Ion Chamber Dose Research Articles

Investigation of linear energy transfer (LET)-dependence behavior and dosimetric response of a flat-panel detector in pencil beam scanning proton therapy

PurposeThis study aims to elucidate the dependence of the flat-panel detector’s response on the linear energy transfer (LET) and evaluate the practical viability of employing flat-panel detectors in proton dosimetry applications through LET-dependent correction factors. MethodsThe study assessed the flat-panel detector’s response across varying depths using solid water and distinct 100, 150, and 200 MeV proton beams by comparing the flat-panel readings against reference doses measured with an ionization chamber. A Monte Carlo code was used to derive LET values, and an LET-dependent response correction factor was determined based on the ratio of the uncorrected flat-panel dose to the ionization chamber dose. The implications of this under-response correction were validated by applying it to a measurement involving a spread-out Bragg peak (SOBP), followed by a comparative analysis against doses calculated using the Monte Carlo code and MatriXX ONE measurement. ResultsThe association between LET and the flat-panel detector’s under-response displayed a positive correlation that intensified with increasing LET values. Notably, with a 10 keV/µm LET value, the detector’s under-response reached 50 %, while the measurement points in the SOBP demonstrated under-response greater than 20 %. However, post-correction, the adjusted flat-panel profile closely aligned with the Monte Carlo profile, yielding a 2-dimensional 3 %/3mm gamma passing rate of 100 % at various verification depths. ConclusionThis study successfully defined the link between LET and the responsiveness of flat-panel detectors for proton dosimetric measurements and established a foundational framework for integrating flat-panel detectors in clinical proton dosimetry applications.

Monte Carlo evaluation of uncertainties in photon and electron TG-51 absorbed dose calibration.

The accuracy of dose delivery to all patients treated with medical linacs depends on the accuracy of beam calibration. Dose delivery cannot be any more accurate than this. Given the importance of this, it seems worthwhile taking another look at the expected uncertainty in TG-51 photon dose calibration and a first look at electron calibration. This work builds on the 2014 addendum to TG-51 for photons and adds to it by also considering electrons. In that publication, estimates were made of the uncertainty in the dose calibration. In this paper, we take a deeper look at this important issue. The methodology used here is more rigorous than previous determinations as it is based on Monte Carlo simulation of uncertainties. It is assumed that mechanical QA has been performed following TG-142 prior to beam calibration and that there are no uncertainties that exceed the tolerances specified by TG-142. Despite the different methodology and assumptions, the estimated uncertainty in photon beam calibration is close to that in the addendum. The careful user should be able to easily reach a 95% confidence interval (CI) of±2.3% for photon beam calibration with standard instrumentation. For electron beams calibrated with a Farmer chamber, the estimated uncertainties are slightly larger, and the 95% CI is ±2.6% for 6 MeV and slightly smaller than this for 18 MeV. There is no clear energy dependence in these results. It is unlikely that the user will be able to improve on these uncertainties as the dominant factor in the uncertainty resides in the ion chamber dose calibration factor . For both photons and electrons, reduction in the ion chamber depth uncertainty below about 0.5mm and SSD uncertainty below 1mm have almost no effect on the total dose uncertainty, as uncertainties beyond the user's control totally dominate under these circumstances.

Development and Evaluation of Multipurpose Phantom for Delivery Quality Assurance of Intensity-modulated Radiation Therapy

