Minimum phantom size for megavoltage photon beam reference dosimetry.

BACKGROUND: Water phantoms are required to perform reference dosimetry and beam quality measurements but there are no published studies about the size requirements for such phantoms. PURPOSE: To investigate, using Monte Carlo techniques, the size requirements for water phantoms used in reference dosimetry and/or to measure the beam quality specifiers % d d ( 10 ) x $\%dd(10)_{\sf x}$ and T P R 10 20 $TPR^{20}_{10}$ . METHODS: The EGSnrc application DOSXYZnrc is used to calculate D ( 10 ) $D(10)$ , the dose per incident fluence at 10 cm depth in a water phantom irradiated by incident 10 × 10 cm 2 $10\,\times \,10 \, {\rm {cm}}^{2}$   beams of 60 Co $^{60}{\rm {Co}}$   or 6 MV photons. The water phantom dimensions are varied from 30 × 30 × 40 cm 3 $30 \,\times \, 30 \,\times \, 40 \, {\rm {cm}}^3$ to 15 × 15 × 22 cm 3 $15 \,\times \, 15 \,\times \, 22 \, {\rm {cm}}^3$ and occasionally smaller. The % d d ( 10 ) x $\%dd(10)_{\sf x}$ and T P R 10 20 $TPR^{20}_{10}$ values are also calculated with care being taken to distinguish T P R 10 20 $TPR^{20}_{10}$ results when using Method A (changing depth of water in phantom) and Method B (moving entire phantom). Typical statistical uncertainties are 0.03%. RESULTS: Phantom dimensions have only minor effects for phantoms larger than 20 × 20 × 25 cm 3 $20 \,\times \, 20 \,\times \, 25 \, {\rm {cm}}^3$ . A table of corrections to the dose at 10 cm depth in 10 × 10 cm 2 $10 \,\times \, 10 \, {\rm {cm}}^{2}$   beams of 60 Co $^{60}{\rm {Co}}$   or 6 MV photons are provided and range from no correction to 0.75% for a 60 Co $^{60}{\rm {Co}}$  beam incident on a 20 × 20 × 15 cm 3 $20 \,\times \, 20 \,\times \, 15 \, {\rm {cm}}^3$ phantom. There can be distinct differences in the T P R 10 20 $TPR^{20}_{10}$ values measured using Method A or Method B, especially for smaller phantoms. It is explicitly demonstrated that, within ± $\pm$ 0.15%, T P R 10 20 $TPR^{20}_{10}$ values for a 30 × 30 × 30 cm 3 $30 \,\times \, 30 \,\times \, 30 \, {\rm {cm}}^3$ phantom measured using Method A or B are independent of source detector distance between 40 and 200 cm. CONCLUSIONS: The phantom sizes recommended in the TG-51 and IAEA TRS-398 reference dosimetry protocols are adequate for accurate reference dosimetry and in some cases are even conservative. Correction factors are necessary for accurate measurement of the dose at 10 cm depth in smaller phantoms and these factors are provided. Very accurate beam quality specifiers are not required for reference dosimetry itself, but for specifying beam stability and characteristics it is important to specify phantom sizes and also the method used for T P R 10 20 $TPR^{20}_{10}$  measurements.

Update of the CLRP Monte Carlo TG-43 parameter database for high-energy brachytherapy sources.

PURPOSE: To update and extend version 2 of the Carleton Laboratory for Radiotherapy Physics (CLRP) TG-43 dosimetry database (CLRP_TG43v2) for high-energy (HE, ≥50 keV) brachytherapy sources (1 169 Yb, 23 192 Ir, 5 137 Cs, and 4 60 Co) using egs_brachy, an open-source EGSnrc application. A comprehensive dataset of TG-43 parameters is compiled, including detailed source descriptions, dose-rate constants, radial dose functions, 1D and 2D anisotropy functions, along-away dose-rate tables, Primary and Scatter Separated (PSS) dose tables, and mean photon energies escaping each source. The database also documents the source models which are freely distributed with egs_brachy. ACQUISITION AND VALIDATION METHODS: Datasets are calculated after a recoding of the source geometries using the egs++ geometry package and its egs_brachy extensions. Air kerma per history is calculated in a 10 × 10 × $\,{\times}\, 10\,{\times}\,$ 0.05 cm3 voxel located 100 cm from the source along the transverse axis and then corrected for the lateral and thickness dimensions of the scoring voxel to give the air kerma on the central axis at a point 100 cm from the source's mid-point. Full-scatter water phantoms with varying voxel resolutions in cylindrical coordinates are used for dose calculations. Most data (except for 60 Co) are based on the assumption of charged particle equilibrium and ignore the potentially large effects of electron transport very close to the source and dose from initial beta particles. These effects are evaluated for four representative sources. For validation, data are compared to those from CLRP_TG43v1 and published data. DATA FORMAT AND ACCESS: Data are available at https://physics.carleton.ca/clrp/egs_brachy/seed_database_v2 or http://doi.org/10.22215/clrp/tg43v2 including in Excel (.xlsx) spreadsheets, and are presented graphically in comparisons to previously published data for each source. POTENTIAL APPLICATIONS: The CLRP_TG43v2 database has applications in research, dosimetry, and brachytherapy planning. This comprehensive update provides the medical physics community with more precise and in some cases more accurate Monte Carlo (MC) TG-43 dose calculation parameters, as well as fully benchmarked and described source models which are distributed with egs_brachy.

