Determination of consensus k Q values for megavoltage photon beams for the update of IAEA TRS-398.

The IAEA is currently coordinating a multi-year project to update the TRS-398 Code of Practice for the dosimetry of external beam radiotherapy based on standards of absorbed dose to water. One major aspect of the project is the determination of new beam quality correction factors, k Q , for megavoltage photon beams consistent with developments in radiotherapy dosimetry and technology since the publication of TRS-398 in 2000. Specifically, all values must be based on, or consistent with, the key data of ICRU Report 90. Data sets obtained from Monte Carlo (MC) calculations by advanced users and measurements at primary standards laboratories have been compiled for 23 cylindrical ionization chamber types, consisting of 725 MC-calculated and 179 experimental data points. These have been used to derive consensus k Q values as a function of the beam quality index TPR20,10 with a combined standard uncertainty of 0.6%. Mean values of MC-derived chamber-specific [Formula: see text] factors for cylindrical and plane-parallel chamber types in 60Co beams have also been obtained with an estimated uncertainty of 0.4%.

A new formalism for reference dosimetry of small and nonstandard fields.

The use of small fields in radiotherapy techniques has increased substantially, in particular in stereotactic treatments and large uniform or nonuniform fields that are composed of small fields such as for intensity modulated radiation therapy (IMRT). This has been facilitated by the increased availability of standard and add-on multileaf collimators and a variety of new treatment units. For these fields, dosimetric errors have become considerably larger than in conventional beams mostly due to two reasons; (i) the reference conditions recommended by conventional Codes of Practice (CoPs) cannot be established in some machines and (ii) the measurement of absorbed dose to water in composite fields is not standardized. In order to develop standardized recommendations for dosimetry procedures and detectors, an international working group on reference dosimetry of small and nonstandard fields has been established by the International Atomic Energy Agency (IAEA) in cooperation with the American Association of Physicists in Medicine (AAPM) Therapy Physics Committee. This paper outlines a new formalism for the dosimetry of small and composite fields with the intention to extend recommendations given in conventional CoPs for clinical reference dosimetry based on absorbed dose to water. This formalism introduces the concept of two new intermediate calibration fields: (i) a static machine-specific reference field for those modalities that cannot establish conventional reference conditions and (ii) a plan-class specific reference field closer to the patient-specific clinical fields thereby facilitating standardization of composite field dosimetry. Prior to progressing with developing a CoP or other form of recommendation, the members of this IAEA working group welcome comments from the international medical physics community on the formalism presented here.

Correction factors for ionization chamber measurements with the 'Valencia' and 'large field Valencia' brachytherapy applicators.

Treatment of small skin lesions using HDR brachytherapy applicators is a widely used technique. The shielded applicators currently available in clinical practice are based on a tungsten-alloy cup that collimates the source-emitted radiation into a small region, hence protecting nearby tissues. The goal of this manuscript is to evaluate the correction factors required for dose measurements with a plane-parallel ionization chamber typically used in clinical brachytherapy for the 'Valencia' and 'large field Valencia' shielded applicators. Monte Carlo simulations have been performed using the PENELOPE-2014 system to determine the absorbed dose deposited in a water phantom and in the chamber active volume with a Type A uncertainty of the order of 0.1%. The average energies of the photon spectra arriving at the surface of the water phantom differ by approximately 10%, being 384 keV for the 'Valencia' and 343 keV for the 'large field Valencia'. The ionization chamber correction factors have been obtained for both applicators using three methods, their values depending on the applicator being considered. Using a depth-independent global chamber perturbation correction factor and no shift of the effective point of measurement yields depth-dose differences of up to 1% for the 'Valencia' applicator. Calculations using a depth-dependent global perturbation factor, or a shift of the effective point of measurement combined with a constant partial perturbation factor, result in differences of about 0.1% for both applicators. The results emphasize the relevance of carrying out detailed Monte Carlo studies for each shielded brachytherapy applicator and ionization chamber.

