Small Field Dosimetry Research Articles

Evaluation of the IAEA-TRS483 protocol for the dosimetry of small fields (square and stereotactic cones) using multiple detectors.

The IAEA TRS 483 protocol1 for the dosimetry of small static fields in radiotherapy was used to calculate output factors for the Elekta Synergy linac at the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). Small field output factors for both square and circular fields were measured using nine different detectors. The “corrected” output factors (ratio of detector readings multiplied by the appropriate correction factor from the protocol) showed better consistency compared to the “uncorrected” output factors (ratio of detector readings only), with the relative standard deviation decreasing by approximately 1% after the application of the relevant correction factors. Comparisons relative to an arbitrarily chosen PTW 60019 microDiamond detector showed a reduction of maximal variation for the corrected values of approximately 3%. A full uncertainty budget was prepared to analyze the consistency of the output factors. Agreement within uncertainties between all detectors and field sizes was found, except for the 15 mm circular field. The results of this study show that the application of IAEA TRS 4831 when measuring small fields will improve the consistency of small field measurements when using multiple detectors contained within the protocol.

Small-field dosimetry of TrueBeamTM flattened and flattening filter-free beams: A multi-institutional analysis.

PurposeDetector‐dependent interinstitutional variations of the beam data may lead to uncertainties of the delivered dose to patients. Here we evaluated the inter‐unit variability of the flattened and flattening filter‐free (FFF) beam data of multiple TrueBeam (Varian Medical Systems) linear accelerators focusing on the small‐field dosimetry.MethodsThe beam data of 6‐ and 10‐MV photon beams with and without flattening filter measured for modeling of an iPLAN treatment planning system (BrainLAB) were collected from 12 institutions — ten HD120 Multileaf Collimator (MLC) and two Millennium120 MLC. Percent‐depth dose (PDD), off‐center ratio (OCR), and detector output factors (OF det) measured with different detectors were evaluated. To investigate the detector‐associated effects, we evaluated the inter‐unit variations of the OF det before and after having applied the output correction factors provided by the International Atomic Energy Agency (IAEA) Technical Reports Series no. 483.ResultsPDD measured with a field size of 5 × 5 mm2 showed that the data measured using an ionization chamber had variations exceeding 1% from the median values. The maximum difference from median value was 2.87% for 10 MV photon beam. The maximum variations of the penumbra width for OCR with 10 × 10 mm2 field size were 0.97 mm. The OF det showed large variations exceeding 15% for a field size of 5 × 5 mm2. When the output correction factors were applied to the OF det, the variations were greatly reduced. The relative difference of almost all field output factors were within ± 5% from the median field output factors.ConclusionIn this study, the inter‐unit variability of small‐field dosimetry was evaluated for TrueBeam linear accelerators. The variations were large at a field size of 5 × 5 mm2, and most occurred in a detector‐dependent manner.

The influence of errors in small field dosimetry on the dosimetric accuracy of treatment plans

Background: Dosimetric effects of inaccuracies of output factors (OFs) implemented in treatment planning systems (TPSs) were investigated.Materials and methods: Modified beam models (MBM) for which the OFs of small fields (down to 1 × 1 cm2) were increased by up to 12% compared to the original beam models (OBM) were created for two TPSs. These beam models were used to recalculate treatment plans of different complexity. Treatment plans using stereotactic 3D-conformal (s3D-CRT) for brain metastasis as well as VMAT plans for head and neck and prostate cancer patients were generated. Dose distributions calculated with the MBM and the OBM were compared to measured dose distributions acquired using film dosimetry and a 2D-detector-array. For the s3D-CRT plans the calculated and measured dose at the isocenter was evaluated. For VMAT, gamma pass rates (GPRs) were calculated using global gamma index with 3%/3 mm, 2%/3 mm, 1%/3 mm and 2%/2 mm with a 20% threshold. Contribution of small fields to the total fluence was expressed as the ratio (F) of fluence trough leaf openings smaller than 2 cm to the total fluence.Results: Using film dosimetry for the s3D-CRT plans, the average of the ratio of calculated dose to measured dose at the isocenter was 1.01 and 1.06 for the OBM and MBM model, respectively. A significantly lower GPR of the MBM compared to the OBM was only found for the localized prostate cases (F = 12.4%) measured with the 2D-detector-array and an acceptance criterion of 1%/3 mm.Conclusion: The effects of uncertainties in small field OFs implemented in TPSs are most pronounced for s3D-CRT cases and can be clearly identified using patient specific quality assurance. For VMAT these effects mainly remain undetected using standard patient specific quality assurance. Using tighter acceptance criteria combined with an analysis of the fluence generated by small fields can help identifying inaccuracies of OFs implemented in TPSs.