Treatments demanding high accuracy, such as intensity-modulated radiation therapy (IMRT), should provide the optimal dose distribution and correct intervention. Otherwise, they may become unsafe and cause adverse effects to patients. Delivery quality assurance (DQA) for treatment verification can be performed considering the absolute dose using an ionization chamber and relative dose using a film. However, a film imposes a long waiting time for measurement and is sensitive to temperature and humidity, development conditions, and noise. We aim to evaluate the usefulness of a multipurpose phantom for fast and simple IMRT DQA. The multipurpose phantom is made of poly (methyl methacrylate)-based resin. The phantom allows the insertion of a 2D array detector and an ionization chamber. Therefore, the relative and absolute doses can be measured simultaneously. The IMRT DQA evaluation provided absolute dose of 0.35 ± 1.74% and relative dose of 99.03 ± 0.6 % in 3 mm/3% gamma evaluation for a linear accelerator. In addition, the absolute and relative doses were 1.37 ± 1.05% and 98.7 ± 0.78% in helical tomotherapy, respectively. Therefore, the dose measurements were within acceptable error limits of 3%. The results demonstrate the multipurpose capabilities of the proposed phantom for evaluating dose distribution and absolute dosimetry.

Understanding entrance-air-kerma as a quality-control metric for dual-energy x-ray absorptiometry.

PurposeThe low exposures, unique x‐ray beam geometry, and scanning design in dual‐energy x‐ray absorptiometry (DXA) make measurement and quality‐control strategies different from traditional x‐ray equipment. This study examines the dependence of measured entrance‐air‐kerma (EAK) on both dose sensor type and scan length. The feasibility of using EAK to compare scanner output between different scan modes, individual scanners, and scanner platforms was also established. Finally, the congruence between measured and vendor‐reported EAK was analyzed.MethodsFour Hologic DXA scanners at two institutions and all four available scan modes were tested. EAK was measured directly by three types of Radcal dose sensors: 60‐cc pancake ion‐chamber (IC), 180‐cc pancake IC, and solid‐state detector. The coefficient of variation (COV) was used to assess the dependence of EAK on scan length. Variations in EAK between the types of dose sensors as well as measured versus vendor‐reported values were evaluated using Bland–Altman analysis: mean ±95% prediction interval (PI): 1.96σ.ResultsDose sensor variations in EAK were minimal, with a −3.5 ± 3.5% (mean ±95% PI) percent difference between the two sizes of IC's. The solid‐state detector produced highly similar measurements to the 180‐cc IC. These small differences were consistent across all scanners and all scan modes tested. Neither measured nor vendor‐reported EAK values were found to show relevant dependence on scan length, with all COV values ≤4%. Differences between measured and reported EAK were higher at −6 ± 48%. Likely errors in vendor‐reported EAK calculations were also identified.ConclusionIt is feasible to quantify DXA scanner stability using EAK as a quality‐control metric with a variety of solid‐state and IC dose sensors, and the scan length used is not critical. Although vendor‐reported EAK was consistent among scanners of the same platform, measured EAK varied significantly from scanner to scanner. As a result, measured and reported EAK may not always be comparable.

The fast calibration model for dosimetry with an electronic portal imaging device.

The aim of this study was to develop an algorithm that corrects the image of an electronic portal imaging device (EPID) of a linear accelerator so that it can be used for dosimetric purposes, such as in vivo dosimetry or quality assurance for photon radiotherapy. For that purpose, the impact of the field size, phantom thickness, and the varying spectral photon distribution within the irradiation field on the EPID image was investigated. The EPID measurements were verified using reference measurements with ionization chambers. Therefore, absolute dose measurements with an ionization chamber and relative dose measurements with a detector array were performed. An EPID calibration and correction algorithm was developed to convert the EPID image to a dose distribution. The algorithm was validated by irradiating inhomogeneous phantoms using square fields as well as irregular IMRT fields. It was possible to correct the influence of the field size, phantom thickness on the EPID signal as well as the homogenization of the image profile by several correction factors within 0.6%. A gamma index analysis (3%, 3mm) of IMRT fields showed a pass rate of above 99%, when comparing to the planning system. The developed algorithm enables an online dose measurement with the EPID during the radiation treatment. The algorithm is characterized by a robust, non-iterative, and thus real-time capable procedure with little measuring effort and does not depend on system-specific parameters. The EPID image is corrected by multiplying three independent correction factors. Therefore, it can easily be extent by further correction factors for other influencing variables, so it can be transferred to other linear accelerators and EPID configurations.

