appears 

in the Error/Warning Message column. 

4. Click Items requiring attention from the View field. 

Shows only the data items highlighted with errors as shown in Figure 17. 

Figure 17: Edit Import Data Window with Treatment Field Errors Only 


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Notes 5. Click in the Import Data column for the highlighted red Course ID data item. 

Changes the field to edit mode. 

6. Type 2, then click in the window. 

Changes the Course ID. The Course ID is now highlighted green, shown in 

Figure 18. 

Figure 18: Edit Import Data Window with Corrected Course ID 

7. Click . 

Saves your change, then closes the Edit Import Data window. The prescription is 

highlighted yellow to warn the user that the Rx Site Name exists in the database. It 

also warns the user that the imported file data will change the existing 

prescription. 

8. Click the second prescription site, then click . 

Opens the Edit Import Data window for the prescription data. The row for the 

Course ID data item is highlighted red. The same error message appears as the 

one in the Edit Import Data window for the first prescription site. 

9. Change the Course ID to 2, then click . 

Changes the Course ID to 2, then closes the Edit Import Data window. 

10. Double-click a treatment field. 

Opens the Edit Import Data window for the selected treatment field, shown in 

Figure 19.


Notes 

Figure 19: Edit Import Data Window for Treatment Field 

Some of the items have a delta ( ) adjacent to them. This indicates that the data 

item has one value in the MOSAIQ database and another value in the RTP file. 

To view the deltas for a treatment field, prescription, or course, click Delta items 

from the View field. 

11. Click the treatment machine in the Import Data column. 

Opens the Machine Location dialog box, shown in Figure 20. 

Figure 20: Machine Location Dialog Box 

The Machine Location dialog box lets you change the treatment machine to match 

the treatment machine in the RTP file. If the machine appears in the dialog box, 

click the machine name, then click . 


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Notes 12. Click , then click . 

Closes the Machine Location dialog box, then closes the Edit Import Data 

window. 

Changing File Data to Ignore Status 

If you do not (or cannot) change the file data, you can change the status of the file 

data to Ignore. MOSAIQ does not import any RTP import file data with a status of 

Ignore. In this exercise, you will change the status of file data to Ignore. 

1. Create an error in a treatment field, then right-click the Action column for the 

treatment field. 

Opens the Action Error drop-down menu, shown in Figure 21. 

Figure 21: Import Treatment Plan with Action Error Drop-Down 

The drop-down box lets you change the Error action to Ignore. When you change 

an error action to Ignore, you can import the file, but the file data marked Ignore is 

not imported. This is useful when, for example, you already have a course and 

radiation prescription in the system. You can ignore the course and radiation 

prescription in the file so that you do not have to remove the data in MOSAIQ. 

2. Click XX – Ignore. 

Changes the ?? error indicator to XX, the indicator for Ignore, shown in Figure 22.


Notes 

Figure 22: Import Treatment Plan with Changed Action Status 

If you change the action status to Ignore, MOSAIQ does not import the treatment 

field data with the RTP file. 

3. Double-click a treatment field with errors or data that differs from MOSAIQ. 

Opens the Edit Import Data window for the selected treatment field. 

4. Right-click a parameter with errors or warnings. 

Opens the Action Import drop-down menu, shown in Figure 23. This lets you 

change the Import action to Ignore. 

Figure 23: Action Import Drop-Down Menu 

5. Click XX – Ignore, then click in the window. 

Changes



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Notes Changing the Tolerance Table and Site Name 

You also can change the tolerance table and site name that applies to the RTP import 

data. In this exercise, you will change the tolerance table and site name. 

1. In the Import Treatment Plan window, click a treatment field in the first 

prescription, then click . 

Opens the Group Edit of Fields for import into Site dialog box, shown in 

Figure 24. 

Figure 24: Group Edit of Fields for import Into Site Dialog Box 

Use this dialog box to select a predefined site name or tolerance for a group of 

treatment fields before you import them. You can apply both the tolerance table 

and site name options, or just one of them. 

2. Click 7 Standard from the Tolerance Table field, then click . 

Changes the tolerance table for the fields in the same prescription as the selected 

field, then closes the dialog box. 

3. Click a treatment field in the second prescription, then right-click or press F4. 

Opens the Import Treatment Plan Options menu, shown in Figure 25. 

Figure 25: Import Treatment Plan Options Menu 

4. Click Group Edit of Fields…. 

Opens the Group Edit of Fields for import into Site dialog box. 

5. Click the second prescription from the Site Name field, then click . 

Changes the site name for the fields in the same prescription as the selected field, 

then closes the dialog box. The fields appear under the Import Data column 

adjacent to the treatment fields. The treatment fields appear under the 

prescription in the Existing Data column. 

6. Move the fields to the original radiation prescription.


Notes Importing RTP Files 

Once you change the file, you can import it into MOSAIQ. In this exercise, you will 

import the file, open the log file, and view the imported information in the system. 

1. In the Import Treatment Plan window, click the file you want to import, then 

click . 

Opens the Delete/Move Imported File message box as shown in Figure 26. 

Figure 26: Delete/Move Imported File Message Box 

If the RTP import configuration for your facility is different, 

this message box does not appear. 

You can remove the imported file or move it to a new subdirectory. Once you 

import the file, you cannot keep a copy in the RTP Import Area. If you click 

, the system removes the file. If you click , the system 

creates an Imported subdirectory and moves a copy of the imported file to this 

location. 

2. Click . 

Imports the file into the system, then closes the Import Treatment Plan window. 

The status of the file appears in the Status column of the RTP Import window, 

shown in Figure 27. 

Status of imported file. 

Figure 27: RTP Import Window with File Imported 


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Opens the contents of the log file for the imported RTP file, shown in Figure 28. 

4. Click , then click . 

Figure 28: Contents of Log File 

Closes the Contents of Log File dialog box, then closes the RTP Import window. 

5. Click eChart | Diagnoses and Interventions…. 

Opens the Diagnoses and Interventions window, shown in Figure 29. 

New fields imported with the RTP import/export feature. 

Figure 29: Diagnoses and Interventions Window with Imported Course



Closes the Diagnoses and Interventions window. 

Viewing IMRT Control Point Data 

You can view and change if necessary the RTP import data for IMRT controls. In this 

exercise, you will view the control points for an IMRT field. 


Opens the RTP Import window. 

2. Double-click an RTP file with IMRT fields. 

Opens the Import Treatment Plan window, shown in Figure 30. 

Figure 30: Import Treatment Plan Window with IMRT Fields 

3. Double-click one of the IMRT treatment fields. 

Opens the Edit Import Data window for the treatment field, shown in Figure 31. 


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Notes 



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Figure 31: Edit Import Data Window for IMRT Field 

The Display Child Data button is only available when you are in the Simulation 

Field or Treatment Field view of the Edit Import Data window. The Edit Import 

Data – Control Point window shows all of the control point data for the treatment 

field selected in the Import Treatment Plan window. 

4. Click . 

Opens the Edit Import Data – Control Point window, shown in Figure 32. 

The treatment field selected in the 

Import Treatment Plan window. 

Number of control points. 

Click to show the data for 

a specific control point. 

Figure 32: Edit Import Data – Control Point Window


Notes 5. Click in the Control Point field, then type 4. 

Shows the data for the 4th control point of this treatment field. 

6. Close the Edit Import Data – Control Point window and the Edit Import Data – 

Treatment Field window. 

Exporting RTP Files 

The RTP Export feature lets you export RTP files for multiple patients. In this 

exercise, you will export an RTP file. 

Before you can export RTP files, you must set up a directory 

for the files. 

1. Click File | Import/Export | RTP Export…. 

Opens the RTP Export Option dialog box, shown in Figure 33. 

Figure 33: RTP Export Option Dialog Box 

Use Tagged to export RTP files from more than one patient. 

2. Click . 

Opens the RTP Export dialog box, shown in Figure 34. 

3. Click . 

Figure 34: RTP Export Dialog Box 

Opens the Browse for Folder dialog box, shown in Figure 35. 


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Notes 



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Figure 35: Browse for Folder Dialog Box 

4. Navigate to the directory from which you export RTP files, click the RTP Export 

directory, then click . 

Opens the RTP export path in the Export Directory field, shown in Figure 36. 

5. Click . 

Figure 36: RTP Export Dialog Box with RTP Export Path 

Exports the file, then opens the View Import/Export Log message box, shown in 

Figure 37. 

Figure 37: View Import/Export Log Message Box



Opens the RTP Import/Export Daily Log window, shown in Figure 38. 

Figure 38: RTP Import/Export Daily Log Window 

To print the RTP export log to your default printer, click . 

7. Click . 

Closes the RTP export log. Some of the data in the RTP file appears in the RTP 

Export dialog box, shown in Figure 39. 

8. Click . 

Figure 39: RTP Export Dialog Box with Exported Data 

Closes the RTP Export dialog box. 


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Notes 



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Viewing Options in Treatment Field Definition 

The Treatment Field Definition dialog box has fields and options that only appear 

when you work with IMRT plans. Before you can use multi-control point plans, such 

as IMRT, your facility must purchase and register SEQUENCER IMRT. There are 

two types of IMRT fields, Step-and-Shoot and Sliding Window. In this lesson, you will 

view IMRT features in the Treatment Field Definition dialog box. 

Use the previous exercises to import an IMRT plan with IMRT 

treatment fields if necessary. 

1. Open the chart of a patient with IMRT treatment fields, then click eChart | 

Diagnoses and Interventions…. 

Opens the Diagnoses and Interventions window. 

2. Click an IMRT treatment field, then click . 

Opens the Treatment Field Definition dialog box for the selected IMRT treatment 

field, shown in Figure 40. 