Verification of representative data for output factors of SRS cones utilizing IAEA TRS 483 recommendations

Measurements of small fields continue to be a clinical challenge despite the recent work done to identify their characteristics. Due to this challenge, many physicists use representative data supplied by their vendors to verify their own measurements for small field output factors. However, with recent guidelines being released in IAEA TRS 483, the question remains if this representative data provides an accurate representation for small field dosimetry. A Sun Nuclear EDGE detector, PTW 60012 stereotactic diode, and GafChromic EBT3 films were used to measure the output factor for a set of Varian SRS cones (4 mm–17.5 mm diameters) on a TrueBeam linear accelerator. The measured output factors were then compared to the Varian provided SRS representative data. IAEA TRS 483 recommendations for measuring small field output factors were applied and the impact of those recommendations were examined. The EDGE detector showed good agreement with the representative data when correction factors were not applied (0.01%–1.64% difference) but the PTW 60012 diode showed larger deviation (0.61%–3.35% difference). The EBT3 film showed the largest difference with the representative data (0.66%–9.19%). After application of IAEA TRS 483 detector specific correction factors the output factors measured by the diodes showed good agreement with the EBT3 film for 6MV (<1.8% difference) but showed a large deviation with the representative data (up to 9% difference). The 6FFF energy output factors agreed between the EDGE, the PTW 60012, and EBT3 Film. This work shows that the use of uncorrected representative data on the Truebeam can lead to a significant over estimation of the SRS cone output factors.

X-Tream dosimetry of synchrotron radiation with the PTW microDiamond

In this study, we demonstrate that the X-Tream dosimetry system developed by the Centre for Medical Radiation Physics can be used with both commercial and non-commercial dosimeters. A custom adaptor was constructed to connect the PTW microdiamond to the X-Tream DAQ. This allowed for the measurements of continuous depth dose curves, broad beam and microbeam profiles. The X-Tream system enables real time measurement of the instantaneous dose rate of synchrotron generated radiation with the PTW microDiamond. Finally, measurements undertaken in this study demonstrate that the X-Tream system is able to mitigate the alignment issue that has previously hampered the uptake of the PTW microdiamond in clinical quality assurance for small field dosimetry.

Quantifying the ionization quenching effect in organic plastic scintillators used in MV photon dosimetry

Miniature organic plastic scintillators attached to optical fiber cables have found important uses in medical dosimetry, in particular for small-field dosimetry and field output factor measurements in megavoltage linear accelerator beams. Plastic scintillators are well suited for these applications due to their high degree of water equivalence and their small size. Plastic scintillators, however, are known to suffer from ionization quenching, meaning that the light production per absorbed dose decreases if the dose deposition is caused by low energy electrons. As MV beams also lead to dose deposition by low energy electrons, ionization quenching will also affect, for example, field output factor measurements in MV beams if the fraction of dose delivered by low energy electrons changes with field size or beam quality. While the influence of ionization quenching on scintillator dosimetry in beams of heavy charge particles or kV x-ray has been subject to much research, the effect in MV beams is less well studied, and it is often implicitly assumed that there is no effect. The purpose of this work therefore was to quantify the influence of ionization quenching on plastic scintillators, specifically BCF-60, for the two application in MV photon dosimetry: (i) field output factor measurements for field sizes from 0.5×0.5 cm2 to 10×10 cm2 for a 6 MV beam and (ii) ionization chambers beam quality correction factor (kQ-factors) measurements for beams between 4 MV and 15 MV at a fixed 10×10 cm2 field size. The quenching was quantified using Monte Carlo modelling of the MV beams, a variation of Birks formalism that accounted for the detailed dose deposition by secondary electrons, and quenching parameters established previously using experiments in kV x-ray beams. This enabled the computation of the light yield in a “quenching free” scintillator and therefore a computation of a correction factor due to ionization quenching. Ionization quenching was found to have a small but statistically significant influence on both of the studied applications: (0.6±0.2)% for the field output factor measurements between 0.5×0.5 cm2 and 10×10 cm2 and about (2±0.4)% for the kQ-factor application for beams between 4 MV and 15 MV. The modelling results were in agreement with experimental measurements. The results support that the ionization quenching effect has a small effect on field-output factor measurements and it can probably be neglected during clinical measurements. For direct scintillator-based measurements of beam quality correction factors for ionization chambers, ionization quenching is larger and this effect needs to be accounted for if anyone wants to measure or verify ionization chamber kQ-factors using organic plastic scintillators.

