Kilovoltage X-ray Beams Research Articles

Dose and energy dependence of response of Gafchromic® XR-QA film for kilovoltage x-ray beams

There is a growing interest in Gafchromic® films for patient dosimetry in radiotherapy and in radiology. A new model (XR-QA) with high sensitivity to low dose was tested in this study. The response of the film to different x-ray beam energies (range 28–145 kVp with various filtrations, dose range 0–100 mGy) and to visible light was investigated, together with the after exposure darkening properties. Exposed films were digitized with a commercially available, optical flatbed scanner. A single functional form for dose versus net pixel value variation has been determined for all the obtained calibration curves, with a unique fit parameter different for each of the used x-ray beams. The film response was dependent on beam energy, with higher colour variations for the beams in the range 80–140 kVp. Different sources of uncertainties in dose measurements, governed by the digitalization process, the film response uniformity and the calibration curve fit procedure, have been considered. The overall one-sigma dose measurement uncertainty depended on the beam energy and decreased with increasing absorbed dose. For doses above 10 mGy and beam energies in the range 80–140 kVp the total uncertainty was less than 5%, whereas for the 28 kVp beam the total uncertainty at 10 mGy was about 10%. The post-exposure colour variation was not negligible in the first 24 h after the exposure, with a consequent increase in the calculated dose of about 10%. Results of the analysis of the sensitivity to visible light indicated that a short exposure of this film to ambient and scanner light during the measurements will not have a significant impact on the radiation dosimetry.

A dosimetric evaluation of water equivalent phantoms for kilovoltage x-ray beams

Solid phantoms are widely used in radiation therapy for both relative and reference dosimetry. Two water equivalent phantoms, RMI-457 Solid Water and Plastic Water, were evaluated for use in kilovoltage x-ray dosimetry in the energy range from 75 to 300 kVp. Relative and reference dosimetry measurements were performed in the solid phantoms and compared with water. The results indicate that RMI-457 Solid Water could be used for output factor determination for all energies tested and the measurement of percentage depth doses for the 300 kVp x-ray beam, with data agreeing to within 1%, compared to the same measurements in water. For the same criteria, Plastic Water could only be used for output factor determination of the 300 kVp x-ray beam. The superior agreement of the calculated mass–energy absorption coefficients for Solid Water and water, as compared to Plastic Water and water was consistent with the experimental results. Reference dosimetry is not recommended with the solid phantoms for the energies studied due to the lack of published correction factors. It is recommended that any solid phantom be tested by comparison with water in the same manner before being used for the dosimetry of kilovoltage x-ray beams.

Energy response of an aluminium oxide detector in kilovoltage and megavoltage photon beams: an EGSnrc Monte Carlo simulation study

A Monte Carlo study of the energy response of an aluminium oxide (Al(2)O(3)) detector in kilovoltage and megavoltage photon beams relative to (60)Co gamma rays has been performed using EGSnrc Monte Carlo simulations. The sensitive volume of the Al(2)O(3) detector was simulated as a disc of diameter 2.85 mm and thickness 1 mm. The phantom material was water and the irradiation depth chosen was 2.0 cm in kilovoltage photon beams and 5.0 cm in megavoltage photon beams. The results show that the energy response of the Al(2)O(3) detector is constant within 3% for photon beam energies in the energy range of (60)Co gamma rays to 25 MV X rays. However, the Al(2)O(3) detector shows an enhanced energy response for kilovoltage photon beams, which in the case of 50 kV X rays is 3.2 times higher than that for (60)Co gamma rays. There is essentially no difference in the energy responses of LiF and Al(2)O(3) detectors irradiated in megavoltage photon beams when these Al(2)O(3) results are compared with literature data for LiF thermoluminescence detectors. However, the Al(2)O(3) detector has a much higher enhanced response compared with LiF detectors in kilovoltage X-ray beams, more than twice as much for the case of 50 kV X rays.

Clinical implementation of AAPM TG61 protocol for kilovoltage x-ray beam dosimetry.

Historically, there have been a variety of dosimetry protocols used for kilovoltage x-ray therapy beams with a set of conversion factors and correction factors taken from different references. Corresponding to the continued installation and use of kilovoltage machines, the American Association of Physicists in Medicine (AAPM) presented a unified protocol developed by Task Group 61 (TG61). TG61 determines the absorbed dose to water with an ionization chamber calibrated in air in terms of air kerma (Nk). TG61 presents both an in-air method and an in-phantom method. In this work we only examine the TG61 in-air method. Our traditional dosimetry procedure, which is based upon NCRP Report 69 and on material found in standard medical physics texts, has been compared to the TG61. A variety of kilovoltage beam energies were examined with a set of various field sizes and source to surface distances. TG61 published updated data for the mass absorption coefficient ratios, backscatter factors, and the average energy per ion pair factor. The following conclusions have been reached: (1) Our traditional procedures and the TG61 protocol for in-air measurements are equivalent. (2) The conversion and correction factors used in TG61 are different by up to 4.5% compared to the old factors that we have used. (3) The application of the TG61 factors can result in up to 5% differences in the determination of the absorbed dose.

