RUBY

The Modular QA Phantoms

SYSTEM QA • LINAC QA • PATIENT QA

All essential QA applications.
Comprehensive testing of the entire treatment chain.

With its unique combination of a compact, easy-to-setup base phantom, the new head phantom and highly versatile test inserts, RUBY provides you with a simple, yet comprehensive solution that helps you evaluate the entire radiotherapy treatment process.

Its scalable, modular design makes it easy for you to stay flexible and add new inserts any time. Customize RUBY to your specific needs.

Choose your insert and start testing.

The RUBY Phantoms for Your Changing Needs

RUBY Base Phantom

Perform integrated tests of the entire treatment chain from imaging to treatment planning and verification with one basic phantom. Add and expand QA capabilities when needed.

As the new modular phantom platform for radiotherapy QA, RUBY comes with a variety of exchangeable, application-specific inserts that satisfy all test requirements in a modern treatment facility.

RUBY Head Phantom

An increasing number of special stereotactic radiations are performed with couch extensions equipped with head shells. For this type of application, the RUBY system can be combined with the RUBY head phantom. The RUBY head phantom is compatible with all inserts containing CT markers that indicate the central position of the inserts. The RUBY head phantom has been successfully tested with the Brainlab mask system as well as the Encompass (QFix) mask system.

RUBY - Manufactured inhouse at our modern workshop with sub-millimeter precision:

The RUBY Inserts

Multiple metastasis applications

Perform System QA for the non-isocentric treatment of multiple metastases, with the “System QA MultiMet” insert.

Key Features

Dedicated to the verification of non-isocentric treatment techniques with or without couch rotation
Enables the positioning of three detectors at different positions within the insert
Detector positions simulate the locations of three brain metastases treated simultaneous using a single isocenter
Three bone equivalent cylinders embedded to provide contrast for positioning using kV imaging systems

System QA

Choose the “System QA” insert for comprehensive end-to-end testing with one single insert.

Key Features

MRI visibility in all commonly used sequences (T1, T2 and FLAIR at 1.5 T) – no additional components required

ICRU-based tissue-equivalent materials (brain, lung, bone) for verification of dose calculations at different tissue densities

CT and MRI cavities for accurate verification of the CT/MRI image fusion algorithm of treatment planning systems

Point dose measurements with different detector types using the same insert

LINAC QA

Perform alignment checks of the entire system, including conventional as well as 6D couches, with the “Linac QA” insert.

Key Features

System alignment and isocenter checks with one single insert
Daily checks of IGRT positioning accuracy as recommended in AAPM TG-179 and TG-142
Optional tilting base for 6D couch QA
Tissue-equivalent bone structures for enhanced visibility in kV and MV images
Ceramic MV visible sphere at isocenter for easy Winston-Lutz testing
Automated analysis of EPID images with optional PTW IsoCheck ^epidsoftware
Integrated with Track-it

Patient QA

Select the “Detector” insert for measurement-based dose verification of patient treatment plans.

Key Features

Fast, accurate point dose measurements with different detector types
“Plug and Measure” convenience using detector holders – no need to replace phantom or exchange inserts
Dose verification of non-coplanar treatment plans

Use the “Film” insert for high-resolution dose distribution measurements in a plane using radiochromic films.

RUBY in Clinical Use

Explore how RUBY supports your QA needs.

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SYSTEM QA
Comprehensive end-to-end test for a non-coplanar treatment plan using RUBY phantom with SYSTEM QA insert

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SYSTEM QA
Compatible with patient positioning systems and patient masks

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SYSTEM QA
RUBY phantom with SYSTEM QA insert and SRS mask set up on CT couch

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SYSTEM QA
Treatment plan calculated on RUBY phantom with SYSTEM QA insert as shown in the treatment planning system. The different cavities (lung, brain, bone, MRI) are clearly visible on the image. CT markers in the base phantom and insert are well detected, allowing an accurate positioning of the isocenter.

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SYSTEM QA
Treatment plan calculated on RUBY phantom with SYSTEM QA insert as shown in Monaco treatment planning system.

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SYSTEM QA
Fusion of RUBY CT and MRI images as shown in the treatment planning system
(grey: CT / red: MRI)

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SYSTEM QA
Treatment plan calculated on RUBY phantom with System QA insert using RayStation treatment planning system

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SYSTEM QA
Fusion of RUBY CT and MRI images in RayStation treatment planning system

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SYSTEM QA
RUBY System QA insert contoured in Eclipse treatment planning system

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SYSTEM QA
HyperArc treatment plan calculated on CT dataset of RUBY phantom with System QA insert

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System QA
RUBY phantom set up on Elekta Unity: Image registration during patient workflow in Monaco treatment planning system

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LINAC QA
Daily accuracy checks of couch shifts:
RUBY with LINAC QA insert and tilting base set up on patient couch with defined offset (red line)

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LINAC QA
Fusion of RUBY CBCT and planning CT images (without tilting base): System detects misalignment.