P08 - Study of ion chamber dose calibration in kV-CBCT-based IGRT using different protocols

P08 - Study of ion chamber dose calibration in kV-CBCT-based IGRT using different protocols

Evaluation of radiophotoluminescent glass dosimeter response for therapeutic spot scanning proton beam: suggestion of linear energy transfer-based correction.

A radiophotoluminescent glass dosimeter (RGD) is used for a postal audit of a photon beam because of its various excellent characteristics. However, it has not been used for scanning proton beams because its response characteristics have not been verified. In this study, the response of RGD to scanning protons was investigated to develop a dosimetry protocol using the linear energy transfer (LET)‐based correction factor. The responses of RGD to four maximum‐range‐energy‐pattern proton beams were verified by comparing it with ionization chamber (IC) dosimetry. The LET at each measurement depth was calculated via Monte Carlo (MC) simulation. The LET correction factor (kLETRGD) was the ratio between the uncorrected RGD dose (DrawRGD) and the IC dose at each measurement depth. kLETRGD can be represented as a function of LET using the following equation: kLETRGDLET=‐0.035LET+1.090. DrawRGD showed a linear under‐response with increasing LET, and the maximum dose difference between the IC dose and DrawRGD was 15.2% at an LET of 6.07 keV/μm. The LET‐based correction dose (DLETRGD) conformed within 3.6% of the IC dose. The mean dose difference (±SD) of DrawRGD and DLETRGD was –2.5 ± 6.9% and 0.0 ± 1.6%, respectively. To achieve accurate dose verification for scanning proton beams using RGD, we derived a linear regression equation based on LET. The results show that with appropriate LET correction, RGD can be used for dose verification of scanning proton beams.

Dosimetric response of a glass dosimeter in proton beams: LET-dependence and correction factor.

A radiophotoluminescent glass dosimeter (RGD) is widely used in postal audit system for photon beams in Japan. However, proton dosimetry in RGDs is scarcely used owing to a lack of clarity in their response to beam quality. In this study, we investigated RGD response to beam quality for establishing a suitable linear energy transfer (LET)-corrected dosimetry protocol in a therapeutic proton beam. The RGD response was compared with ionization chamber measurement for a 100-225MeV passive proton beam. LET of the measurement points was calculated by the Monte Carlo method. An LET-correction factor, defined as a ratio between the non-corrected RGD dose and ionization chamber dose, of 1.226×(LET)-0.171 was derived for the RGD response. The magnitude of the LET-dependence of RGD increased with LET; for an LET of 8.2keV/μm, the RGD under-response was up to 16%. The coefficient of determination, mean difference±SD of non-corrected RGD dose, residual range-corrected RGD dose, and LET-corrected RGD dose to the ionization chamber are 0.923, 3.7±4.2%, -2.4±7.5%, and 0.04±2.1%, respectively. The LET-corrected RGD dose was within 5% of the corresponding ionization chamber dose at all energies until 200MeV, where it was 5.3% lower than the ionization chamber dose. A corrected LET-dependence of RGD using a correction factor based on a power function of LET and precise dosimetric verification close to the maximum LET were realized here. We further confirmed establishment of an accurate postal audit under various irradiation conditions.

Use of Receiver Operating Curve Analysis and Machine Learning With an Independent Dose Calculation System Reduces the Number of Physical Dose Measurements Required for Patient-Specific Quality Assurance

