Construction Procedure for Instrument Calibration (MS)

TABLE OF CONTENTS

1           PURPOSE

2                        SCOPE

3                        REFERENCE, CODE & STANDARD

4                       DEFINITIONS

5                       RESPONSIBILITY AND AUTHORITY

6                        WORK PROCEDURE

7                        SAFETY

8                        QUALITY CONTROL

1       PURPOSE

The purpose of this procedure is to specify responsibilities and describe the

     steps Instrument Calibration work for United Steel Company (SULB) Project.

2          SCOPE

This method statement (M/S) shall be applied to Instrument Calibration work.

3          REFERENCE, CODE & STANDARD

3.1  Subcontractor document

3.2  Work index, symbol and detailed drawing

       3.3  Process Control And Automation Engineering Standard Specification.

            European (IEC and EN) standards shall be adopted throughout,

            unless otherwise Specified in the technical specification.

4          DEFINITIONS

                        4.1        Within this document following definitions shall apply.

                  OWNER / COMPANY        

                  CONTRACTOR                      

                  SUBCONTRACTOR      

                  PROJECT                                             

5          RESPONSIBILITY AND AUTHORITY

5.1             Site Manager

5.1.1      Site manager bears the responsibility and authority on work and quality related to this method statement.

                        51.2      Site manager approves work plans.

5.2 Construction Superintendent

5.2.1      A construction Superintendent bears the responsibility and authority to train their staff and subcontractor’s after preparing work plan according to this method statement.

5.2.2      A construction team manager takes the responsibility of all Instrument calibration work execution and preparation. 

5.3            Construction Supervisor

5.3.1      Construction Supervisor shall execute inspections and tests to secure quality materials, take adequate measures, manage results as quality records, and utilize checklist.

5.3.2      Construction supervisor bears the responsibility of Instrument Calibration according to the dimensions specified in specifications or drawings, and submits reports to the owner for approval

5.4            Quality Manager

5.4.1      Site Quality Manager is responsible for management and supervision of implementing inspection work as specified in this method statement.

5.4.2      Inspection request to QC when portions of the work are ready for inspection, as depicted in the ITP’s.

5.4.3      Responsible for preservation and maintenance of equipment at site.

6.0     INSTRUMENT CALIBRATION PROCEDURE

6.1       General Requirements

6.1.1       All instruments in a loop are calibrated, installed and inspected prior to commencing loop check in accordance with the applicable procedures and specifications.

6.1.2       Ensure that all procedures, IFC drawings, specifications, manufacturer’s instruction manual and other relevant references are available prior to commencing any activities.

6.1.3       Special tools (as applicable) and calibration equipment to be used shall bear a valid     calibration certificate. All Calibration equipments shall be initially calibrated & periodically

        checked.

6.1.4       Calibration of instruments shall be carried out in accordance with OWNER specification & procedure and Manufacturer’s Instruction Manual.

6.1.5       Particular attention shall be observed when connecting electrical power supply to electrical and electronic instruments ensuring its correct voltage, frequency, polarity and grounding.

6.1.6       Ensure that there is sufficient available qualified & competent  Instrument Calibration Technician to conduct the required instrument calibration and works.

6.1.7       All calibration shall be recorded on approved forms, signed, dated and approved by OWNER, Keep in QC Section, and incorporated in the Inspection Record Books.

6.2       Calibration Room (Workshop) Facility Requirements

6.2.1       A fully equipped instrument calibration workshop and it is intended only for calibration works which is required for instrumentation.

6.2.2       Instruments shall be calibrated in a clean, dry and air-conditioned calibration workshop. Ensure daily housekeeping before and after worked. Use appropriate vacuum cleaner and rugs to keep away dirt / foreign materials.

6.2.3       Always ensure that the calibration facilities must be orderly and systematically arranged. It should also be equipped and complete with correct electrical and pneumatic supplies. A stable supply of clean dry air must be provided for instrument air and pneumatic signal generation.

6.3        Calibration Procedure

6.3.1       Calibration for each kind of instrument shall be covered by individual Application for Inspection (AFI) form and be witnessed in accordance with Inspection Test Plan (ITP).

6.3.2       To ensure instrument operability, remove all shipping stops, check pointer travels and verify capability of instrument to measure, operate and stroke in the direction and manner required to the process application.

6.3.3       Instruments shall be checked to ensure that there is no sign of physical damage upon receipt at site prior to calibration. Any damage found shall be recorded in Non Confirmation Report (NCR) and shall be handled in accordance with NCR procedure.

6.3.4       Instruments shall be identified by tag number and checked against its corresponding data / specification sheet, ensuring particular attention that it is supplied with the correct calibration range. All name plate details shall be noted on the calibration data sheet.

6.3.5       Maintain an Instrument Calibration Log for each piece of test and calibration equipment. Valid calibration stickers must be fixed to the equipment and calibration certificates available for each item.

6.3.6       Calibration shall be done as per manufacturer’s instruction, where available. Zero, span, range adjustments, repairing and modification of instruments to be carried out only after getting permission from OWNER and added updating to data sheet specification.

6.3.7       For all instruments / gauges calibration where applicable, five (5) point testing method shall be followed, say 0%, 25%, 50%, 75% and 100%. After completion of each calibration, the instrument shall be attached with a calibration sticker bearing the date of the calibration and the initials of the witnessing parties. The following colour code stickers shall be applied:

a)      Blue        -      Pre-installation Tested (Calibrated)

b)    Yellow                 -       Pressure Tested

c)     Green      -       Cables Tested

d)    White       -       Pre-commissioned

e)     Red             -   Test Failed (written message is attached the cause of failure)               

6.3.8       This identification shall be shown on all components in the loop making all personnel aware of the current status of any installation.

6.3.9       All instruments are to be calibrated and adjusted in both rising and falling directions until accuracy is within the specified limits.

6.3.10     Fluid introduced to instrument bodies for the purpose of calibration shall be compatible with the fluidized material of the instrument and the fluid with which the instrument will be filled during normal operation.

6.3.11      Fluid shall be drained after calibration, and if necessary, blown dry with dry air or nitrogen. Any air system, permanent or temporary used must be dry and clean and shall be blown down thoroughly before using. In case permanent instrument air is not available, nitrogen cylinder as a temporary air source.

6.3.12     Seal all connections and entries to prevent moisture and dirt.

6.3.13     No test shall be carried out on electronic instruments until an adequate warm-up period has elapsed as per Vendor’s recommendation. (Ex. EJA Transmitter more than 5 minutes, YTA Transmitters more than 3 minutes).

6.3.14     A 100% calibration check is required for all transmitters prior to installation.

6.3.15     Bench test for smart transmitters shall include a configuration check out. The following configuration parameters, as a minimum, shall be set or checked against the instrument data sheet:

    a)      Software Tag

           b)      Calibration Range

           c)      Output Unit

           e)      Output Type ( FF/Hart)

           d)      Sensor Type (Temperature transmitter only)

           f)       Damping Value

           g)      Transfer Function (linear / square root)

        Note : Refer to other parameter specification in specification data sheet,

              where applicable specifically for FF parameter 

All parameters can be read and written using FF/HART communicator.

6.3.16     During configuration check full tag number shall be input into descriptor field.

6.3.17     Incoming Instrument Procedure:

a)   Instruments to be bench calibrated will be withdrawn from warehouse and stored in the Calibration shop “incoming shelves”.

b)   Calibration shop Foreman will keep a record book to monitor incoming and outgoing calibrated instrument.

c)   Instrument Engineer / Supervisor shall checked and ensure that copies of Manufacturer’s Instructions (If applicable) and Test Certificates, Instrument Data / Specification sheets are available and latest revisions ( IFC ).

d)   QC Supervisor / Calibration Foreman will prepare Calibration Sheets or incoming instruments.