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LINAC QA
Fusion of RUBY CBCT and planning CT images (with tilting base): System detects misalignment, including phantom tilt.

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LINAC QA
Fusion of RUBY DRR and portal (MV) images: The LINAC QA insert is clearly visible on the MV image. The DRR image can be fused with the MV image to detect alignment errors.

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LINAC QA
DRR generation using
RayStation treatment planning system

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LINAC QA
Table alignment checks using VARIAN OSMS:
Left: RUBY with LINAC QA insert is setup on patient couch with defined offset (grey line). Misalignment (translation) is detected by OSMS.
Right: RUBY after CBCT imaging and needed table shift –
phantom position matches reference data set.

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LINAC QA
Table alignment checks using VARIAN OSMS:
Left: RUBY with LINAC QA insert and tiling base is set up on patient couch with defined offset (red line). Misalignment (translation/rotation) is detected by OSMS.
Right: RUBY after CBCT imaging and needed table shift and rotation –
phantom position matches reference data set.

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LINAC QA
Alignment errors detected using CBCT images generated by VARIAN TrueBeam system

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LINAC QA
Alignment errors detected using kV images generated by VARIAN TrueBeam system

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LINAC QA
Alignment errors detected using MV images (EPID) generated by VARIAN TrueBeam system

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PATIENT QA
Treatment plan calculated on RUBY phantom with PATIENT QA Detector insert as shown in the treatment planning system. The CT markers are clearly visible, allowing an accurate positioning of the isocenter.

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PATIENT QA
Single-point dose verification of a non-coplanar patient treatment plan using a detector. Detector is plugged into RUBY PATIENT QA Detector insert using the appropriate detector holder – no need to replace phantom or exchange inserts.

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Treatment plan calculated on RUBY phantom with PATIENT QA Detector insert as shown in RayStation treatment planning system

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Multiple metastasis applications: Single isocenter treatment plan irradiating three target volumes. Target volumes are contoured at the detector positions. Isocenter is placed at the center of the phantom.

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Multiple metastasis applications: Single isocenter treatment plan irradiating three target volumes. Target volumes are contoured at the detector positions. Isocenter is placed at the center of the phantom.

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RUBY head phantom: Single isocenter treatment plan optimized on RUBY head phantom and System QA MultiMet insert with Raystation, 5 mm target volume diameter.

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RUBY head phantom: Single isocenter treatment plan optimized on RUBY head phantom and System QA MultiMet insert with Raystation, 20 mm target volume diameter.

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RUBY head phantom: Single isocenter treatment plan optimized on RUBY head phantom and System QA MultiMet insert with Eclipse Hyperarc.

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RUBY head phantom: Single isocenter treatment plan optimized on RUBY head phantom and System QA MultiMet insert with Eclipse Hyperarc, Virtual Dry Run option.

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RUBY head phantom: CBCT imaging on Varian Truebeam system of RUBY head phantom with System QA MultiMet insert.

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RUBY head phantom: CBCT imaging on Varian Truebeam system of RUBY head phantom with System QA MultiMet insert.

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RUBY head phantom: CBCT imaging using Elekta XVI software of RUBY head phantom with System QA MultiMet insert.

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RUBY head phantom: CBCT imaging using Elekta XVI software of RUBY head phantom with System QA MultiMet insert.

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RUBY head phantom: Monitored by Vision-RT surface guided system, misaligned

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RUBY head phantom: Monitored by Vision-RT surface guided system. Aligned after CBCT imaging.