An improved physics-based approach for unfolding megavoltage bremsstrahlung spectra using transmission analysis.

PURPOSE: To develop a physics-based approach to improve the accuracy and robustness of the ill-conditioned problem of unfolding megavoltage bremsstrahlung spectra from transmission data. METHODS: Spectra are specified using a rigorously-benchmarked functional form. Since ion chambers are the typical detector used in transmission measurements, the energy response of a Farmer chamber is calculated using the EGSnrc Monte Carlo code, and the effect of approximating the energy response on the accuracy of the unfolded spectra is studied. A proposal is introduced to enhance spectral sensitivity by combining transmission data measured with multiple detectors of different energy response and by combining data from multiple attenuating materials. Monte Carlo methods are developed to correct for nonideal exponential attenuation (e.g., scatter effects and secondary attenuation). The performance of the proposed methods is evaluated for a diverse set of validated clinical spectra (3.5-25 MV) using analytical transmission data with simulated experimental noise. RESULTS: The approximations commonly used in previous studies for the ion-chamber energy response lead to significant errors in the unfolded spectra. Of the configurations studied, the one with best spectral sensitivity is to measure four full transmission curves using separate low-Z and high-Z attenuators in conjunction with two detectors of different energy response (the authors propose a Farmer-type ion chamber, once with a low-Z, and once with a high-Z buildup cap material), then to feed the data simultaneously to the unfolding algorithm. Deviations from ideal exponential attenuation are as much as 1.5% for the smallest transmission signals, and the proposed methods properly correct for those deviations. The transmission data with enhanced spectral sensitivity, combined with the accurate and flexible spectral functional form, lead to robust unfolding without requiring a priori knowledge of the spectrum. Compared with the commonly-used methods, the accuracy is improved for the unfolded spectra and for the unfolded mean incident electron kinetic energy by at least factors of three and four, respectively. With simulated experimental noise and a lowest transmission of 1%, the unfolded energy fluence spectra agree with the original spectra with a normalized root-mean-square deviation, %Δ(ψ), of 2.3%. The unfolded mean incident electron kinetic energies agree, on average, with the original values within 1.4%. A lowest transmission of only 10% still allows unfolding with %Δ(ψ) of 3.3%. CONCLUSIONS: In the presence of realistic experimental noise, the proposed approach significantly improves the accuracy and robustness of the spectral unfolding problem for all therapy and MV imaging beams of clinical interest.

Beam quality conversion factors for parallel-plate ionization chambers in MV photon beams.

PURPOSE: To investigate the behavior of plane-parallel ion chambers in high-energy photon beams through measurements and Monte Carlo simulations. METHODS: Ten plane-parallel ion chamber types were obtained from the major ion chamber manufacturers. Absorbed dose-to-water calibration coefficients are measured for these chambers and k(Q) factors are determined. In the process, the behaviors of the chambers are characterized through measurements of leakage currents, chamber settling in cobalt-60, polarity and ion recombination behavior, and long-term stability. Monte Carlo calculations of the absorbed dose to the air in the ion chamber and absorbed dose to water are obtained to calculate k(Q) factors. Systematic uncertainties in Monte Carlo calculated k(Q) factors are investigated by varying material properties and chamber dimensions. RESULTS: Chamber behavior was variable in MV photon beams, especially with regard to chamber leakage and ion recombination. The plane-parallel chambers did not perform as well as cylindrical chambers. Significant differences up to 1.5% were observed in calibration coefficients after a period of eight months although k(Q) factors were consistent on average within 0.17%. Chamber-to-chamber variations in k(Q) factors for chambers of the same type were at the 0.2% level. Systematic uncertainties in Monte Carlo calculated k(Q) factors ranged between 0.34% and 0.50% depending on the chamber type. Average percent differences between measured and calculated k(Q) factors were - 0.02%, 0.18%, and - 0.16% for 6, 10, and 25 MV beams, respectively. CONCLUSIONS: Excellent agreement is observed on average at the 0.2% level between measured and Monte Carlo calculated k(Q) factors. Measurements indicate that the behavior of these chambers is not adequate for their use for reference dosimetry of high-energy photon beams without a more extensive QA program than currently used for cylindrical reference-class ion chambers.

Unfolding linac photon spectra and incident electron energies from experimental transmission data, with direct independent validation.

