Date: 15.10.

2018

DETAILS OF THE EQUIPMENT AND MEASURING INSTRMENTS

AND TOOLS
Equipment Type : Radiography (Fixed)
Installed At :

Contact Details Contact Details (Accounts)

Name of Person : Name :
Phone No. : Phone :
Email Address : Email :
Generator Details
Name of Manufacturer : Wipro GE Healthcare Private Limited
Model : HF Advantage
Serial Number : 2124RB6

Mr. Siddhartha Sankar Maity

Name & Signature Signature & Stamp
of the Engineer of the Authorized person
of the Institution
 R/F detector unit in Gy/min Survey meter unit in R/h

SET kVp SET mAs MEASURED kVp DOSE mGy

Distance in cm cm
50 5 49.75 kVp 1.223 mGy
50 8 50.00 kVp 1.977 mGy
50 10 49.78 kVp 2.459 mGy
60 5 59.90 kVp 1.796 mGy
60 8
60 10
70 5
70 8
70 10
90 5
50 5
50 5
50 5
50 5
50 8
50 8
50 10
50 10 49.83 kVp 2.461 mGy
60 5 59.84 kVp 1.788 mGy
60 5 59.78 kVp 1.796 mGy
60 5 59.92 kVp 1.795 mGy
60 5 59.91 kVp 1.795 mGy
Tube Leakage Test
To get time value with R/F
90 8
detector
90 8 Tube (Left) 0.001 mR 0.155 mR/h
Collimator (Left) 0.000 mR 0.036 mR/h
Tube (Right)
Collimator (Right)
Tube (Front) 0.000 mR 0.055 mR/h
Collimator (Front) 0.000 mR 0.113 mR/h
Tube (Back) 0.000 mR 0.084 mR/h
Collimator (Back) 0.000 mR 0.033 mR/h
Tube (Top) 0.000 mR 0.031 mR/h
Collimator (Top) 0.001 mR 0.185 mR/h
Area Surveillance
kVp mAs
80 8 To get time value with R/F detector

Lead Glass without sutter 0.026 mR 6.854 mR/h

lead glass with shutter 0.000 mR 0.085 mR/h
 Lead Wall 0.001 mR 0.216 mR/h
Operator Position 0.001 mR 0.359 mR/h
Patient Entrance Door 0.000 mR 0.125 mR/h
Patient Waiting Area 0.000 mR 0.000 mR/h

Work load details

Max. mAs used mAs ( mA x s )

Avg no of patient per day

Work load 0

0 8
0 8
0 8
0 8
0 8
0 8
0 8
0 8
0 8
0 8
0 8
0 8
DOSE RATE TIMER PULSE Frame/pulse
mGy/min f/s

24.560 mGy/s 0.049778 s 1 pulse

24.741 mGy/s 0.07989 s 1 pulse
24.644 mGy/s 0.09978 s 1 pulse
35.993 mGy/s 0.04989 s 1 pulse

24.637 mGy/s 0.09989 s 1 pulse

35.842 mGy/s 0.04989 s 1 pulse
35.929 mGy/s 0.05 s 1 pulse
35.980 mGy/s 0.04989 s 1 pulse
35.973 mGy/s 0.04989 s 1 pulse

0.239 mR/h 13 s 1 231674 / 15-10-201 14:12:02

0.022 mR/h 18.5 s 2 231674 / 15-10-201 14:12:22
231674 / 15-10-201 14:12:39
231674 / 15-10-201 14:13:06
0.151 mR/h 22 s 5 231674 / 15-10-201 14:13:33
0.198 mR/h 8.5 s 6 231674 / 15-10-201 14:13:44
0.182 mR/h 9 s 7 231674 / 15-10-201 14:13:55
0.016 mR/h 14.5 s 8 231674 / 15-10-201 14:14:12
0.016 mR/h 19 s 9 231674 / 15-10-201 14:14:32
0.795 mR/h 10.5 s 10 231674 / 15-10-201 14:14:47