Shows the IMRT control points, index, and 

MU of the imported IMRT plan. 

Figure 40: Treatment Field Definition Dialog Box with IMRT Control Points 

The Asy check boxes for Jaw X1 and Jaw Y1 do not appear because they do not 

apply to this treatment field. The IMRT group replaces the MLC checkbox and 

.


Notes 3. Click in the IMRT group. 

Shows a list the control points for this treatment field, shown in Figure 41. 

Figure 41: Control Point List for the IMRT Field 

The indices in this figure repeat for every 2 control points. This identifies the 

treatment field as a Step-and-Shoot IMRT. For this type of IMRT field, radiation 

is not delivered while the leaves move. The treatment sequence moves the leaves 

into position (the Step segment), then treats (the Shoot segment). 

For Sliding Window IMRT fields, the indices do not repeat every 2 control points. 

For these fields, the radiation treatment is delivered continuously, even while the 

leaves move. 

4. Click in the IMRT group. 

Shows the IMRT sequence in the viewer as if the treatment machine is executing 

the plan. 

5. Click . 

Stops the test run of the IMRT sequence in the viewer. 


Navigates to other control points and shows an image of the plan for the selected 

control point in the viewer, and the point, index, and MU data in the IMRT group. 

7. Click . 

Shows an image of the plan for the last control point in the viewer and the point, 

index, and MU data in the IMRT group. 

8. Click . 

Repeating indices 

every two control 

points is considered 

a segment. 

Shows an image of the plan for the first control point in the viewer and the point, 

index, and MU data in the IMRT group. 


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Notes 9. Right-click or press F4, then click Enlarge/Edit Beam’s Eye View…, or click 

in the viewer. 

Opens the Beam’s Eye View dialog box for the IMRT plan, shown in Figure 42. 

Figure 42: Beam's Eye View Dialog Box with IMRT Plan 

The same IMRT group in the Treatment Field Definition dialog box appears in 

the Beam’s Eye View dialog box. 

10. Click . 

You cannot change an imported IMRT plan in the Beam’s Eye 

View dialog box. 


11. Right-click or press F4, then click Display Shaped Port…. 

Opens the Beam’s Eye View dialog box for the IMRT shaped port, shown in 

Figure 43.


Notes 

Figure 43: Beam's Eye View Dialog Box with IMRT Shaped Port 

The Shaped Port is the outermost leaf positions for the IMRT treatment field. It is 

also called the CIAO or Completely Irradiated Area Outline. 

12. Click . 


13. Right-click or press F4, then click Import…. 

Opens the Treatment Field Definitions window, shown in Figure 44. 

Figure 44: Treatment Field Definitions Window 


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Notes The Treatment Field Definitions window lets you import MLC plan parameters 

from another treatment field definition into the current definition. Only fields 

with MLC plans are listed, including MLC fields that are not IMRT. If any of the 

MLC fields include a field shape, a Yes appears in the Shape group. 

14. Click . 

The Import… option is also available for static MLC fields. 

Closes the Treatment Field Definition dialog box. 

Importing and Changing Treatment Plan 

Documents 

You can import PDF documents or JPEG and TIFF images generated during 

treatment planning into the Diagnoses and Interventions window with eSCAN. The 

Treatment Plan Import feature lets you import treatment plan documents to a 

treatment folder. You can then view, change the name of, add and remove image and 

PDF files from, and add notes to the imported treatment plan document. You can 

also approve, print, and associate treatment courses and prescriptions. In the following 

exercises, you will configure multiple approvals, import a treatment plan document, 

and change a treatment plan document. 

Configuring Multiple Approvals for Treatment Plan Documents 

Your system administrator can configure MOSAIQ to require that imported treatment 

plan documents are approved before treatment delivery. MOSAIQ requires a 

minimum of one electronic signature to approve the treatment plan document. Your 

system administrator can also set up multiple mandatory and optional approvals at 

your facility that use Staff Type (such as Doctor or Physicist). In this exercise, you will 

configure MOSAIQ to make clinicians approve treatment plan documents before they 

can treat the patient. 

1. Click File | System Utilities | Department Setup…. 

Opens the Department Setup dialog box. 

2. In the General tab, click . 

Opens the Multi User Status Configuration window, shown in Figure 45.


Notes 

Figure 45: Multi User Status Configuration Window 

Multi User Status Configuration lets you add, change, or view the Staff Types that 

can approve a treatment plan document. You can configure the approval as 

required or optional. You cannot change the Department and Type fields. 

3. Click . 

Opens the Multi User Status Configuration dialog box, shown in Figure 46. 

Figure 46: Multi User Status Configuration Dialog Box 

4. Click Physicist from the Staff Type field. 

Specifies the staff type to approve the treatment plan document. 

5. In the Priority group, click Required. 

Specifies that the Staff Type must approve the treatment plan document before 

you can treat the patient. 

6. Click . 

Adds the Staff Type approval. 

7. Add an optional approval for the Therapist Staff Type. 

Adds the new approval as shown in Figure 47. 


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Notes 



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Figure 47: Multiple Treatment Plan Approvals Configured 


Closes the Multi User Status Configuration window, then closes the Department 

Setup dialog box. 

Importing Files for the Treatment Plan Document 

You can import PDF document files and JPEG or TIFF image files to add a 

treatment plan document in the Import Tx Plan window. In this exercise, you will 

import the treatment plan document files into MOSAIQ. 

1. Open the chart for a patient, then click eChart | Diagnoses and 

Interventions…. 

Opens the Diagnoses and Interventions window. 

2. Click . 

You can also right-click or press F4, then click Add New Tx 

Plan. 

Opens the Import Tx Plan window shown in Figure 48.


Notes 

Figure 48: Import Tx Plan Window 

From the Import Tx Plan window, you can import PDF document and image files 

generated during treatment planning. You can also print, save, and navigate 

through multiple-page files in this window. The imported treatment plan can 

include multiple PDF documents and/or image files. Multiple-page treatment plan 

documents can have multiple files and/or multiple pages from one or more files. 

The Import Tx Plan window contains the information and components below: 

Documents Available 

Pane 

Documents Saved 

Pane 

Preview Pane 

(not labeled) 

Fit to Page 

(checkbox) 

Documents and images 

available to add, then import. 

Shows documents and images 

ready for import. 

Shows all of the scanned images and/or PDF files 

and sub-directories available in the scanned image 

directory. Click adjacent to the folder to show 

the files. If there are sub-folders, click adjacent 

to a sub-folder to show the files in that subfolder. 

Shows the Document folder and the files you added 

to it from the Documents Available pane. You can 

add as many files to the Document folder as 

necessary. 

Shows the image or document of any highlighted 

file in the Documents Available or Documents Saved 

panes. 

Adjusts the width of the selected PDF document 

or image file to fit in the Preview pane. 


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Notes 



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Imports the treatment plan document files into the 

Diagnoses and Interventions window. Before you 

add and import the files, the Import Tx Plan dialog 

box opens. This lets you name the treatment plan 

document file(s) you are about to import. With 

multiple files, MOSAIQ combines all of the files 

into one treatment plan document, so you only 

type one name for the treatment plan document. If 

you do not type a treatment plan document name, 

the name defaults to the filename of the currently 

selected file in the Documents Saved pane. 

Closes the window. If you have not imported a 

new treatment plan document, other changes made 

in this window are lost when you click . 

If you click after you import a treatment 

plan document, this does not affect the imported 

treatment plan document. 

Refreshes the Documents Available pane if you add 

new scanned files or create new folders in your 

scanned images directory. You can also close and 

open the Import Tx Plan window to show the 

newly added files. 

Lets you change/navigate through the files in the 

treatment plan document that appears in the Preview 

pane. The inside arrows let you scroll through 

consecutive files. The outside arrows let you scroll 

to the end or start of the files in the treatment plan 

document. 

Lets you select the size of the document or image 

in the Preview pane. This option is disabled when 

you click Fit to Page. 

3. Click adjacent to the folder in the Documents Available pane. 

Shows the files available for import. 

The folder with the files to import via eSCAN appears in the 

Documents Available pane of the Import Tx Plan window. 

Your system administrator must add the location of this 

folder from the Department Setup. 

4. Click a PDF document in the Documents Available pane. 

Shows the PDF document in the Preview pane to the right side of the window, 

shown in Figure 49.


Notes 

Use to move page in viewer. 

Click to print. 

Click to copy. 

Navigate through multi-page documents. 

Create annotations. 

Figure 49: Import Tx Plan Window with Selected PDF File and Toolbar 

Figure 49 also shows the toolbar that appears when you click a PDF document. 

The toolbar contains the components below: 

Prints the PDF document that appears in the Preview pane. 

Copies the PDF document that appears in the Preview pane. 

Add/remove pages. 

Moves the page (of text or image) shown to a desired position in the 

Preview pane. 

Changes the size (zoom factor) of the PDF document shown in the 

Preview pane. The options include Zoom In, Zoom Out, Actual Size, 

Fit Page, Fit Width, and Zoom Level. 

Adds a text annotation to the PDF document. Click to open a 

menu, then click Note. Click in the PDF document where you want 

to add the note to open the Note text box. Click in the Note text box, 

then type your note. A Note icon appears where you added your 

note. Right-click the Note icon to hide, remove, or show the note. 


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Notes 



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5. Click an image file. 

Adds a graphic annotation to the PDF document. Click to open a 

menu, then click the type of graphic: Line, Square, Circle, or Pencil. 

Add the graphic with your mouse. Release your mouse button to 

complete. Right-click the graphic annotation, then click Delete to 

remove it. 

