Percentage Depth Dose Measurements Research Articles

Application of a novel diamond detector for commissioning of FLASH radiotherapy electron beams.

PurposeA diamond detector prototype was recently proposed by Marinelli et al. (Medical Physics 2022, https://doi.org/10.1002/mp.15473) for applications in ultrahigh‐dose‐per‐pulse (UH‐DPP) and ultrahigh‐dose‐rate (UH‐DR) beams, as used in FLASH radiotherapy (FLASH‐RT). In the present study, such so‐called flashDiamond (fD) was investigated from the dosimetric point of view, under pulsed electron beam irradiation. It was then used for the commissioning of an ElectronFlash linac (SIT S.p.A., Italy) both in conventional and UH‐DPP modalities.MethodsDetector calibration was performed in reference conditions, under 60Co and electron beam irradiation. Its response linearity was investigated in UH‐DPP conditions. For this purpose, the DPP was varied in the 1.2–11.9 Gy range, by changing either the beam applicator or the pulse duration from 1 to 4 μs. Dosimetric validation of the fD detector prototype was then performed in conventional modality, by measuring percentage depth dose (PDD) curves, beam profiles, and output factors (OFs). All such measurements were carried out in a motorized water phantom. The obtained results were compared with the ones from commercially available dosimeters, namely, a microDiamond, an Advanced Markus ionization chamber, a silicon diode detector, and EBT‐XD GAFchromic films. Finally, the fD detector was used to fully characterize the 7 and 9 MeV UH‐DPP electron beams delivered by the ElectronFlash linac. In particular, PDDs, beam profiles, and OFs were measured, for both energies and all the applicators, and compared with the ones from EBT‐XD films irradiated in the same experimental conditions.ResultsThe fD calibration coefficient resulted to be independent from the investigated beam qualities. The detector response was found to be linear in the whole investigated DPP range. A very good agreement was observed among PDDs, beam profiles, and OFs measured by the fD prototype and reference detectors, both in conventional and UH‐DPP irradiation modalities.ConclusionsThe fD detector prototype was validated from the dosimetric point of view against several commercial dosimeters in conventional beams. It was proved to be suitable in UH‐DPP and UH‐DR conditions, for which no other commercial real‐time active detector is available to date. It was shown to be a very useful tool to perform fast and reproducible beam characterizations in standard clinical motorized water phantom setups. All of the previously mentioned demonstrate the suitability of the proposed detector for the commissioning of UH‐DR linac beams for preclinical FLASH‐RT applications.

Efficient dose-rate correction of silicon diode relative dose measurements.

Silicon diodes are often the detector of choice for relative dose measurements, particularly in the context of radiotherapy involving small photon beams. However, a major drawback lies in their dose-rate dependency. Although ionization chambers are often too large for small field output factor (OF) measurements, they are valuable instruments to provide reliable percent-depth dose (PDD) curves in reference beams. The aim of this work is to propose a practical and accurate method for the characterization of silicon diode dose-rate dependence correction factors using ionization chamber measurements as a reference. The robustness of ionization chambers for PDD measurements is used to quantify the dose-rate dependency of a diode detector. A mathematical formalism, which exploits the error induced in percent-depth ionization (PDI) curves for diodes by their dose-rate dependency, is developed to derive a dose-rate correction factor applicable to diode relative measurements. The method is based on the definition of the recombination correction factor given in the addendum to TG 51 and is applied to experimental measurements performed on a CyberKnife M6 radiotherapy unit using a PTW 60012 diode detector. A measurement-based validation is provided by comparing corrected PDI curves to measurements performed with a PTW 60019 diamond detector, which does not exhibit dose-rate dependence. Results of dose-rate correction factors for PDI curves, off-axis ratios (OARs), tissue-phantom ratios, and small field OFs are coherent with the expected behavior of silicon diode detectors. For all considered setups and field sizes, the maximum correction and the maximum impact of the uncertainties induced by the correction are obtained for OARs for the 60 mm collimator, with a correction of 2.5% and an uncertainty of 0.34%. For OFs, corrections range from 0.33% to 0.82% for all field sizes considered, and increase with the reduction of the field size. Comparison of PDI curves corrected for dose-rate and for in-depth beam quality variations illustrates excellent agreement with measurements performed using the diamond detector. The proposed method allows the efficient and precise correction of the dose-rate dependence of silicon diode detectors in the context of clinical relative dosimetry.