Configuration of the electron transport algorithm of PENELOPE to simulate ion chambers.

The stability of the electron transport algorithm implemented in the Monte Carlo code PENELOPE with respect to variations of its step length is analysed in the context of the simulation of ion chambers used in photon and electron dosimetry. More precisely, the degree of violation of the Fano theorem is quantified (to the 0.1% level) as a function of the simulation parameters that determine the step size. To meet the premises of the theorem, we define an infinite graphite phantom with a cavity delimited by two parallel planes (i.e., a slab) and filled with a 'gas' that has the same composition as graphite but a mass density a thousand-fold smaller. The cavity walls and the gas have identical cross sections, including the density effect associated with inelastic collisions. Electrons with initial kinetic energies equal to 0.01, 0.1, 1, 10 or 20 MeV are generated in the wall and in the gas with a uniform intensity per unit mass. Two configurations, motivated by the design of pancake- and thimble-type chambers, are considered, namely, with the initial direction of emission perpendicular or parallel to the gas-wall interface. This version of the Fano test avoids the need of photon regeneration and the calculation of photon energy absorption coefficients, two ingredients that are common to some alternative definitions of equivalent tests. In order to reduce the number of variables in the analysis, a global new simulation parameter, called the speedup parameter (a), is introduced. It is shown that setting a = 0.2, corresponding to values of the usual PENELOPE parameters of C1 = C2 = 0.02 and values of WCC and WCR that depend on the initial and absorption energies, is appropriate for maximum tolerances of the order of 0.2% with respect to an analogue, i.e., interaction-by-interaction, simulation of the same problem. The precise values of WCC and WCR do not seem to be critical to achieve this level of accuracy. The step-size dependence of the absorbed dose is explained in the light of the properties of PENELOPE's transport mechanics. This work is intended to help users to adopt an optimal configuration that guarantees both a high-accuracy calculation of the absorbed dose and a reasonably short computing time.

Calculation of stopping power ratios for carbon ion dosimetry.

Water-to-air stopping power ratio calculations for the ionization chamber dosimetry of clinical carbon ion beams with initial energies from 50 to 450 MeV/u have been performed using the Monte Carlo technique. To simulate the transport of a particle in water the computer code SHIELD-HIT v2 was used, which is a newly developed version where substantial modifications were implemented on its predecessor SHIELD-HIT v1 (Gudowska et al 2004 Phys. Med. Biol. 49 1933-58). The code was completely rewritten replacing formerly used single precision variables with double precision variables. The lowest particle transport specific energy was decreased from 1 MeV/u down to 10 keV/u by modifying the Bethe-Bloch formula, thus widening its range for medical dosimetry applications. In addition, the code includes optionally MSTAR and ICRU-73 stopping power data. The fragmentation model was verified and its parameters were also adjusted. The present code version shows excellent agreement with experimental data. It has been used to compute the physical quantities needed for the calculation of stopping power ratios, s(water,air), of carbon beams. Compared with the recommended constant value given in the IAEA Code of Practice, the differences found in the present investigations varied between 0.5% and 1% at the plateau region, respectively for 400 MeV/u and 50 MeV/u beams, and up to 2.3% in the vicinity of the Bragg peak for 50 MeV/u.

The RBE issues in ion-beam therapy: conclusions of a joint IAEA/ICRU working group regarding quantities and units.