Adds a text-based mark-up annotation to the PDF document. 

Adds a multimedia annotation, such as a .wav file to the PDF 

document. 

Adds a hyperlink to the PDF document. 

Imports the PDF document. 

Merges or splits pages within the PDF document. 

Encrypts the PDF document. 

Digitally signs the PDF document. 

Opens online Help for the PDF document. 

Shows the image file without the upper toolbar, shown in Figure 50. 

Figure 50: Import Tx Plan Window with JPEG File Selected 

6. Right-click the PDF document in the Documents Available pane. 

Opens the Documents Available Options menu, shown in Figure 51.


Notes 

7. Click Add. 

Figure 51: Documents Available Options Menu 

Adds the PDF document to the Documents Saved pane. You also can use your 

mouse to drag and drop files between the Documents Available and Documents Saved 

panes. 

8. Add one or more PDF documents or image files to the treatment plan document. 

Adds the PDF documents or image files to the treatment plan document. 

If you import multiple files, MOSAIQ merges the files into 

one multiple-page treatment plan document. 

9. Click one of the files you added to the Documents Saved pane, then click . 

Opens the Import Tx Plan dialog box, shown in Figure 52. 

Figure 52: Import Tx Plan Dialog Box 

The Import Tx Plan dialog box lets you change the name of the PDF document(s) 

and/or image file(s). This is especially useful if multiple documents and files make 

up a treatment plan document. The default treatment plan document name is the 

same as the name of the first file that appears in the Documents Saved pane. 

Alternatively, if you clicked a file before you clicked , the name of that 

file appears, as in step 9. 

10. Type the treatment plan document name for the imported file(s) in the Tx Plan 

Name field. 

Specifies the name of the treatment plan document in MOSAIQ. 

11. Click . 

Imports the selected files. The imported treatment plan document appears in a Tx 

Plans folder in the Diagnoses and Interventions window as shown in Figure 53. 


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Notes 



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Figure 53: Diagnoses and Interventions with New Treatment Plan 

The imported treatment plan documents appear in the 

order you import them into MOSAIQ. The most recent or last 

treatment plan document you imported appears first in the 

Tx Plans folder of the Diagnoses and Interventions window. 

Viewing/Changing Treatment Plan Documents 

When you import treatment plan document file(s), you can view the plan, change its 

name, and add and remove image and text files. You can also add notes, approve, 

print, and associate treatment courses and prescriptions to the treatment plan 

document. In this exercise, you will view the treatment plan document and associate it 

with a prescription in the Treatment Plan Editor window. 

1. In the Diagnoses and Interventions window, double-click the imported treatment 

plan document in the Tx Plan folder. 

Opens the Treatment Plan Editor window, shown in Figure 54.


Notes 

Click to associate the treatment plan 

document with prescriptions or courses. 

Figure 54: Treatment Plan Editor Window 

The Treatment Plan Editor window uses the same toolbars as the Import Tx Plan 

window. You can also view approvals from the Approvals group. The Treatment 

Plan Editor window contains the information and components below: 

Patient Shows the patient name. 

MedRc Shows the patient medical record number. 

Age - DOB Shows the patient age and date of birth. 

Tx Plan Name Shows the default treatment plan document name. You can 

type a new name in this field. 

Tx Plan 

Description 

Shows the treatment plan 

document name as imported. 

Lets you type a short 

description. 

Click to view approvals if your 

facility uses multiple approvals. 

Shows the description added for the treatment plan 

document, if any. This field defaults to blank. 

Associations Shows the name of the associated prescription(s) and/or 

course(s). 

Approval If only one approval is required, shows the initials of the 

doctor who approved the treatment plan document. Also 

shows the date on which the treatment plan document was 

approved. For multiple approvals, shows the staff type, 

initials of the staff member, and the date of approval. 

Optional approvals appear in italics. 


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Notes 



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Opens the Tx Plan Association dialog box, from which you 

can associate the treatment plan document with prescriptions 

and/or courses. 

Opens the Tx Plan Approvers window, from which you can 

see who approved the treatment plan document. 

Opens a Note window, from which you can type a note 

about the treatment plan. The Treatment Plan Editor Note 

window is the same as all of the note windows in MOSAIQ. 

A green checkmark appears adjacent to after you 

add a note. 

Opens the Record Status dialog box, from which you can set 

the status of the treatment plan document. 

Opens the Edit Tx Plan window, from which you can change 

the treatment plan document. 

Prints all files in the imported treatment plan document. 

2. Type a short description in the Tx Plan Description field. 

Specifies information about the treatment plan document. 

3. Click . 

Opens the Tx Plan Association window with the courses and prescriptions for the 

selected patient as shown in Figure 55. 

Figure 55: Tx Plan Association Window 

If the patient has multiple prescriptions and/or courses, press SPACEBAR to tag 

the prescriptions and/or courses to associate them with the treatment plan 

document. 

If you do not want the treatment plan document associated 

with a prescription, click in the Tx Plan Association 

window.


Notes 4. Click a prescription, then click . 

Associates the prescription with the treatment plan document. The associated 

prescription appears in the Treatment Plan Editor window, shown in Figure 56. 

Figure 56: Treatment Plan Editor with Associated Prescription 

5. Click . 

Opens the Edit Tx Plan window, shown in Figure 57. 

Figure 57: Edit Tx Plan Window 

This window lets you remove or add PDF documents and image files with the 

same options available in the Import Tx Plan window. 


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Notes 6. Click adjacent to the folder in the Documents Available pane that contains the 

image file or PDF document. 

Shows all available files in the selected folder. 

7. Right-click a file, then click Add. 

Adds the selected file to the Documents Saved pane. 

8. Repeat steps 6 and 7 until you have added all of the files to the imported 


9. Click . 

Right-click the file, then click Delete to remove files from the 

Documents Available or Documents Saved panes. You can 

also drag and drop files between the panes. 

Saves your changes to the treatment plan document, then opens the Treatment 

Plan Editor window. 

10. Close the Treatment Plan Editor window. 

What's Next 

In this lesson, you learned how to set RTP import defaults, change import data, 

import an RTP file, view IMRT control point data, and export an RTP file. You also 

learned how to review IMRT treatment options, configure multiple approvals, import 

treatment plan documents, and associate treatment plan documents with courses 

and/or prescriptions. Use the Quick Version as a concise, step-by-step guide when 

you must quickly apply any of the skills you have learned in this lesson or if you simply 

want to reinforce what you have learned. 

In the next lesson, you will learn how to set up dose tracking. You will learn how to 

add prescription and secondary dose tracking sites, change and add dose coefficients, 

and add prior dose. You will also learn how to add dose action points and configure 

treatment charts.


Notes 

Quick Version 

Setting RTP Import Defaults 

1. Click File | System Utilities | Machine Characterization… to open the 

Machine Characterization dialog box. 

2. Double-click the machine location, such as ELEKTA., to open the Machine 

Characterization Editor dialog box. 

3. In the Reference group, click RTP Import Defaults from the Section field. 

4. Click IMRT Doserate from the Key field, then click . 

5. In the Characterization group, click IMRT Doserate from the Key field, then type 

the IMRT doserate in the Value field. 

6. In the Reference group, click No Wedge Label from the Key field, then click 

. 

7. In the Characterization group, click No Wedge Label from the Key field, type 

NONE in the Value field. 

8 Click . 

9. In the Machine Characterization dialog box, click the machine location, then click 

. 

10. In the Approve dialog box, type your password, then click . 

11. Close the Machine Characterization dialog box. 

Changing Data in the Edit Import Data Window 


2. If the new import path does not appear in the Look in field, click , then click the 

path. 

3. Click the name of the patient file that you wish to import, then click . 

4. In the Import Treatment Plan window, click a prescription or course error 

highlighted red in the Import Data column. 

5. Click to open the Edit Import Data window for the selected file data. 

6. Click in the Import Data column for the data item highlighted red or any data item 

to change the field to the edit mode. 

7. Type the new data to fix the error, then click anywhere in the window. 

8. Click Items requiring attention from the View field. 


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LTGRAD0005B /1.0/20-Feb-2009 

Notes 9. If the error is No Matching Treatment Machine Name, click the machine name in the 

Import Data column to open the Machine Location dialog box. 

10. If the machine is listed in this dialog box, click the machine name, then click 

. 

11. Click to close the Edit Import Data window. 

Changing File Data to Ignore Status 

1. In the Import Treatment Plan window, click ?? in the Action column for errors 

highlighted red, then click XX – Ignore if you do not wish to import the file data 

with the error. 

2. Click


Notes Viewing IMRT Control Point Data 

1. Open the RTP import file for an IMRT treatment plan. 

2. In the Import Treatment Plan window, double-click an IMRT treatment field. 

3. In the Edit Import Data window, click . 

4. In the Edit Import Data – Control Point window, click in the Control Point 

field to search for the control point(s) that show warning/error messages. 

5. Click , or if you make a change in the Edit Import Data – Control Point 

window, click . 

Exporting RTP Files 

1. Click File | Import/Export | RTP Export… to open the RTP Export Option 

dialog box. 

2. Click to open the RTP Export dialog box. 

3. Click to open the Browse for Folder dialog box. 

4. Navigate to the directory from which you export RTP files, click the RTP Export 

directory, then click . 

5. Click . 

6. In the View Import/Export Log message box, click . 

7. Click to print the RTP import/export log to your default printer. 


Reviewing IMRT Options in Treatment Field Definition 

1. Click eChart | Diagnoses and Interventions… to open the Diagnoses and 

Interventions window. 

2. Click an IMRT treatment field, then click . 

3. If you receive the MU Per Segment Warning Differences message box, contact 

your system administrator. For more information about the error message, click 

in the message box to open the Segment MU Details dialog box. 