PURPOSE: In a recent computational study, an improved physics-based approach was proposed for unfolding linac photon spectra and incident electron energies from transmission data. In this approach, energy differentiation is improved by simultaneously using transmission data for multiple attenuators and detectors, and the unfolding robustness is improved by using a four-parameter functional form to describe the photon spectrum. The purpose of the current study is to validate this approach experimentally, and to demonstrate its application on a typical clinical linac. METHODS: The validation makes use of the recent transmission measurements performed on the Vickers research linac of National Research Council Canada. For this linac, the photon spectra were previously measured using a NaI detector, and the incident electron parameters are independently known. The transmission data are for eight beams in the range 10-30 MV using thick Be, Al and Pb bremsstrahlung targets. To demonstrate the approach on a typical clinical linac, new measurements are performed on an Elekta Precise linac for 6, 10 and 25 MV beams. The different experimental setups are modeled using EGSnrc, with the newly added photonuclear attenuation included. RESULTS: For the validation on the research linac, the 95% confidence bounds of the unfolded spectra fall within the noise of the NaI data. The unfolded spectra agree with the EGSnrc spectra (calculated using independently known electron parameters) with RMS energy fluence deviations of 4.5%. The accuracy of unfolding the incident electron energy is shown to be ∼3%. A transmission cutoff of only 10% is suitable for accurate unfolding, provided that the other components of the proposed approach are implemented. For the demonstration on a clinical linac, the unfolded incident electron energies and their 68% confidence bounds for the 6, 10 and 25 MV beams are 6.1 ± 0.1, 9.3 ± 0.1, and 19.3 ± 0.2 MeV, respectively. The unfolded spectra for the clinical linac agree with the EGSnrc spectra (calculated using the unfolded electron energies) with RMS energy fluence deviations of 3.7%. The corresponding measured and EGSnrc-calculated transmission data agree within 1.5%, where the typical transmission measurement uncertainty on the clinical linac is 0.4% (not including the uncertainties on the incident electron parameters). CONCLUSIONS: The approach proposed in an earlier study for unfolding photon spectra and incident electron energies from transmission data is accurate and practical for clinical use.

Detailed high-accuracy megavoltage transmission measurements: a sensitive experimental benchmark of EGSnrc.

PURPOSE: There are three goals for this study: (a) to perform detailed megavoltage transmission measurements in order to identify the factors that affect the measurement accuracy, (b) to use the measured data as a benchmark for the EGSnrc system in order to identify the computational limiting factors, and (c) to provide data for others to benchmark Monte Carlo codes. METHODS: Transmission measurements are performed at the National Research Council Canada on a research linac whose incident electron parameters are independently known. Automated transmission measurements are made on-axis, down to a transmission value of ∼1.7%, for eight beams between 10 MV (the lowest stable MV beam on the linac) and 30 MV, using fully stopping Be, Al, and Pb bremsstrahlung targets and no fattening filters. To diversify energy differentiation, data are acquired for each beam using low-Z and high-Z attenuators (C and Pb) and Farmer chambers with low-Z and high-Z buildup caps. Experimental corrections are applied for beam drifts (2%), polarity (2.5% typical maximum, 6% extreme), ion recombination (0.2%), leakage (0.3%), and room scatter (0.8%)-the values in parentheses are the largest corrections applied. The experimental setup and the detectors are modeled using EGSnrc, with the newly added photonuclear attenuation included (up to a 5.6% effect). A detailed sensitivity analysis is carried out for the measured and calculated transmission data. RESULTS: The developed experimental protocol allows for transmission measurements with 0.4% uncertainty on the smallest signals. Suggestions for accurate transmission measurements are provided. Measurements and EGSnrc calculations agree typically within 0.2% for the sensitivity of the transmission values to the detector details, to the bremsstrahlung target material, and to the incident electron energy. Direct comparison of the measured and calculated transmission data shows agreement better than 2% for C (3.4% for the 10 MV beam) and typically better than 1% for Pb. The differences can be explained by acceptable photon cross section changes of ≤0.4%. CONCLUSIONS: Accurate transmission measurements require accounting for a number of influence quantities which, if ignored, can collectively introduce errors larger than 10%. Accurate transmission calculations require the use of the most accurate data and physics options available in EGSnrc, particularly the more accurate bremsstrahlung angular sampling option and the newly added modeling of photonuclear attenuation. Comparison between measurements and calculations implies that EGSnrc is accurate within 0.2% for relative ion chamber response calculations. Photon cross section uncertainties are the ultimate limiting factor for the accuracy of the calculated transmission data (Monte Carlo or analytical).

Dosimetry of (125)I and (103)Pd COMS eye plaques for intraocular tumors: report of Task Group 129 by the AAPM and ABS.