6.4           Detail Calibration Method for each type of instruments

6.4.1  Flow Instruments

6.4.2  Differential Pressure Flow Type Transmitter

Prefer to be Bench calibrated

Hook up testing equipment as shown below:

                                                                              

LP

VENT

HP

                                                                                                 Differential Pressure Flow Type Transmitter

a)   Vent low side.

b)   When no pressure is applied to the high side, the transmitter should be 0% of output range. If it is not, adjust zero adjustment until the output indicates 0% by FF/HART communicator.

c)   Increase input signal to full range (100%) as shown in the specification sheet. The transmitter output shall be 100% of its range. If it is not, adjust span adjustment by FF/HART communicator.

d)   Recheck zero after span adjustment. Repeat until both reading are correct.

e)   Check output signal and scale readings at 0, 25, 50, 75 & 100% of the input signal instrument range (Measuring DP range) with signal rising and falling.

         f)  Corresponding mA or FF output signals is as follows:

 Square-root extraction from transmitter is usually 0%, 25%, 50%, 75%, 100%.             Using FF/HART communicator to enter the tag number/ scale range (LRV, URV)

            Damping, /Display range. Refer to other parameter specification in specification

            data sheet ,where applicable specifically for FF type.

g)   Every output reading shall be within error limit specified by manufacturer. If it is not, adjust linearity adjustment and repeat steps c) thru f) until output reading corresponds with input signal within acceptable error limit. FF/HART communicator will be utilized for adjustment.

h)   If the instrument is equipped with high/low range limit mechanism, adjust it to meet proper

    requirements. After the initial calibration test, the high and low pressure sides of the

    meter element shall be subject, in turn, to a static pressure equal to the

    maximum expected working pressure. The calibration test shall then be repeated to

    ensure that the results are unaffected by the static pressure loading (Refer to spec.

    for the static pressure test).

i)    After the tests have been completed, the instrument shall be identified with a colour sticker.

j)    Test results / readings will be filed and recorded on applicable calibration form including

    vendor specific requirement/information.

                       

6.4.3    Vortex Flow Meter

Hook up testing equipment as shown below:                                                            

                               Vortex Flow Transmitter

a)   Visual check and smart transmitter configuration check shall be performed.

b)   Check the tag number, Scale range (LRV, URV),Units and damping ect.

   Note : Refer to other parameter specification in specification data sheet ,

c)   FF/Hart communicator should be used for configuration check.

d)   After the tests have been completed, the instrument shall be identified with a colour sticker.

f)      Test results / readings will be filed and recorded on applicable calibration form including

  vendor specific requirement/information.

6.4.4   Ultrasonic Flow Meter

            Hook up testing equipment as shown below:  

 

Ultrasonic flow meters

a)   Visual check of transmitter configuration shall be performed.

b)   Check the tag number, Scale range (LRV, URV),Units and damping ect.

   Note : Refer to other parameter specification data sheet ,

c)   FF/Hart communicator should be used for configuration check.

d)   After the tests have been completed, the instrument shall be identified with a colour sticker.

e)   Test results / readings will be filed and recorded on applicable calibration form including

    vendor specific requirement/information.

6.5         Pressure Instruments

6.5.1      Pressure Transmitter

Prefer to be Bench calibrated

Hook up testing equipment as shown below:                                           

                                   Pressure Transmitter

         Note : Refer to other parameter in specification data sheet

a)     When no pressure is applied to the instrument, the output of transmitter should be 0% of its range. If it is not, adjust zero adjustment until the output indicates 0% of its range by FF/HART Communicator.

b)    Increase input signal to full range (100%) as shown in the specification sheet. The transmitter output should be 100% of its range. If is not, adjust the span by FF/HART communicator.

c)     Recheck zero after span adjustment. Repeat until both reading are correct.

d)    Check output signal and/or scale readings at 0, 25, 50, 75 & 100% of the instrument range with signal rising and falling.

e)     Every output reading shall be within error limit specified by manufacturer. If it is not, adjust linearity adjustment and repeat steps a) to d) until output reading corresponds with input signal within acceptable error limit.

f)     After the tests have been completed, the instrument shall be identified with a colour sticker.

g)    Test results / readings will be filed and recorded on applicable calibration form including vendor specific requirement/information.

6.5.2   Differential Pressure Transmitter

              Prefer to be Bench Calibrated

              Hook up testing equipment as shown below:

VENT

LP

HP

                                                         Differential Pressure Type Transmitter

a)     Vent low side.

b)    When no pressure is applied to the high side, the transmitter should be 0% of output range. If it is not, adjust zero adjustment until the output indicates 0% by FF/HART communicator.

c)     Increase input signal to full range (100%) as shown in the specification sheet. The transmitter output shall be 100% of its range. If it is not, adjust span adjustment by FF/HART communicator.

d)    Recheck zero after span adjustment. Repeat until both reading are correct.

e)     Check output signal and/or scale readings at 0, 25, 50, 75 & 100% of the instrument input signal range (Measuring DP range ) with signal rising and falling.

f)     Every output reading shall be within error limit specified by manufacturer. If it is not, adjust linearity adjustment and repeat steps c) to f) until output reading corresponds with input signal within acceptable error limit. FF/HART communicator will be utilized for adjustment.

g)    If the instrument is equipped with high/low range limit mechanism, adjust it to meet proper requirements. After the initial calibration test, the high and low pressure sides of the meter element shall be subject, in turn, to a static pressure equal to the maximum expected working pressure. The calibration test shall then be repeated to ensure that the results are unaffected by the static pressure loading.

h)     After the tests have been completed, the instrument shall be identified with a

                 colour sticker.

i)      Test results / readings will be filed and recorded on applicable calibration form

    including vendor Specific requirement/information..

6.5.3    Pressure & Differential Pressure Gauges

a)         Pressure and Differential gauges shall be checked by means of Hydraulic Gauge Comparator. This is a means of testing a gauge against a Standard pressure gauge.

b)        The gauge Comparator is firmly fixed to a bench. A test gauge with range comparable to the gauge under test is fitted to one branch of comparator. The gauge to be tested is fitted to the other branch and the hand pump on comparator in order to check the gauge readings against the test gauge. Reading shall be checked for pressures corresponding to 0, 25, 50, 75 and 100% of the range of the gauge under test. Actual gauge reading shall be noted for both rising and falling.

c)         Test gauges shall have an accuracy of or better than 0.25% of full scale and shall be periodically checked for accuracy against a dead-weight tester.

d)        Low side on differential pressure gauge must be vented to atmosphere.

e)         After the initial calibration test, the high & low-pressure sides of the PDI shall be subjected in turn to a static pressure equal to the maximum expected working pressure. The calibration test shall then repeated to ensure that the results are unaffected by static pressure loading.

f)         After the tests have been completed, the instrument shall be identified with a colour sticker.

g)        Test results / readings will be filed and recorded on applicable calibration form including vendor specific requirement/information.

6.6    Level Instruments

6.6.1   Differential Pressure Type Level Transmitter

               Prefer to be Bench calibrated.

               Hook up testing equipment as shown below

VENT

LP

HP

Differential Pressure Type Level Transmitter

Note: Hook up Testing Procedural Step: (Refer to Differential Pressure Type Transmitter on the above Fig 10.4.2.4)

6.6.2   Level Switch

           Support the level switch on a test stand vertically

           Hook up testing equipment as shown below:

                       

	VIBRATION TYPE

 

                                                             Level Switch

          Vibration Type:

a)          Check switching action with ohmmeter (multimeter) while simulating level condition. Actual operating fluid preferred as a testing fluid, if the fluid available, similar characteristic (specific gravity or conductivity) fluid should be used.

b)         Marked switching level on level switch so that mark can be used as a reference during field installation.

c)          Test results / readings will be filed & recorded on applicable calibration form.