Intercalibration of a polycrystalline 3D diamond detector for small field dosimetry

In medical radiation dosimetry, the use of small photon fields is almost a prerequisite for high precision localized dose delivery to delineated target volumes. The accurate measurement of standard dosimetric quantities in such situations depends on the size of the detector with respect to the field dimensions. Polycrystalline diamond devices with 3-dimensional structures are produced by using laser pulses to create graphitic paths in the diamond bulk. By fabricating very narrow and close-by columnar electrodes perpendicular to the detector surface, it is possible to create arrays of 3-D cells (pixels) with a very small sensitive volume. In order to present a solution to the problem of the detector size for small field dosimetry the 3-D technology aims to a new highly segmented larger polycrystalline diamond dosimeter to obtain field profiles in a single measurement, reducing the uncertainty of the delivered dose. To this purpose a 3D all carbon detector with an array of 9 3-D pixels has been produced. Due to the heterogeneous structure of the polycrystalline diamond substrate, it was necessary to study the response of each pixel under a standard field photon beam (10 x 10 cm2). For 6 pixels of the array was demonstrated that they present different sensitivities to the radiation beam, but the response is linear and stable hence different calibration factors can be applied to obtain an overall detector response and reduce the uncertainty of the delivered dose.

Verification of lithium formate monohydrate in 3D-printed container for electron paramagnetic resonance dosimetry in radiotherapy

The nondestructive dosimetry achieved with electron paramagnetic resonance (EPR) dosimetry facilitates repetitive recording by the same dosimeter to increase the reliability of data. In precedent studies, solid paraffin was needed as a binder material to make the lithium formate monohydrate (LFM) EPR dosimeter stable and nonfragile; however, its use complicates dosimetry. This study proposes a newly designed pure LFM EPR dosimeter created by inserting LFM into a 3D-printed container. Dosimetric characteristics of the LFM EPR dosimeter and container, such as reproducibility, linearity, energy dependence, and angular dependence, were evaluated and verified through a radiation therapy planning system (RTPS). The LFM EPR dosimeters were irradiated using a clinical linear accelerator. The EPR spectra of the dosimeters were acquired using a Bruker EMX EPR spectrometer. Through this study, it was confirmed that there is no tendency in the EPR response of the container based on irradiation dose or radiation energy. The results show that the LFM EPR dosimeters have a highly sensitive dose response with good linearity. The energy dependence across each photon and electron energy range seems to be negligible. Based on these results, LFM powder in a 3D-printed container is a suitable option for dosimetry of radiotherapy. Furthermore, the LFM EPR dosimeter has considerable potential for in vivo dosimetry and small-field dosimetry via additional experiments, owing to its small effective volume and highly sensitive dose response compared with a conventional dosimeter.