Measurement of linear accelerator spectra, reconstructed from percentage depth dose curves by neural networks

Purpose Linear accelerator (linac) spectra, used to improve the accuracy of dose calculation and to produce a complete description of beam quality, among other aspects, are relevant in radiotherapy and linear accelerator physics.Methods In this work we apply neural networks in solving an ill-conditioned system of linear equations, to indirectly measure the linear accelerator spectra via the percentage depth dose curves. The photon beam spectra are related to radiation doses through a Fredholm integral equation. To address our problem we measured the percentage depth dose curve in water and solved a discretized Fredholm equation using artificial neural network. After analysing the typology of our physical problem we selected a MultiLayer Perceptron Neural Network and designed the most suitable neural network architecture.Results The reconstructed spectra were compared with spectra from three linacs, two of them obtained by us through simulations and the third produced by another author, achieving a concordance between 92 % and 96 %.Conclusions Therefore, the spectrum of any accelerator can be quickly and easily reconstructed from measured percent depth dose curves, applying a trained artificial neural network.

Design, realization, and characterization of a novel diamond detector prototype for FLASH radiotherapy dosimetry.

PurposeFLASH radiotherapy (RT) is an emerging technique in which beams with ultra‐high dose rates (UH‐DR) and dose per pulse (UH‐DPP) are used. Commercially available active real‐time dosimeters have been shown to be unsuitable in such conditions, due to severe response nonlinearities. In the present study, a novel diamond‐based Schottky diode detector was specifically designed and realized to match the stringent requirements of FLASH‐RT.MethodsA systematic investigation of the main features affecting the diamond response in UH‐DPP conditions was carried out. Several diamond Schottky diode detector prototypes with different layouts were produced at Rome Tor Vergata University in cooperation with PTW‐Freiburg. Such devices were tested under electron UH‐DPP beams. The linearity of the prototypes was investigated up to DPPs of about 26 Gy/pulse and dose rates of approximately 1 kGy/s. In addition, percentage depth dose (PDD) measurements were performed in different irradiation conditions. Radiochromic films were used for reference dosimetry.ResultsThe response linearity of the diamond prototypes was shown to be strongly affected by the size of their active volume as well as by their series resistance. By properly tuning the design layout, the detector response was found to be linear up to at least 20 Gy/pulse, well into the UH‐DPP range conditions. PDD measurements were performed by three different linac applicators, characterized by DPP values at the point of maximum dose of 3.5, 17.2, and 20.6 Gy/pulse, respectively. The very good superimposition of three curves confirmed the diamond response linearity. It is worth mentioning that UH‐DPP irradiation conditions may lead to instantaneous detector currents as high as several mA, thus possibly exceeding the electrometer specifications. This issue was properly addressed in the case of the PTW UNIDOS electrometers.ConclusionsThe results of the present study clearly demonstrate the feasibility of a diamond detector for FLASH‐RT applications.

A Large Area Pixelated Silicon Array Detector for Independent Transit In Vivo Dosimetry

A large area pixelated silicon array detector named “MP987” has been developed for in vivo dosimetry. The detector was developed to overcome the non-water equivalent response of EPID (Electronic Portal Imaging Device) dosimetry systems, due to the shortfalls of the extensive corrections required. The detector, readout system and software have all been custom designed to be operated independently from the linac with the array secured directly above the EPID, to be used in combination with the 6 MV imaging system. Dosimetry characterisation measurements of percentage depth dose (PDD), dose rate dependence, radiation damage, output factors (OF), profile measurements, linearity and uniformity were performed. Additionally, the first pre-clinical tests with this novel detector of a transit dosimetry characterization and a collapsed IMRT (intensity-modulated radiation therapy) study are presented. Both PDD and OF measurements had a percentage difference of less than 2.5% to the reference detector. A maximum change in sensitivity of 4.3 ± 0.3% was observed after 30 kGy of gamma accumulated dose. Transit dosimetry measurements through a homogeneous Solid Water phantom had a measured dose within error of the TPS calculations, for field sizes between 3 × 3 cm2 and 10 × 10 cm2. A four-fraction collapsed IMRT plan on a lung phantom had absolute dose pass fractions between the MP987 and TPS (treatment planning system) from 94.2% to 97.4%, with a 5%/5 mm criteria. The ability to accurately measure dose at a transit level, without the need for correction factors derived from extensive commissioning data collection procedures, makes the MP987 a viable alternative to the EPID for in vivo dosimetry. This MP987 is this first of its kind to be successfully developed specifically for a dual detector application.