6.7     Temperature Instruments

6.7.1   Thermocouple Type Temperature Transmitter

        Prefer to be Bench calibrated.

Determine mV value at 0, 25, 50, 75 & 100% of temperature range from temperature conversion table.

        

Hook up testing equipment as shown below:

                                Thermocouple Type Temperature transmitter

           Types of Thermocouple: K, T, J, E, R, S,…ect.

                                   

a)          If the transmitter is equipped with type and/or range changing jumpers or switches,

put them on proper position.

b)      Measure ambient temperature and determine mV value from the conversion table.

c)      Calculate calibration value at each calibration point using the formula below:

mVcal = mVoper. – mVamb.

where:

mVcal = millivolt value of calibration

mVoper = millivolt value of operating temperature

mVamb = millivolt value of ambient temperature

d)      Hook Simulate 0% of calibration signal and check output. The output should be 0% of its range. If it is not, adjust zero by FF/HART communicator until correct value is obtained.

f)       Simulate 100% of calibration signal and check output. Adjust span by FF/HART communicator when error is found.

g)      Recheck zero after span adjustment and repeat step d) to f) until both are correct.

h)      Check output at 0, 25, 50, 75 and 100% of input range with signal rising and falling. Every output reading shall be within error limit. If it is not, adjust linearity adjustment and repeat steps d) to f) until every output reading correspond with input signal within acceptable error limit.

i)       Ambient temperature effect is to be checked, change ambient temperature of the instrument and check output change.

j)       If the instrument is equipped with burnout option, check this function by opening the input terminal and check output changing. When improper burnout action is observed, correct it by changing jumper or switching in accordance with the manufacturer’s instruction.

k)      After the tests have been completed, the instrument shall be identified with a colour sticker.

l)       Test results / readings will be filed and recorded on applicable calibration form.

6.7.2          RTD Type Temperature Transmitter

        Prefer to be Bench calibrated.

Determine RTD (Resistance Temperature Detector) type and operating conversion table.

           

Determine resistance value at 0, 25, 50, 75 & 100% of input range from temperature conversion table.

           

Hook up testing equipment as follows:

                                                   RTD Type Temperature Transmitter

a)      Simulate 0% of input signal by adjusting decade resistance box and check output. Adjust zero by FF/HART communicator until 0% of output is obtained.

b)      Increase input signal up to 100% of its range and check output. The output shall be 100% of its range. If it is not, adjust span by FF/HART communicator.

c)      Recheck zero after span adjustment and repeat until both are correct.

d)      Check output at 0, 25, 50, 75 and 100% of input range with signal rising and falling. Every output reading shall be within error limit. If it is not, adjust linearity adjustment and repeat steps a) to f) until every output reading correspond with input signal within acceptable error limit.

e)      After the tests have been completed, the instrument shall be identified with a colour sticker.

f)       Test results / readings will be filed and recorded on applicable calibration form.

6.7.3     Resistance Temperature Detector

a)      Sheath shall be removed from the thermowell and checked for damage.

b)      Resistance between terminals shall be measured and recorded. Measured resistance value shall be compared with the value obtained from the conversion charts correspondent to ambient temperature. If accuracy is within the required limit, it is acceptable.

c)      Resistance between terminals and sheath to be checked. If sheath and terminals are isolated, it is acceptable.

d)      After testing, sheath shall be replaced in their thermowells, it is important to ensure that the sheath is “bottomed” in the thermowell.

e)      Test results / readings will be filed and recorded on applicable calibration form.

6.7.4    Thermocouple Element

a)      Sheath shall be removed from the thermowell and checked for damage.

b)      Continuity between terminals shall be checked. If continuity is confirmed, it is acceptable.

c)      After testing, sheath shall be replaced in their thermowells, it is important to ensure that the sheath tip is “bottomed” in the thermowell.

d)      Test results / readings will be filed and recorded on applicable calibration Form.

6.8.        CONVERTER

6.8.1      Current to Air Converter (I/P)

          Hook up testing equipment as shown below:

 

                                                      

                mA / FF Signal

                                                                        I/P Converter

a)     Inject 0% of input signal and check output. Adjust zero when error found.

b)    Inject 100% of input signal and check output. Adjust span when the output deviates more than the error limit from 100% of its range.

c)     Recheck zero after span adjustment and repeat steps a) to c) until both are correct.

d)    Simulate input signal 0, 25. 50, 75 and 100% and check output (0.2kg/cm sq., 0.4kg/cm sq., 0.6kg/cm sq., 0.8kg/cm sq. and 1.0kg/cm sq.) with input rising and falling. Every output reading shall be within error limit. If it is not, adjust linearity and repeat a) to d) until desired input-output is obtained.

e)     After the tests have been completed, the instrument shall be identified with a colour sticker.

f)     Test results / readings will be filed and recorded on applicable calibration Form.

6.9         Control Valve

6.9.1          General

a)      Calibration test will be carried out in the instrument workshop for 4” to 6” or smaller valves. For large size valves calibration will be done in site, after the valve has been installed in the line. Test should not be carried out until the valves in its final operating state, ex., after line flushing operations and hydrostatic tests have been completed.

b)      Hydrostatic testing and line flushing should be carried out with the valve removed.

c)      Check that the valve and data plate agree with the control valve specification.

6.9.2         Diaphragm actuator spring adjustment (Bench Set).

a)     The diaphragm actuator shall be checked thru the following items :

-   Size and type

-   Stroke and range

-   Spring range

b)    Adjust pneumatic signal so that the valve close slowly, and stop when the valve fully closed.

c)     Read the pneumatic signal value and compare it with the actuator range. If the difference is greater than 2%, adjust spring adjusting nut and repeat steps c) to d) until the desired value is obtained. If the desired value cannot be obtain with spring adjustment, change stem length by adjusting connector assembly and repeat steps c) to d).

d)    Adjust pneumatic signal so that the valve open slowly, and stop when the valve is fully opened.

e)     Read the pneumatic signal value and compare it with the actuator range. If the difference is greater than 15%, change spring and recheck closing and opening.

f)     Adjust position indicator scale so that the indication works correctly.

g)    Inject pneumatic signal 0, 25, 50, 75 and 100% of its range and read valve position with signal rising and falling.

h)     Speed of stroking time from full open to full close is to be checked, if required.

6.9.3         Other Type Actuator

a)     The actuators other than diaphragm type shall be tested for stroking and failure action in  

  accordance with manufacturer's instructions. In addition the following items shall

  be checked before the stroke check (positioner calibration).

                      A. Piston Type Actuator

 -  Size and type

 -  Stroke range

 -  Leakage

b)    Control valves having leakage class V and VII (TSO), leakage testing shall

   be performed. A test ring must be fabricated comprising a blind flange on the

   valve outlet fitted with a 6mm bleed pipe and a suitably rated isolation valve from

   the center of the flange. The open end of the bleed pipe shall be immersed

           in a container of water so that the discharge bubbles can be observed. The valve inlet shall be connected to a source of pressure equal to the valve shut-off pressure. The specified signal corresponding to the valve closed position under normal operating conditions shall be applied to the valve actuator and if necessary adjustments made to the valve until the leakage bubble rate is within the specified tolerance (Specify        standard to be followed per project spec).

