An international film dosimetry intercomparison to establish a multi-center audit framework.

BACKGROUND: In 2021, a Technical Meeting was hosted by the International Atomic Energy Agency (IAEA) where it was recommended that a standardized method for assessing the accuracy of film dose calculations should be established. PURPOSE: To design an audit that evaluates the accuracy of film dosimetry processes. To propose a framework for identifying out-of-tolerance results and to perform an international pilot study to test the audit design. METHODS: Six members of an international Dosimetry Audit Network (DAN) developed an audit for radiochromic film dosimetry. A single host center provided the materials to each participating DAN member to conduct the audits. Materials included: (1) a set of two irradiated audit films (10 Sq: 10 cm × 10 cm, 15 Sq: 15 cm × 15 cm), (2) a reference calibration film set, and (3) a blank sheet of film. The participants were blinded to the dose and tasked with producing dose maps using their standard film dosimetry process. Average Region-Of-Interest (ROI: 2 cm × 2 cm) dose was measured from the dose maps and compared to the known dose. In the audit, all participants used their local scanning and software protocols. Film calibration was performed in two distinct ways: (1) using a calibration film set which was provided by the host center and (2) using a calibration film set which was locally irradiated. Several variations of the audit were also performed to examine how scanning and software processing can affect film dosimetry results. In the first variation of the audit (VariantA), a set of film scans was processed using five different software solutions. In the second variation of the audit (VariantB), all films were scanned on the same scanner and processed using two in-house software solutions. RESULTS: Taking one film scan from each participant, the standard deviations (1σ) (SD) in the dose returned from the host calibration and returned from the local calibration were ±7.2% and ±6.5% respectively, with variations from -12.4% to 12.9% of the known dose. The larger dose variations in the data set were attributed to the corrections applied for variations in scanner brightness during processing and incorrectly assigned calibration doses. When the raw image data set was processed by an expert user of each software solution (VariantA) the SDs were ±2.7% and ±3.7% for in-house and vendor-based software, respectively. When the films were scanned on a single scanner and processed with the two in-house software solutions (VariantB) the results had a SD of ±2.3%. CONCLUSIONS: An audit has been designed and tested for radiotherapy film dosimetry at an international level. A framework for diagnosing issues within a film dosimetry process has been proposed that could be used to audit centers that use film as a dosimeter. Incorporating quality assurance throughout the film process is important in obtaining accurate and consistent film dosimetry. A better understanding of vendor-based software systems is necessary for users to process accurate and consistent film dosimetry.

Dosimetric evaluation of irradiation geometry and potential air gaps in an acrylic miniphantom used for external audit of absolute dose calibration for a hybrid 1.5 T MR-linac system.

INTRODUCTION: To investigate the impact of partial lateral scatter (LS), backscatter (BS) and presence of air gaps on optically stimulated luminescence dosimeter (OSLD) measurements in an acrylic miniphantom used for dosimetry audit on the 1.5 T magnetic resonance-linear accelerator (MR-linac) system. METHODS: The following irradiation geometries were investigated using OSLDs, A26 MR/A12 MR ion chamber (IC), and Monaco Monte Carlo system: (a) IC/OSLD in an acrylic miniphantom (partial LS, partial BS), (b) IC/OSLD in a miniphantom placed on a solid water (SW) stack at a depth of 1.5 cm (partial LS, full BS), (c) IC/OSLD placed at a depth of 1.5 cm inside a 3 cm slab of SW/buildup (full LS, partial BS), and (d) IC/OSLD centered inside a 3 cm slab of SW/buildup at a depth of 1.5 cm placed on top of a SW stack (full LS, full BS). Average of two irradiated OSLDs with and without water was used at each setup. An air gap of 1 and 2 mm, mimicking presence of potential air gap around the OSLDs in the miniphantom geometry was also simulated. The calibration condition of the machine was 1 cGy/MU at SAD = 143.5 cm, d = 5 cm, G90, and 10 × 10 cm2 . RESULTS: The Monaco calculation (0.5% uncertainty and 1.0 mm voxel size) for the four setups at the measurement point were 108.2, 108.1, 109.4, and 110.0 cGy. The corresponding IC measurements were 109.0 ± 0.03, 109.5 ± 0.06, 110.2 ± 0.02, and 109.8 ± 0.03 cGy. Without water, OSLDs measurements were ∼10% higher than the expected. With added water to minimize air gaps, the measurements were significantly improved to within 2.2%. The dosimetric impacts of 1 and 2 mm air gaps were also verified with Monaco to be 13.3% and 27.9% higher, respectively, due to the electron return effect. CONCLUSIONS: A minimal amount of air around or within the OSLDs can cause measurement discrepancies of 10% or higher when placed in a high b-field MR-linac system. Care must be taken to eliminate the air from within and around the OSLD.