Pre-clinical and small field dosimetry

Preclinical in vivo studies have drastically improved over the past decade with the development of cone beam computed tomography (CBCT) image-guided small animal irradiation systems. Such systems produce 220 or 225 kV x-rays with square and circular field sizes ranging from 0.5 to 10 mm. The dosimetry of such equipment involving kilovoltage small-field dosimetry has not received as much attention as the megavoltage small-field dosimetry. The dosimetry of megavoltage small fields can be challenging due to lateral charged particle disequilibrium, detector volume averaging effect, and high dose gradients. Clinically there has been a rapid increase in the use of small fields in modern radiotherapy techniques such as stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SBRT). This study presents dosimetric properties of image-guided small animal irradiation systems. Both EBT Gafchromic films and 3-D PRESAGE measured beam data were presented and compared with the calculated dose distribution from a commissioned planning system. For megavoltage small-field dosimetry, EBT3 films and PRESAGE dosimeters were used to measure the dose distributions for MLC-delimited 6 x 6 to 20 x 20 mm2 square fields, and for selected IMRT and VMAT plans with small field sizes or segments of 1-4 cm. A single-beam optical CT scanner was used as the readout mechanism of the radiation-induced 3-D information in the PRESAGE phantoms. Measured data sets were compared with calculated results from Eclipse Acuros XB. The results for kilovoltage small animal irradiator showed that PDD data measured from EBT films and PRESAGE dosimeters are in agreement within 3%; profiles and 2-D dose distributions measured from PRESAGE present a larger penumbra compared with those from EBT films. Discrepancies between measured beam data and treatment planning data were identified. For megavoltage small fields, the measured data percent depth dose, beam profiles, and dose distributions were found to agree within experimental uncertainties for EBT films and PRESAGE dosimeters. Beam profiles for MLC-delimited field sizes less than 10 mm reveal some discrepancies in the penumbra region between measured data and calculated results. Dose distributions from EBT film and PRESAGE measurements demonstrate that 3-D dosimetry measurement for small-field IMRT and VMAT QA may be necessary to ensure a complete verification of dose delivery and accuracy.

Technical Note: Characterization of the new microSilicon diode detector.

PurposeDosimetric properties of the new microSilicon diode detector (60023) have been studied with focus on application in small‐field dosimetry. The influences of the dimensions of the sensitive volume and the density of the epoxy layer surrounding the silicon chip of microSilicon have been quantified and compared to its predecessor (Diode E 60017) and the microDiamond (60019, all PTW‐Freiburg, Germany).MethodsDose linearity has been studied in the range from 0.01 to 8.55 Gy and dose‐per‐pulse dependence from 0.13 to 0.86 mGy/pulse. The effective point of measurement (EPOM) was determined by comparing measured percentage depth dose curves with a reference curve (Roos chamber). Output ratios were measured for nominal field sizes from 0.5 × 0.5 cm2 to 4 × 4 cm2. The corresponding small‐field output correction factors, k, were derived with a plastic scintillation detector as reference. The lateral dose–response function, K(x), was determined using a slit beam geometry.ResultsMicroSilicon shows linear dose response (R 2 = 1.000) in both low and high dose range up to 8.55 Gy with deviations of only up to 1% within the dose‐per‐pulse values investigated. The EPOM was found to lie (0.7 ± 0.2) mm below the front detector’s surface. The derived k for microSilicon (0.960 at s eff = 0.55 cm) is similar to that of microDiamond (0.956), while Diode E requires larger corrections (0.929). This improved behavior of microSilicon in small‐fields is reflected in the slightly wider K(x) compared to Diode E. Furthermore, the amplitude of the negative values in K(x) at the borders of the sensitive volume has been reduced.ConclusionsCompared to its predecessor, microSilicon shows improved dosimetric behavior with higher sensitivity and smaller dose‐per‐pulse dependence. Profile measurements demonstrated that microSilicon causes less perturbation in off‐axis measurements. It is especially suitable for the applications in small‐field output factors and profile measurements.

Three-dimensional characterization of the active volumes of PTW microDiamond, microSilicon, and Diode E dosimetry detectors using a proton microbeam.