Deep learning-enabled EPID-based 3D dosimetry for dose verification of step-and-shoot radiotherapy.

The study aims at a novel dosimetry methodology to reconstruct a 3D dose distribution as imparted to a virtual cylindrical phantom using an electronic portal imaging device (EPID). A deep learning-based signal processing strategy, referred to as 3DosiNet, is utilized to learn a mapping from an EPID image to planar dose distributions at given depths. The network was trained with the volumetric dose exported from the clinical treatment planning system (TPS). Given the latent inconsistency between measurements and corresponding TPS calculations, unsupervised learning is formulated in 3DosiNet to capture abstractive image features that are less sensitive to the potential variations. Validation experiments were performed using five regular fields and three clinical intensity-modulated radiation therapy (IMRT) cases. The measured dose profiles and percentage depth dose (PDD) curves were compared with those measured using standard tools in terms of the 1D gamma index. The mean gamma pass rates (2%/2mm) over the regular fields are 100% and 97.3% for the dose profile and PDD measurements, respectively. The measured volumetric dose was compared to the corresponding TPS calculation in terms of the 3D gamma index. The mean 2%/2mm gamma pass rates are 97.9% for square fields and 94.9% for the IMRT fields. The system promises to be a practical 3D dosimetric tool for pre-treatment patient-specific quality assurance and further developed for in-treatment patient dose monitoring.

Small-field beam data acquisition, detector dependency, and film-based validation for a novel self-shielded stereotactic radiosurgery system.

This study reports a single-institution experience with beam data acquisition and film-based validation for a novel self-shielded sterotactic radiosurgery unit and investigates detector dependency on field output factors (OFs), off-axis ratios (OARs), and percent depth dose (PDD) measurements within the context of small-field dosimetry. The delivery platform for this unit consists of a 2.7-MV S-band linear accelerator mounted on coupled gimbals that rotate around a common isocenter (source-to-axis distance [SAD]=450mm), allowing for more than 260 noncoplanar beam angles. Beam collimation is achieved via a tungsten collimator wheel with eight circular apertures ranging from 4mm to 25mm in diameter. Three diodes (PTW 60012 Diode E, PTW 60018 SRS Diode, and Sun Nuclear EDGE) and a synthetic diamond detector (PTW 60019micro Diamond [µD] detector) were used for OAR, PDD, and OF measurements. OFs were also acquired with a PTW 31022 PinPoint ionization chamber. Beam scanning was performed using a 3D water tank at depths of 7, 50, 100, 200, and 250mm with a source-to-surface distance of 450mm. OFs were measured at the depth of maximum dose (dmax =7mm) with the SAD at 450mm. Gafchromic EBT3 film was used to validate OF and profile measurements and as a reference detector for estimating correction factors for active detector OFs. Deviations in field size, penumbra, and PDDs across the different detectors were quantified. Relative OFs (ROFs) for the diodes were within 1.4% for all collimators except for 5 and 7.5mm, for which SRS Diode measurements were higher by 1.6% and 2.6% versus Diode E. The µD ROFs were within 1.4% of the diode measurements. PinPoint ROFs were lower by >10% for the 4-mm and 5-mm collimators versus the Diode E and µD. Corrections to OFs using EBT3 film as a reference were within 1.2% for all diodes and the µD detector for collimators 10mm and greater and within 2.0%, 2.8%, and 1.1% for the 7.5-, 5-, and 4-mm collimators, respectively. The maximum difference in full width at half maximum (FWHM) between the Diode E and the other active detectors was for the 25-mm collimator and was 0.09mm (µD), 0.16mm (SRS Diode), and 0.65mm (EDGE). Differences seen in PDDs beyond the depth of dmax were <1% across the three diodes and the µD. FWHM and penumbra measurements made using EBT3 film were within 1.34% and 3.26%, respectively, of the processed profile data entered into the treatment planning system. Minimal differences were seen in OAR and PDD measurements acquired with the diodes and the µD. ROFs measured with the three diodes were within 2.6% and within 1.4% versus the µD. Gafchromic Film measurements provided independent verification of the OAR and OF measurements. Estimated corrections to OFs using film as a reference were <1.6% for the Diode E, EDGE, and µD detector.