Dosimetry of eye plaques for ocular tumors presents unique challenges in brachytherapy. The challenges in accurate dosimetry are in part related to the steep dose gradient in the tumor and critical structures that are within millimeters of radioactive sources. In most clinical applications, calculations of dose distributions around eye plaques assume a homogenous water medium and full scatter conditions. Recent Monte Carlo (MC)-based eye-plaque dosimetry simulations have demonstrated that the perturbation effects of heterogeneous materials in eye plaques, including the gold-alloy backing and Silastic insert, can be calculated with reasonable accuracy. Even additional levels of complexity introduced through the use of gold foil "seed-guides" and custom-designed plaques can be calculated accurately using modern MC techniques. Simulations accounting for the aforementioned complexities indicate dose discrepancies exceeding a factor of ten to selected critical structures compared to conventional dose calculations. Task Group 129 was formed to review the literature; re-examine the current dosimetry calculation formalism; and make recommendations for eye-plaque dosimetry, including evaluation of brachytherapy source dosimetry parameters and heterogeneity correction factors. A literature review identified modern assessments of dose calculations for Collaborative Ocular Melanoma Study (COMS) design plaques, including MC analyses and an intercomparison of treatment planning systems (TPS) detailing differences between homogeneous and heterogeneous plaque calculations using the American Association of Physicists in Medicine (AAPM) TG-43U1 brachytherapy dosimetry formalism and MC techniques. This review identified that a commonly used prescription dose of 85 Gy at 5 mm depth in homogeneous medium delivers about 75 Gy and 69 Gy at the same 5 mm depth for specific (125)I and (103)Pd sources, respectively, when accounting for COMS plaque heterogeneities. Thus, the adoption of heterogeneous dose calculation methods in clinical practice would result in dose differences >10% and warrant a careful evaluation of the corresponding changes in prescription doses. Doses to normal ocular structures vary with choice of radionuclide, plaque location, and prescription depth, such that further dosimetric evaluations of the adoption of MC-based dosimetry methods are needed. The AAPM and American Brachytherapy Society (ABS) recommend that clinical medical physicists should make concurrent estimates of heterogeneity-corrected delivered dose using the information in this report's tables to prepare for brachytherapy TPS that can account for material heterogeneities and for a transition to heterogeneity-corrected prescriptive goals. It is recommended that brachytherapy TPS vendors include material heterogeneity corrections in their systems and take steps to integrate planned plaque localization and image guidance. In the interim, before the availability of commercial MC-based brachytherapy TPS, it is recommended that clinical medical physicists use the line-source approximation in homogeneous water medium and the 2D AAPM TG-43U1 dosimetry formalism and brachytherapy source dosimetry parameter datasets for treatment planning calculations. Furthermore, this report includes quality management program recommendations for eye-plaque brachytherapy.

The central electrode correction factor for high-Z electrodes in small ionization chambers.

PURPOSE: Recent Monte Carlo calculations of beam quality conversion factors for ion chambers that use high-Z electrodes [B. R. Muir and D. W. O. Rogers, Med. Phys. 37, 5939-5950 (2010)] have shown large deviations of kQ values from values calculated using the same techniques as the TG-51 and TRS-398 protocols. This report investigates the central electrode correction factor, Pcel, for these chambers. METHODS: Ionization chambers are modeled and Pcel is calculated using the EGSnrc user code egs_chamber for three cases: in photon and electron beams under reference conditions; as a function of distance from an iridium-192 point source in a water phantom; and as a function of depth in a water phantom on which a 200 kVp x-ray source or 6 MV beam is incident. RESULTS: In photon beams, differences of up to 3% between Pcel calculations for a chamber with a high-Z electrode and those used by TG-51 for a 1 mm diameter aluminum electrode are observed. The central electrode correction factor for a given value of the beam quality specifier is different depending on the amount of filtration of the photon beam. However, in an unfiltered 6 MV beam, Pcel, varies by only 0.3% for a chamber with a high-Z electrode as the depth is varied from 1 to 20 cm in water. The difference between Pcel calculations for chambers with high-Z electrodes and TG-51 values for a chamber with an aluminum electrode is up to 0.45% in electron beams. The central electrode correction, which is roughly proportional to the chambers absorbed dose sensitivity, is found to be large and variable as a function of distance for chambers with high-Z and aluminum electrodes in low-energy photon fields. CONCLUSIONS: In this work, ionization chambers that employ high-Z electrodes have been shown to be problematic in various situations. For beam quality conversion factors, the ratio of Pcel in a beam quality Q to that in a Co-60 beam is required; for some chambers, kQ is significantly different from current dosimetry protocol values because of central electrode effects. It would be best for manufacturers to avoid producing ion chambers that use high-Z electrodes.

Measured and Monte Carlo calculated K(Q) factors: accuracy and comparison.

PURPOSE: The journal Medical Physics recently published two papers that determine beam quality conversion factors, k(Q), for large sets of ion chambers. In the first paper [McEwen Med. Phys. 37, 2179-2193 (2010)], k(Q) was determined experimentally, while the second paper [Muir and Rogers Med. Phys. 37, 5939-5950 (2010)] provides k(Q) factors calculated using Monte Carlo simulations. This work investigates a variety of additional consistency checks to verify the accuracy of the k(Q) factors determined in each publication and a comparison of the two data sets. Uncertainty introduced in calculated k(Q) factors by possible variation of W/e with beam energy is investigated further. METHODS: The validity of the experimental set of k(Q) factors relies on the accuracy of the NE2571 reference chamber measurements to which k(Q) factors for all other ion chambers are correlated. The stability of NE2571 absorbed dose to water calibration coefficients is determined and comparison to other experimental k(Q) factors is analyzed. Reliability of Monte Carlo calculated k(Q) factors is assessed through comparison to other publications that provide Monte Carlo calculations of k(Q) as well as an analysis of the sleeve effect, the effect of cavity length and self-consistencies between graphite-walled Farmer-chambers. Comparison between the two data sets is given in terms of the percent difference between the k(Q) factors presented in both publications. RESULTS: Monitoring of the absorbed dose calibration coefficients for the NE2571 chambers over a period of more than 15 yrs exhibit consistency at a level better than 0.1%. Agreement of the NE2571 k(Q) factors with a quadratic fit to all other experimental data from standards labs for the same chamber is observed within 0.3%. Monte Carlo calculated k(Q) factors are in good agreement with most other Monte Carlo calculated k(Q) factors. Expected results are observed for the sleeve effect and the effect of cavity length on k(Q). The mean percent differences between experimental and Monte Carlo calculated k(Q) factors are -0.08, -0.07, and -0.23% for the Elekta 6, 10, and 25 MV nominal beam energies, respectively. An upper limit on the variation of W/e in photon beams from cobalt-60 to 25 MV is determined as 0.4% with 95% confidence. The combined uncertainty on Monte Carlo calculated k(Q) factors is reassessed and amounts to between 0.40 and 0.49% depending on the wall material of the chamber. CONCLUSIONS: Excellent agreement (mean percent difference of only 0.13% for the entire data set) between experimental and calculated k(Q) factors is observed. For some chambers, k(Q) is measured for only one chamber of each type--the level of agreement observed in this study would suggest that for those chambers the measured k(Q) values are generally representative of the chamber type.