4. In the Treatment Field Definitions dialog box, click in the IMRT group to 

show a list the control points for this treatment field. You can determine whether 

the field is an IMRT Sliding Window or an IMRT Step and Shoot from this list. 


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Notes 5. Click in the IMRT group to show the IMRT sequence in the viewer as if the 

treatment machine is executing the plan. 

6. Click to stop the IMRT sequence. 

7. Click , then to navigate to other control points. This shows an image of the 

plan for the selected control point in the viewer, and the point, index, and MU 

data in the IMRT group. 

8. Click to show an image of the plan for the last control point in the viewer and 

the point, index, and MU data in the IMRT group. 

9. Click to show an image of the plan for the first control point in the viewer and 

the point, index, and MU data in the IMRT group. 

10. Right-click or press F4, then click Enlarge/Edit Beam’s Eye View…, or click 

in the viewer to open the Beam’s Eye View dialog box for the IMRT plan. 

11. Click to close the dialog box. 

12. Right-click or press F4, then click Display Shaped Port… to open the Beam’s 

Eye View for the IMRT shaped port. 

13. Click to close the dialog box. 

14. Right-click or press F4, then click Import… to open the Treatment Field 

Definitions window. 

15. Click to close the window. 

Configuring Multiple Approvals for Treatment Plan Documents 

1. Click File | System Utilities | Department Setup… to open the Department 

Setup dialog box. 

2. In the General tab, click to open the Multi User 

Status Configuration window. 

3. Click to open the Multi User Status Configuration dialog box. 

4. Click the staff type, such as Physicist, from the Staff Type field. 

5. In the Priority group, click Required or Optional. 

6. Click to add the Staff Type. 

7. Click , then click to save your changes.


Notes Importing Files for the Treatment Plan Document 

1. Open the Diagnoses and Interventions window. 

2. Click to open the Import Tx Plan window. You can also right-click or 

press F4, then click Add New Tx Plan. 

3. Click adjacent to the folder in the Documents Available pane. 

4. Click a PDF document or image file in the Documents Available pane. 

5. Right-click the PDF document or image file in the Documents Available pane. 

6. In the menu, click Add. You also can use your mouse to drag and drop files 

between the panes. 

7. Add one or more PDF documents or image files to the treatment plan document. 

8. Click one of the files you added to the Documents Saved pane, then click . 

9. In the Import Tx Plan dialog box, type the treatment plan document name for the 

imported file(s) in the Tx Plan Name field. 

10. Click to close the Import Tx Plan window. 

Viewing/Changing Treatment Plan Documents 

1. In the Diagnoses and Interventions window, double-click the imported treatment 

plan document in the Tx Plan folder. 

2. In the Treatment Plan Editor window, type a short description of the treatment 

plan document in the Tx Plan Description field. 

3. Click to open the Tx Plan Association window. 

4. Click the course or prescription, then click . 

5. Click to open the Edit Tx Plan window. 

6. Click adjacent to the folder in the Documents Available pane that contains the 

image file or PDF document you wish to add. 

7. Right-click the file, then click Add. 

8. Repeat steps 6 and 7 until you have added all of the files to the imported 


9. Click . 

10. Close the Treatment Plan Editor window. 


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Notes 



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Lesson 6 Setting Up Dose 

Tracking 

Objectives 


• Review Primary Dose Tracking Sites 

• Add Secondary Dose Tracking Sites 

• Change and add dose coefficients 

• Add Prior Dose 

• Define dose action points 

• Configure treatment charts 

The Dosimetry Setup feature uses dose information to automatically track dose as you 

record patient treatments. After you add the diagnosis, Care Plan, and prescription, 

use the Dosimetry Setup feature to add dose tracking sites. This feature automatically 

adds primary dose tracking sites and assigns default coefficients for field contributions 

to the primary dose tracking sites. Tracking doses to a site is important. You not only 

want to track doses from the current prescription site, but also doses from other past 

or current prescription sites as secondary dose tracking sites. 

In this lesson, you will review primary dose tracking sites, change and add dose 

coefficients, and add secondary dose tracking sites. You will also add prior dose, 

define dose action points, and configure treatment charts. 

To set up Dosimetry and add dose tracking sites, you must 

have Clinical | Dosimetry Gen | Modify security rights. 

To change prescriptions, you must have Clinical | 

Prescription | Modify security rights. 

To add/change dose coefficients, you must have Clinical | 

Coefficients | Modify and Approve security rights. 

To add dose action points, you must have Clinical | Action 

Points | Modify and Approve security rights.


Notes 

Defining Dose Tracking for Prescription Sites 

The Dosimetry Setup window manages dose tracking sites and the coefficients used to 

calculate the dose in the Treatment Chart or where actual dose appears in the system. 

You can also add Secondary Dose Tracking Sites and Secondary Cumulative Dose 

Tracking sites to the Dosimetry Setup window. This lets you monitor and follow dose 

to all sites related to the prescribed site. In these exercises, you will review the dose 

tracking sites and coefficients added from the field and prescription information, add 

secondary dose tracking sites, and change and add dose coefficients. 

Reviewing Primary Dose Tracking Sites 

The Dosimetry feature adds dose tracking sites from the field and prescription 

information. You use the Dosimetry Setup window to monitor the sites and track 

cumulative dose. In the upper pane of the Dosimetry Setup window, Cumulative 

Primary Dose Tracking Sites appear in columns for the prescription sites. In the lower 

pane, Primary Dose Tracking Sites appear in columns for the treatment fields. In this 

exercise, you will review Primary and Cumulative Primary dose tracking sites. 

1. Open the chart for your lesson patient, then open the Diagnoses and 

Interventions window. 

2. Click , or right-click (or press F4) in the Diagnoses and Interventions 

window, then click Dosimetry…. 

Opens the Dosimetry Setup Information window, shown in Figure 58. 

Figure 58: Dosimetry Setup Information Window 

The Dosimetry Setup Information window shows new or changed prescription 

sites, treatment fields, and cumulative dose sites. Dose tracking is automatically set 

up for a radiation prescription. Dose coefficients are also automatically assigned 

for each treatment field, with a default coefficient of 1. Dose coefficients identify 

the relative dose contribution of a treatment field or radiation prescription to a 

volume of interest. 


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Lesson 6: Setting Up Dose Tracking 


LTGRAD0005B /1.0/20-Feb-2009 

Notes This window also identifies if dose tracking sites or coefficients are invalid or 

inconsistent. For example, if you remove the dose amount in the Total Cum field 

for a prescription, this window appears when you later open the Dosimetry 

window. It tells you that the Cumulative Primary Dose Tracking Site for the 

prescription was removed. 

3. Click . 

Sets up dose tracking for the listed prescriptions and treatment fields, then opens 

the Dosimetry Setup window, shown in Figure 59. 

The upper pane tracks dose at the prescription level. 

Dose sites as defined 

in the prescription. 

Prescribed dose. 

The lower pane of this window tracks 

dose at the treatment field level. 

Total dose being administered 

from all prescription sites. 

Figure 59: Dosimetry Setup Window 

Dose tracking sites defined from 

the prescription. 

The upper pane shows the cumulative dose tracking site information and assigns 

the relative contribution of prescription site doses to cumulative dose tracking 

sites. The lower pane shows direct dose tracking site information and assigns the 

relative contribution of treatment field doses to direct dose tracking sites. The 

Cumulative Primary Dose Tracking Sites in the upper pane and Primary Dose 

Tracking Sites in the lower pane are defined in the prescriptions. You cannot 

change or remove them in the Dosimetry Setup window. 

In the upper pane, two cumulative dose tracking sites appear: Cum: Heart and Cum 

Rx: Lung Boost. You added the cumulative secondary dose tracking site Cum: Heart 

when you added the dose limit dose action point in Lesson 2 of Module I of this 

guide. When you added the cumulative dose to the Lung Boost prescription, also 

in Lesson 2, you added the cumulative primary dose tracking site Cum: Lung Boost.


Notes Adding Cumulative Secondary Dose Tracking Sites 

MOSAIQ can track dose delivered to secondary sites or critical structures, such as the 

spinal cord, so patients do not receive more dose than is planned. There are 

Cumulative Secondary Dose Tracking Sites and Secondary Dose Tracking Sites. 

Cumulative Secondary Dose Tracking Sites track the dose contribution to nonprescribed 

volume, such as a critical structure, from multiple prescription sites. You 

can add a Cumulative Secondary Dose Tracking Site from the upper pane of the 

Dosimetry window or from the Dose Limits window. Secondary Dose Tracking Sites 

are covered in the next exercise. In this exercise, you will add cumulative secondary 

dose tracking sites. 

You can add as many dose tracking sites as necessary. You 

can only show a maximum of 21 dose tracking site columns 

at one time. These columns include CumRx and Cum dose 

tracking site columns. 

1. In the Dosimetry Setup window, double-click Add New Dose Tracking Site in the 

upper pane. 

You can also use the buttons in the Dose Site and Coefficient 

groups to add, change, and remove dose site and coefficient 

information in the upper and lower panes of the Dosimetry 

Setup window. 

Opens the Cumulative Secondary Dose Tracking Site dialog box, shown in 

Figure 60. 

Figure 60: Cumulative Secondary Dose Tracking Site Dialog Box 

You can add a prior dose for the Cumulative Secondary Dose Tracking Site in the 

dialog box. Refer to the Adding Prior Dose exercise of this lesson. 

2. Type Whole Lung in the Site Name field. 

Specifies a name for the Cumulative Secondary Dose Tracking Site. 