PurposeThe purpose of this work is the three‐dimensional characterization of the active volumes of commercial solid‐state dosimetry detectors. Detailed knowledge of the dimensions of the detector’s active volume as well as the detector housing is of particular interest for small‐field photon dosimetry. As shown in previous publications from different groups, the design of the detector housing influences the detector signal for small photon fields. Therefore, detailed knowledge of the active volume dimension and the surrounding materials form the basis for accurate Monte Carlo simulations of the detector.MethodsA 10 MeV proton beam focused by the microbeam system of the Physikalisch‐Technische Bundesanstalt was used to measure two‐dimensional response maps of a synthetic diamond detector (microDiamond, type 60019, PTW Freiburg) and two silicon detectors (microSilicon, type 60023, PTW Freiburg and Diode E, type 60017, PTW Freiburg). In addition, the thickness of the active volume of the new microSilicon was measured using the method developed in a previous study.ResultsThe analysis of the response maps leads to active area of 1.18 mm2 for the Diode E, 1.75 mm2 for the microSilicon, and 3.91 mm2 for the microDiamond detector. The thickness of the active volume of the microSilicon detector was determined to be (17.8 ± 2) µm.ConclusionsThis study provides detailed geometrical data of the dosimetric active volume of three different solid‐state detector types.

Соотношение между поглощенной дозой, кермой и ионизационной кермой для полей малых размеров

Purpose: Research of the relationships between spatial distributions in water of the main dosimetric values, namely the absorbed dose, kerma and ionization kerma, for small-size fields with a circular cross section created by divergent beams of bremsstrahlung spectrum with a maximum energy of 6 MeV.&#x0D; Material and methods: Using the Monte-Carlo method with the codes EGSnrc and MCNP4C2, calculations were carried out for these distributions in a water phantom for beam radii on the phantom surface from 0.1 to 3.0 cm and for depths up to 40 cm. The ratio at depths up to 5 cm, where there is a so-called build-up area, is studied in particular detail.&#x0D; Results: The results of calculations show that the ratio of ionization kerma to kerma for such beams at depths up to 40 cm is practically constant and equal to 0.9930 ± 0.0005. The ratio of the absorbed dose to the ionization kerma, in contrast to conventional square beams with a cross-sectional area  20 cm2, is much less than unity at radii of 1 cm at all the depths considered.&#x0D; Conclusion: The data obtained show that the relationship between absorbed dose, kerma and ionization kerma for photon fields produced by beams of small cross sections is very different from that for traditional beams. This circumstance should be taken into account when conducting dosimetry of small fields.

Phantom development and implementation for Gamma Knife® dosimetry

Stereotactic radiosurgery is a procedure that primarily treats intracranial lesions to destroy tumour cells that are inaccessible surgically. Gamma Knife® is a stereotactic radiosurgery unit that can treat brain lesions using 60Co beams, non-invasively. Fields from Gamma Knife® helmets are considered small, therefore, in order to ensure accurate dosimetry, detectors for dose measurements have to be carefully chosen. The IAEA TRS 483 code of practice is a standardized guide for dosimetric procedures and indication of detectors for reference dosimetry of small fields used in radiotherapy beams. The objective of this work was to assess the implementation of the TRS 483 recommendations for Gamma Knife® dosimetry, using two micro-ionization chambers, Exradin A16 and PTW Pinpoint 3D 31016. An acrylic phantom with the same dimensions as those provided by Elekta, Gamma Knife’s manufacturer, was built as an alternative. The phantom was characterized for its implementation for Gamma Knife® dosimetry and to be used as part of an audit kit by a Secondary Standard Dosimetry Laboratory (SSDL) in Brazil. Alanine pellets were used as reference detector. Dosimetry results for the acrylic phantom were compared with the ones obtained in phantoms specified by Elekta, which are made of Acrylonitrile Butadiene Styrene (ABS) and Solid Water materials. TRS 483 recommended correction factors were used to calculate the absorbed dose to the water taking into consideration the phantom material. Absorbed dose measurements performed using the designed acrylic phantom showed results comparable to the ones obtained with commercially available phantoms. The new phantom is suitable for Gamma Knife reference and relative dosimetry. The results of this work aim to contribute to the implementation of the TRS 483, mainly in the area of Gamma Knife dosimetry and the use of small volume ionization chambers.