Changes in dose with segmentation of breast tissues in Monte Carlo calculations for low-energy brachytherapy.

PURPOSE: To investigate the use of various breast tissue segmentation models in Monte Carlo dose calculations for low-energy brachytherapy. METHODS: The EGSnrc user-code BrachyDose is used to perform Monte Carlo simulations of a breast brachytherapy treatment using TheraSeed Pd-103 seeds with various breast tissue segmentation models. Models used include a phantom where voxels are randomly assigned to be gland or adipose (randomly segmented), a phantom where a single tissue of averaged gland and adipose is present (averaged tissue), and a realistically segmented phantom created from previously published numerical phantoms. Radiation transport in averaged tissue while scoring in gland along with other combinations is investigated. The inclusion of calcifications in the breast is also studied in averaged tissue and randomly segmented phantoms. RESULTS: In randomly segmented and averaged tissue phantoms, the photon energy fluence is approximately the same; however, differences occur in the dose volume histograms (DVHs) as a result of scoring in the different tissues (gland and adipose versus averaged tissue), whose mass energy absorption coefficients differ by 30%. A realistically segmented phantom is shown to significantly change the photon energy fluence compared to that in averaged tissue or randomly segmented phantoms. Despite this, resulting DVHs for the entire treatment volume agree reasonably because fluence differences are compensated by dose scoring differences. DVHs for the dose to only the gland voxels in a realistically segmented phantom do not agree with those for dose to gland in an averaged tissue phantom. Calcifications affect photon energy fluence to such a degree that the differences in fluence are not compensated for (as they are in the no calcification case) by dose scoring in averaged tissue phantoms. CONCLUSIONS: For low-energy brachytherapy, if photon transport and dose scoring both occur in an averaged tissue, the resulting DVH for the entire treatment volume is reasonably accurate because inaccuracies in photon energy fluence are compensated for by inaccuracies in localized dose scoring. If dose to fibroglandular tissue in the breast is of interest, then the inaccurate photon energy fluence calculated in an averaged tissue phantom will result in inaccurate DVHs and average doses for those tissues. Including calcifications necessitates the use of proper tissue segmentation.

Comparison of dose calculation methods for brachytherapy of intraocular tumors.

PURPOSE: To investigate dosimetric differences among several clinical treatment planning systems (TPS) and Monte Carlo (MC) codes for brachytherapy of intraocular tumors using 125I or 103Pd plaques, and to evaluate the impact on the prescription dose of the adoption of MC codes and certain versions of a TPS (Plaque Simulator with optional modules). METHODS: Three clinical brachytherapy TPS capable of intraocular brachytherapy treatment planning and two MC codes were compared. The TPS investigated were Pinnacle v8.0dp1, BrachyVision v8.1, and Plaque Simulator v5.3.9, all of which use the AAPM TG-43 formalism in water. The Plaque Simulator software can also handle some correction factors from MC simulations. The MC codes used are MCNP5 v1.40 and BrachyDose/EGSnrc. Using these TPS and MC codes, three types of calculations were performed: homogeneous medium with point sources (for the TPS only, using the 1D TG-43 dose calculation formalism); homogeneous medium with line sources (TPS with 2D TG-43 dose calculation formalism and MC codes); and plaque heterogeneity-corrected line sources (Plaque Simulator with modified 2D TG-43 dose calculation formalism and MC codes). Comparisons were made of doses calculated at points-of-interest on the plaque central-axis and at off-axis points of clinical interest within a standardized model of the right eye. RESULTS: For the homogeneous water medium case, agreement was within approximately 2% for the point- and line-source models when comparing between TPS and between TPS and MC codes, respectively. For the heterogeneous medium case, dose differences (as calculated using the MC codes and Plaque Simulator) differ by up to 37% on the central-axis in comparison to the homogeneous water calculations. A prescription dose of 85 Gy at 5 mm depth based on calculations in a homogeneous medium delivers 76 Gy and 67 Gy for specific 125I and 103Pd sources, respectively, when accounting for COMS-plaque heterogeneities. For off-axis points-of-interest, dose differences approached factors of 7 and 12 at some positions for 125I and 103Pd, respectively. There was good agreement (approximately 3%) among MC codes and Plaque Simulator results when appropriate parameters calculated using MC codes were input into Plaque Simulator. Plaque Simulator and MC users are perhaps at risk of overdosing patients up to 20% if heterogeneity corrections are used and the prescribed dose is not modified appropriately. CONCLUSIONS: Agreement within 2% was observed among conventional brachytherapy TPS and MC codes for intraocular brachytherapy dose calculations in a homogeneous water environment. In general, the magnitude of dose errors incurred by ignoring the effect of the plaque backing and Silastic insert (i.e., by using the TG-43 approach) increased with distance from the plaque's central-axis. Considering the presence of material heterogeneities in a typical eye plaque, the best method in this study for dose calculations is a verified MC simulation.