A performance comparison of flat-panel imager-based MV and kV cone-beam CT.

The use of cone-beam computed tomography (CBCT) has been proposed for guiding the delivery of radiation therapy, and investigators have examined the use of both kilovoltage (kV) and megavoltage (MV) x-ray beams in the development of such CBCT systems. In this paper, the inherent contrast and signal-to-noise ratio (SNR) performance for a variety of existing and hypothetical detectors for CBCT are investigated analytically as a function of imaging dose and object size. Theoretical predictions are compared to the results of experimental investigations employing largearea flat-panel imagers (FPIs) at kV and MV energies. Measurements were performed on two different FPI-based CBCT systems: a bench-top prototype incorporating an FPI and kV x-ray source (100 kVp x rays), and a system incorporating an FPI mounted on the gantry of a medical linear accelerator (6 MV x rays). The SNR in volume reconstructions was measured as a function of dose and found to agree reasonably with theoretical predictions. These results confirm the theoretically predicted advantages of employing kV energy x rays in imaging soft-tissue structures found in the human body. While MV CBCT may provide a valuable means of correcting 3D setup errors and may offer an advantage in terms of simplicity of mechanical integration with a linear accelerator (e.g., implementation in place of a portal imager), kV CBCT offers significant performance advantages in terms of image contrast and SNR per unit dose for visualization of soft-tissue structures. The relatively poor SNR performance at MV energies is primarily a result of the low x-ray quantum efficiencies (approximately a few percent or less) that are currently achieved with FPIs at high energies. Furthermore, kV CBCT with an FPI offers the potential of combined volumetric and radiographic/fluoroscopic imaging using the same device.

Gold microspheres: a selective technique for producing biologically effective dose enhancement

Purpose : To investigate dose enhancement and radiosensitization associated with electrons produced and scattered from gold particles suspended in cells in vitro and with tumour cells growing in vivo irradiated with low-energy photons. Materials and methods : CHO-K1, EMT-6 and DU-145 cells were irradiated with kilovoltage X-ray and Cs-137 beams in slowly stirred suspensions in the presence of various concentrations of gold particles (1.5-3.0 μ m); cell survival was measured by clonogenic assay. Gold particles were injected directly into EMT-6 tumours growing in scid mice prior to their irradiation. Tumour cell killing was assayed by an in vivo-in vitro technique. Results : Dose enhancement was confirmed by both Fricke dosimetry and cell killing for 100, 140, 200 and 240kVp X-rays, but not for Cs-137 γ-rays. For the chemical dosimeter, a dose enhancement (DMF) of 1.42 was measured for 1% gold particle solutions irradiated with 200 kVp X-rays. When rodent and human cells were irradiated in the presence of 1% gold particles, DMF values at the 10% survival level ranged from 1.36 to 1.54, with an overall average value of 1.43. Preliminary attempts to deliver these gold particles to tumour cells in vivo by intra-tumour injection resulted in modest radiosensitization but extremely heterogeneous distribution. Conclusions : An increased biologically effective dose can be produced by gold microspheres suspended in cell culture or distributed in tumour tissue exposed to kilovoltage photon beams. With the increasing use of interstitial brachytherapy with isotopes that produce low-energy photons, high-Z particles might find a role for significantly improving the therapeutic ratio.

Comparison of kilovoltage x-ray and electron beam dose distributions for radiotherapy of the sternum

The dose distributions for a patient with cancer involving the sternum were calculated for both a kilovoltage x-ray beam and a megavoltage electron beam. The minimum target dose and dose uniformity over the target volume were significantly better using electrons (90%–101%) than kilovoltage x-rays (68%–119%). The calculated lung dose and integral patient dose were also less for electrons than kilovoltage x-rays. For treating cancers of the sternum with radical intent, megavoltage electrons are recommended as the treatment mode of choice rather than kilovoltage x-rays.