6.10          Positioner (Stroke check)

a)        After checking the valve stroke without the positioner shall be checked.

b)        Determine signal range and characteristic curve through full stroke of the valve. Before calibration characteristic curve shall be provided. Select proper travel character cam if provided.

c)        Connect power supply and/or air supply to the positioner and actuator.

d)        Connect proper input signal source (4mA to 20mA or 24VDC) to the positioner.

e)        Adjust input signal so that the valve open slowly, and stop when the valve is fully closed.

f)         Read the input signal and adjust zero adjustment when error found. Repeat step e) and f) until valve corresponds with closing signal within error limit.

g)        Adjust input signal so that the valve open slowly, and stop when the valve fully opened.

h)        Read the input signal and adjust zero adjustment when error found. Repeat step g) and h) until the valve corresponds with closing and opening signal within error limit.

i)         Inject 0, 25, 50, 75 and 100% of its range and read valve position with signal rising and falling. Action of the positioner shall be checked (direct or reverse).

j)         Analyze the stroke characteristic curve and figure out the reproducibility, which include dead band and hysteresis.

k)        If the character of the reproducibility are not acceptable, check feed back cam style and / or mechanical condition of all moving parts and correct deficiency if exist. Repeat step j) and k)

l)         Mechanical stops shall be checked as per data sheet.

6.11            Valve Action on Supply Failure

a)       The action of the valve on supply failure shall be checked with appropriate method.

b)       If the control valve is equipped with special accessories for the action of supply failure. The functional check and / or calibration shall be executed.

c)       Volume tank and lock up valves operability will also be checked.

d)       After the tests have been completed, the instrument shall be identified with a colour sticker.

e)       Test results / readings will be filed and recorded on applicable calibration form.

6.12      Limit Switches / Proximity sensor

6.12.1    The function of the limit switches / Proximity sensor shall be checked using a continuity test

          set, for correctness of setting and operation.

6.12.2   On motorized valves, care shall be taken to check the setting of limit switches before putting power on the actuator and the actuator manually placed at mid-travel prior to attempting to stroke the valve for the first time. Reference manufacturer’s instructions.

6.12.3    After the tests have been completed, the instrument shall be identified with a colour sticker.

6.12.3    Test results / readings will be filed and recorded on applicable calibration form.

6.13   Solenoid Valves

6.13.1     Connect an appropriate power supply via a switch.

6.13.2     Connect an air supply to the appropriate port or ports.

6.13.3     Check the operation of the valve by operating the switch and observing correct change over action.

6.13.4     Check the tightness of shut-off by connecting a flexible tube to the outlet ports or port an immersing the free end in the water to ensure that the valve closure is bubble-tight at the stated design pressure.

6.13.5     Check where applicable, electrical & manual reset, override and time delay features as called for on the valve specification.

6.13.6     Check that the coil resistance is correct to the specification.

6.13.7     After the test had been completed, the instrument shall be identified with a colour sticker.

6.13.8     Test results / readings will be filed and recorded on applicable calibration form.

6.14.   Flow Elements

6.14.1     Flow elements e.g. orifice plates, vortex, etc. shall not be installed until the flushing has been completed.

6.14.2     Flow elements such as vortex meters, magnetic flow meters, etc., which are not usually tested in the field shall be checked at the workshop or for its manufacturer’s test certificate.

6.14.3     Before installation, the flow element should be checked to ensure that the data and material specification stamped on the data plate or tab handle is the same as the specification sheet.

6.14.4     Orifice plate should be examined for flatness, bore siize and other dimensions against

        Vendor appproved drawings and to ensure that they are undamaged. Do not damage

        orifice edge. The bore shall be checked with Vernier caliper. Flow direction to be also    verified prior to on line installation.

6.14.5     Venturi system shall be checked against specification for bore diameter, length and throat diameter.

6.14.6     Test results / readings will be filed and recorded on applicable calibration form.

6.15   Analyzers (Conductivity meter/ PH meter)

        Analyzers shall check out by Vendor’s representative with the assistance of subcontractor

        technicians based on vendor approved procedure or SAT where applicable.

7      SAFETY

7.1.1     To ensure best practice HSE control is being implemented throughout all Instrumentation work, Contractor Instrument Supervisors and HSE Supervisor with Sub contractors Instrumentation Supervisors and HSE Supervisor shall carry out inspections prior to Work commencing and at regular intervals during the activities.

7.1.2       Persons working at height (above 1.8 meters) shall be protected from falling by the installation of safe access/ egress and working platforms.

7.1.3       Persons involved in Instrument calibration work shall be provided with and use the necessary PPE and as a standard each person shall wear a Safety Helmet and Safety footwear. The requirement for additional PPE shall be identified in the Risk Assessment and may include the use of the following:

7.1.4       Eye protection.

7.1.5        Hand Protection.

7.1.6        Dust masks.

7.1.7        Reflective jackets if working in the vicinity of moving traffic.

7.1.8        Any other necessary PPE

Note: - The issue and use of PPE is the final step in protecting people and must not be see as the only safety control method. Risks must be reduced to the smallest amount possible and the PPE is the ‘back up’ equipment.

8          QUALITY CONTROL

8.1         ITP is a document submitted to the owner or owner’s representative formulated in an orderly manner by the construction supervisor or site quality manager to record main working processes for tests and quality inspections, and to enable the owner or owner’s representative to assign inspection points.

     

     8.2         Witness Point

8.2.1                Point where permission to the next level is granted without Owner’s agreement.

     8.3             Hold Point

8.3.1      Point where further progress is not allowed without Owner’s written permission

     8.4         Inspector

8.4.1      Person that inspects whether processes quality of materials or specifications are consistent with prescribed or desired requisites.

கேஸ் சிலிண்டர் வாங்கும்போது A-17, B-17, C-17, D-17 என்று கண்டிப்பா பார்த்து வாங்குங்க

கேஸ் சிலிண்டர் வாங்கும்போது A-17, B-17, C-17, D-17 என்று கண்டிப்பா பார்த்து வாங்குங்க

எல்லோருடைய வீட்டிலும் சிலிண்டர் பயன்படுத்துகிறோம். ஆனால் இதை சரியாகப் பயன்படுத்தவில்லை என்றால், அதன்மூலம் பேராபத்து இருக்கிறது என்பது நமக்குத் தெரியும் தான். ஆனால் அதில் இன்னொரு அதிர்ச்சிமிக்க விஷயமும் இருக்கிறது.

காலியாக உள்ள எரிவாயு சிலிண்டருக்கும் காலாவதியாகும் காலமுண்டு (expiry)என்பது உங்களுக்குத் தெரியுமா? ஆம். அதைப்பற்றி நாம் எப்போதுமே கவலைப்பட்டதே இல்லை. காலியாக உள்ள சிலிண்டரால் கூட ஆபத்துகள் நேரும் என்பதை நாம் முதலில் தெரிந்து கொள்ள வேண்டும்.

இரும்பு ஒரு உலோகம் தான். ஆனால் எந்த வகை இரும்பாக இருந்தாலும் கந்தக அமிலத்தை ஊற்றினால் இரும்பை அரித்துவிடும். அதேபோல நாம் பயன்படுத்தும் எல்பிஜி கேஸிலும் கூட இரும்பை அரிக்கும் ஆற்றல் உண்டு.தொடர்ச்சியை கீழே வாசியுங்கள்…

அதனாலேயே சிலிண்டர் குறிப்பிட்ட ஆண்டுகள் வரை பயன்படுத்திய பின், மீண்டும் அவை உருக்கி, மறுசுழற்சி மூலம் மீண்டும் புதிய சிலிண்டர்க்ள தயாரிக்கப்படுகின்றன.