Monte Carlo calculations of kQ, the beam quality conversion factor.

PURPOSE: To use EGSnrc Monte Carlo simulations to directly calculate beam quality conversion factors, kQ, for 32 cylindrical ionization chambers over a range of beam qualities and to quantify the effect of systematic uncertainties on Monte Carlo calculations of kQ. These factors are required to use the TG-51 or TRS-398 clinical dosimetry protocols for calibrating external radiotherapy beams. METHODS: Ionization chambers are modeled either from blueprints or manufacturers' user's manuals. The dose-to-air in the chamber is calculated using the EGSnrc user-code egs_chamber using 11 different tabulated clinical photon spectra for the incident beams. The dose to a small volume of water is also calculated in the absence of the chamber at the midpoint of the chamber on its central axis. Using a simple equation, kQ is calculated from these quantities under the assumption that W/e is constant with energy and compared to TG-51 protocol and measured values. RESULTS: Polynomial fits to the Monte Carlo calculated kQ factors as a function of beam quality expressed as %dd(10)x and TPR10(20) are given for each ionization chamber. Differences are explained between Monte Carlo calculated values and values from the TG-51 protocol or calculated using the computer program used for TG-51 calculations. Systematic uncertainties in calculated kQ values are analyzed and amount to a maximum of one standard deviation uncertainty of 0.99% if one assumes that photon cross-section uncertainties are uncorrelated and 0.63% if they are assumed correlated. The largest components of the uncertainty are the constancy of W/e and the uncertainty in the cross-section for photons in water. CONCLUSIONS: It is now possible to calculate kQ directly using Monte Carlo simulations. Monte Carlo calculations for most ionization chambers give results which are comparable to TG-51 values. Discrepancies can be explained using individual Monte Carlo calculations of various correction factors which are more accurate than previously used values. For small ionization chambers with central electrodes composed of high-Z materials, the effect of the central electrode is much larger than that for the aluminum electrodes in Farmer chambers.

Monte Carlo calculated absorbed-dose energy dependence of EBT and EBT2 film.

PURPOSE: The absorbed-dose energy dependence of GAFCHROMIC EBT and EBT2 film irradiated in photon beams is studied to understand the shape of the curves and the physics behind them. METHODS: The absorbed-dose energy dependence is calculated using the EGSnrc-based EGS_chamber and DOSRZnrc codes by calculating the ratio of dose to water to dose to active film layers at photon energies ranging from 3 keV to 18 MeV. These data are compared to the mass energy absorption coefficient ratios and the restricted stopping power ratios of water to active film materials as well as to previous experimental results. RESULTS: In the photon energy range of 100 keV to 18 MeV the absorbed-dose energy dependence is found to be energy independent within +/- 0.6%. However, below 100 keV, the absorbed-dose energy dependence of EBT varies by approximately 10% due to changes in mass energy absorption coefficient ratios of water to film materials, as well as an increase in the number of electrons being created and scattered in the central surface layer of the film. Results are found to disagree with previous experimental studies suggesting the possibility of an intrinsic energy dependence at lower photon energies. For EBT2 film the absorbed-dose energy dependence at low photon energies varies by 50% or 10% depending on the manufacturing lot due to changes in the ratio of mass energy absorption coefficients of the active emulsion layers to water. CONCLUSIONS: Caution is recommended when using GAFCHROMIC EBT/EBT2 films at photon energies below 100 keV. It is recommended that the effective atomic number of future films be produced as close to that of water and that thicker active layers are advantageous.

Monte Carlo dosimetry for 125I and 103Pd eye plaque brachytherapy with various seed models.

PURPOSE: Dose distributions are calculated for various models of 125I and 103Pd seeds in the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). The sensitivity to seed model of dose distributions and dose distributions relative to TG-43 are investigated. METHODS: Monte Carlo simulations are carried out with the EGSnrc user-code BrachyDose. Brachytherapy seeds and eye plaques are fully modeled. Simulations of one seed in the central slot of a 20 mm Modulay (gold alloy) plaque backing with and without the Silastic (silicone polymer) insert and of a 16 mm fully loaded Modulay/Silastic plaque are performed. Dose distributions are compared to those calculated under TG-43 assumptions, i.e., ignoring the effects of the plaque backing and insert and interseed attenuation. Three-dimensional dose distributions for different 125I and 103Pd seed models are compared via depth-dose curves, isodose contours, and tabulation of doses at points of interest in the eye. Results are compared to those of our recent BrachyDose study for COMS plaques containing model 6711 (125I) or 200 (103Pd) seeds [R. M. Thomson et al., Med. Phys. 35, 5530-5543 (2008)]. RESULTS: Along the central axis of a plaque containing one seed, variations of less than 1% are seen in the effect of the Modulay backing alone for different seed models; for the Modulay/Silastic combination, variations are 2%. For a 16 mm plaque fully loaded with 125I (103Pd) seeds, dose decreases relative to TG-43 doses are 11%-12% (19%-20%) and 14%-15% (20%) at distances of 0.5 and 1 cm from the inner sclera along the plaque's central axis, respectively. For the same prescription dose, doses at points of interest vary by up to 8% with seed model. Doses to critical normal structures are lower for all 103Pd seed models than for 125I with the possible exception of the sclera adjacent to the plaque; scleral doses vary with seed model and are not always higher for 103Pd than for 125I. CONCLUSIONS: Dose decreases relative to doses calculated under TG-43 assumptions vary slightly with seed model (for each radionuclide). Dose distributions are sensitive to seed model; however, variations are generally no larger than the magnitudes of other systematic uncertainties in eye plaque therapy.