Direct energy spectrum measurement of X-ray from a clinical linac.

A realistic X‐ray energy spectrum is essential for accurate dose calculation using the Monte Carlo (MC) algorithm. An energy spectrum for dose calculation in the radiation treatment planning system is modeled using the MC algorithm and adjusted to obtain acceptable agreement with the measured percent depth dose (PDD) and off‐axis ratio. The simulated energy spectrum may not consistently reproduce a realistic energy spectrum. Therefore, direct measurement of the X‐ray energy spectrum from a linac is necessary to obtain a realistic spectrum. Previous studies have measured low photon fluence directly, but the measurement was performed with a nonclinical linac with a thick target and a long target‐to‐detector distance. In this study, an X‐ray energy spectrum from a clinical linac was directly measured using a NaI(Tl) scintillator at an ultralow dose rate achieved by adjusting the gun grid voltage. The measured energy spectrum was unfolded by the Gold algorithm and compared with a simulated spectrum using statistical tests. Furthermore, the PDD was calculated using an unfolded energy spectrum and a simulated energy spectrum was compared with the measured PDD to evaluate the validity of the unfolded energy spectrum. Consequently, there was no significant difference between the unfolded and simulated energy spectra by nonparametric, Wilcoxon's rank‐sum, chi‐square, and two‐sample Kolmogorov–Smirnov tests with a significance level of 0.05. However, the PDD calculated from the unfolded energy spectrum better agreed with the measured compared to the calculated PDD results from the simulated energy spectrum. The adjustment of the incident electron parameters using MC simulation is sensitive and takes time. Therefore, it is desirable to obtain the energy spectrum by direct measurement. Thus, a method to obtain the realistic energy spectrum by direct measurement was proposed in this study.

Estimation of X-ray Energy Spectrum of Cone-Beam Computed Tomography Scanner Using Percentage Depth Dose Measurements and Machine Learning Approach

This study presents, for the first time, a method to indirectly estimate the cone-beam computed tomography (CBCT) x-ray spectrum in the diagnostic energy range from the percentage depth dose (PDD) ...

NanoDot™ OSLDs in verifying radiotherapy dose calculations in the presence of metal implants: A Monte Carlo assisted research

The goal of this work is to evaluate the dosimetric accuracy of nanoDot optically stimulated luminescence dosimeters (OSLDs) for small field sizes both at phantom-implant interfaces and deeper depths of a phantom. The central axis percentage depth-dose (PDD) curves were obtained by 6 MV flattening-filter-free (FFF) photon beams in conjunction with the homogeneous and nonhomogeneous RW3 slab phantoms with aluminum (Al), titanium alloy grade 5 (Ti5), and stainless steel grade 316 L (SS) implant material sheets inserted into, in small fields: 2 × 2 cm2 and 4 × 4 cm2. Three different depths were defined within the heterogeneous phantoms created to compare the measured and calculated doses: The soft tissue/metal implant upper interface (level I), metal implant/soft tissue lower interface (level II), and deeper depth from the implant (level III). The assessment of OSLDs was performed at defined depths comparing by Monte Carlo simulation (EGSnrc-based DOSXYZnrc/BEAMnrc) and Acuros XB (AXB) algorithm with GafChromic™ EBT3 film and PTW 31014 pinpoint ion chamber (IC) measurements. The PDDs using OSLDs were compared to those predicted by MC, and AXB, and those measured by EBT3 and IC and found to agree with uncertainty (<3%) in a homogeneous medium. The mean relative differences between OSLD and MC simulation at the level I interface of the Al, Ti5, and SS implants were analyzed as 2.5%, 5.6%, and 9.8% for 2 × 2 cm2 and 3.0%, 5.2%, and 8.8% for 4 × 4 cm2, respectively. When using implant material with lower electron density such as Al, the OSLD measurement values were found to agree with each measurement and calculation technique. At level II, the relative doses measured using OSLDs were similar to those of MC calculations for both field sizes. The maximum difference was found at 3.2% for SS implant. Except for the vicinity of the metal implant/RW3 phantom slab interfaces, the OSLD relative dose values were similar to those of PDD measurements in homogeneous media at depths away from the implant material. The OSLDs present a high capacity for radiotherapy dosimetry in homogeneous medium.But we can not adequately consider the dose to the interface between tissue and high Zeff materials in the case of the Ti5 and SS implant materials for small fields using OSLDs.