காலாவதியான சிலிண்டரில் எரிவாயு நிரப்பி கொடுக்கப்படும் போதே மிக அதிக அளவில் விபத்துகள் அதிகமாக உண்டாகின்றன. அதனால் நாம் ஒவ்வொரு முறை சிலிண்டர் வாங்கும் போதும் அதன் காலாவதி தேதியை சரிபார்ப்பது மிக அவசியம்.

ஒரு சிலிண்டர் டிரம் உற்பத்தி செய்யப்பட்டு, பத்து ஆண்டுகள் வரை மட்டுமே பயன்படுத்தப்படும்.

கேஸ் நிரப்பும் ஆலைகளில் கேஸ் நிரப்புவதற்கு முன்பாக இவை சரிபார்க்கப்படும். சிலிண்டரில் மேல் பகுதியில், இருக்கும் பேட்ச்சில், எப்போது சரிபார்க்கப்பட்டது. எப்போது வரையிலும் இந்த சிலிண்டரை பயன்படுத்தலாம் என்பது போன்ற விவரங்கள் இருக்கும்.தொடர்ச்சியை கீழே வாசியுங்கள்…

சிலிண்டர் காலாவதியாகிவிட்டதா என்பதை எப்படி தெரிந்து கொள்ளலாம்?

சிலிண்டரின் மேல் பகுதியில் மூன்று கம்பிகள் இருக்கும். அதில் ஒரு கம்பியின் பக்கவாட்டில் சிலிண்டரின் எடை விவரங்கள் எழுதப்பட்டிருக்கும்.

மற்றொரு கம்பியில், காலாவதி தேதி குறித்த எண்கள் சுருக்கெழுத்தில் குறிக்கப்பட்டிருக்கும். அதனுடன் ஒரு நம்பரும் இருக்கும்.

ஜனவரி முதல் மார்ச் வரை என்றால் A என்றும் ஏப்ரல் முதல் ஜூன் வரை B என்றும் ஜூலை முதல் செப்டம்பர் வரை C என்றும் அக்டோபர் முதல் டிசம்பர் வரை என்றால் D என்றும் குறிப்பிடப்பட்டிருக்கும்.

உதாரணமாக, உங்கள் சிலிண்டரில் A 17 என்று எழுதப்பட்டிருந்தால், உங்கள் சிலிண்டர் காலாவதியாகும் நாள் மார்ச் 2017 என்று அர்த்தம். அதனால் அந்த தேதிக்கு மேல் அந்த சிலிண்டரை பயன்படுத்தக் கூடாது.தொடர்ச்சியை கீழே வாசியுங்கள்…

மேற்கண்ட படத்தில் உள்ள சிலிண்டரில் B13 என்று இருக்கிறது. இது ஏற்கனவே காலாவதியாகிப் போன சிலிண்டர். இந்த சிலிண்டர் 2013 ஜூன் மாதமே காலாவதியாகிவிட்டது.

அந்த தேதிக்கு மிக அருகில் நீங்கள் வாங்கும் சிலிண்டர் இருந்தாலோ அதை நிராகரித்துவிட்டு, வேறு சிலிண்டரை வாங்குங்கள். அப்படி நிராகரித்து மாற்று சிலிண்டரை கேட்டு வாங்கும் உரிமை எல்லா நுகர்வோருக்கும் உண்டு.

இதன்மூலம் தேவையில்லாமல் உண்டாகும் விபத்துக்களைத் தவிர்க்க முடியும்.

தொகுப்பு  : அ. தையுபா அஜ்மல்.

Do you want know about Radiologist ??

A radiologist is a medical doctor, He Could treat diseases, such as cancer or heart disease, by means of radiation or minimally invasive, image-guided surgery. Radiologists are often able to see problems early by interpreting the results of your imaging study and can provide an accurate diagnosis to your referring physician.

Generally, a radiologist:

• Acts as an expert imaging consultant to your referring physician
• Directs radiology technologists (the specialists who operate the equipment) to ensure quality exams
• Helps determine the appropriate imaging exam for your needs
• Recommends further exams or other next steps in your treatment
• Reviews and interprets the images from your exam
• Provides your physician with a detailed report of your exam

Radiologists specialize in analyzing the medical images of patients and making primary recommendations for initial treatment to the care physicians. While hospitals and clinics typically employ doctors who specialize in this area, there are also specialized radiology and imaging clinics that employ individuals for this position.


Interventional radiologists take imaging technology a step further by using it to treat certain diseases and conditions. These professionals create electronic maps to guide their instruments as they insert catheters, remove malignant tissue and perform other delicate procedures. This gentle approach allows patients to recover faster and with fewer complications.

If you thrive on intellectual stimulation, you may find radiology an especially rewarding area of practice. Given the constant state of flux and continued innovation in radiology, there is always something new and exciting to learn. These specialists are among the first to pilot cutting-edge imaging technologies and procedures developed in clinical and translational research laboratories. Radiologists also enjoy the challenge of interpreting complex studies and putting together medical clues to arrive at an accurate diagnosis, ultimately at the benefit of the patient.

Radiologists are medical doctors who use diagnostic machines and procedures to assess and treat patients. They do imaging tests, such as CAT scans, PET scans, MRIs, and x-rays, and read the results. Some radiologists may rarely consult directly with patients, but many interact with patients and their team of doctors. To become a radiologist, go to med school, pass all your exams, and complete your residency.

 
About  PG course of Radiology ( MD/DMRD)

There are almost 268 medical schools across the country that run radiology courses and out of 35,000 total medical students, approximately 747 get to do 3-year postgraduate training in radiology every year, out of which 537 seats are under Medical council of India (MCI) and 210 seats under National board of examinations [Diplomate of National board (DNB)], which are two medical governing bodies in India. In addition, there are about 253 2-year diploma course seats known as Diploma in Medical Radio-Diagnosis (DMRD), in which candidates are not given any research thesis and these candidates are not eligible for teaching posts. This selection is based on the various postgraduate entrance examinations conducted at both all-India and state level. The living cost for the trainees is managed by the residents themselves, however, at most of the Government medical colleges, charges for accommodation and food are very much subsidized by the State. Nevertheless, there are few institutes which offer paid seats to students charging huge amount of money.

MD Radiology is a 3- year long postgraduate course in medicine, the minimum eligibility for which is an M.B.B.S competed with a 1- year compulsory internship. As part of the curriculum, students are offered advanced insight into subjects such as Radio Physics, Basic Concepts, Production of X-Rays, and Interaction of Radiation with Matter, Radiation Detection and Measurement, Radiography, Fluoroscopy, Special Radiography, Computed Tomography, Ultrasonography etc.adiology is one of the most sought after specialties in medicine and it is the first choice of many top-rankers in India for almost a decade. This is for the reason that diagnostics have become an integral part of most patients’ work-up due to existing practice of evidence-based medicine. More importantly, rapid advancements in imaging have further increased its demand.
The radiology residency training program is of 3-year duration and residents are imparted training in both conventional radiology and modern imaging techniques to make them well versed with broad discipline of radiology including ultrasonography, color Doppler, computed tomography and magnetic resonance imaging. There is a change in the training focus in majority of the institutes in the last few years to keep pace with the new developments in imaging. Currently, premiere institutes also provide experience in vascular and non-vascular interventional radiology to trainees.