This paper summarises the conclusions of a working group established jointly by the International Atomic Energy Agency (IAEA) and the International Commission on Radiation Units and Measurements (ICRU) to address some of the relative biological effectiveness (RBE) issues encountered in ion-beam therapy. Special emphasis is put on the selection and definition of the involved quantities and units. The isoeffective dose, as introduced here for radiation therapy applications, is the dose that delivered under reference conditions would produce the same clinical effects as the actual treatment in a given system, all other conditions being identical. It is expressed in Gy. The reference treatment conditions are: photon irradiation, 2 Gy per fraction, 5 daily fractions a week. The isoeffective dose D(IsoE) is the product of the physical quantity absorbed dose D and a weighting factor W(IsoE). W(IsoE) is an inclusive weighting factor that takes into account all factors that could influence the clinical effects like dose per fraction, overall time, radiation quality (RQ), biological system and effects. The numerical value of W(IsoE) is selected by the radiation-oncology team for a given patient (or treatment protocol). It is part of the treatment prescription. Evaluation of the influence of RQ on W(IsoE) raises complex problems because of the clinically significant RBE variations with biological effect (late vs. early) and position in depth in the tissues which is a problem specific to ion-beam therapy. Comparison of the isoeffective dose with the equivalent dose frequently used in proton- and ion-beam therapy is discussed.

Monte Carlo calculated and experimentally determined output correction factors for small field detectors in Leksell Gamma Knife Perfexion beams.

The measurement of output factors (OF) for the small photon beams generated by Leksell Gamma Knife® (LGK) radiotherapy units is a challenge for the physicist due to the under or over estimation of these factors by a vast majority of the detectors commercially available. Output correction factors, introduced in the international formalism published by Alfonso (2008 Med. Phys. 35 5179-86), standardize the determination of OFs for small photon beams by correcting detector-reading ratios to yield OFs in terms of absorbed-dose ratios. In this work output correction factors for a number of detectors have been determined for LGK Perfexion™ (60)Co γ-ray beams by Monte Carlo (MC) calculations and measurements. The calculations were made with the MC system PENELOPE, scoring the energy deposited in the active volume of the detectors and in a small volume of water; the detectors simulated were two silicon diodes, one liquid ionization chamber (LIC), alanine and TLD. The calculated LIC output correction factors were within ± 0.4%, and this was selected as the reference detector for experimental determinations where output correction factors for twelve detectors were measured, normalizing their readings to those of the LIC. The MC-calculated and measured output correction factors for silicon diodes yielded corrections of up to 5% for the smallest LGK collimator size of 4 mm diameter. The air ionization chamber measurements led to extremely large output correction factors, caused by the well-known effect of partial volume averaging. The corrections were up to 7% for the natural diamond detector in the 4 mm collimator, also due to partial volume averaging, and decreased to within about ± 0.6% for the smaller synthetic diamond detector. The LIC, showing the smallest corrections, was used to investigate machine-to-machine output factor differences by performing measurements in four LGK units with different dose rates. These resulted in OFs within ± 0.6% and ± 0.2% for the 4 mm and 8 mm collimators, respectively, providing evidence for the use of generic OFs for these LGK beams. Using the experimentally derived output correction factors, OFs can be measured using a wide range of commercially available detectors.

Uncertainties in dosimetric data and beam calibration.

Recent studies indicate that the calibration of therapeutic beams is one of the main sources of uncertainty in the mean absorbed dose to the target volume in radiotherapy. Interaction coefficients and data used through the different steps in the calibration are pointed out as the main contribution to this uncertainty. Procedures used to select dosimetric data, that is, input parameters used in the specification of the quality of the beam, cause another contribution. In this paper the actual status of the data used for the dosimetry of photon and electron beams is introduced first. Uncertainties along the dosimetric chain are analyzed according to the procedure and data used in recent publications. Uncertainties in stopping-power ratios, considered the main contribution, are discussed in detail starting from the basic electron stopping-power data. Overall uncertainties in the presently available set of stopping-power ratios are analyzed. Recent developments in the dosimetry of electron beams, related to the effect of energy and angular spread and electron and photon contamination, are discussed in connection with the procedure to select stopping-power ratios for clinical dosimetry. Uncertainties along the dosimetric chain are evaluated in terms of the present knowledge of error sources.

The IAEA/WHO TLD postal programme for radiotherapy hospitals.