Our purpose was to assess the use of machine learning methods and Mobius 3D (M3D) dose calculation software to reduce the number of physical ion chamber (IC) dose measurements required for patient-specific quality assurance during corona virus disease2019. In this study, 1464 inversely planned treatments using Pinnacle or Raystation treatment planning software (TPS) were delivered using Elekta Versa HD and Varian Truebeam and Truebeam STx linear accelerators between June 2018 and November 2019. For each plan, an independent dose calculation was performed using M3D, and an absolute dose measurement was taken using a Pinpoint IC inside the Mobius phantom. The point dose differences between the TPS and M3D calculation and between TPS and IC measurements were calculated. Agreement between the TPS and IC was used to define the ground truth plan failure. To reduce the on-site personnel during the pandemic, 2 methods of receiver operating characteristic analysis (n = 1464) and machine learning (n = 603) were used to identify patient plans that would require physical dose measurements. In the receiver operating characteristic analysis, a predelivery M3D difference threshold of 3% identified plans that failed an IC measurement at a 4% threshold with 100% sensitivity and 76.3% specificity. This indicates that fewer than 25% of plans required a physical dose measurement. A threshold of 1% on a machine learning model was able to identify plans that failed an IC measurement at a 3% threshold with 100% sensitivity and 54.3% specificity, leading to fewer than 50% of plans that required a physical dose measurement. It is possible to identify plans that are more likely to fail IC patient-specific quality assurance measurements before delivery. This possibly allows for a reduction of physical measurements taken, freeing up significant clinical resources and reducing the required amount of on-site personnel while maintaining patient safety.

Analysis of corrected Cerenkov emission during electron radiotherapy by Monte Carlo method

Cerenkov emission during electron radiotherapy had been emerging as a new dose assessment approach for clinical radiotherapy and could be imaged through a standard commercial camera. The purpose of this work aimed to study the accuracy of corrected Cerenkov emission method during electron radiotherapy by Monte Carlo (MC) method. GAMOS MC software was used to model the physics of electron therapy and calculated dose and Cerenkov photon distribution in water phantom. Compared to ionization chamber and diode measurement, MC simulated dose discrepancy was less than 1% in percentage depth dose (PDD) curves and less than.2% in crossline profile curves, which was acceptable for clinical criterion. Compared to ionization chamber dose measurement, MC simulated Cerenkov discrepancy was less than 2% in crossline profile distribution, which was acceptable for clinical criterion. However, the Cerenkov PDD curves tended to overestimate the dose at the build-up region and underestimate the dose at the remaining attenuation region. After increasing the Cerenkov distribution depth to 2–3 mm, the discrepancy became well within 1% at the remaining attenuation region, which was acceptable for clinical criterion. Therefore, corrected Cerenkov emission could be used to assess PDD accuracy and crossline profile accuracy during electron radiotherapy.

Technical Note: Comparison of the internal target volume (ITV) contours and dose calculations on 4DCT, average CBCT, and 4DCBCT imaging for lung stereotactic body radiation therapy (SBRT).

PurposeTo investigate the differences between internal target volumes (ITVs) contoured on the simulation 4DCT and daily 4DCBCT images for lung cancer patients treated with stereotactic body radiotherapy (SBRT) and determine the dose delivered on 4D planning technique.MethodsFor nine patients, 4DCBCTs were acquired before each fraction to assess tumor motion. An ITV was contoured on each phase of the 4DCBCT and a union of the 10 ITVs was used to create a composite ITV. Another ITV was drawn on the average 3DCBCT (avgCBCT) to compare with current clinical practice. The Dice coefficient, Hausdorff distance, and center of mass (COM) were averaged over four fractions to compare the ITVs contoured on the 4DCT, avgCBCT, and 4DCBCT for each patient. Planning was done on the average CT, and using the online registration, plans were calculated on each phase of the 4DCBCT and on the avgCBCT. Plan dose calculations were tested by measuring ion chamber dose in the CIRS lung phantom.ResultsThe Dice coefficients were similar for all three comparisons: avgCBCT‐to‐4DCBCT (0.7 ± 0.1), 4DCT‐to‐avgCBCT (0.7 ± 0.1), and 4DCT‐to‐4DCBCT (0.7 ± 0.1); while the mean COM differences were also comparable (2.6 ± 2.2mm, 2.3 ± 1.4mm, and 3.1 ± 1.1mm, respectively). The Hausdorff distances for the comparisons with 4DCBCT (8.2 ± 2.9mm and 8.1 ± 3.2mm) were larger than the comparison without (6.5 ± 2.5mm). The differences in ITV D95% between the treatment plan and avgCBCT calculations were 4.3 ± 3.0% and −0.5 ± 4.6%, between treatment plan and 4DCBCT plans, respectively, while the ITV V100% coverages were 99.0 ± 1.9% and 93.1 ± 8.0% for avgCBCT and 4DCBCT, respectively.ConclusionThere is great potential for 4DCBCT to evaluate the extent of tumor motion before treatment, but image quality challenges the clinician to consistently delineate lung target volumes.