Candidates are assigned a dissertation on a particular topic in radiology under the supervision of an experienced and eligible teacher, on which they work on and submit it to university at the end of two and a half years. Moreover, students are assessed periodically every 6 months (may vary in certain institutes) by a local appraiser with both theory and practical exams for the syllabus covered during the period. Furthermore, pupils need to maintain a logbook with remarks from the supervisors. The logbook should mention about number and details of the radiological procedures done and assisted, lectures attended various presentations by the student. Various academic activities like seminars, journal clubs and case discussions are regularly conducted in the departments as a part of teaching curriculum. The final examination is divided into four theory papers (related to radiation physics and various body systems) and practical test (consists of long & short cases, spot diagnosis of images and viva).

The goal of the training is to develop a competent, safe and logical radiologist who can conduct and interpret various diagnostic and interventional imaging studies and is also able to pursue teaching and research activities, while following medical ethics and consumer protection act.

The first medical degree in India is Bachelor of Medicine and Bachelor of Surgery (MBBS), while the postgraduate degree given by schools under MCI is Doctor of medicine (MD) and by NBE is DNB. Both are considered almost equivalent now, unlike few years back when DNB passed candidates were not considered eligible for teaching posts in MCI recognized universities without further teaching experience, as many hospitals running DNB courses were small private hospitals or diagnostic centers, where facilities for teaching and research were less as well as the criteria of selection of students were also not very defined and these were not recognized by MCI. Now national board of examination has started a common entrance test for selecting the students. However, even now, if students have a choice of both, majority prefer MD Radiology compared to DNB, as most institutes of national importance are running MD.

Thereafter, in most institutes, Radiologists need to do senior residency for 3 years to enhance their expertise, before they can be appointed as a faculty. Their selection and promotions are based on their academic performance and scientific contribution apart from the clinical skills.

Unlike few years back, when most radiologists used to work on all modalities and pursue general radiology, the current trend in the nation is to gain proficiency and experience in one or two subspecialties to excel in that particular field. This is being followed in institutes of academic excellence and many other reputed imaging centers. I foresee many other practitioners across the country embracing this practice and strengthening their abilities as radiologists. Overwhelmingly, many continuing medical education programs are being held in various subspecialties and modalities periodically to further the knowledge and skills of practicing radiologists.

Workplace Details :

Though most radiologists still work in hospitals and outpatient diagnostic centers, advances in digital technology now allow imaging studies to be transmitted electronically. This practice, which is known as teleradiology, means radiologists can now practice in any location equipped with a computer, high-resolution monitor and Internet connectivity. Teleradiology helps emergency departments and intensive care units obtain emergency consultations after hours. Teleradiology also promotes consultation among experts around the globe.

Unlike most other physicians, radiologists have limited patient contact. In fact, some go weeks without a face-to-face consultation. Instead, these specialists spend their time analyzing image results and formulating diagnoses.

Radiologists who work in the hospital work long, irregular shifts that include nights, weekends and holidays. Those employed by outpatient centers are more likely to work regular business hours. However, depending on the specifics of a given radiologist’s employment contract, overall hours worked and length of vacation are often balanced against the amount of compensation.




Salary Details :

India is a populous country with over a billion people and there is approximately one radiologist for every 100,000 population (compared to US where the corresponding ratio is 1:10,000). Therefore, clinical practices are becoming increasingly busy because of the need to perform diagnostic examinations for many cases. Many hospitals already have installed and many more are in the process of acquiring picture archival and communications systems (PACS) and radiology information systems (RIS) to increase the efficiency and productivity of radiology departments. The technology gap compared to the west is being narrowed due to adoption of newer technologies by increasing number of hospitals. Additionally, teleradiology is becoming increasingly popular throughout the country serving four major purposes: easing staffing shortages, delivering emergency radiology services, providing radiology services to remote and underserved areas, increasing the reach of subspecialty diagnosis and thus becoming harbinger of a bright future. 

In addition, this also acts as an additional financial opportunity for the radiologists 
Pay by Experience for a Physician / Doctor, Radiologist has a positive trend. An entry-level Physician / Doctor, Radiologist with less than 5 years of experience can expect to earn an average total compensation of Rs 1,769,000 based on 149 salaries provided by anonymous users. Average total compensation includes tips, bonus, and overtime pay. A Physician / Doctor, Radiologist with mid-career experience which includes employees with 5 to 10 years of experience can expect to earn an average total compensation of Rs 2,432,000 based on 42 salaries. An experienced Physician / Doctor, Radiologist which includes employees with 10 to 20 years of experience can expect to earn an average total compensation of Rs 2,700,000 based on 23 salaries. A Physician / Doctor, Radiologist with late-career experience which includes employees with greater than 20 years of experience can expect to earn an average total compensation of Rs 3,537,000 based on 7 salaries.

The majority of the radiologists work in private imaging centers and nongovernmental hospitals. The common reasons are: shortage of institutional posts, difference in salary structure of the two areas, more vacancies of private jobs etc. While the income of salaried radiologists vary from 1 to 6 lakhs INR (1,635-9,800 USD) per month (depending on their expertise, experience and working hours), the earnings of people who start their own practice is quite variable and depend on many factors 

Conclusion :

Competition for radiology residencies is fierce, students seeking to enter this field must be top academic performers with excellent medical school grades, PG outstanding NEET(National Eligibility cum Enterance Test) scores, glowing letters of recommendation, and preferably a decent amount of exposure to the field.

Radiologists must be strong communicators and team players in order to work well with patients and colleagues. They must be compassionate and empathetic to properly support patients through difficult and stressful medical situations..


Prepared by M.Ajmal Khan.

Thanks to:Dr J.Fathima Jaffar MBBS,MD (Radio Therapy)

                   Adyar Cancer Institute, Chennai.

Radio Therapy Course, Treament and side Effects,,

Radiotherapy means the use of radiation, usually x-rays, to treat cancer cells. You might have radiotherapy from inside the body, this is called internal radiotherapy. Or external radiotherapy is from outside of the body.

Radiotherapy can be used to try to cure cancer, reduce the chance of cancer coming back or to help relieve symptoms. You might have it by itself or with other treatments such as chemotherapy or surgery.

Nearly 50 out of 100 (50%) people have radiotherapy at some point during their cancer treatment.

Most types of radiotherapy use photons. But you might have electrons or more rarely protons. Your doctor will decide which type you need.

Radiotherapy Technicians work in cancer hospitals and aid in chemotherapy treatment. The subject of Radiotherapy is also an integral part of B.Sc. in Medical Technology pursed by Medical Technologists.


Top Institutes offering this course are: 

Adayr Cancer Institute, Chennai.
AIIMS, New Delhi
Christian Medical College, Vellore
Kasturba Medical College, Mangalore
Madras Medical College, Chennai
Government Medical College, Nagpur


The curriculum covers areas of study such as Radiation Physics, Radiobiology, Radiation Oncology, Chemotherapy and related topics. Eligible candidates are needed to be well- versed in the constantly evolving techniques and drugs applied in chemotherapy, besides the use of computers, radiological concepts etc.


The average tuition fee charged in India for the course ranges between INR 80000 and 10 Lacs. Admission to the course is based on the candidate’s rank in the National Eligibility cum Entrance Test (NEET).

MD Radiotherapy: Eligibility


Applicants aspiring to pursue the course need to have completed any of M.B.B.S., B.D.S., D.M.S., D.H.M.S., B.H.M.S., B.A.M.S., B.A.S.M., B.E.M.S., B.I.A.M.S., B.N.Y.T., B.A.T.S., B.U.M.S., B.P.T., B.Pharma., N.O., and M.D (A.M).


Practitioners and research workers who have been practicing for the last 10 years, are exempted from fulfilling such requirements of basic minimum qualification, and may directly apply for the program.