BACKGROUND AND PURPOSE: Since 1969 the International Atomic Energy Agency (IAEA), together with the World Health Organization (WHO), has performed postal TLD audits to verify the calibration of radiotherapy beams in developing countries. MATERIALS AND METHODS: A number of changes have recently been implemented to improve the efficiency of the IAEA/WHO TLD programme. The IAEA has increased the number of participants and reduced significantly the total turn-around time to provide results to the hospitals within the shortest possible time following the TLD irradiations. The IAEA has established a regular follow-up programme for hospitals with results outside acceptance limits of +/- 5%. RESULTS: The IAEA has, over 30 years, verified the calibration of more than 3300 clinical photon beams at approximately 1000 radiotherapy hospitals. Only 65% of those hospitals who receive TLDs for the first time have results within the acceptance limits, while more than 80% of the users that have benefited from a previous TLD audit are successful. The experience of the IAEA in TLD audits has been transferred to the national level. The IAEA offers a standardized TLD methodology, provides guidelines and gives technical back-up to the national TLD networks. CONCLUSION: The unsatisfactory status of the dosimetry for radiotherapy, as noted in the past, is gradually improving; however, the dosimetry practices in many hospitals in developing countries need to be revised in order to reach adequate conformity to hospitals that perform modern radiotherapy in Europe, USA and Australia.

Recent developments in basic dosimetry.

CCEMRI(I) (1985) has recommended that from January 1st 1986 the Primary Standard Dosimetry Laboratories (PSDLs) should adopt new values for W/e (33.97 J/C), stopping powers for electrons (ICRU Report 37, 1984), g value in air for 60Co (3.2 X 10-3), and energy absorption coefficients [17]. The consistency of the whole dosimetric chain requires the same basic physical data at the users' beam quality and PSDLs, but most of the existing dosimetry protocols are not generally based on such a set of data and in some cases old and new data have been employed together. A review of the basic data included in the dosimetry protocols is presented here, together with a comparison with experimental data. The most recent data include the recommendations of CCEMRI(I) and at the same time, some of the inconsistencies existing in dosimetry protocol have been eliminated. The new set of data is presented in this work. New dosimetry protocols and updated versions of protocols published before 1986 are discussed in terms of their basic data.

On the beam quality specification of high-energy photons for radiotherapy dosimetry.

An overview of common photon beam quality specifiers used in radiotherapy dosimetry introduces a reasoned discussion on the advantages and disadvantages of TPR20,10 and PDD(10)x. It is shown that some of the potential advantages of PDD(10)x are also present in other well known beam quality specifiers such as d80. However, all PDD-based beam quality indices, including PDD(10)x, are subject to electron contamination and their determination is affected by practical limitations. The proposed filtration of contaminant electrons by Kosunen and Rogers [Med. Phys. 20, 1181-1188 (1993)] and by Li and Rogers [Med. Phys. 21, 791-798 (1994)] is questioned, not only with regard to the adequacy of using lead as an electron filter, but also in relation to its efficiency (if there were no contamination, restrictions for beam calibrations at dmax would be removed) and practical measurement. It is argued that (i) there is no unique beam quality specifier that works satisfactorily in all possible conditions, for the entire energy range of photon energies used in radiotherapy and all possible accelerators used in hospitals and in standards laboratories, and (ii) TPR20,10 remains to be the most appropriate specifier for clinical photon beams as it has less practical drawbacks than PDD-based quality indices. The final impact on clinical photon beam dosimetry resulting from the use of different photon beam quality specifiers, is that they are not expected to yield a significant change (i.e., more than 0.5% and in most cases well within 0.2%) in the absorbed dose to water in reference conditions for most clinical beams.

Mean energy in electron beams.