Evaluation of SrAl2 O4 :Eu, Dy phosphor for potential applications in thermoluminescent dosimetry.

PurposeTo evaluate the use of commercial‐grade strontium aluminate phosphorescent powder as a thermoluminescent (TL) dosimeter for clinical radiotherapy beams.Materials and MethodCommercially available Eu2+, Dy3+ co‐doped strontium aluminate powder (SrAl2O4:Eu, Dy) was annealed and then irradiated using 20 × 20 cm2 field size, with 6‐MV (PDD10 = 70.7) and 18‐MV (PDD10 = 79.4) photon beams and and 9‐MeV (R50 = 3.6), 15 MeV (R50 = 5.9) and 18‐MeV (R50 = 7.2) electron beams. To calibrate the relationship between the TL readings and the irradiated doses, TL glow curves were acquired for doses up to 600 cGy at all beam energies. For the percentage depth dose (PDD) measurement, the SrAl2O4:Eu, Dy powder was sandwiched by solid water phantoms, with varying thickness of solid water placed above to determine the depth. PDDs were measured at four representative depths and compared against the commissioning depth dose data for each beam energy.ResultsLinear dose response models of doses up to 200 cGy were created for all beam energies. Superlinearity was observed with doses greater than 200 cGy. The PDD measurement acquired experimentally agrees well with the commissioning data of the medical linear accelerator. Trapping parameters such as order of kinetics, activation energy and frequency factor have been obtained via TL glow curve analysis.ConclusionThe linear dose response demonstrates that SrAl2O4:Eu, Dy is a potential TLD dosimeter for both electron beams and photon beams at different beam energies. The PDD measurements further support its potential use in quality assurance and radiation dosimetry.

Dosimetric characterization of a small-scale (Zn,Cd)S:Ag inorganic scintillating detector to be used in radiotherapy.

In modern radiotherapy techniques, to ensure an accurate beam modeling process, dosimeters with high accuracy and spatial resolution are required. Therefore, this work aims to propose a simple, robust, and a small-scale fiber-integrated X-ray inorganic detector and investigate the dosimetric characteristics used in radiotherapy. The detector is based on red-emitting silver-activated zinc-cadmium sulfide (Zn,Cd)S:Ag nanoclusters and the proposed system has been tested under 6 MV photons with standard dose rate used in the patient treatment protocol. The article presents the performances of the detector in terms of dose linearity, repeatability, reproducibility, percentage depth dose distribution, and field output factor. A comparative study is shown using a microdiamond dosimeter and considering data from recent literature. We accurately measured a small field beam profile of 0.5×0.5cm2 at a spatial resolution of 100µm using a LINAC system. The dose linearity at 400 MU/min has shown less than 0.53% and 1.10% deviations from perfect linearity for the regular and smallest field. Percentage depth dose measurement agrees with microdiamond measurements within 1.30% and 2.94%, respectively for regular to small field beams. Besides, the stem effect analysis shows a negligible contribution in the measurements for fields smaller than 3x3 cm2. This study highlights the drastic decrease of the convolution effect using a point-like detector, especially in small dimension beam characterization. Field output factor has shown a good agreement while comparing it with the microdiamond dosimeter. All the results presented here anticipated that the developed detector can accurately measure delivered dose to the region of interest, claim accurate depth dose distribution hence it can be a suitable candidate for beam characterization and quality assurance of LINAC system.

An alternative to the use of lead for patient treatment shielding in superficial radiotherapy.