3. Click . 

Closes the Cumulative Secondary Dose Tracking Site dialog box, and adds the 

new cumulative secondary dose tracking column to the Dosimetry Setup window. 


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Notes Adding and Changing Dose Coefficients 

Dose coefficients define the relative dose contribution of a treatment field or radiation 

prescription to a volume of interest. When you set up dose tracking for the 

prescription, a default dose coefficient of 1.000 is automatically assigned to each 

treatment field. You can also set up multiple coefficients for a single field. For 

example, if you start the first day of treatment delivering a specified dose to a site, then 

add a block to the setup halfway through the treatment schedule, you can specify a 

different coefficient to be effective on the day you start with the block. You can also 

change the coefficient for secondary sites that normally do not receive the full dose. In 

this exercise, you will change and add dose coefficients. 

1. In the Dosimetry Setup window, double-click in the first row of the CumRx: Lung 

Boost column, which is the row for the Lung prescription site. 

Adds the dose coefficient of 1.000 to activate cumulative dose tracking for the 

Lung prescription site. The full prescribed dose of the Lung prescription site 

contributes dose to the Cum Rx: Lung Boost column. 

2. Double-click in the second row of the CumRx: Lung Boost column, which is the 

row for the Lung Boost prescription site. 

Adds the dose coefficient of 1.000 to activate cumulative dose tracking for the 

Lung Boost prescription site, shown in Figure 61. The full prescribed dose of the 

to the Lung Boost prescription site contributes dose to the Cum Rx: Lung Boost 

column. 

Figure 61: Dosimetry Setup With New Dose Coefficients 

3. Double-click the first field under the Cum: Heart column, then press TAB. 

Assigns a dose coefficient of 1.000 to the dose tracking site for the corresponding 

treatment field. This indicates a 1:1 relationship between the dose tracked to the 

treatment field and the dose tracking site. 

You can also click in the column, click , then press 

TAB.


Notes 4. Double-click the 1.000 that you added in the Cum: Heart column, or click 1.000, 

then click . 

Highlights the dose coefficient so you can change it. 

5. Type 0.500, then press TAB. 

Changes the dose coefficient. You change the coefficient if, as in this exercise, you 

wish to track 50 percent of the dose delivered to a cumulative dose site. 

6. Click in the second field for Cum: Heart column, right-click or press F4. 

Opens the Dosimetry Options menu, shown in Figure 62. 

7. Click Edit Coefficients…. 

Figure 62: Dosimetry Options Menu 

Opens the Dose Coefficient dialog box, shown in Figure 63. 

Figure 63: Dose Coefficient Dialog Box 

You can use the Dose Coefficient dialog box to add and change coefficients and 

identify the date on which to start the dose calculation. You can also add an 

effective date to an existing coefficient. 

8. Type the current date in the Start Date field. 

Specifies the effective date. 

9. Type .5 in the Coefficient field, then press ENTER. 

Specifies the coefficient. The coefficient and effective date appear in the Dose 

Coefficients window, shown in Figure 64. 


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Notes 



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Figure 64: Dose Coefficients Window 

The Lung radiation prescription contributes 50% of the dose to the Cum: Heart 

dose tracking site. You can use the Dose Coefficients window to add dose 

coefficients for a field and to change the effective date of existing fields. 

10. Click . 

Opens the Dose Coefficient dialog box. 

11. Click adjacent to the Start Date field, then double-click a date one week later 

than the previous date. 

Specifies the effective date for the new coefficient. 

12. Type .25, then press ENTER. 

Specifies the new coefficient, then closes the Dose Coefficient dialog box. Two 

separate coefficients now appear for the Cum: Heart dose tracking site. 

13. Click . 

Closes the Dose Coefficients window. In the Dosimetry Setup window, the 

coefficient with the most future date in the list appears, shown in Figure 65. 

Figure 65: Dosimetry Setup with Multiple Dose Coefficients 

An ellipsis (…) appears to the left of the coefficient because the Cum: Heart dose 

tracking site has multiple dose coefficients.


Notes Adding Secondary Dose Tracking Sites 

Secondary Dose Tracking Sites track dose contributions to any point or volume (not 

prescribed), and can include off-axis points and critical structures. In this exercise, you 

will add a secondary dose tracking site. 

1. In the Dosimetry Setup window, click in the Add New Dose Tracking Site column in 

the lower pane, then click . 

Opens the Secondary Dose Tracking Site dialog box, shown in Figure 66. 

Figure 66: Secondary Dose Tracking Site Dialog Box 

You can also add a prior dose for the Secondary Dose Tracking Site. 

2. Type Spinal Cord in the Site Name field. 

Specifies a name for the Secondary Dose Tracking Site. 

3. Click . 

Closes the Secondary Dose Tracking Site dialog box, then adds the new Secondary 

Dose Tracking Site to the Dosimetry Setup window, shown in Figure 67. 

Secondary sites you 

added. 

Use the buttons to add, change, and remove 

information in the upper and lower panes. 

Figure 67: Dosimetry Setup with New Dose Tracking Sites 


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Notes Adding Prior Dose 

If you know the amount of dose administered to a site before you record the site in 

MOSAIQ, you can record the prior dose in the Dosimetry Setup window. You can 

assign prior dose to any dose site and include dose from earlier treatments or 

treatment at another facility. You can add prior dose to current dose and show it on 

the Dose Site Summary window. In this exercise, you will add prior dose. 

1. In the upper pane of the Dosimetry Setup window, double-click near the Prior 

field for CumRx: Lung Boost. 

Opens the Cumulative Primary Dose Tracking Site dialog box, shown in 

Figure 68. 

Figure 68: Cumulative Primary Dose Tracking Site Dialog Box – Prior Dose 

Double-click the Prior field for secondary dose tracking sites 

in the upper and lower panes to add prior dose to the sites. 

2. Type 900 in the Prior Dose field. 

Specifies the prior dose. 

3. Click . 

Opens a note window for the selected dose tracking site. 

4. Type Dose from tx at another facility in 2006 in the Subject field, then click 

. 

Adds a note about the prior dose, shown in Figure 69. 

Figure 69: Cumulative Primary Dose Tracking Site with Note


Notes 

IMPAC recommends that you add a note if you have any 

information about the prior dose. 

A green checkmark appears adjacent to because you added a note for 

the prior dose. 

5. Click . 

Closes the Cumulative Primary Dose Tracking Site dialog box. 900 appears in the 

Prior field for CumRx: Lung Boost in the upper pane of the Dosimetry Setup 

window. 

6. Double-click adjacent to the Prior field for Rx: Lung in the lower pane of the 

Dosimetry Setup window. 

Opens the Primary Dose Tracking Site dialog box, shown in Figure 70. 

Figure 70: Primary Dose Tracking Site Dialog Box for Prior Dose 

7. Repeat steps 2-5 for the Rx: Lung Boost primary dose tracking site. 

Adds the prior dose for the Rx: Lung Boost primary dose tracking site, shown in 

Figure 71. 

Figure 71: Dosimetry Setup with Prior Dose 


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Notes 



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Adding Dose Action Points 

When you track dose to patients under treatment, you can use Dose Action Points to 

automatically tell therapists when they reach a specified dose for a specific site. You 

can also include instructions so that therapists know when to do specific actions. Dose 

action points can make sure that necessary procedures are acknowledged and done at 

the correct time. There are three types of dose action points: Standard, Mandatory, 

and Dose Limit. You added a Dose Limit dose action point in Lesson 3 of Module I 

of this guide. In this exercise, you will add dose action points. 

1. In the Dosimetry Setup window, click . 

Opens the Dose Action Points window, shown in Figure 72. 

Figure 72: Dose Action Points Window 

The Cum: Heart dose tracking site was automatically added in an earlier exercise. It 

is a Dose Limit dose action point. Dose Limit dose action points (DAP) are a 

special type of mandatory dose action points. MOSAIQ makes a copy of the Dose 

Limit dose action point after each acknowledgment. 

2. Click . 

Dose Limit dose action points appear at every treatment 

after you first acknowledge them. They are copied on 

acknowledgement so that they appear at treatment until 

someone with the correct security rights changes the Type 

to Mandatory or Standard. This makes sure that the activity 

is completed and not forgotten. 

Opens the Dose Action Point dialog box, shown in Figure 73.


Notes 

Figure 73: Dose Action Point Dialog Box 

The Dose Action Point dialog box contains the information and components 

below: 

Dose Site Specifies the dose site for which you want to add a dose 

action point. The field contains a list of all the primary and 

secondary sites. This is a required field. 

Action Dose Specifies the dose at which you must complete the action 

defined in the Comment field. This is a required field. 

Lead Dose Shows the dose quantity subtracted from the Action Dose to 

change its status to Active. Active dose action points trigger 

notification at treatment delivery that an Action Point is 

near. 

Use Default If checked, MOSAIQ uses the default lead dose. You can 

specify a default dose in the Department Setup dialog box. 

Dose Action Point Type 

Standard Specifies the dose action point is NOT mandatory. 

Warnings appear during treatment delivery for Standard 

dose action points, but you do not have to acknowledge the 

warnings to continue treatment. 

Mandatory Specifies the dose action point is mandatory. You cannot 

administer treatments until you acknowledge Mandatory 

dose action points at the Action Dose. 

Dose Limit Specifies a Dose Limit dose action point, which is 

mandatory and continues to trigger warning notes during 

treatment delivery even after acknowledgment. 


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Notes Comment Specifies an action to complete when the patient has 

received the specified dose. You can type up to 60 

characters of text. For longer comments, use the Note 

button/option. 