MD Radiotherapy: Admission Process


Admission to the course is based on the candidate’s performance in any of the following entrance examinations: 

Centrally-conducted NEET PG (conducted by NBE)
A State- level PG exam
Autonomously- conducted entrance exam such as those conducted by any of AIIMS, PGI and JIPMER
Institute- specific entrance examination conducted by a concerned college.



Successful postgraduates of the course are hired in capacities such as Radiation Oncologist/ Radiation Therapist, Radiology Technicians, Ultrasound Technician/ Diagnostic Medical Sonographer, MRI Technician, CT Tech/ CAT Scan Technologist/ CT Scan Technologist etc.


They are hired in industries related to healthcare, including Hospitals, Physician Practices, Integrative Healthcare Clinics, Public Health Clinics, College Health Centers, Natural Apothecaries etc. The average annual salary offered in India for such positions varies between INR 2 and 10 Lacs.


Radiologist Technologists aid the Radiologist in processes of diagnosis and imaging. They take the imaging and take care of the safety and comfort of the patient. The RT is not involved in the actual diagnosis as it is performed by the Radiologist.


Radiologist Assistants perform advanced techniques to investigate disorders. They help Radiologists in complex radiology procedures and perform fluoroscopy under his supervision. They are a channel between the radiology department and the physician. Venous diagnostic exams and feeding tube installation are the other duties.


Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. He or she works closely with other team members to develop the treatment plan.

Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:

• Answering questions about treatments
• Monitoring your health during treatment
• Helping you manage potential side effects

Medical radiation physicist: This professional has expertise in radiation equipment. He or she helps design treatment plans.

Dosimetrist :This professional helps the radiation oncologist calculate the right dose of radiation.

Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.

Other health care professionals. Additional team members may help care for physical, emotional, and social needs during treatment. These professionals include:


Social workers,Nutritionists or dietitians,Physical therapists,Dentists


Your course of treatment


When deciding on your course of treatment your doctor takes into account:

• your type of cancer
• the position of the cancer in the body
• any other treatment you've had, are having, or is planned for you
• your general health and fitness

Aim of radiotherapy treatment

The principal platform for external beam radiotherapy delivery, the Linear Accelerator (LinAc), had also reached something of a plateau of development, albeit with improved reliability, but few fundamental changes. Caesium tubes were transported from the “radium safe”, locked in an underground vault, to the operating theatre in a lead-lined trolley, where they were only loaded into “central tubes” and “ovoids” after the examination under anaesthetic (which was performed with the patient in the knee-chest position); they were then manually placed into the patient, who went to be nursed on an open ward, albeit behind strategically placed lead barriers.

For no sites outside the cranium was Computer Tomography (CT) scanning available. Magnetic Resonance Imaging (MRI) was still a vision seen only by a small number of enthusiasts.

All these limitations were met by a developing team of scientific and clinical enthusiasts believing in the future of radiotherapy if only technology could deliver solutions to address an improving understanding of the differing cancers and their radiobiology.

In the latter half of the eighties these solutions began to crystallise. Computers were being introduced across the NHS and their impact was not lost in radiotherapy. Pads of tracing paper were replaced with the first generation of planning computers. The simple “Bentley-Milan” algorithms could account for patient outlines accurately and speedily and optimising different beam configurations became practical. Consideration of Organs at Risk, as defined by the various International Commission on Radiation Units (ICRU) publications, became increasingly relevant. Recognition of the importance of delineating the target volumes and protecting normal tissue required improved imaging and this was provided by the new generation of CT scanners. In the nineties these were shared facilities with diagnostic radiology departments. However, the improvements provided by this imaging, enabling accurate 3-dimensional mapping of the disease with adjacent normal tissues and organs at risk, dictated their inclusion into every radiotherapy department soon after the millennium. The added bonus of using the grey scale pixel information, or Hounsfield numbers, to calculate accurate radiation transport distributions soon followed when the mathematical and computer technology caught up with the task. The value of MR and Positron Emission Tomography (PET) imaging was also recognised in the diagnosis, staging and planning of radiotherapy and the new century saw all of these new technologies embedded within the department.

Mould room technology was also improving with “instant” thermoplastic immobilisation shells replacing the uncomfortable plaster and vacuum forming methods. Custom shielding with low melting high density alloys was becoming routine and it was not long before these techniques were married with the emerging CT planning to provide “conformal” treatments.

LinAc technology also received added impetus. Computers were firstly coupled as a front end to conventional LinAcs as a safety interface to reduce the potential for “pilot error”. Their values were soon recognised by the manufacturers and were increasingly integrated into the machine, monitoring performance digitally and driving the new developments of Multi Leaf Collimators (MLC) and On Board Imaging (OBI).

The dominos for the radiotherapy renaissance were stacked up, but it needed the radiographers, clinicians and scientists to decide on the direction of travel. Computer power coupled with advanced electro-mechanical design had transformed MLC efficiency and resolution. Conventional conformal planning was now progressively superseded by sophisticated planning algorithms using merged CT and MR images. Intensity Modulated RadioTherapy (IMRT) had arrived in its evolving guises of multiple fixed field, dynamic arc therapy (RapidArc) or Tomotherapy. Whichever technique, they all offered the radiotherapy “Holy Grail” of providing three dimensional homogeneous dose distributions conformed to the Planning Target Volume (PTV) whilst achieving the required dose constraints for organs at risk and normal tissue preservation.
Radiotherapy with the aim of curing cancer usually lasts between 1 to 7 weeks.

For radiotherapy to relieve symptoms, you might have anything between a single treatment to 2 weeks of treatment. It might be longer than this. Your doctor will tell you how many treatments you’ll have.

Most people have daily treatment from Monday to Friday, with a rest at weekends. But this can vary. For example, you might have treatment once a week for a set number of weeks. It is also sometimes possible to have more than one treatment per day.

Let your radiographer (sometimes called a radiotherapist) know at your planning radiotherapy appointment if you have any commitments such as work or childcare that mean you need a specific time for your appointments. They will try to be as flexible as possible, but it can difficult depending on how busy the department is.




Understanding Radiation Therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.
Goals of radiation therapy

Radiation oncologists use this type of treatment to destroy cancer cells and slow tumor growth without harming nearby healthy tissue.

Sometimes, doctors recommend radiation therapy as the first cancer treatment. Other times, people receive radiation therapy after surgery or chemotherapy. This is called adjuvant therapy. It targets cancer cells remaining after the initial treatment.

When it is not possible to destroy all of the cancer, doctors may use radiation therapy to shrink tumors and relieve symptoms. This is called palliative radiation therapy. Palliative radiation therapy may reduce pressure, pain, and other symptoms. The goal is to improve a person’s quality of life.

More than half of people with cancer receive some type of radiation therapy. For some cancers, radiation therapy alone is an effective treatment. Other types of cancer respond best to combination treatments. This may include radiation therapy plus surgery, chemotherapy, or immunotherapy.

1,External-beam radiation therapy

This is the most common type of radiation therapy. It delivers radiation from a machine outside the body. It can treat large areas of the body, if needed.

A machine called a linear accelerator, or linac, creates the radiation beam for x-ray or photon radiation therapy. Special computer software adjusts the beam’s size and shape. This helps target the tumor while avoiding healthy tissue near the cancer cells.

Most treatments are given every weekday for several weeks. Form-fitting supports or plastic mesh masks are used for radiation therapy to the head, neck, or brain to help people stay still during treatment.

The types of external-beam radiation therapy are:

Three-dimensional conformal radiation therapy (3D-CRT):  Detailed 3-dimensional pictures of the cancer are created, typically from computed tomography (CT) or magnetic resonance imaging (MRI) scans. This allows the treatment team to aim the radiation therapy more precisely. It often means that they can safely use higher doses of radiation therapy while reducing damage to healthy tissue. This lowers the risk of side effects. For instance, dry mouth is common after radiation therapy for head and neck cancer. But 3D-CRT can limit the damage to the salivary glands that causes dry mouth.