Lead shielding is commonly used in the delivery of superficial radiotherapy albeit that the toxicity of this substance is of concern. The feasibility of using a non-toxic alternative, AttenuFlex™, is assessed using Xstrahl and Sensus treatment units. A series of lead and AttenuFlex™ circular cut outs and applicators were used with superficial beams (1.0-8.5mm Al HVL) to measure percentage depth dose (PDD), output factors (OF) and surface dose correction factors (DCF). X-ray transmission for each material was determined for each beam quality. For these measurements an Advanced Markus chamber either embedded within a virtual water phantom (PDD, OF, transmission) or placed on the surface of the phantom with entrance window downstream (DCF), was used. The depth of the phantom is 10cm for PDD and surface OF measurements. DCF(t) measurements were obtained with underlying lead or AttenuFlex™ at depth t = 0.1-10cm. Additionally, using EBT3 film fluorescent surface doses, to non-target tissue, due to underlying lead or AttenuFlex™ were compared.PDDs and OFs for both materials were within ± 1%. Lead and AttenuFlex™ transmission differences were clinically acceptable, all transmission values were < 5% and non-target doses were comparable. The variation of DCF(t) for lead and AttenuFlex™ exhibit a minima for all beams. In the minima region energy and applicator dependent differences between DCF(lead) and DCF(AttenuFlex™) are observed. These differences do not preclude the use of AttenuFlex™ as an alternative to lead in superficial therapy.

Dosimetric Characteristics of 6 MV Medical Linac at BAEC

Dosimetric characteristic is one of the essential parameters of a medical linear accelerator (LINAC), which must be obtained before clinical use. The dosimetric characteristics for 6 MV photon beam were measured and compared with the corresponding published data. The study was done using a Varian linear accelerator (Model Clinac-iX) at the Institute of Nuclear Medical Physics (INMP), AERE, Savar, Dhaka, under the Bangladesh Atomic Energy Commission (BAEC). The data is taken for 10 field sizes (2 × 2, 3 × 3, 5 × 5, 7 × 7, 10 × 10, 15 × 15, 20 × 20, 25 × 25, 30 × 30 and 40 × 40 cm2) at same conditions. The measured Percent Depth Dose (PDD) curves were obtained for 6 MV photon beams with the field as mentioned above and compared with the calculated PDD curves. The measured depth dose (Dmax) for reference field size (FS) 10 × 10 cm2 is 15.99 mm, and the PDD at 10 cm depth (D10) is 66.87% for 6 MV photon energies that are found to be compatible with the published report BJR supplement 25. The measured PDD curves for photon energies show a good agreement with the standard PDD curves. The photon beam dosimetry data found in the current study are compatible and all the tolerances are within the clinically acceptable tolerance limit.

Monte Carlo simulations of EBT3 film dose deposition for percentage depth dose (PDD) curve evaluation.

PurposeTo use Monte Carlo (MC) calculations to evaluate the effects of Gafchromic EBT3 film orientation on percentage depth dose (PDD) curves.MethodsDose deposition in films placed in a water phantom, and oriented either parallel or perpendicular with respect to beam axis, were simulated with MC and compared to PDDs scored in a homogenous water phantom. The effects of introducing 0.01–1.00 mm air gaps on each side of the film as well as a small 1°‐3° tilt for film placed in parallel orientation were studied. PDDs scored based on two published EBT3 film compositions were compared. Three photon beam energies of 120 kVp, 220 kVp, and 6 MV and three field sizes between 1 × 1 and 5 × 5 cm2 were considered. Experimental PDDs for a 6‐MV 3 × 3 cm2 beam were acquired.ResultsPDD curves for films in perpendicular orientation more closely agreed to water PDDs than films placed in parallel orientation. The maximum difference between film and water PDD for films in parallel orientation was −12.9% for the 220 kVp beam. For the perpendicular film orientation, the maximum difference decreased to 5.7% for the 120 kVp beam. The inclusion of an air gap had the largest effect on the 6‐MV 1 × 1 cm2 beam, for which the dose in the buildup region was underestimated by 21.2% compared to the simulation with no air gap. A 2° film tilt decreased the difference between the parallel film and homogeneous water phantom PDDs from −5.0% to −0.5% for the 6 MV 3 × 3 cm2 beam. The “newer” EBT3 film composition resulted in larger PDD discrepancies than the previous composition. Experimental film data qualitatively agreed with MC simulations.ConclusionsPDD measurements with films should either be performed with film in perpendicular orientation to the beam axis or in parallel orientation with a ~ 2º tilt and no air gaps.