Specifications

Design	Polyhedron phantom with octahedral symmetry (10 cm side length) and cubic hole for QA test inserts in phantom center
Laser Alignment Marks:	Black: phantom center Gray: translational shift - coronal: 18 mm - transversal: 14 mm - sagittal: -25 mm Red: translational and rotational shift - coronal: -12 mm, rotation -1° - transversal: -10 mm, rotation +2.5° - sagittal: 15 mm, rotation -1.5°
Material:	Polystyrene
Density:	1.05 g/cm³
Dimensions:	241.4 mm x 231.4 mm x 241.4 mm (W x D x H)
Weight:	6.7 kg

Design	Head-shaped phantom with cubic hole for QA test inserts in phantom center
Laser Alignment Marks:	Black: phantom center Gray: translational shift - coronal: 18 mm - transversal: 14 mm - sagittal: -25 mm
Material:	Polystyrene
Density:	1.05 g/cm³
Dimensions:	181 mm x 231.42 mm x 229.35 mm (W x D x H)
Weight:	3.0 (without insert) kg

Design:	Cubic insert with automatic locking mechanism, containing 9 cylindrical CT markers (three for each detector position), three tissue-equivalent Ø 8.5 mm bone rods in the volume, three detector boreholes Detector holders for: Semiflex 3D ionization chamber (31021), Semiflex ionization chamber (31010), PinPoint® 3D ionization chamber (31022), microSilicon diode (60023), microDiamond® ( 60019 )
Material:	Polystyrene
Density:	1.05 g/m³
Density of ICRU-based bone-equivalent material:	1.68 g/m³
Dimensions:	118 mm x 241.4 mm x 118 mm (W x D x H)
Weight:	2.5 kg

Design	Cubic insert with automatic locking mechanism, containing three cylindrical CT markers, multiple cavities and a detector borehole in the center. Detector holders for: Semiflex 3D ionization chamber (31021), Semiflex ionization chamber (31010), PinPoint® 3D ionization chamber (31022), microSilicon diode (60023), microDiamond® ( 60019 )
Cavities:	Three cavities with MRI-visible material: Ø 25 mm, Ø 15 mm und Ø 10 mm Three cavities with tissue-equivalent, CT-visible material: Lung, brain and bone (according to ICRU-44 /-46 standards)
Material:	Polystyrene
Density:	1.05 g/m³
Density of ICRU-based tissue-equivalent materials
Lung:	0.24 g/m³
Brain:	1.04 g/m³
Bone:	1.68 g/m³
Dimensions:	118 mm x 241.4 mm x 118 mm (W x D x H)
Weight:	2.4 kg

Design	Homogeneous cubic insert with automatic locking mechanism, containing three cylindrical CT markers, a ceramic MV visible 8 mm sphere in the center, four tissue-equivalent Ø 12 mm bone rods in the volume
Material:	Polystyrene
Density:	1.05 g/m³
Density of ICRU-based bone-equivalent material:	1.68 g/m³
Dimensions:	118 mm x 241.4 mm x 118 mm (W x D x H)
Weight:	2.5 kg

Design	Base plate with red laser alignment marks for correct setup of RUBY phantom. Requires RUBY insert for “LINAC QA”.
Material:	Polystyrene
Density:	1.05 g/m³
Dimensions:	130 mm x 130 mm x 20 mm (W x D x H)
Weight:	0.25 kg

Design	Homogeneous cubic insert with automatic locking mechanism, containing three cylindrical CT markers and a detector borehole in the center. Dummy plug for CT scans included. Detector holders for: Semiflex 3D ionization chamber (31021), Semiflex ionization chamber (31010), PinPoint® 3D ionization chamber (31022), microSilicon diode (60023), microDiamond® ( 60019)
Material:	Polystyrene
Density:	1.05 g/m³
Dimensions:	118 mm x 241.4 mm x 118 mm (W x D x H)
Weight:	2.5 kg

Design	Homogeneous cubic insert for radiochromic films with automatic locking mechanism and three cylindrical CT markers. Plastic needle for film perforation included.
Material:	Polystyrene
Density:	1.05 g/m³
Dimensions:	118 mm x 241.4 mm x 118 mm (W x D x H)
Weight:	2.5 kg

RUBY Sets for All Tasks

	RUBY All in L981660	RUBY System QA L981636	RUBY Linac QA L981637	RUBY Patient QA L981638	RUBY head phantom MultiMet L981654
RUBY base phantom T40072.1.001	X	X	X	X	--
RUBY head phantom (case included) T40072.1.800	X	--	--	--	X
RUBY insert Patient QA – detector T40072.1.100	X	--	--	X	--
RUBY insert Patient QA – film T40072.1.400	X	--	--	X	--
RUBY insert Linac QA T40072.1.200	X	--	X	--	--
RUBY tilted base T40072.1.030	X	--	X	--	--
RUBY insert System QA T40072.1.300	X	X	--	--	--
RUBY insert System QA – MultiMet T40072.1.500	X	X	--	--	X
RUBY case T40072.1.040	X	X	X	X	--
RUBY detector holders	X	X	--	X	X