45.122 mR/h 13.5000 s 11 231674 / 15-10-201 14:15:59

0.257 mR/h 16.5000 s 13 231674 / 15-10-201 14:17:22
0.243 mR/h 10.0000 s 14 231674 / 15-10-201 14:18:17
1.148 mR/h 8.5000 s 15 231674 / 15-10-201 14:18:29
0.245 mR/h 14.0000 s 16 231674 / 15-10-201 14:18:53
0.000 mR/h 12.5000 s 17 231674 / 15-10-201 14:19:09
Dose/pulse HVL mAs
mmAl

1.223 mGy/puls 1.626 mmAl 1 231674 /

1.977 mGy/puls 1.588 mmAl 10 231674 /
2.459 mGy/puls 1.609 mmAl 11 231674 /
1.796 mGy/puls 1.899 mmAl 12 231674 /
2.864 mGy/puls 1.904 mmAl 13 231674 /
3.590 mGy/puls 1.897 mmAl 14 231674 /

3.687 mGy/puls 2.781 mmAl 15 231674 /

1.228 mGy/puls 1.612 mmAl 2 231674 /
1.234 mGy/puls 1.603 mmAl 3 231674 /
1.229 mGy/puls 1.607 mmAl 4 231674 /
1.236 mGy/puls 1.616 mmAl 5 231674 /
1.962 mGy/puls 1.609 mmAl 6 231674 /
1.966 mGy/puls 1.616 mmAl 7 231674 /
2.460 mGy/puls 1.619 mmAl 8 231674 /
2.461 mGy/puls 1.597 mmAl 9 231674 /
1.788 mGy/puls 1.914 mmAl 16 231674 /
1.796 mGy/puls 1.901 mmAl 17 231674 /
1.795 mGy/puls 1.902 mmAl 18 231674 /
1.795 mGy/puls 1.901 mmAl 19 231674 /
Date Time
15-10-201 14:04:09
15-10-201 14:07:45
15-10-201 14:07:55
15-10-201 14:08:11
15-10-201 14:08:21
15-10-201 14:08:29

15-10-201 14:08:48
15-10-201 14:05:38
15-10-201 14:05:54
15-10-201 14:06:02
15-10-201 14:06:20
15-10-201 14:06:44
15-10-201 14:06:53
15-10-201 14:07:07
15-10-201 14:07:15
15-10-201 14:09:34
15-10-201 14:09:41
15-10-201 14:09:48
15-10-201 14:10:20
 0 mmAl
0 mmAl
0 mmAl
2.43732 mmAl
2.44099 mmAl
2.43146 mmAl

2.53148 mmAl
0 mmAl
0 mmAl
0 mmAl
0 mmAl
0 mmAl
0 mmAl
0 mmAl
0 mmAl
2.46193 mmAl
2.4423 mmAl
2.44046 mmAl
2.43998 mmAl
 [Periodic Quality Assurance shall be carried out at least once in two years and also
after any repairs having radiation safety implications]

GOVERNMENT OF INDIA
RADIOLOGICAL SAFETY DIVISION
ATOMIC ENERGY REGULATORY BOARD,
NIYAMAK BHAVAN, ANUSHAKTINAGAR
MUMBAI-400 094

Periodic Quality Assurance Test Report For Radiography (Fixed)

1. Name and Address of the :0

Institution where unit is tested 0

2. Type of Equipment : Radiography (Fixed)

3. Name of the Manufacturer : Wipro GE Healthcare Private Limited

4. Model Name : HF Advantage

5. Serial No. : 2124RB6

6. Name of the Person testing : Mr. Siddhartha Sankar Maity

the equipment

7. Dates and Time of the Test : 15.10.2018

8. Due Date of next Q/A test :

9. Name of the Service Agency : R K Consultant, Kolkata

10. AERB Authorisation No. : 16-AFSXE-136112

Page 9 of 15
 [Periodic Quality Assurance shall be carried out at least once in two years and also
after any repairs having radiation safety implications]

SUMMARY OF RADIATION SAFETY PERFORMANCE TEST REPORT

Measure
Measur
ment
Sr No Parameter's Used ed Tolerance Remark's
Condition
Value's
| X | 's
+ | X' | 0.00 Select
1 Congruency Test 2% of FFD
| Y | + | Y' | 0.00 Select
2 Central Beam Select < 1.5⁰ Select
alignment
1 2.0 Tolerance: Select
Effective focal spot 1. + 0.5 f for f < 0.8 mm
3 measurement 2. + 0.4 f for 0.8
FFD = 60 cm ≤ f ≤ 1.5 mm 3. +
3 4.0 0.3 f for f > 1.5 mm Select