A Comprehensive Quality Assurance Program of Small Animal Irradiators for Preclinical Radiation Research

Draeger et al. (Red Journal, 2020) raised awareness on the importance of the standardization of dosimetry protocols in pre-clinical radiobiology research and the inclusion of physicists on the research team. At our institute, a QA program of the small animal radiation research platform (SARRP, Xstrahl) that includes daily, monthly and annual tests have been implemented to ensure minimal delivery uncertainties. Details of the QA procedures, feasibility and results will be reported. End-to-end imaging and radiation isocenter coincidence testing using a Winston-Lutz phantom and EBT3 films, as well as CBCT imaging quality visual check, were performed daily by the research team. Monthly QA (mechanical and dosimetric tests such as the star-shot test and output constancy of the reference field), and annual QA (TG61 absolute dosimetry, imaging quality phantom check, output factor, beam profiles and percent depth dose measurements) were performed by the physics staff. The estimated time to complete the daily, monthly and annual tests were twenty minutes, one and two hours, respectively. The frequency of each QA item had been established based on the failure occurrence rate. The tolerance results of the daily, monthly and annual testing are displayed in the table. The results of the daily isocenter coincidence check show a discrepancy between the radiation isocenter and set-up center combined with the uncertainty from the couch movement of the image-guided system smaller than 1.5 mm. This test has successfully caught failures in the entire delivery process. For the monthly QA, diameter of the radiation isocenter was consistently smaller than 0.5 mm and the output has been measured to be within ±1% of baseline. The results of the annual QA, using an ion chamber and EBT3 films, match the beam data of the treatment planning system as well as the data from our in-house Monte Carlo calculation within the tolerance. Additionally, we used EBT3 films and a mouse solid water phantom as tools for verification of dosimetrically complex plans. The maximum dosimetry error observed has been consistently within 2%. With the implemented QA program, the fidelity of overall system delivery was ensured for robust and accurate small animal radiation studies without excess burden on the medical physicists and research team.Tabled 1Abstract 2596; TableProcedureToleranceDailyEnd to end imaging and radiation isocenter coincidence2 mmCBCT imaging quality visual checkBaselineLocalizing lasers1 mmMonthlyOutput constancy2%Isocentricity1 mmGantry position check1 mmAnnualOutput, flatness and symmetry, PDD, output factor1%CBCT imaging quality phantom checkBaseline Open table in a new tab

Feasibility study of using Stereotactic Field Diode for field output factors measurement and evaluating three new detectors for small field relative dosimetry of 6 and 10MV photon beams.

This study assesses the feasibility of using stereotactic field diode (SFD) as an alternate to gaf chromic films for field output factor (FF) measurement and further evaluating three new detectors for small field dosimetry. Varian 21EX linear accelerator was used to generate 6 and 10 MV beams of nominal square fields ranging from 0.5 × 0.5 cm2 to 10 × 10 cm2. One passive (EBT3 films) and five active detectors including IBA RAZOR diode(RD), SFD, RAZOR nanochamber (RNC), pinpoint chamber (PTW31023), and semiflex chamber (PTW31010) were employed. FFs were measured using films and SFD while beam profiles and percentage depth dose (PDD) distribution were acquired with active detectors. Polarity (kpol) and recombination (ks) effects of ion chambers were determined and corrected for output ratio measurement. Correction factors (CF) of RD, RNC, and PTW31023 in axial and radial orientation were also measured. Stereotactic field diode measured FFs have shown good agreement with films (with difference of <1%). RD and RNC measured beam profiles were within 3% deviation from the SFD values. Variation in kpol with field size for RNC and PTW31023 was up to 4% and 0.4% (for fields ≥ 1 × 1 cm2), respectively, while variation in ks of PTW31023 was <0.2 %. The maximum values of CF have been calculated to be 5.2%, 2.0%, 13.6%, and 25.5% for RD, RNC, PTW31023‐axial, and PTW31023‐radial respectively. This study concludes that SFD with appropriate CFs as given in TRS 483 may be used for measuring FFs as an alternate to EBT3 films. Whereas RD and RNC may be used for beam profile and PDD measurement in small fields. Considering the limit of usability of 2%, RNC may be used without CF for FF measurement in the smallfields investigated in this study.