Acknowledged 

By/Date 

3. Click adjacent to the Dose Site field. 

When a dose action point is acknowledged, shows the 

initials of the staff member who acknowledged the dose 

action point and the date of the acknowledgment. 

Opens the Dose Site list, shown in Figure 74. 

Figure 74: Dose Site List 

Only the defined dose sites for the current patient appear in the Dose Site list. 

4. Click Lung. 

The Dose Site list is blank if you did not set up Dosimetry. 

Specifies the dose site. 

5. Type 1000 in the Action Dose field. 

Specifies the dose at which the action takes place. Keep the Lead Dose and Use 

Defaults fields at their defaults. The Lead Dose identifies how soon before the Action 

Dose that a Mandatory or Dose Limit dose action point becomes active. After the 

Lead Dose, but before the Action Dose, you see the warning, but do not have to 

acknowledge it. The Use Default checkbox identifies whether to use the default 

lead dose added in the Department Setup dialog box. 

6. Click Mandatory from the Dose Action Point Type group. 

Specifies that you must acknowledge the dose action point before you can treat 

the patient at the specified dose. 

7. Type Take ports and notify Dr. Gannon in the Comment field. 

Specifies the action to take when the specified dose is reached, shown in 

Figure 75.


Notes 

8. Click . 

Figure 75: Completed Dose Action Point 

Saves the dose action point and add the Rx: Lung dose action point to the list, 


Figure 76: Dose Action Points Window with New Dose Action Point 

9. Click Active from the View field. 

Shows only active dose action points. Dose action points become active when the 

task is due. The task is due when the total dose is at the amount in the Action Dose 

field or within the amount specified in the Lead Dose field. 

10. Click All from the View field. 

Shows all dose action points again. 

11. Click . 

Closes the Dose Action Points window. 

12. Close the Dosimetry Setup and the Diagnoses and Interventions windows. 


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Notes 



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Configuring Treatment Charts 

The Configure Treatment Charts feature lets you choose the sequence that dose sites 

appear on the printed treatment chart for the patient. In this exercise, you will 

configure treatment charts. 

1. Click eChart | Radiotherapy Treatment…. 

Opens the Treatment Chart window. 

2. Right-click or press F4 in the Treatment Chart window. 

Opens the Treatment Chart Options menu, shown in Figure 77. 

3. Click Chart Configuration…. 

Figure 77: Treatment Chart Options Menu 

Opens the Chart Configuration dialog box, shown in Figure 78. 

Figure 78: Chart Configuration Dialog Box 

Use the Chart Configuration dialog box to specify the fields to include on the 

printed patient chart and the sequence in which they appear on the chart. The 

Chart Configuration dialog box has 5 entry fields with asterisks (*), one for each 

of the treatment chart columns when you print the chart.


Notes For each column, you can select a dose site from the Dose Site list. If you add a 

field for columns 1 and 3, and skip column 2, column 2 is blank in that report, but 

column 2 still appears on-screen. The Chart Configuration dialog box contains the 

information and components below: 

4. Click . 

Adds the field highlighted in the Dose Site list to the next 

available space in the Treatment Chart list. 

Removes the field highlighted in the Treatment Chart list. 

Moves the field highlighted in the Treatment Chart list up 

one position in the list. 

Moves the field highlighted in the Treatment Chart list down 

one position in the list. 

Configures the printed chart using the first 5 available 

prescription sites. The default is the sequence in which 

prescription sites appear on the dose site list. 

Adds the Rx: Lung site to the Treatment Chart list. 

5. Click . 

Adds the Rx: Lung Boost site to the Treatment Chart list. 

6. Click Rx: Lung Boost in the Treatment Chart list, then click . 

Moves the Rx: Lung Boost site up one position in the chart. 

7. Click . 

Moves the Rx: Lung Boost site down one position in the chart. 

8. Click . 

Removes the Rx: Lung Boost site from the Treatment Chart list. 

9. Click . 

Puts all sites in a default configuration, shown in Figure 79. 


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Notes 



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Figure 79: Completed Chart Configuration Dialog Box 


Saves the configuration, closes the Chart Configuration dialog box, then closes the 

Treatment Chart window. 

What's Next 

In this lesson, you learned how to add primary dose tracking sites, add secondary dose 

tracking sites, and change and add dose coefficients. You also learned how to add 

prior dose, add dose action points, and configure the treatment chart. Use the Quick 

Version as a concise, step-by-step guide when you must quickly apply any of the skills 

you have learned in this lesson or if you simply want to reinforce what you have 

learned. 

In the next lesson, you will learn how to manually record a treatment and view the 

Dose and Fractions Review window.


Notes 

Quick Version 

Adding Primary Dose Tracking Sites 

1. Open the chart for your patient, then open the Diagnoses and Interventions 

window. 

2. Click or right-click in the Diagnoses and Interventions window, then 

click Dosimetry… to open the Dosimetry Setup Information dialog box. 

3. Click to open the Dosimetry Setup window. 

4. Double-click the Prior field in the CumRx dose site column. 

5. Click to add information about the prior dose delivered to this site 

outside of the department EMR. 

6. Click . 

7. Double-click near the Prior field for Rx dose site column. 

8. Click to add information about the prior dose delivered to this site 

outside of the department EMR. 

9. Click . 

10. Click . 

Adding Cumulative Secondary Dose Tracking Sites 

1. In the Dosimetry Setup window, double-click the Add New Dose Tracking Site in 

the upper pane to open the Cumulative Secondary Dose Tracking Site dialog box. 

2. Type the name for the Cumulative Secondary Dose Tracking Site, such as Whole 

Lung, in the Site Name field. 

3. Click . 

Adding and Changing Dose Coefficients 

1. In the Dosimetry Setup window, double-click a field under a dose site column, 

then press TAB, or click in the column, click , then press TAB. 

2. Double-click 1.000 that you just added in a dose site column, or click 1.000, 

then click . 

3. Type the new dose coefficient, such as 0.500, then press TAB. 

4. Click in a dose site column, right-click or press F4, then click Edit 

Coefficients…. 


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Notes 5. In the Dose Coefficient dialog box, type the date in the Start Date field. 

6. Type a dose coefficient, such as .5, then press ENTER. 

7. In the Dose Coefficients window, click . 

8. In the Dose Coefficient dialog box, click adjacent to the Start Date field. 

9. Click a Start Date, then click . 

10. Type the new coefficient, such as .25, then press ENTER. 

11. Click . 

Adding Secondary Dose Tracking Sites 

1. Click in the Add New Dose Tracking Site column in the lower pane of the Dosimetry 

Setup window. 

2. Click to open the Secondary Dose Tracking Site dialog box. 

3. Type a name for the Secondary Dose Tracking Site in the Site Name field. 

4. Click . 

Adding Prior Dose 

1. In the Dosimetry Setup window, double-click the Prior field for any of the primary 

or secondary dose tracking site columns. This includes Cumulative Primary and 

Cumulative Secondary dose tracking site columns. 

2. In the dialog box for the selected dose tracking site, type the dose delivered to this 

site outside of the department EMR in the Prior Dose field. 

3. Click , add a note about prior dose if applicable, then click . 

4. Click . 

Adding Dose Action Points 

1. In the Dosimetry Setup window, click to open the Dose Action Points 

window. 

2. Click to open the Dose Action Point dialog box. 

3. Click adjacent to the Dose Site field. 

4. Click or type the name of the dose site. 

5. Type the dose at which the action should take place in the Action Dose field. 

6. In the Dose Action Type group, click Mandatory or Standard, then press TAB.


Notes 7. Type the action to take when the specified dose is reached in the Comment field. 

8. Click . 

9. In the Dose Action Points window, click Active from the View field. 

10. Click All from the View field. 

11. Click . 

12. Close the Dosimetry Setup and the Diagnoses and Interventions windows. 

Configuring Treatment Charts 

1. Click eChart | Radiotherapy Treatment… to open the Treatment Chart 

window. 

2. Right-click or press F4 to open the Options menu. 

3. Click Chart Configuration… to open the Chart Configuration dialog box. 

4. To add a dose tracking site to the chart configuration, click . 

5. To move a dose tracking site, click or click . 

6. To remove a dose tracking site, click . 

7. To set the chart configuration to the default configuration, click . 

8. Click to close the Chart Configuration dialog box. 

9. Click to close the Treatment Chart window. 


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Notes 



LTGRAD0005B /1.0/20-Feb-2009 

Lesson 7 Manually 

Recording 

Treatments 

Objectives 

• Manually record treatments from the Treatment Chart 

• Open the Dose and Fractions Review window 

If you do not use MOSAIQ to treat the patient, you still must record the treatment in 

MOSAIQ, so that the patient electronic chart is up to date. The Manual Treatment 

feature lets you do this from the Treatment Chart. You can also manually record 

treatments from the Location Schedule if you also add and change appointments. In 

this lesson, you will manually record treatments directly from the Treatment Chart, 

then open the Dose and Fractions Review window. 

To open the Treatment Chart window and Dose and 

Fractions Review window, you must have Clinical | General | 

View security rights. 

To open the Treatment Delivery Table dialog box and 

manually record/treat a patient, you must have Clinical | Tx 

Delivery | View and Modify security rights. 

To acknowledge a Dose Action Point message, you must 

have Clinical | Dose Action Points | View and Modify rights.


Notes 

Recording Manual Treatments 

Make sure you are at a computer that is not a verify-andrecord 

workstation. You can only record a manual 

treatment for a non-SEQUENCER machine. 

1. Open the chart of a patient with fields available for treatment. 

2. Click in the toolbar. 

Opens the Treatment Chart window, shown in Figure 80. 