On pathlength and energy straggling of megavoltage electrons slowing down.

PURPOSE: to elucidate the effects of multiple scattering and energy-loss straggling on electron beams slowing down in materials. METHODS: EGSnrc Monte Carlo simulations are done using a purpose-written user-code. RESULTS: Plots are presented of the primary electron's energy as a function of pathlength for 20 MeV electrons incident on water and tantalum as are plots of the overall distribution of pathlengths as the 20 MeV electrons slow down under various Monte Carlo scenarios in water and tantalum. The distributions range from 1 % to 135 % of the CSDA range in water and from 1 % to 186 % in tantalum. The effects of energy-loss straggling on energy spectra at depth and electron fluence at depth are also presented. CONCLUSIONS: The role of energy-loss straggling and multiple scattering are shown to play a significant role in the range straggling which determines the dose fall-off region in electron beam dose vs depth curves and a significant role in the energy distributions as a function of depth.

Update of the CLRP TG-43 parameter database for low-energy brachytherapy sources.

PURPOSE: To update the Carleton Laboratory for Radiotherapy Physics (CLRP) TG-43 dosimetry database for low-energy (≤50 keV) photon-emitting low-dose rate (LDR) brachytherapy sources utilizing the open-source EGSnrc application egs_brachy rather than the BrachyDose application used previously for 27 LDR sources in the 2008 CLRP version (CLRPv1). CLRPv2 covers 40 sources ( 103 Pd, 125 I, and 131 Cs). A comprehensive set of TG-43 parameters is calculated, including dose-rate constants, radial dose functions with functional fitting parameters, 1D and 2D anisotropy functions, along-away dose-rate tables, Primary-Scatter separation dose tables (for some sources), and mean photon energies at the surface of the sources. The database also documents the source models which will become part of the egs_brachy distribution. ACQUISITION AND VALIDATION METHODS: Datasets are calculated after a systematic recoding of the source geometries using the egs++ geometry package and its egs_brachy extensions. Air-kerma strength per history is calculated for models of NIST's Wide-Angle Free-Air chamber (WAFAC) and for a point detector located at 10 cm on the source's transverse axis. Full scatter water phantoms with varying voxel resolutions in cylindrical coordinates are used for dose calculations. New statistical uncertainties of source volume corrections for phantom voxels which overlap with brachytherapy sources are implemented in egs_brachy, and all CLRPv2 data include these uncertainties. For validation, data are compared to CLRPv1 and other data in the literature. DATA FORMAT AND ACCESS: Data are available at https://physics.carleton.ca/clrp/egs_brachy/seed_database_v2, http://doi.org/10.22215/clrp/tg43v2. As well as being presented graphically in comparisons to previous calculations, data are available in Excel (.xlsx) spreadsheets for each source. POTENTIAL APPLICATIONS: The database has applications in research, dosimetry, and brachytherapy treatment planning. This comprehensive update provides the medical physics community with more accurate TG-43 dose evaluation parameters, as well as fully benchmarked and described source models which are distributed with egs_brachy.

Study of the effective point of measurement for ion chambers in electron beams by Monte Carlo simulation.

In current dosimetry protocols for electron beams, for plane-parallel chambers, the effective point of measurement is at the front face of the cavity, and, for cylindrical chambers, it is at a point shifted 0.5r upstream from the cavity center. In this study, Monte Carlo simulations are employed to study the issue of effective point of measurement for both plane-parallel chambers and cylindrical thimble chambers in electron beams. It is found that there are two ways of determining the position of the effective point of measurement: One is to match the calculated depth-ionization curve obtained from a modeled chamber to a calculated depth-dose curve; the other is to match the electron fluence spectrum in the chamber cavity to that in the phantom. For plane-parallel chambers, the effective point of measurement determined by the first method is generally not at the front face of the chamber cavity, which is obtained by the second method, but shifted downstream toward the cavity center by an amount that could be larger than one-half a millimeter. This should not be ignored when measuring depth-dose curves in electron beams. For cylindrical chambers, these two methods also give different positions of the effective point of measurement: The first gives a shift of 0.5r, which is in agreement with measurements for high-energy beams and is the same as the value currently used in major dosimetry protocols; the latter gives a shift of 0.8r, which is closer to the value predicted by a theoretical calculation assuming no-scatter conditions. The results also show that the shift of 0.8r is more appropriate if the cylindrical chamber is to be considered as a Spencer-Attix cavity. In electron beams, since the water/air stopping-power ratio changes with depth in a water phantom, the difference of the two shifts (0.3r) will lead to an incorrect evaluation of the water/air stopping-power ratio at the point of measurement, thus resulting in a systematic error in determining the absorbed dose by cylindrical chambers. It is suggested that a shift of 0.8r be used for electron beam calibrations with cylindrical chambers and a shift of 0.4r-0.5r be used for depth-dose measurements.