Dosimetric impact of failing to apply correction factors to ion recombination in percentage depth dose measurements and the volume-averaging effect in flattening filter-free beams

PurposeTo examine whether it is essential to apply correction factors for ion recombination (kS) to percentage depth dose (PDD) measurements and to the volume-averaging effect (kvol) to ensure accurate absolute dose calibration for flattening filter-free (FFF) beams for the most commonly used ionization chambers. MethodsWe surveyed medical physicists worldwide (n = 159) to identify the five most common ionization chamber combinations used for absolute and relative reference dosimetry of FFF beams. We then assessed the overall absolute dose calibration error for FFF beams of the Artiste Siemens and TrueBeam Varian linear accelerators resulting from failing to apply correction factors kS in the PDD(10) and the volume-averaging effect (kvol) to such chamber combinations. ResultsAll the chamber combinations examined—the Farmer PTW 30013 ionization chamber used for absolute dosimetry, and the PTW 31010, PTW 30013, IBA CC04, IBA CC13, and PTW 31021 ionization chambers used for PDD curves measurements—showed non-negligible errors (≥0.5%). The largest error (1.6%) was found for the combination of the Farmer PTW 30013 chamber with the IBA CC13 chamber, which was the most widely used chamber combination in our survey. ConclusionsBased on our findings, we strongly recommend assessing the impact of failing to apply correction factors kS in the PDD(10) and kvol prior to using any chamber type for FFF beam reference dosimetry purposes.

Calibration of MTT assay in proton beams using radiochromic films.

This study provides methodology of calibrating as well as controlling the output for an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) colorimetric assay irradiated in a low energy proton beam using EBT3-model GAFCHROMICTM film, without correcting for quenching effect. A calibrated Markus ionization chamber was used to measure the depth dose and beam output for 26.5 MeV protons produced by a CS30 cyclotron. A time-controlled aluminum cylinder was added in front of the horizontal beam-exit serving as a radiation shutter. Following the TRS-398 reference dosimetry protocol for proton beams, the output was calibrated in water at a reference depth of 3 mm. EBT3 film was calibrated for doses up to 8 Gy at the same depth. To verify the dose distribution for each 96-well MTT assay plate, EBT3 film was placed at the reference depth during irradiation and cell doses were scaled by measured percent depth dose (PDD) data. The radiochromic film dosimetry system in this study provides dose measurements with an uncertainty better than 3.3% for doses higher than 1 Gy. From a single exposure and utilizing the Gaussian shape of the beam, multiple dose points can be obtained within different wells of the same plate ranging from 6.9 Gy (sigma ∼4%) in the central well, and 2 Gy (sigma ∼8%) for wells positioned closer to the periphery. We described a methodology for radiochromic film-based dose monitoring system, using low-energy protons, which can be used for the MTT assay in any proton beam, except within Bragg peak region.

Characterization of an inorganic scintillator for small-field dosimetry in MR-guided radiotherapy.

IntroductionAim of this study is to dosimetrically characterize a new inorganic scintillator designed for magnetic resonance‐guided radiotherapy (MRgRT) in the presence of 0.35 tesla magnetic field (B).MethodsThe detector was characterized in terms of signal to noise ratio (SNR), reproducibility, dose linearity, angular response, and dependence by energy, field size, and B orientation using a 6 MV magnetic resonance (MR)‐Linac and a water tank.Field size dependence was investigated by measuring the output factor (OF) at 1.5 cm. The results were compared with those measured using other detectors (ion chamber and synthetic diamond) and those calculated using a Monte Carlo (MC) algorithm.Energy dependence was investigated by acquiring a percentage depth dose (PDD) curve at two field sizes (3.32 × 3.32 and 9.96 × 9.96 cm2) and repeating the OF measurements at 5 and 10 cm depths.ResultsThe mean SNR was 116.3 ± 0.6. Detector repeatability was within 1%, angular dependence was <2% and its response variation based on the orientation with respect to the B lines was <1%.The detector has a temporal resolution of 10 Hz and it showed a linear response (R2 = 1) in the dose range investigated. All the OF values measured at 1.5 cm depth using the scintillator are in accordance within 1% with those measured with other detectors and are calculated using the MC algorithm. PDD values are in accordance with MC algorithm only for 3.32 × 3.32 cm2 field. Numerical models can be applied to compensate for energy dependence in case of larger fields.ConclusionThe inorganic scintillator in the present form can represent a valuable detector for small‐field dosimetry and periodic quality controls at MR‐Linacs such as dose stability, OFs, and dose linearity.In particular, the detector can be effectively used for small‐field dosimetry at 1.5 cm depth and for PDD measurements if the field dimension of 3.32 × 3.32 cm2 is not exceeded.