Small field correction factors determination for several active detectors using a Monte Carlo method in the Elekta Axesse linac equipped with circular cones

A Monte Carlo (MC) method was used to determine small field output correction factors for several active detectors (Exradin A16, Exradin A26, PTW microLion, PTW microDiamond, Exradin W1 and IBA RAZOR) for an Elekta Axesse linac equipped with circular cones. MC model of the linac was built with the GamBet software, using the Penelope code system. The dose-to-water simulation for each cone, ranging from 5 to 30 mm of diameter size, was used to calculate field factors and the results were validated together with Gafchromic EBT3 film. Output factors (OFs) were measured with the active detectors and correction factors were determined using the MC results. The MC simulations agreed with films within 1.2%. OFs measured with Exradin W1 scintillator were in agreement within 0.8% with MC simulations. The Exradin A16 and A26 microchambers under-responded for small fields relative to the MC (−13.1% and −4.6%, respectively). PTW microLion, IBA RAZOR and PTW microDiamond overestimated the output factor for the smallest field (+3.9%, +5.4 and +7.1%, respectively). The present study pointed out that it is crucial to apply the appropriate correction factors in order to provide accurate measurements in small beams geometry. The results showed that the Exradin W1 can be used for very small field dosimetry without correction factors, which shall be contrariwise employed for other detectors.

Study of detectors response on the scatter radiation of 6 MV flattening filter free beams

Small field dosimetry which related to the use of Flattening Filter Free (FFF) beams is a great challenge because of the perturbation effects caused by the size of the detector’s active volume or detector’s materials. This phenomenon encourages researchers to do a further study about detector response. In this study, scatter and primary radiation from 6 MV FFF photon beams were studied to evaluate the detector response in small fields for a better understanding of the contribution of every phenomenon. Ion chamber and Gafchromic films were used in three measurement configurations representing open field measurement and approximations of both primary and scatter part of the beam, described as follows: (i) detectors positioned under steel block, exposing the detectors only to scatter part of radiation field, (ii) detectors positioned inside mini phantom, approximating the detector response to primary radiation with minimum scatter, (iii) detectors positioned in the standard open field, which was the superposition of the primary and scatter radiation. The results show that detector responses were heavily depended on its design (i.e. active volume) especially in small beams. The detector response in the open field could be reproduced from the blocked and primary beam set-up with a discrepancy ranging from 1.0% to 36%. Moreover, the volume averaging and other phenomenon affecting the detector response could be observed in the blocked beam.

The role of radiation-induced charge imbalance on the dose-response of a commercial synthetic diamond detector in small field dosimetry.

PurposeDiscrepancy between experimental and Monte Carlo simulated dose–response of the microDiamond (mD) detector (type 60019, PTW Freiburg, Germany) at small field sizes has been reported. In this work, the radiation‐induced charge imbalance in the structural components of the detector has been investigated as the possible cause of this discrepancy.Materials and methodsOutput ratio (OR) measurements have been performed using standard and modified versions of the mD detector at nominal field sizes from 6 mm × 6 mm to 40 mm × 40 mm. In the first modified mD detector (mD_reversed), the type of charge carriers collected is reversed by connecting the opposite contact to the electrometer. In the second modified mD detector (mD_shortened), the detector's contacts have been shortened. The third modified mD detector (mD_noChip) is the same as the standard version but the diamond chip with the sensitive volume has been removed. Output correction factors were calculated from the measured OR and simulated using the EGSnrc package. An adapted Monte Carlo user‐code has been used to study the underlying mechanisms of the field size‐dependent charge imbalance and to identify the detector's structural components contributing to this effect.ResultsAt the smallest field size investigated, the OR measured using the standard mD detector is >3% higher than the OR obtained using the modified mD detector with reversed contact (mD_reversed). Combining the results obtained with the different versions of the detector, the OR have been corrected for the effect of radiation imbalance. The OR obtained using the modified mD detector with shortened contacts (mD_shortened) agree with the corrected OR, all showing an over‐response of less than 2% at the field sizes investigated. The discrepancy between the experimental and simulated output correction factors has been eliminated after accounting for the effect of charge imbalance.Discussions and conclusionsThe role of radiation‐induced charge imbalance on the dose–response of mD detector in small field dosimetry has been studied and quantified. It has been demonstrated that the effect is significant at small field sizes. Multiple methods were used to quantify the effect of charge imbalance with good agreement between Monte Carlo simulations and experimental results obtained with modified detectors. When this correction is applied to the Monte Carlo data, the discrepancy from experimental data is eliminated. Based on the detailed component analysis using an adapted Monte Carlo user‐code, it has been demonstrated that the effect of charge imbalance can be minimized by modifying the design of the detector's contacts.