Intensity modulated radiation therapy (IMRT): This a more complex form of 3D-CRT. The radiation therapy intensity is varied within each beam in IMRT unlike conventional 3D-CRT, which uses the same intensity in each beam. IMRT targets the tumor and avoids healthy tissue better than conventional 3D-CRT.


Proton beam therapy: This treatment uses protons rather than x-rays. A proton is a positively charged particle. At high energy, protons can destroy cancer cells. The protons go to the targeted tumor and deposit the specific dose of radiation therapy. Unlike with x-ray beams, the radiation therapy does not go beyond the tumor. This limits damage to nearby healthy tissue. Currently, doctors use proton therapy to treat certain types of cancer. This therapy is relatively new and requires special equipment. Therefore, it is not available at every medical center.

Image-guided radiation therapy (IGRT): This type of therapy allows the doctor to take images of a patient throughout treatment. These images can then be compared to the images used to plan treatment. It allows better targeting of the tumor and helps reduce damage to healthy tissue.

Stereotactic radiation therapy: This treatment delivers a large, precise radiation therapy dose to a small tumor area. The patient must remain very still. Head frames or individual body molds help limit movement. This therapy is often given as a single or a few treatments. But some patients may need several treatments.

2,Internal radiation therapy

This type of radiation therapy is also called brachytherapy. Radioactive material is placed into the cancer or surrounding tissue. Implants may be permanent or temporary and may require a hospital stay.

Types of internal radiation therapy include:

Permanent implants. These are tiny steel seeds that contain radioactive material. The capsules are about the size of a grain of rice. They deliver most of the radiation therapy around the implant area. But some radiation may exit the patient’s body. This requires safety measures to protect others from radiation exposure. Over time, the implants lose radioactivity. And the inactive seeds remain in the body.

Temporary internal radiation therapy. This is when radiation therapy is given in one of these ways:

• Needles
• Tubes, called catheters, that carry fluid in or out of the body
• Special applicators

The radiation stays in the body for anywhere from a few minutes to a few days. Most people receive radiation therapy for just a few minutes. Sometimes, people receive internal radiation therapy for more time. If so, they stay in a private room to limit other people's exposure to the radiation.

3,Other radiation therapy options

Intraoperative radiation therapy (IORT). This treatment delivers radiation therapy to the tumor during surgery using either external-beam or internal radiation therapy. IORT allows surgeons to move away healthy tissue in advance. This treatment is useful when vital organs are close to the tumor.

Systemic radiation therapy. Patients swallow or receive an injection of radioactive material that targets cancer cells. The radioactive material leaves the body through saliva, sweat, and urine. These fluids are radioactive. Therefore, people in close contact with the patient should take the safety measures recommended by the health care team.

Radioimmunotherapy. This is a type of systemic therapy. It uses monoclonal antibodies to deliver radiation directly to cancer cells. This therapy delivers low doses of radiation directly to the tumor. It does not affect noncancerous cells. Examples include ibritumomab (Zevalin) and tositumomab (Bexxar).

Radiosensitizers and radioprotectors. Researchers are studying radiosensitizers. They are substances that help radiation therapy better destroy tumors. Radioprotectors are substances that protect healthy tissues near the treatment area. Examples of radiosensitizers include fluorouracil (5-FU, Adrucil) and cisplatin (Platinol). Amifostine (Ethyol) is a radioprotector.

Peptide receptor radionuclide therapy (PRRT). This type of radioactive therapy works by attaching to specific proteins that can be found on the surface of certain tumor cells. These proteins are called receptors. After attaching to the receptor, the drug enters the cell, allowing radiation to damage the tumor cell. Recently, the FDA approved a treatment called 177Lu-dotatate (Lutathera) for advanced neuroendocrine tumors of the gastrointestinal tract.

Safety for the patient and family

Doctors have safely and effectively used radiation therapy to treat cancer for more than 100 years.

Having radiation therapy slightly increases the risk of developing a second cancer. But for many people, radiation therapy eliminates the existing cancer. This benefit is greater than the small risk that the treatment could cause a new cancer.

During external-beam radiation therapy, the patient does not become radioactive. And the radiation remains in the treatment room.

However, internal radiation therapy causes the patient to give off radiation. As a result, visitors should follow these safety measures:

Do not visit the patient if you are pregnant or younger than 18.
Stay at least 6 feet from the patient’s bed.
Limit your stay to 30 minutes or less each day.

Permanent implants remain radioactive after the patient leaves the hospital. Because of this, the patient should not have close or more than 5 minutes of contact with children or pregnant women for 2 months.

Similarly, people who have had systemic radiation therapy should use safety precautions. For the first few days after treatment, take these precautions:

Wash your hands thoroughly after using the toilet.


Where radiotherapy is given

You usually have radiotherapy in a hospital that has a major cancer treatment centre. This means you may have some treatment at your local hospital, such as surgery or chemotherapy. But you may have radiotherapy at a different hospital.

You usually have external beam radiotherapy as an outpatient. If you are unwell, or are having chemotherapy at the same time, you may need to stay in hospital. In this case, you will go to the radiotherapy department each day from the ward.

If you are having some types of internal radiotherapy, you may have to stay in hospital for a few days.

A Radiotherapist / Radiation Oncologist is a specialist who deals with treatment of cancer patients mainly with the use of different modalities of radiation. The treatment of cancer is a multimodality comprehensive treatment with surgical oncology, radiation oncology and medical oncology being integral parts of it.


CT Tech is responsible for producing computerized tomographic scans of certain sections of the patient’s body. CAT Scan Technologists perform abdominal scans, gynecological and obstetric scans, ultrasound examinations, as well as retroperitoneal scans to create three-dimensional cross-sections or slices of the body.

MRI Techs operate a magnetic resonance scanner to obtain two- or three-dimensional maps of various tissue types within the patient’s body that are used by physicians in the diagnosis and treatment of pathologies. After entering and monitoring the patient’s data, the MRI Technician transfers images from disk to magnetic media in order to create and develop the film for the doctor or radiologist to analyze.

Diagnostic Medical Sonographers are skilled technicians who use ultrasound technology on a wide range of soft-tissue procedures, including obstetric and gynecologic sonography, abdominal, cardiac, and neuro-sonography.

X-ray Technicians (also known as X-ray Technologists or Radiologic Technologists) use cutting-edge imaging methods to visualize the inside of the human body. The pictures they create help physicians diagnose and treat illnesses or injuries with great accuracy.

Radiotherapy can cause side effects.

 Your side effects may depend on

• the area of your body being treated
• the type of radiotherapy you have
• other treatments you are also having.

Most people have a few side effects during or after radiotherapy. Your radiotherapy team will tell you about the possible side effects. They will explain if you have a risk of side effects that may be long-term or only start months or years after radiotherapy. General side effects may include:

• tiredness
• problems with eating and drinking
• feeling sick
• skin reactions
• hair loss.

Side effects do not usually happen straight away. They may develop during treatment or in the days or weeks after treatment finishes. Sometimes side effects get worse for a time before they get better.

There are ways to manage side effects. If you feel unwell, or need any help and advice, tell your radiotherapy team. Always tell them if you have signs of infection or unexplained bleeding or bruising. Levels of cells in your blood may be low and may need treatment.

Prepared by M.Ajmal Khan.

Thanks to:Dr J.Fathima Jaffar MBBS,MD (Radio Therapy)

                   Adyar Cancer Institute, Chennai.