Figure 80: Treatment Chart Window 

The Treatment Chart window lets you schedule treatment sessions and treat a 

patient. You click to schedule the treatment fields. Refer to Lesson 9 in 

Module III for more information on the Treatment Calendar. 

3. Click . 

Opens the Treatment Delivery Table dialog box, shown in Figure 81. 

If the Dose Action Points window opens, click to 

bypass it for this exercise. 


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Notes 

Lesson 7: Manually Recording Treatments 


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Figure 81: Treatment Delivery Table Dialog Box 

The Treatment Delivery Table dialog box shows all treatment fields currently 

available for treatment. You cannot change any of the information that appears. 

4. Click the first treatment field, then click . 

Opens the Manual Treatment dialog box, shown in Figure 82. 

Figure 82: Manual Treatment Dialog Box


Notes The Manual Treatment dialog box is view-only with field information defined in 

the Treatment Field Definition dialog box. You must make any applicable changes 

in the Treatment Field Definition dialog box. 

5. Click . 

Opens the Manually Record a Treatment message box, shown in Figure 83. 

6. Click . 

Figure 83: Manually Record a Treatment Message Box 

Opens the Record Treatment dialog box, shown in Figure 84. 

Figure 84: Record Treatment Dialog Box 

The date, time, and prescription MU automatically appear in the applicable fields. 

7. Make sure that the treatment date, MU, and treatment time are correct, then type 

Treated out of IMPAC in the Note field. 

Adds a note regarding the manual treatment. 

8. Click . 

Opens the Treatment Delivery Table dialog box for the other treatment fields, as 



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Notes 



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Figure 85: Treatment Delivery Table After First Field Recorded 

The treatment field you recorded does not appear in the list of fields, and 1 

appears in Treated Fields field. 

9. Repeat steps 4-8 to manually treat the other fields. 

When you record the treatment for the last field, the All Fields Treated message 

box opens, shown in Figure 86. 

10. Click . 

Figure 86: All Fields Treated Message Box 

Closes the All Fields Treated message box, closes the Treatment Delivery Table 

dialog box, then opens the Treatment Chart window, shown in Figure 87.


Notes 

Shows all fields 

treated. 

11. Click . 

Figure 87: Treatment Chart with Treated Fields 

Closes the Treatment Chart window. 

The note you typed in the 

Record Treatment dialog box. 

Opening the Dose and Fractions Review Window 

The Dose and Fractions Review window lets you see existing treatments for a 

prescription and to change the prescription if the dose delivered in any treatment 

session is not equal to the prescribed fractional dose. In this exercise, you will open 

the Dose and Fractions Review window. 

1. Open the Diagnoses and Interventions window, then double-click the radiation 

prescription you treated. 

Opens the Radiation Prescriptions dialog box. 

2. Right-click, then click Fx Dose Threshold…. 

Opens the Fractional Dose Threshold window. You can change the Department 

defaults for individual treatment prescriptions where clinically necessary, such as a 

short course of treatment where default rules do not apply. 

3. Right-click, then click Fx Dose Review…. 

Opens the Dose and Fractions Review window, shown in Figure 88. 

m status for Manually 

Recorded Treatments. 


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Notes 



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Figure 88: Dose and Fractions Review Window 

The Dose and Fractions Review window is a summary of the dose and fractions 

for the prescription site. It shows the prescribed dose and fractions, the dose and 

fractions delivered to date, and the projected dose. It also shows the fractions to 

be counted if the remainder of the prescription is delivered as planned. The 

summary shows partial treatment dose amounts. Partial treatment amount are 

those amount where the dose delivered was less than the established threshold. 

This means the treatment did not “count” as a fraction. 

A treatment session is counted as a fraction only if the dose 

is at least the minimum (threshold) dose as defined for the 

site in the Fractional Dose Threshold dialog box, or the 

default department settings in the Department Setup. 

You can change the total prescribed dose to manage discrepancies between 

prescribed and actual treatments. You can also change the threshold or 

prescription dose for one or more fractions. 

If you make any changes, use the Radiation Prescriptions 

dialog box if you must make more changes. For example, 

you can add or remove remaining fractions from the 

Radiation Prescriptions dialog box. You can also change the 

dose to deliver with the remaining fractions.


Notes 

What's Next 

In this lesson, you learned how to manually record treatments with the Treatment 

Chart and open the Dose and Fractions Review window. Use the Quick Version as a 

concise, step-by-step guide when you must quickly apply any of the skills you have 

learned in this lesson or if you simply want to reinforce what you have learned. 

In the next lesson, you will learn how to change total doses, prescribed fractional 

doses, and MU/dose coefficients. 


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Notes Quick Version 

Recording Manual Treatments 

1. Open the patient chart. 

2. Click in the toolbar to open the Treatment Chart window. 

3. Click to open the Treatment Delivery Table dialog box. 

4. Click the first treatment field, then click to open the Manual Treatment 

dialog box. 

5. Click to open the Manually Record a Treatment message box. 

6. Click to open the Record Treatment dialog box. 

7. Verify that the treatment date, MU, and treatment time are correct in the Record 

Treatment dialog box. 

8. Type a note about the manual treatment in the Note field. 

9. Click to record the manual treatment. 

10. Repeat steps 4-9 to manually treat the other fields. 

11. In the All Fields Treated message box, click . 

12. Click in the Treatment Chart window. 

Opening Dose and Fractions Review Window 

1. Open the Diagnoses and Interventions window, then double-click the radiation 

prescription you treated to open the Radiation Prescriptions dialog box. 

2. Right-click, then click Fx Dose Review… to open the Dose and Fractions 

Review window.


Notes 


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Notes 



LTGRAD0005B /1.0/20-Feb-2009 

Lesson 8 Changing Dose 

Objectives 


• Change total doses 

• Change prescribed fractional doses 

• Change MU/dose coefficients 

MOSAIQ provides the flexibility to change approved prescriptions, fractional doses, 

and MU/dose coefficients. For this lesson, you will need to use a different patient 

provided in the Practice database. The patients whose names appear in all capital 

letters have usable data. In this lesson, you will change total doses, prescribed 

fractional doses, and MU/dose coefficients. 



To change prescriptions, you must have Clinical | 

Prescription | View, Modify, and Approve security rights. 

To open the Treatment Chart window, you must also have 

Clinical | General | View security rights. 

To open the Historical Treatment dialog box from the 

Treatment Chart window and edit MU/dose coefficients, you 

must have Clinical | General | View and Approve and Clinical 

| Coefficients | View and Modify rights.


Notes 

Changing Prescribed Doses 

You can change the total prescribed dose and the fractional dose for an approved 

prescription. The radiation oncologist must then re-approve the prescription after you 

have made your change, which also creates a historical record of the change. In this 

exercise, you will change a prescribed total dose. 

1. Open the chart for a patient. 

2. Open the Diagnoses and Interventions window, then click the Radiation tab if it 

does not appear by default. 

3. Double-click a prescription. 

Opens the Radiation Prescriptions dialog box for the selected prescription. 

4. Click the prescription site in the upper pane of the Radiation Prescriptions dialog 

box, then click . 

Opens the prescription in edit mode. 

5. Double-click a fractionation phase. 

Specifies the dose that you want to change. 

6. Type 1050 in the Rx Dose field, then press TAB. 

Opens the Total Dose Calculation message box, as shown in Figure 89. 

Figure 89: Total Dose Calculation Message Box 

This error message appears because the Fractional Dose does not equal a whole 

number when divided by the Number of Fractions. You must adjust the total 

prescribed dose or fractional dose to fix this error. 

7. Click , then type a total dose in the Rx Dose field that does equal a 

whole number when divided by the number of fractions. 

Changes the total prescribed dose. 

8. Click . 

Saves the change to the prescription. 


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Notes 

Lesson 8: Changing Dose 


LTGRAD0005B /1.0/20-Feb-2009 

Changing Fractional Dose 

You must follow the same steps in the exercise to change the fractional dose. In this 

exercise, you will change the fractional dose. 

When you change fractional dose, you must also change the 

dose in the Treatment Field Definition dialog box for ALL of 

the treatment fields associated with the radiation 

prescription. 

1. In the Diagnoses and Interventions window, double-click another prescription. 

Opens the Radiation Prescriptions dialog box for the selected prescription. 

2. Click the prescription site in the upper pane of the Radiation Prescriptions dialog 

box, then click . 

3. Type 220 in the Fractional Dose field of the second fractionation phase, then press 

TAB. 

Opens the Total Dose Calculation message box. You must adjust the total 

fractional dose to fix this error. 

4. Click , then type 270 in the Fractional Dose field. 

Changes the total prescribed dose. 


Does not save the changes to the prescription.


Notes 

Changing MU/Dose Coefficients 

You can change the MU/dose coefficient for an already treated field if there was an 

error in patient treatment documentation. In this exercise, you will change MU/dose 

coefficients. 

1. Open the chart of the patient you manually treated in the previous lesson, then 

click eChart | Radiotherapy Treatment… or click . 


2. Double-click any historical treatment field entry that does not have a “+” in the 

Sts column. 

Opens the Historic Treatment dialog box, shown in Figure 90. 

Figure 90: Historic Treatment Dialog Box 

The Historic Treatment dialog box can appear different 

from the figure shown above. Specifically, the console and 

geometric settings can also appear and make the dialog box 

larger. 

3. Open the chart of another patient with previously treated fields, then click 

eChart | Radiotherapy Treatment… or click . 


4. Double-click any historical treatment field entry that does not have a “+” in the 

Sts column. 

Opens the Historic Treatment dialog box with the beam and console information, 



LTGRAD0005B /1.0/20-Feb-2009

Notes 



LTGRAD0005B /1.0/20-Feb-2009 

Figure 91: Historic Treatment Dialog Box 

5. Double-click in the cGy/MU field, type 0 (zero), then press TAB twice. 

Changes the cGy/MU to zero, then moves the insertion point to the Tx Note 

field. 