Penumbra Measurements and Comparison of In-House and Standard Circular Cones by the Gafchoromic Film, Pinpoint Ion Chamber, and MCNPX Monte Carlo Simulation

Introduction: Penumbra is an important property of the radiation beam to obtain a suitable margin surrounding the target volume. Therefore, the precise penumbra width determination in stereotactic radiotherapy is necessary for treatment planning. This study aimed to compare the obtained results of penumbra width by in-house and standard circular cones by different dosimeters, as well as evaluating the function of EBT3 for dosimetric properties of the small field radiation. Material and Methods: Different circular cones were mounted on the head of the accelerator to produce 12, 20, and 40 mm field sizes at isocenter. Dosimetric measurements were performed with the EBT3 film, PinPoint ion chamber. Afterwards, MCNPX Monte Carlo simulation was used to evaluate the dosimetric parameters. Results: According to the obtained results, the penumbra width was increased by larger diameters of circular cones. The obtained measured data by PinPoint ion chamber showed a larger penumbra width compared to those calculated by Monte Carlo at all field sizes. The gamma index analysis revealed distance-to-agreement and dose-difference of 2 mm /2%/ at all points. The results of this study showed that source to diaphragm distance had a major role in penumbra size determination of small field dosimetry with PinPoint ion chamber, EBT3 film, and Monte Carlo simulation. Conclusion: As findings of this study reported, EBT3 films are reliable detectors for relative dosimetry due to high spatial resolution for small field sizes. Furthermore, they can be used for measuring beam profile and percentage depth dose curves.

Evaluating small field dosimetry with the Acuros XB (AXB) and analytical anisotropic algorithm (AAA) dose calculation algorithms in the eclipse treatment planning system

AbstractBackground:An increasing number of external beam treatment modalities including intensity modulated radiation therapy, volumetric modulated arc therapy (VMAT) and stereotactic radiosurgery uses very small fields for treatment planning and delivery. However, there are major challenges in small photon field dosimetry, due to the partial occlusion of the direct photon beam source’s view from the measurement point, lack of lateral charged particle equilibrium, steep dose-rate gradient and volume averaging effect of the detector response and variation of the energy fluence in the lateral direction of the beam. Therefore, experimental measurements of dosimetric parameters such as percent depth doses (PDDs), beam profiles and relative output factors (ROFs) for small fields continue to be a challenge.Materials and Methods:In this study, we used a homogeneous water phantom and the heterogeneous anthropomorphic stereotactic end-to-end verification (STEEV) head phantom for all dose measurements and calculations. PDDs, lateral dose profiles and ROFs were calculated in the Eclipse Treatment Planning System version 13·6 using the Acuros XB (AXB) and the analytical anisotropic algorithms (AAAs) in a homogenous water phantom. Monte Carlo (MC) simulations and measurements using the Exradin W1 Scintillator were also accomplished for four photon energies: 6 MV, 6FFF, 10 MV and 10FFF. Two VMAT treatment plans were generated for two different targets: one located in the brain and the other in the neck (close to the trachea) in the head phantom (CIRS, Norfolk, VA, USA). A Varian Truebeam linear accelerator (Varian, Palo Alto, CA, USA) was used for all treatment deliveries. Calculated results with AXB and AAA were compared with MC simulations and measurements.Results:The average difference of PDDs between W1 Exradin Scintillator measurements and MC simulations, AAA and AXB algorithm calculations were 1·2, 2·4 and 3·2%, respectively, for all field sizes and energies. AXB and AAA showed differences in ROF of about 0·3 and 2·9%, respectively, compared with W1 Exradin Scintillator measured values. For the target located in the brain in the head phantom, the average dose difference between W1 Exradin Scintillator and the MC simulations, AAA and AXB were 0·2, 3·2 and 2·7%, respectively, for all field sizes. Similarly, for the target located in the neck, the respective dose differences were 3·8, 5·7 and 3·5%.Conclusion:In this study, we compared dosimetric parameters such as PDD, beam profile and ROFs in water phantom and isocenter point dose measurements in an anthropomorphic head phantom representing a patient. We observed that measurements using the W1 Exradin scintillator agreed well with MC simulations and can be used efficiently for dosimetric parameters such as PDDs and dose profiles and patient-specific quality assurance measurements for small fields. In both homogenous and heterogeneous media, the AXB algorithm dose prediction agrees well with MC and measurements and was found to be superior to the AAA algorithm.