Experimental measurement of ionization chamber angular response and associated magnetic field correction factors in MR-linac.

To measure ionization chamber dose response as a function of the angle between magnetic field direction and ionization chamber orientation in magnetic resonance-guided radiation therapy (MRgRT) system, and to evaluate angular dependence of magnetic field correction factor for reference dosimetry. Measurements were performed on an Elekta MR-linac that integrates a 1.5-T Philips MRI and a 7-MV FFF photon beam accelerator. The response of four reference class chambers (Exradin-A19, A1SL, IBA FC65-G, and CC13, paired with a PTW UE electrometer) was studied. An in-house built MR-compatible water tank and an accompanying cylindrical insert that allowed chamber rotation around the cylinder's axis was used. The EPID onboard imaging was used to center chamber at the MR-linac isocenter (143.5cm, SAD), as well as to verify position at each datapoint. A clear angular dependence of dose response for all chambers has been measured. The most significant effect of magnetic field on relative chamber response in the presence of magnetic field was observed in the orientation when chamber axis is perpendicular to the direction of magnetic field with the tip pointing in the same direction as Lorentz force. This effect is more pronounced for larger volume chambers; the maximum relative variation in the chamber response (between the setup described above and the one where chamber and magnetic field are parallel) is a 5.3% and 4.6% increase for A19 and FC65-G, respectively, and only 2.0% and 1.9% for smaller volume A1SL and CC13 chamber, respectively. We measured the absolute magnitude of the magnetic field correction factor for the Exradin-A19, A1SL, IBA FC65-G, and CC13 to be 0.938±1.13%, 0.968±0.99%, 0.950±1.13%, and 0.975±1.13%, respectively. The values are for perpendicular orientation of the chamber relative to magnetic field and parallel to the Lorentz force. Experimental measurements carried out in this study have verified the optimal orientation of ionization chamber in terms of minimizing effect of magnetic field on the chamber dose response. This study provides a detailed high-resolution measurement of absolute values for four reference class chambers as a function of the angle between ionization chamber's central axis and the direction of strong magnetic field over a full 360° rotation. The experimental results of this study can further be used for optimization of the actual sensitive volume of the chamber (and analysis of dead volume) in future Monte Carlo chamber simulations in the presence of strong magnetic fields. In addition, it will provide some necessary data for future reference dosimetry protocols for MR-linac.

Assessment of uncertainties associated with Monte Carlo-based personalized dosimetry in clinical CT examinations

