Cawangan Keselamatan Sinaran Bahagian Perkhidmatan Kejuruteraan
Cawangan Keselamatan Sinaran Bahagian Perkhidmatan Kejuruteraan
Cawangan Keselamatan Sinaran Bahagian Perkhidmatan Kejuruteraan
BUTIR-BUTIR KLINIK/HOSPITAL
NO. FAIL :
NAMA KLINIK/HOSPITAL :
MODEL/JENIS : (Static/Mobile) :
NO. SIRI (PANEL KAWALAN) : : TAHUN DIBELI :
(KEPALA TIUB) :
P - pass, F - fail, N/A - not applicable, N/P - not performed; NOTE - recommendation suggested
Test 1: kV Accuracy
The purpose of this test is to verify that the average kVp is within 5 % or 5kV, whichever
is greater of set kVp
Set kVp mA mA mA
Measured % of Dev Measured % of Dev Measured % of Dev
50
60
70
80
90
100
110
120
1 2 3 4 5
Measured kVp
Exposure (mR)
kVp Reproducibility Exposure Reproduce.
Mean Exposure
Standard Deviation
Coefficient of Variation
Result (Pass/Fail)
Set kVp :
Set kVp : 80
FS (S/L) Ave kVp mA Sec mAs mAs mR mR/mAs COV
S
S
L
L
L
L
Set kVp :
Filter Thickness Exposure
mm of Al mR
0.0
2.5
3.8 HVL : mm of Al
SID : 100 cm
a) Congruence of Light and Radiation Field
c) Beam Alignment
X
X
X
a) Contrast b) Unsharpness
Previous Latest Previous Latest
Date: Date:
kVp : kVp :
mAs: mAs:
Filter Thickness : 2 mm Cu
Background Density : B/g density :
Circle Seen Lp/mm seen :
(Large) :
(Small) :
mR
A
100 cm
mR mR
Anode Cathode
B 100 cm 100 cm D
100 cm
C
mR
COMMENT :
Inspection Done by : a)
b)
Date :
kV/Exposure Reproducibility
mA : Time : mAs : 0
kVp kV Ave kV eff kV peak Timer Dose
80
80
80
80
80
mA/mAs Linearity
Set kVp
Time Reading
mA mAs kV Ave kV eff kV peak Timer Dose
100
200
250
300
HVL Measurement
50% of LF open
Timer Accuracy
(Please select timer differs from timer setting in kV Accuracy Test )