Characterization of the plastic scintillation detector Exradin W2 for small field dosimetry.

Small field dosimetry has been an active area of research for over a decade. It is now known that large dosimetric errors can be introduced if proper detectors or correction factors are not used. The International Atomic Energy Agency (IAEA) through the technical report series No. 483 provides guidelines for small field dosimetry procedures as well as correction factors for most detectors available in the market. The plastic scintillator detector (PSD) Exradin W1 has been found to have a correction factor close to unity; however, it is not designed for beam scanning. To overcome this limitation, the new PSD Exradin W2 has been developed to be used as a scanning as well as a relative dosimeter. Characterization of this detector in small field dosimetry is presented in this study. A 6MV beam from a Varian-Edge linac was used to collect data for the characterization of a W2 detector. Cerenkov light ratio (CLR) is corrected through a separate new electrometer system that comes with the W2 detector. The parameters investigated include the dose and dose rate linearity, beam profiles, percent depth dose (PDD), field output factors, and temperature response. The results were compared with Gafchromic film (EBT-3 film) for beam profiles. The field output factor and temperature response were compared to the Exradin W1 detector. The dose linearity measured with 600MU/min dose rate showed minimal variations (<0.5%) even for small MU, and similar results were seen for dose rate linearity. The comparison of field output factors between the W2 and W1 showed small differences for various depth and field sizes. The temperature response showed small variation when the temperature was varied from to . The slope was and for the W2 and the W1 detector, respectively. The differences in profiles are 0.5% in umbra and penumbra region for field size when compared to the EBT-3 film profile. The W2 scintillator detector showed similar dosimetric and temperature properties to the W1 scintillator detector. The main advantage of the W2 detector among other plastic scintillators is the beam scanning capabilities that, combined with its correction factor of 1.0, make it an ideal detector for commissioning of SRS and SBRT techniques.

Estimation of Dosimetric Parameters based on KNR and KNCSF Correction Factors for Small Field Radiation Therapy at 6 and 18 MV Linac Energies using Monte Carlo Simulation Methods.

Estimating dosimetric parameters for small fields under non-reference conditions leads to significant errors if done based on conventional protocols used for large fields in reference conditions. Hence, further correction factors have been introduced to take into account the influence of spectral quality changes when various detectors are used in non-reference conditions at different depths and field sizes. Determining correction factors (KNR and KNCSF) recommended recently for small field dosimetry formalism by American Association of Physicists in Medicine (AAPM) for different detectors at 6 and 18 MV photon beams. EGSnrc Monte Carlo code was used to calculate the doses measured with different detectors located in a slab phantom and the recommended KNR and KNCSF correction factors for various circular small field sizes ranging from 5-30 mm diameters. KNR and KNCSF correction factors were determined for different active detectors (a pinpoint chamber, EDP-20 and EDP-10 diodes) in a homogeneous phantom irradiated to 6 and 18 MV photon beams of a Varian linac (2100C/D). KNR correction factor estimated for the highest small circular field size of 30 mm diameter for the pinpoint chamber, EDP-20 and EDP-10 diodes were 0.993, 1.020 and 1.054; and 0.992, 1.054 and 1.005 for the 6 and 18 MV beams, respectively. The KNCSF correction factor estimated for the lowest circular field size of 5 mm for the pinpoint chamber, EDP-20 and EDP-10 diodes were 0.994, 1.023, and 1.040; and 1.000, 1.014, and 1.022 for the 6 and 18 MV photon beams, respectively. Comparing the results obtained for the detectors used in this study reveals that the unshielded diodes (EDP-20 and EDP-10) can confidently be recommended for small field dosimetry as their correction factors (KNR and KNCSF) was close to 1.0 for all small field sizes investigated and are mainly independent from the electron beam spot size.