The clinical value of x-ray computed tomography (CT) has skyrocketed in the last decade while at the same time being the main source of medical exposure to the population. Concerns regarding the potential health hazards associated with the use of ionizing radiation were raised and an appropriate estimation of absorbed dose to patients is highly desired. In this work, we aim to validate our developed Monte Carlo CT simulator using in-phantom dose measurements and further assess the impact of personalized scan-related parameters on dosimetric calculations. We developed a Monte Carlo-based CT simulator for personalized organ level dose calculations, in which the CT source model, patient-specific computational model and personalized scanning protocol were integrated. The CT simulator was benchmarked using an ionization chamber and standard CT Dose Index phantom while the dosimetry methodology was validated through experimental measurements using thermoluminescent dosimeters (TLDs) embedded within an anthropomorphic phantom. Patient-specific scan protocols extracted from CT raw data and DICOM image metadata, respectively, were fed as input into the CT simulator to calculate individualized dose profiles. Thereby, the dosimetric uncertainties associated with using different protocol-related parameters were investigated. The absolute absorbed dose difference between measurements and simulations using the ionization chamber was less than 3%. In the case of the anthropomorphic phantom, the absolute absorbed dose difference between simulations and TLD measurements ranged from −8.3% to 22%, with a mean absolute difference of 14% while the uncertainties of protocol-related input parameters introduced an extra absolute error of 15% to the simulated results compared with TLD measurements. The developed methodology can be employed for accurate estimation of organ level dose from clinical CT examinations. The validated methodology can be further developed to produce an accurate MC simulation model with a reduced computational burden.

Radiotherapy Quality Assurance for the CHHiP Trial: Conventional Versus Hypofractionated High-Dose Intensity-Modulated Radiotherapy in Prostate Cancer

AimsThe CHHiP trial investigated the use of moderate hypofractionation for the treatment of localised prostate cancer using intensity-modulated radiotherapy (IMRT). A radiotherapy quality assurance programme was developed to assess compliance with treatment protocol and to audit treatment planning and dosimetry of IMRT. This paper considers the outcome and effectiveness of the programme. Materials and methodsQuality assurance exercises included a pre-trial process document and planning benchmark cases, prospective case reviews and a dosimetry site visit on-trial and a post-trial feedback questionnaire. ResultsIn total, 41 centres completed the quality assurance programme (37 UK, four international) between 2005 and 2010. Centres used either forward-planned (field-in-field single phase) or inverse-planned IMRT (25 versus 17). For pre-trial quality assurance exercises, 7/41 (17%) centres had minor deviations in their radiotherapy processes; 45/82 (55%) benchmark plans had minor variations and 17/82 (21%) had major variations. One hundred prospective case reviews were completed for 38 centres. Seventy-one per cent required changes to clinical outlining pre-treatment (primarily prostate apex and base, seminal vesicles and penile bulb). Errors in treatment planning were reduced relative to pre-trial quality assurance results (49% minor and 6% major variations). Dosimetry audits were conducted for 32 centres. Ion chamber dose point measurements were within ±2.5% in the planning target volume and ±8% in the rectum. 28/36 films for combined fields passed gamma criterion 3%/3 mm and 11/15 of IMRT fluence film sets passed gamma criterion 4%/4 mm using a 98% tolerance. Post-trial feedback showed that trial participation was beneficial in evolving clinical practice and that the quality assurance programme helped some centres to implement and audit prostate IMRT. ConclusionOverall, quality assurance results were satisfactory and the CHHiP quality assurance programme contributed to the success of the trial by auditing radiotherapy treatment planning and protocol compliance. Quality assurance supported the introduction of IMRT in UK centres, giving additional confidence and external review of IMRT where it was a newly adopted technique.

An Efficiency Studying of an Ion Chamber Simulation Using Vriance Reduction Techniques with EGSnrc.

Background:Radiotherapy is an important technique of cancer treatment using ionizing radiation. The determination of total dose in reference conditions is an important contribution to uncertainty that could achieve 2%. The source of this uncertainty comes from cavity theory that relates the in-air cavity dose and the dose to water. These correction factors are determined from Monte Carlo calculations of ionization chambers. The main problem of this type of calculation is the extremely long computation time to achieve reasonable statistics. Objective:The main purpose of this work is to present a combination with variance reduction techniques for the case of an ionization chamber in water. Methods:The egs_chamber code allows for very efficient computation of ionization chamber doses and dose ratios by using various variance reduction techniques, and also permits realistic simulations of the experimental setup due to the use of EGSnrc C++ library. Russian roulette and Photon Cross Section Enhancement were used with egs_chamber code. Tests were performed to obtain the parameters of variance reduction techniques resulting in a maximum efficiency. Results:It can be seen that the parameters which result in improved Monte Carlo calculation of the efficiency values are XCSE 64 and Russian Roulette (RR) 128. Conclusion:This study determines the parameters of variance reduction techniques that result in an optimal computational efficiency.