The mean energy of the energy spectrum is an essential parameter for the dosimetry of therapeutic electron beams. Frequently it is assumed that the mean energy of such beams remains constant across the beam and only its degradation with depth is considered. The present work analyzes the variation of the mean energy of primary electrons with depth and lateral position in an electron beam using the Monte Carlo method. Results are compared with relations commonly employed for determination of mean energy at a depth. For the variation of the mean electron energy with depth in broad beams, good agreement was found between Monte Carlo results and an analytic continuous slowing down expression, which takes the variation of radiation stopping power with depth into account. Due to the calculated lateral variation of the mean energy, the relative absorbed dose profile determined with an air ionization chamber in a clinical beam should differ by less than 1% from the measured ionization profile.

A study of interface effects in 60Co beams using a thin-walled parallel plate ionization chamber.

A large plane-parallel ionization chamber has been constructed to investigate interface effects in 60Co beam. The designed geometry yields negligible perturbation from the side walls, as opposed to the large effects existing in commercially available plane-parallel chambers. The chamber has been used to investigate interface phenomena in transition zones using a wide range of elements (Z = 4-82) as front- and back-scattering media and a clinically relevant 60Co gamma-ray field size. The effects of varying the chamber height discretely (0.5-11 mm) and increasing the wall thickness (1-9 mg/cm2) have been investigated. The variation of the measured ionization with the experimental setup (air gap between backscatter material and chamber wall, measurements at dmax and at 5-cm depth, varying the material both in front of and behind the chamber, etc.) has also been investigated. The simple geometry of the ion chamber has been found optimum for benchmark studies of Monte Carlo calculations. The ion chamber is suited for investigating experimentally the effects of varying transport parameters used in Monte Carlo simulations. The results presented show that the complex physical mechanisms governing 60Co interface dosimetry still make Monte Carlo condensed-history (macroscopic) techniques uncertain. It has been found that the EGS4 Monte Carlo system, together with the user code DOSRZ V4.0 and the PRESTA algorithm, yields good agreement with experiments for low and medium Z (main interest in dosimetry and radiotherapy), but may underestimate up to 10% the backscatter from high-Z materials even when transport parameters are optimized.

Reference dosimetry in clinical high-energy photon beams: comparison of the AAPM TG-51 and AAPM TG-21 dosimetry protocols.

Task Group 51 (TG-51) of the Radiation Therapy Committee of the American Association of Physicists in Medicine (AAPM) has recently developed a new protocol for the calibration of high-energy photon and electron beams used in radiation therapy. The formalism and the dosimetry procedures recommended in this protocol are based on the use of an ionization chamber calibrated in terms of absorbed dose-to-water in a standards laboratory's 60Co gamma ray beam. This is different from the recommendations given in the AAPM TG-21 protocol, which are based on an exposure calibration factor of an ionization chamber in a 60Co beam. The purpose of this work is to compare the determination of absorbed dose-to-water in reference conditions in high-energy photon beams following the recommendations given in the two dosimetry protocols. This is realized by performing calibrations of photon beams with nominal accelerating potential of 6, 18 and 25 MV, generated by an Elekta MLCi and SL25 series linear accelerator. Two widely used Farmer-type ionization chambers having different composition, PTW 30001 (PMMA wall) and NE 2571 (graphite wall), were used for this study. Ratios of AAPM TG-51 to AAPM TG-21 doses to water are found to be 1.008, 1.007 and 1.009 at 6, 18 and 25 MV, respectively when the PTW chamber is used. The corresponding results for the NE chamber are 1.009, 1.010 and 1.013. The uncertainties for the ratios of the absorbed dose determined by the two protocols are estimated to be about 1.5%. A detailed analysis of the reasons for the discrepancies is made which includes comparing the formalisms, correction factors and quantities in the two protocols, as well as the influence of the implementation of the different standards for chamber calibration. The latter has been found to have a considerable influence on the differences in clinical dosimetry, even larger than the adoption of the new data and recommended procedures, as most intrinsic differences cancel out due to the adoption of the new formalism.

Bremsstrahlung production at 50 MeV in different target materials and configurations.