Make sure you document all changes to a recorded 

treatment with a note. 

6. Type Patient not treated, documentation correction made, then press 

ENTER. 

Saves the changes to the treatment. The cumulative dose for the site automatically 

changes to reflect the correction. 

7. Click . 

Closes the Treatment Chart window. 

If you change the coefficient, it does not remove the field 

from view. It only changes the dose contributed from the 

field to the prescription site.


Notes What's Next 

Congratulations! You have completed Module II of the Dosimetrist/Physicist training. 

In this lesson, you learned how to change prescribed doses, fractional doses, and 

MU/dose coefficients. Use the Quick Version as a concise, step-by-step guide when 

you must quickly apply any of the skills you have learned in this lesson or if you simply 

want to reinforce what you have learned. 


LTGRAD0005B /1.0/20-Feb-2009



LTGRAD0005B /1.0/20-Feb-2009 

Notes Quick Version 

Changing Prescribed Doses and Fractionation Doses 

1. Open the chart for your patient. 

2. Open the Diagnoses and Interventions window. The Radiation tab should appear 

by default. 

3. Double-click any prescription. 

4. Click the prescription site in the table in the upper pane of the Radiation 

Prescriptions dialog box, then click . 

5. To change the total prescribed dose, click in the Rx Dose field of the fractionation 

phase for the remaining dose, type the new total prescribed dose, then press TAB. 

6. To change the fractional dose, click in the Fractional Dose field of the fractionation 

phase for the remaining dose, type the new fractional dose, then press TAB. 

7. If you receive the error message box for total dose calculation, click . 

Repeat step 5 or 6 to correct the total prescribed dose or fractional dose. 

8. Click in the Radiation prescription dialog box. The radiation oncologist 

must re-approve the prescription after you change the dose. 

Changing MU/Dose Coefficients 

1. Click eChart | Radiotherapy Treatment… or click . 

2. In the Treatment Chart window, double-click any treatment field entry that does 

not have + shown in the Sts column. 

3. Click in the cGy/MU field, type the new dose/monitor units, then press TAB 

twice. 

4. Type a brief note explaining the change, then press ENTER. 

5. Click .


Notes 


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Notes 



LTGRAD0005B /1.0/20-Feb-2009 

Appendix A – MLC Fit 

Import/Export 

Most facilities will import treatment plans that include MLC leaf plans. The sections 

below cover how to import or export MLC leaf plans if your treatment planning file 

does not include MLC leaf plans. 

Refer to Exporting MLC Shapes for Varian Machines 

(LPN75003) and Accessing MLC Shapes Offline for Varian 

Machines (LPN75004) for information on how to export a 

Varian MLC leaf plan. 

Importing MLC Leaf Plans 

In this section, you will import an MLC leaf plan. 

1. Click File | Import/Export | MLC Import.... 

Opens the Specify File Type and Import Directory dialog box, shown in 

Figure 92. 

Figure 92: Specify File Type and Import Directory Dialog Box 

2. In the MLC Type group, click Varian/BrainLab if it is not already selected. 

Specifies which type of MLC file you are importing. The radio button you click 

determines which of the three checkboxes below it are active.


Notes 3. Click , then browse to the directory where your MLC file(s) are located. 

Specifies the directory that appears in the Import Directory field. 

4 Verify the information in the Import Files no older than days field. 

Specifies the maximum “age” of the files. For example, if the Import files no older 

than days field is set to 7, MLC only imports files that are a week or less old. If you 

use the default (0 or 999), all MLC files are imported. 

5. Click the Only Import files having extension of MLC, Dnn, or Ann checkbox. 

Specifies that the MLC file must have an extension of .mlc, .dnn, or .ann or the 

import feature does not recognize them. For this exercise, skip the Map MLC File 

IDs to checkbox/field that lets map the imported MLC files to a specific field ID. 

6. Click . 

Opens the MLC File Import dialog box, shown in Figure 93. 

Figure 93: MLC File Import Dialog Box 

7. Click the Patient ID of your lesson patient shown in the list on the left. 

Shows the patient name and ID in the fields. 


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Notes 8. From the list on the right, click the field ID into which to import the MLC file. 

Shows the geometric parameter(s) to import from the MLC file as shown in 

Figure 94. The Field ID appears in the list to the right and is the treatment field 

into which you will import the MLC. 

Figure 94: MLC File Import with Field ID Selected 

Below the header, the name of the patient, geometric settings (Gantry, etc.) 

appear. Settings can appear in red and checkmarks appear in the Import column 

checkbox adjacent to those settings. The settings that appear in red indicate that 

the values for the geometric settings are different than those in MOSAIQ. The 

settings for the fields that have checkmarks in the applicable Import column 

checkboxes are imported, and the imported geometric settings overwrite the 

current geometric settings in the treatment field. If you do not want to import the 

MLC geometric settings, de-select the Import column checkbox. 

9. Click . 

Imports the MLC file with the specified, shown in Figure 95. If a message box 

appears and tells you that a definition for that field already exists, click 

to continue.


Notes 

Figure 95: MLC File Import with MLC File Imported 

Imported appears in the right-hand Status column and the current date appears in 

the File Date column adjacent to it. 

10. Click . 

Closes the MLC File Import dialog box. 


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Notes 



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Exporting an MLC Leaf Plan 

You can extract MLC leaf plans from the database, then copy the file(s) to a local disk 

so that the most current leaf plans are available if the network goes down and your 

treatment machine supports offline access to MLC plans. In this section, you will 

export the MLC leaf plan you changed in the previous exercise. 

1. Click File | Import/Export | MLC Export.... 

Opens the MLC Export dialog box, shown in Figure 96. 

Figure 96: MLC Export Dialog Box 

2. Click the linear accelerator from the Machine field. 

Specifies the treatment machine for which you are exporting the MLC file. 

3. Type the current date in the Starting Date field. 

Specifies to export only files added during the current day. 

4. If necessary, click , then browse to the directory where your MLC file(s) are 

located in the Output Path field. 

Specifies the output path. 

If the Output Path field is blank and you do not know the 

location of the MLC file(s), contact your system 

administrator. 

5. Click the Break, Re-Evaluation, Treatment Complete, Follow Up, Inactive, and Other 

checkboxes in the Treatment Status group. 

Removes the checkmarks from these checkboxes, and specifies the MLC file you 

are exporting can only be used for patients with new or on treatment status. All of 

the checkboxes in this group are selected by default.


Notes 6. Click Current in the Patient group if it is not already selected. 

Specifies that you can only use the MLC files for the current patient, shown in 

Figure 97. 

7. Click . 

Click All when you export to Varian machines. Refer to 

Exporting MLC Shapes for Varian Machines (LPN75003) and 

Accessing MLC Shapes Offline for Varian Machines 

(LPN75004) for more information. 

Figure 97: Completed MLC Export Dialog Box 

Completes the export and closes the dialog box. 


LTGRAD0005B /1.0/20-Feb-2009

Course Evaluation: Dosimetrist/Physicist 

Module II 

Now that you have completed Dosimetrist/Physicist Module II Training, please answer the following by placing a 

checkmark in the appropriate box. Mark the tasks that were covered in class on the left, then indicate your “comfort” 

level with each task that was covered in class. Each task is followed by a lesson reference. If you answer “Cannot do” 

for any of the tasks, you can refer to the appropriate lesson in the Training Guide to review the course information. 

Check tasks 

covered 

Can you do the following tasks? 

Can do 

Can do 

with help 

Cannot 

do 

Viewing MLC Leaf Plans (Lesson 4) 

Changing MLC Leaf Plans (Lesson 4) 

Opening the Import Treatment Plan Window (Lesson 5) 

Setting RTP Import Defaults (Lesson 5) 

Changing Data in the Edit Import Data Window (Lesson 5) 

Changing File Data to Ignore Status (Lesson 5) 

Changing the Tolerance Table and Site Name (Lesson 5) 

Importing the RTP Files (Lesson 5) 

Viewing IMRT Control Point Data (Lesson 5) 

Exporting RTP Files (Lesson 5) 

 

Viewing IMRT Options in Treatment Field Definition 

(Lesson 5) 

 

Configuring Multiple Approvals for Treatment Plans 

(Lesson 5) 

Importing Files for the Treatment Plan (Lesson 5) 

Viewing/Changing Treatment Plans (Lesson 5) 

Reviewing Primary Dose Tracking Sites (Lesson 6) 

Adding and Changing Dose Coefficients (Lesson 6) 

Adding Secondary Dose Tracking Sites (Lesson 6) 

Adding Prior Dose (Lesson 6) 

Defining Dose Action Points (Lesson 6) 

Configuring Treatment Charts (Lesson 6) 

Recording Manual Treatments (Lesson 7) 

Copyright 2009, IMPAC Medical Systems 105

Check tasks 

covered 

Can you do the following tasks? 

Opening the Dose and Fractions Review Window 

Can do 

Can do 

with help 

Cannot 

do 

(Lesson 7) 

 

Changing Prescribed Doses and Fractionation Doses 

(Lesson 8) 

Changing MU/Dose Coefficients (Lesson 8) 

Importing MLC Leaf Plans (Appendix A) 

Exporting MLC Leaf Plans (Appendix A) 

Name: Date: 

Facility: 

106 Copyright 2009, IMPAC Medical Systems

100 Mathilda Place, Fifth Floor, Sunnyvale, CA 94086

Dosimetrist/Physicist Training Guide - UCSF Radiation Oncology

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