Mass-energy absorption coefficient and backscatter factor ratios for kilovoltage x-ray beams

For low-energy (up to 150 kV) x-rays, the ratio of mass-energy absorption coefficients for water to air, , and the backscatter factor B are used in the conversion of air kerma, measured free-in-air, to water kerma on the surface of a water phantom. For clinical radiotherapy, similar conversion factors are needed for the determination of the absorbed dose to biological tissues on (or near) the surface of a human body. We have computed the ratios and B factor ratios for different biological tissues including muscle, soft tissue, lung, skin and bone relative to water. The ratios were obtained by integrating the respective mass-energy absorption coefficients over the in-air primary photon spectra. We have also calculated the ratios at different depths in a water phantom in order to convert the measured in-phantom water kerma to the absorbed dose to various biological tissues. The EGS4/DOSIMETER Monte Carlo code system has been used for the simulation of the energy fluence at different depths in a water phantom irradiated by a kilovoltage x-ray beam of variable beam quality (HVL: 0.1 mm Al-5 mm Cu), field size and source-surface distance (SSD). The same code was also used in the calculation of the B factor ratios, soft tissue to water and bone to water. The results show that the B factor for bone differs from the B factor for water by up to 20% for a 100 kV beam (HVL: 2.65 mm Al) with a 100 field. On the other hand, the difference in the B factor between water and soft tissue is insignificant (well within 1% generally). This means that the B factors for water may be directly used to convert the `in-air' water kerma to surface kerma for human soft tissues.

A Monte Carlo study of the quality dependence factors of common TLD materials in photon and electron beams

A Monte Carlo simulation of the quality dependence of different TL materials, in the form of discs 3.61 mm in diameter and 0.9 mm thick, in radiotherapy photon beams relative to -rays has been performed. The beam qualities ranged from 50 kV to 25 MV x-rays. The TL materials were: , , LiF and . The effects of the dopants on energy deposition in the TL material have also been determined for the highly sensitive LiF:Mg:Cu:P (TLD-100H) and for :Mn. It was found that there was a significant difference in the quality dependence factor derived from Monte Carlo simulations between LiF and LiF:Mg:Cu:P but not between and :Mn. The quality dependence factors for varied from (1 sd) for 25 MV x-rays to (1 sd) for 50 kV x-rays relative to -rays; Monte Carlo simulations were also performed for in megavoltage electron beams. For , the quality dependence factor varied from (1 sd) for 25 MV x-rays to (1 sd) for 50 kV x-rays. The figure for ranged from (1 sd) for 25 MV x-rays to (1 sd) for 50 kV x-rays. The quality dependence factor for increases by up to 5% with depth and by up to 15% with field size for the kilovoltage x-ray beams. For LiF-TLD, however, there was no significant dependence on the field size or depth of irradiation in the kilovoltage energy range.

Measurement of percentage depth dose and lateral beam profile for kilovoltage x-ray therapy beams

In this work, nine commonly used dosimetry detectors have been investigated to determine suitable relative dosimeters for kilovoltage x-ray beams. By comparison with the Monte Carlo calculated data, it was determined that for the detectors studied the PTW N23342, Markus and NACP parallel-plate chambers are more suitable for the measurement of percentage depth dose (PDD) data for this beam quality range with an uncertainty of about 3%. A diode detector may be used to measure the PDD for the 100 kVp beam, but it is not suitable for higher energies (300 kVp). The Capintec parallel-plate chamber may be adequate for medium-energy photons, but it has a slightly higher uncertainty for low-energy x-rays (100 kVp). For the measurement of beam profiles, diode and film yield incorrect profile tails, which can be corrected using the RK ionization chamber.

Backscatter dose perturbation in kilovoltage photon beams at high atomic number interfaces.

Dose perturbations at tissue interfaces have been of significant concern since the beginning of this century. However, comprehensive studies related to the backscatter perturbation in kilovoltage beams are still limited. The dose perturbation depends on various parameters, including beam energy, field size, and the thickness, width, position, and atomic number, Z, of the inhomogeneity creating the interface with soft tissue. Using a thin window parallel plate ion chamber having relatively flat response at low energies, the dose perturbation was measured as backscatter dose perturbation factor, BSDF, at various interfaces in kilovoltage x-ray beams. The BSDF is defined as the ratio of doses with and without an interface for identical setup conditions. Results indicate that the BSDF is strongly dependent on beam energy, like the backscatter factor. Contrary to its behavior in megavoltage beams, BSDF in kilovoltage beams does depend on the field size, suggesting a contribution from scattered photons and fluorescent radiation, originating in the high-Z material. The thickness of the high-Z medium is not critical, since a fraction of a millimeter is sufficient to provide full backscatter. The interface effect with wide inhomogeneity has two distinct regions: the high dose region (BSDF > 1.0), which is very localized and disappears within a fraction of a millimeter, and the low dose region (BSDF < 1.0), which is observed up to 10 cm. The dependence of BSDF is neither a quadratic function of Z nor a cube root of beam energy, indicating that the interface effect is complex and not predominantly due to photoelectron transport.