A combination of Monte Carlo, convolution, and experimental techniques have been used to investigate bremsstrahlung production at 50 MeV in full-range targets to produce narrow elementary photon beams for scanning. Calculations using the ITS 3.0 Monte Carlo system for various target designs, including particle transport through the treatment head of an MM5O racetrack microtron and a water phantom, have been compared to experimental dose profiles from narrow photon beams at 10-cm depth in water. A reduction in the ITS 3.0 default substep size has been found necessary even for incomplete agreement, in consistency with the findings of Faddegon and Rogers [Nucl. Instrum. Meth. A 327, 556-565 (1993)] for a different experimental setup and energy using the previous version of ITS. Results show that the calculated shape of the tail of dose distributions from narrow photon beams agrees well with measurements, but CYLTRAN/ITS 3.0 fails to reproduce the central part of the distribution. The discrepancy at small angles, reported previously for EGS4 and ITS 2.1 simulations, possess a limitation to Monte Carlo simulations of narrow photon beams used in scanned systems of clinical accelerators. Radial dose profiles have been calculated by convolution of the energy fluence at the exit of the target with one polyenergetic Monte Carlo calculated dose kernel and also a database consisting of ten different dose kernels corresponding to different monoenergetic photon pencil beams for comparison. The agreement with the much slower fully detailed Monte Carlo calculations was better when using the database kernels than the polyenergetic kernel. Results for the mean energy, mean polar angle, and energy fluence at different depths within various targets have been obtained. These are discussed in the context of the design characteristics of bremsstrahlung targets with emphasis on their utilization for scanning photon beam techniques.

Constraints of the multiple-scattering theory of Molière in Monte Carlo simulations of the transport of charged particles.

The breakdown of Molière's multiple-scattering theory for short pathlengths occurring during Monte Carlo simulations with charged particles is demonstrated. It has been found that in certain conditions where the theory is assumed to be valid, significant distortions of the angular distribution occur that make the sampling of the polar angle questionable in numerous steps of Monte Carlo simulations. The limits of the theory have been investigated, both using a large number of terms in the Molière's series and using steps of Molière's theory where 1/B expansions are not involved. At B = 4.5 the commonly accepted 3-term series expansion yields differences up to +/- 6% compared with the evaluation of the complete Molière angular distribution, and up to 7 terms in the series are needed in order to achieve agreement within +/- 2%. One percent agreement requires B = 10. Numerical values of the full distribution are given in terms of Molière's parameters B and reduced angle theta. By using the general dependence of the distribution results are valid for both electron and proton Monte Carlo simulations in any material.

Reference dosimetry in clinical high-energy electron beams: comparison of the AAPM TG-51 and AAPM TG-21 dosimetry protocols.

A comparison of the determination of absorbed dose to water in reference conditions with high-energy electron beams (Enominal of 6, 8, 10, 12, 15, and 18 MeV) following the recommendations given in the AAPM TG-51 and in the original TG-21 dosimetry protocols has been made. Six different ionization chamber types have been used, two Farmer-type cylindrical (PTW 30001, PMMA wall; NE 2571, graphite wall) and four plane parallel (PTW Markus, and Scanditronix-Wellhöfer NACP, PPC-05 and Roos PPC-40). Depending upon the cylindrical chamber type used and the beam energy, the doses at dmax determined with TG-51 were higher than with TG-21 by about 1%-3%. Approximately 1% of this difference is due to the differences in the data given in the two protocols; another 1.1%-1.2% difference is due to the change of standards, from air-kerma to absorbed dose to water. For plane-parallel chambers, absorbed doses were determined by using two chamber calibration methods: (i) direct use of the ADCL calibration factors N(60Co)D,w and Nx for each chamber type in the appropriate equations for dose determination recommended by each protocol, and (ii) cross-calibration techniques in a high-energy electron beam, as recommended by TG-21, TG-39, and TG-51. Depending upon the plane-parallel chamber type used and the beam energy, the doses at dmax determined with TG-51 were higher than with TG-21 by about 0.7%-2.9% for the direct calibration procedures and by 0.8%-3.2% for the cross-calibration techniques. Measured values of photon-electron conversion kecal, for the NACP and Markus chambers were found to be 0.3% higher and 1.7% lower than the corresponding values given in TG-51. For the PPC-05 and PPC-40 (Roos) chamber types, the values of kecal were measured to be 0.889 and 0.893, respectively. The uncertainty for the entire calibration chain, starting from the calibration of the ionization chamber in the standards laboratory to the determination of absorbed dose to water in the user beam, has been analyzed for the two formalisms. For cylindrical chambers, the observed differences between the two protocols are within the estimated combined uncertainty of the ratios of absorbed doses for 6 and 8 MeV; however, at higher energies (10< or =E< or =18 MeV), the differences are larger than the estimated combined uncertainties by about 1%. For plane-parallel chambers, the observed differences are within the estimated combined uncertainties for the direct calibration technique; for the cross-calibration technique the differences are within the uncertainty estimates at low energies whereas they are comparable to the uncertainty estimates at higher energies. A detailed analysis of the reasons for the discrepancies is made which includes comparing the formalisms, correction factors, and quantities in the two protocols, as well as the influence of the implementation of the different standards for chamber calibration.