Set kVp Measured kV

50 49.84
4 Accuracy of Operating 60 19.97 ± 5 kv Select
Potential
70 0.00
90 #REF!
Accuracy of irradiation Set Time % Error
5 ≤ ± (10 % ) Not Applicable
time NA
kV TF • For Less than 70
Min. Total Filtration 1.5 mm Al
90 #REF! • For 70<kVp≤100
6 Total Filtration Min. Total Filtration 2.0 mm Al Select
mm Al • For kVp> 100
Min. Total Filtration 2.5 mm Al

7 mAs Linearity 0.336 Coefficient of Linearity <0.1 Select

kV COV
8 Consistency of 50 2.236 CoV < 0.05 Select
radiation output
60 0.002
9 Exposure Rate at NA Not Applicable
Tabletop
10 Low contrast resolution NA Not Applicable
11 High contrast NA Not Applicable

On –Position Radiation Tube #DIV/0!

Leakage level from X-Ray
tube housing measured at mGy in 1 hr
12 < 1mGy in one hour

90 kV Collimator #DIV/0!
8 mAs mGy in 1 hr
I hereby undertake that all the information provided above is correct
and in accordance with the detailed Quality Assurance report enclosed herewith.

Date: Signature
Place: 0 Name of Service Engineer Mr. Siddhartha Sankar Maity
Name of Service Agency R K Consultant, Kolkata
Seal/Stamp of Service Agency

Signature of Institution's representative:

Name of Institution: 0
Seal/ Stamp of Institution:

# Quality Assurance Tests Report shall be signed by Institution’s Representative and duly stamped by the User’s Institution

Page 10 of 15
 [Periodic Quality Assurance shall be carried out at least once in two years and also
after any repairs having radiation safety implications]

1. CONGRUENCE OF RADIATION & OPTICAL FIELD

Operating Parameters:

FFD (cm) 100 kV mAs

Shift in the edges of the radiation field

Dimensions (cm) Observed shift % of FFD Tolerance Remark
| X | + | X' | 0 2% of FFD Select
| Y | + | Y' | 0 2% of FFD Select

2. CENTRAL BEAM ALIGNMENT

Operating Parameters:

FFD (cm) 100 kV 0 mAs 0

Observed tilt in beam Remark
Select Select
Tolerance: Central beam alignment < 1.50

3. EFFECTIVE FOCAL SPOT MEASUREMENT

FFD (cm) 60
Tolerance:
Focus Stated Value of focal Measured Value of focal 1. + 0.5 f for f < Remark
spot size (mm x mm) spot size (mm x mm) 0.8 mm
Select 1 2.0 2. + 0.4 f for 0.8 ≤ f ≤ 1.5 mm Select
Select 3 4.0 3. + 0.3 f for f > Select
1.5 mm

Table 1 : Effective focal spot size of for a magnification of 4/3

Smallest Group line-pair/mm Effective focal spot

Resolved size
1 0.6 2.0
2 0.7 2.0
3 0.8 2.0
4 0.9 2.0
5 1.0 1.8
6 1.2 1.5
7 1.4 1.3
8 1.6 1.0
9 1.8 1.0
10 2.0 1.0
11 2.2 0.8
12 2.5 0.8
13 2.8 0.7
14 3.1 0.6
15 3.4 0.5

Page 11 of 15
 [Periodic Quality Assurance shall be carried out at least once in two years and also
after any repairs having radiation safety implications]
4. ACCURACY OF OPERATING POTENTIAL & TOTAL FILTRATION

FFD (cm) 0
Measured kVp
Applied mAs mAs Station mAs Station Average Deviation
kVp Station 1 2 3 kVp ( kVp )
5 8 10
50 49.75 50.00 49.78 49.84 -0.16
60 59.90 0.00 0.00 19.97 -40.03
70 0.00 0.00 0.00 0.00 -70.00
90 #REF! -- -- #REF! #REF!
Tolerance: For kVp ± 5 kVp

Total filtration measured at 90 kV Remark

TF = #REF! mm of Al Select

Tolerance for Total Filtration

1.5 mm Al for kV ≤ 70 The Total Filtration values are
2.0 mm Al for 70 < kV ≤ 100 measured directly from
2.5 mm Al for kV > 100 RaySafe Xi Platinum System.