An Efficiency Studying of an Ion Chamber Simulation Using Vriance Reduction Techniques with EGSnrc

Background: Radiotherapy is an important technique of cancer treatment using ionizing radiation. The determination of total dose in reference conditions is an important contribution to uncertainty that could achieve 2%. The source of this uncertainty comes from cavity theory that relates the in-air cavity dose and the dose to water. These correction factors are determined from Monte Carlo calculations of ionization chambers. The main problem of this type of calculation is the extremely long computation time to achieve reasonable statistics.Objective: The main purpose of this work is to present a combination with variance reduction techniques for the case of an ionization chamber in water.Methods: The egs_chamber code allows for very efficient computation of ionization chamber doses and dose ratios by using various variance reduction techniques, and also permits realistic simulations of the experimental setup due to the use of EGSnrc C++ library. Russian roulette and Photon Cross Section Enhancement were used with egs_chamber code. Tests were performed to obtain the parameters of variance reduction techniques resulting in a maximum efficiency.Results: It can be seen that the parameters which result in improved Monte Carlo calculation of the efficiency values are XCSE 64 and Russian Roulette (RR) 128.Conclusion: This study determines the parameters of variance reduction techniques that result in an optimal computational efficiency.

Technical Note: Sensitive volume effects on ion chamber responses in longitudinal magnetic fields.

It has been shown that ion chamber dose response Monte Carlo simulations, in transverse magnetic fields, are susceptible to small changes in the scored sensitive volume. Changes in sensitive volumes have been investigated as a surrogate for modeling the true collection volume governed by the electric field. This work has not been fully extended to longitudinal fields. This study investigates the effect of the sensitive volume of ion chambers on magnetic field dose response within longitudinal magnetic fields. The egs_chamber application within EGSnrc was used to model the Exradin A19, A28, and A1SL ion chambers within a uniform longitudinal magnetic field. The sensitive volume of the ion chambers was varied by removing portions of the air volume (from 0.2 to 3mm) closest to the chamber stem from the dose scoring region; the dose to the scoring volume as a function of magnetic fields strength was normalized to 0T in all cases. With the chamber long axis oriented parallel to the radiation and magnetic fields, for every magnetic field strength, all investigated chambers' dose response remained inside statistical variations for all investigated chamber sensitive volumes. When the chamber long axis is oriented perpendicular to the radiation and magnetic fields, the A28 and A1SL show negligible sensitive volume effects, while the A19 under responded by 0.5% for the largest removed volume of 3mm. When the ion chambers' long axis is parallel to the radiation and magnetic fields, the magnetic field dose response is unaffected by small changes in sensitive volume. When oriented perpendicularly, only the A19 exhibits sensitive volume based magnetic field dose response changes, and only with≥1mm of assumed insensitive volume. We can therefore safely assume complete charge collection in Monte Carlo calculated correction factors involving similar chambers in similar conditions.

Calibration strategies for use of the nanoDot OSLD in CT applications.