A comparison between calculated and experimental kQ photon beam quality correction factors.

To validate the calculated values of kQ for high-energy photon beams given in the International Code of Practice for radiotherapy dosimetry based on water-absorbed-dose standards, a comparison with experimental values derived in standards laboratories and in clinical beams has been made. The study includes a compilation of experimental values for ionization chambers of the type NE2561/2611, NE2571, PTW30001 and PR06. The energy dependence of the G(Fe3+) ratio of high-energy x-rays to 60Co gamma-rays by Klassen et al is taken into account for all the Fricke-derived values. For three of the chamber types analysed, the comparison shows that the calculated values are a very good estimate of the average values of kQ in the entire range of photon beam qualities available for clinical use. For the NE2571 chamber type a difference which increases with energy between calculated and experimental kQ factors has been observed; however, the largest difference with a fit describing the entire set of experimental data is always smaller than 0.4%. It is concluded that if the recommendation of the Code of Practice for an individual calibration of the user's chamber at a range of photon beam qualities is not available, the use of calculated kQ factors will yield absorbed dose to water determinations accurate within the uncertainty limits of the majority of experimental data available. The good agreement between calculated and measured values, obtained for practically all the experimental data using TPR(20,10) as photon beam quality specifier, is not satisfied in some cases for two high-energy soft beams used at the Canadian NRC. There appears to be no justification for a change to a different photon beam quality specifier solely on the grounds that such a limited set of data is not described by the same distributions as the rest of the experimental data.

Stopping power data for high-energy photon beams.

Spencer-Attix stopping power ratios for the dosimetry of high-energy photon beams used in radiation therapy have been calculated using the Monte Carlo method. The stopping power ratios are calculated in a more consistent way than previously and are given as a function of the attenuation properties of the beam. The dependence of the stopping power ratio on the electron contamination of the beam as well as on depth and field size has also been investigated. Results are compared with stopping power ratios recommended in different dosimetry protocols and to experimental results. The agreement with most dosimetry protocols is within about one per cent and with recent experimental data is better than half a per cent.

Determination of effective bremsstrahlung spectra and electron contamination for photon dose calculations.

A method is described for determining an effective, depth dose consistent bremsstrahlung spectra for high-energy photon beams using depth dose curves measured in water. A simple, analytical model with three parameters together with the nominal accelerating potential is used to characterise the bremsstrahlung spectra. The model is used to compute weights for depth dose curves from monoenergetic photons. These monoenergetic depth doses, calculated with the convolution method from Monte Carlo generated point spread functions (PSF), are added to yield the pure photon depth dose distribution. The parameters of the analytical spectrum model are determined using an iterative technique to minimise the difference between calculated and measured depth dose curves. The influence from contaminant electrons is determined from the difference between the calculated and the measured depth dose.