5. LINEARITY OF mAs LOADING STATION

Operating parameters

FFD (cm) 0 kV 50
mAs Output (mGy) mGy/
Range Average COL Remark
1 2 3 mAs
5 1.223 0.000 0.000 0.408 0.08150
8 1.977 0.000 0.000 0.659 0.08235 0.3360 Select
10 2.459 0.000 2.461 1.640 0.16400
Tolerance in COL : < 0.1

6. OUTPUT CONSISTENCY

FFD (cm) 0
Applied Output (mGy)
mAs Average COV Remark
kVp 1 2 3 4 5
50 5 1.223 0.000 0.000 0.000 0.000 0.245 2.236 Select
60 5 1.796 1.788 1.796 1.795 1.795 1.794 0.002 Select
Tolerance : COV < 0.05

7. LOW CONTRAST SENSITIVITY

Not Applicable

Page 12 of 15
 [Periodic Quality Assurance shall be carried out at least once in two years and also
after any repairs having radiation safety implications]
8. HIGH CONTRAST SENSITIVITY

Not Applicable

9. EXPOSURE RATE AT TABLE TOP

Not Applicable

10. RADIATION LEAKAGE LEVELS FROM X-RAY TUBE HOUSING AT 1m FROM THE FOCUS

kVp = 90 mAs = 8 mA = #DIV/0!

Location Radiation Leakage Level (mR/hr)
(at 1m from focus) Cathode Anode Front Back Top
Tube 0.2385 0.0000 0.1514 0.1817 0.0155
Collimator 0.0218 0.0000 0.1978 0.0160 0.7949

Work load = 180 mA-min in one hour

Maximum Leakage = 180 mA-min in one hour x max mR/hr

60 x #DIV/0! mA used for measurement

mGy in
Maximum radiation leakage mR in 1 hr 1 Result
hr
Tube housing #DIV/0! #DIV/0! Pass
Collimator #DIV/0! #DIV/0! Pass

Acceptable Tolerance Limit: Leakage Radiation level at 1 metre from the focus should be
≤ 114 mR in one hour
or ≤ 1 mGy in one hour

11. DETAILS OF THE QA TOOLS/ INSTRUMENT USED

Type of Date of Whether

Type of QA Tools/ Instrument Make Model Detector Calibration Calibration Valid ?
kVp + Dose Meter RaySafe 20.11.2017
Unfors RaySafe AB, Solid Yes
Survey Meter Sweden Xi State 17.11.2017
Imaging Phantom Leeds Test Objects TOR IQ 2 NA NA NA

Page 13 of 15
 [Periodic Quality Assurance shall be carried out at least once in two
years and also after any repairs having radiation safety implications]

RADIATION PROTECTION SURVEY REPORT OF THE

INSTALLATION

Name & Address of the 0

Institute
0

Type of Equipment : Radiography (Fixed)

Model : HF Advantage

Date of radiation protection survey : 15.10.2018

Meter used for survey has valid calibration : Yes
certificate

Equipment setting

kVp 80 mAs 8 mA 8

Work Load 0 mA-min/week

Measurement:

Max. Radiation mR/week

Locations Remark
level (mR/hr)

Lead Glass without sutter ### mR/hr 0.0000 Safe

Lead Wall 0.24325 mR/hr 0.0000

Operator Position 1.14804 mR/hr 0.0000

Patient Entrance Door 0.24460 mR/hr 0.0000

Patient Waiting Area 0.00000 mR/hr 0.0000

0 0.00000 mR/hr 0.0000

0 0.00000 mR/hr 0.0000

Permissible Limit :
 [Periodic Quality Assurance shall be carried out at least once in two
years and also after any repairs having radiation safety implications]

For location of Radiation Worker 20 mSv in a year (40 mR/week)

For location of Member of Public 1 mSv in a year (2 mR/week)