Aluminum oxide based optically stimulated luminescent dosimeters (OSLD) have been recognized as a useful dosimeter for measuring CT dose, particularly for patient dose measurements. Despite the increasing use of this dosimeter, appropriate dosimeter calibration techniques have not been established in the literature; while the manufacturer offers a calibration procedure, it is known to have relatively large uncertainties. The purpose of this work was to evaluate two clinical approaches for calibrating these dosimeters for CT applications, and to determine the uncertainty associated with measurements using these techniques. Three unique calibration procedures were used to calculate dose for a range of CT conditions using a commercially available OSLD and reader. The three calibration procedures included calibration (a) using the vendor‐provided method, (b) relative to a 120 kVp CT spectrum in air, and (c) relative to a megavoltage beam (implemented with 60Co). The dose measured using each of these approaches was compared to dose measured using a calibrated farmer‐type ion chamber. Finally, the uncertainty in the dose measured using each approach was determined. For the CT and megavoltage calibration methods, the dose measured using the OSLD nanoDot was within 5% of the dose measured using an ion chamber for a wide range of different CT scan parameters (80–140 kVp, and with measurements at a range of positions). When calibrated using the vendor‐recommended protocol, the OSLD measured doses were on average 15.5% lower than ion chamber doses. Two clinical calibration techniques have been evaluated and are presented in this work as alternatives to the vendor‐provided calibration approach. These techniques provide high precision for OSLD‐based measurements in a CT environment.

Exradin W1 plastic scintillation detector for in vivo skin dosimetry in passive scattering proton therapy

In vivo skin dosimetry is desirable in passive scattering proton therapy because of the possibility of high entrance dose with a small number of fields. However, suitable detectors are needed to determine skin dose in proton therapy. Plastic scintillation detectors (PSDs) are particularly well suited for applications in proton therapy because of their water equivalence, small size, and ease of use. We investigated the utility of the Exradin W1, a commercially available PSD, for in vivo skin dosimetry during passive scattering proton therapy. We evaluated the accuracy of the Exradin W1 in six patients undergoing proton therapy for prostate cancer, as part of an Institutional Review Board-approved protocol. Over 22 weeks, we compared in vivo PSD measurements with in-phantom ionization chamber measurements and doses from the treatment planning system, resulting in 96 in vivo measurements. Temperature and ionization quenching correction factors were applied on the basis of the dose response of the PSD in a phantom. The calibrated PSD exhibited an average 7.8% under-response (±1% standard deviation) owing to ionization quenching. We observed 4% under-response at 37 °C relative to the calibration-temperature response. After temperature and quenching corrections were applied, the overall PSD dose response was within ±1% of the expected dose for all patients. The dose differences between the PSD and ionization chamber measurements for all treatment fields were within ±2% (standard deviation 0.67%). The PSD was highly accurate for in vivo skin dosimetry in passively scattered proton beams and could be useful in verifying proton therapy delivery.

Patient-Specific Quality Assurance Using Monte Carlo Dose Calculation and Elekta Log Files for Prostate Volumetric-Modulated Arc Therapy.

Log file–based methods are attracting increasing interest owing to their ability to validate volumetric-modulated arc therapy outputs with high resolution in the leaf and gantry positions and in delivered dose. Cross-validation of these methods for comparison with measurement-based methods using the ionization chamber/ArcCHECK-3DVH software (version 3.2.0) under the same conditions of treatment anatomy and plan enables an efficient evaluation of this method. In this study, with the purpose of cross-validation, we evaluate the accuracy of a log file–based method using Elekta log files and an X-ray voxel Monte Carlo dose calculation technique in the case of leaf misalignment during prostate volumetric-modulated arc therapy. In this study, 10 prostate volumetric-modulated arc therapy plans were used. Systematic multileaf collimator leaf positional errors (±0.4 and ±0.8 mm for each single bank) were deliberately introduced into the optimized plans. Then, the delivered 3-dimensional doses to a phantom with a certain patient anatomy were estimated by our system. These doses were compared with the ionization chamber dose and the ArcCHECK-3DVH dose. For the given phantom and patient anatomy, the estimated dose strongly coincided with the ionization chamber/ArcCHECK-3DVH dose (P < .01). In addition, good agreement between the estimated dose and the ionization chamber/ArcCHECK-3DVH dose was observed. The dose estimation accuracy of our system, which combines Elekta log files and X-ray voxel Monte Carlo dose calculation, was evaluated.