Replacement correction factors for cylindrical ion chambers in electron beams.

PURPOSE: In the TG-21 dosimetry protocol, for cylindrical chambers in electron beams the replacement correction factor Prepl (or the product PdisPcav in the IAEA's notation), was conceptually separated into two components: the gradient correction (Pgr) accounting for the effective point of measurement and the fluence correction (Pfl) dealing with the change in the electron fluence spectrum. At the depth of maximum dose (dmax), Pgr is taken as 1. There are experimental data available at dmax for the values of Pfl (or Prepl). In the TG-51 dosimetry protocol, the calibration is at the reference depth dref=0.6R50-0.1 (cm) where Pgr is required for cylindrical chambers and Pfl is unknown and so the measured values at dmax are used with the corresponding mean electron energy at dref. Monte Carlo simulations are employed in this study to investigate the replacement correction factors for cylindrical chambers in electron beams. METHODS: Using previously established Monte Carlo calculation methods, the values of Prepl and Pfl are calculated with high statistical precision (<0.1%) for cylindrical cavities of a variety of diameters and lengths in a water phantom irradiated by various electron beams. The values of Pgr as defined in the TG-51 dosimetry protocol are also calculated. RESULTS: The calculated values of the fluence correction factors Pfl are in good agreement with the measured values when the wall correction factors are taken into account for the plane-parallel chambers used in the measurements. An empirical formula for Pfl for cylindrical chambers at dref in electron beams is derived as a function of the chamber radius and the beam quality specifier R50. CONCLUSIONS: The mean electron energy at depth is a good beam quality specifier for Pfl. Thus TG-51's adoption of Pfl at dmax with the same mean electron energy for use at dref is proven to be accurate. The values of Pgr for a Farmer-type chamber as defined in the TG-51 dosimetry protocol may be wrong by 0.3% for high-energy electron beams and by more than 1% for low-energy electron beams.

Accuracy of Spencer-Attix cavity theory and calculations of fluence correction factors for the air kerma formalism.

EGSnrc calculations of ion chamber response and Spencer-Attix (SA) restricted stopping-power ratios are used to test the assumptions of the SA cavity theory and to assess the accuracy of this theory as it applies to the air kerma formalism for 60Co beams. Consistent with previous reports, the EGSnrc calculations show that the SA cavity theory, as it is normally applied, requires a correction for the perturbation of the charged particle fluence (K(fl)) by the presence of the cavity. The need for K(fl) corrections arises from the fact that the standard prescription for choosing the low-energy threshold delta in the SA restricted stopping-power ratio consistently underestimates the values of delta needed if no perturbation to the fluence is assumed. The use of fluence corrections can be avoided by appropriately choosing delta, but it is not clear how delta can be calculated from first principles. Values of delta required to avoid K(fl) corrections were found to be consistently higher than delta values obtained using the conventional approach and are also observed to be dependent on the composition of the wall in addition to the cavity size. Values of K(fl) have been calculated for many of the graphite-walled ion chambers used by the national metrology institutes around the world and found to be within 0.04% of unity in all cases, with an uncertainty of about 0.02%.

Systematic uncertainties in the Monte Carlo calculation of ion chamber replacement correction factors.

In a previous study [Med. Phys. 35, 1747-1755 (2008)], the authors proposed two direct methods of calculating the replacement correction factors (P(repl) or P(cav)P(dis)) for ion chambers by Monte Carlo calculation. By "direct" we meant the stopping-power ratio evaluation is not necessary. The two methods were named as the high-density air (HDA) and low-density water (LDW) methods. Although the accuracy of these methods was briefly discussed, it turns out that the assumption made regarding the dose in an HDA slab as a function of slab thickness is not correct. This issue is reinvestigated in the current study, and the accuracy of the LDW method applied to ion chambers in a 60Co photon beam is also studied. It is found that the two direct methods are in fact not completely independent of the stopping-power ratio of the two materials involved. There is an implicit dependence of the calculated P(repl) values upon the stopping-power ratio evaluation through the choice of an appropriate energy cutoff delta, which characterizes a cavity size in the Spencer-Attix cavity theory. Since the delta value is not accurately defined in the theory, this dependence on the stopping-power ratio results in a systematic uncertainty on the calculated P(repl) values. For phantom materials of similar effective atomic number to air, such as water and graphite, this systematic uncertainty is at most 0.2% for most commonly used chambers for either electron or photon beams. This uncertainty level is good enough for current ion chamber dosimetry, and the merits of the two direct methods of calculating P(repl) values are maintained, i.e., there is no need to do a separate stopping-power ratio calculation. For high-Z materials, the inherent uncertainty would make it practically impossible to calculate reliable P(repl) values using the two direct methods.