End-to-end quality assurance for stereotactic radiotherapy with Fricke-Xylenol orange-Gelatin gel dosimeter and dual-wavelength cone-beam optical CT readout.

PURPOSE: The end-to-end (E2E) quality assurance (QA) test is a unique tool for validating the treatment chain undergone by patients in external radiotherapy. It should be conducted in three dimensions (3D) to get accurate results. This study aims to implement these tests with Fricke-Xylenol orange-Gelatin (FXG) gel dosimeter and a newly developed dual-wavelength reading method on the Vista16™ optical Computed Tomography (CT) scanner (ModusQA) for three treatment techniques in stereotactic radiotherapy, on Novalis (Varian) and CyberKnife (Accuray) linear accelerators. METHODS: The tests were performed in head phantoms. Gel measurements were compared with planned dose distributions and measured by film and ion chamber measurements by plotting isodose curves and dose profiles, and by conducting a 3D local gamma-index analysis (2%/2mm criteria). RESULTS: Gamma passing rates were higher than 95 %. Point dose differences between treatment planning and gel and ion chamber measurements at the isocenter were < 2.3 % for both treatments delivered on the Novalis accelerator, while this difference was higher than 4 % for the treatment delivered on the CyberKnife, highlighting a small overdosing of the tumor volume. A good agreement was observed between gel and film dose profiles. CONCLUSIONS: This study presents the successful implementation of 3D E2E QA tests for stereotactic radiotherapy with FXG gel dosimetry and a dual-wavelength reading method on an optical CT scanner. This dosimetric method provides 3D absolute dose distributions in the 0.25 - 10 Gy dose range with a high spatial resolution and a dose uncertainty of around 2 % (k=1).

Dose area product primary standards established by graphite calorimetry at the LNE-LNHB for small radiation fields in radiotherapy.

PURPOSE: To present primary standards establishment in terms of Dose Area Product (DAP) for small field sizes. METHODS: A large section graphite calorimeter and two plane-parallel ionization chambers were designed and built in-house. These chambers were calibrated in a 6MV FFF beam at the maximum dose rate of 1400 UM/min for fields defined by specifically designed circular collimators of 5, 7.5, 10, 13 and 15 mm diameter and jaws of 5, 7, 10, 13 and 15 mm side length on a Varian TrueBeam linac. RESULTS: The two chambers show the same behaviour regardless of field shape and size. From 5 to 15 mm, calibration coefficients slightly increase with the field size with a magnitude of 1.8% and 1.1% respectively for the two chambers, and are independent of the field shape. This tendency was confirmed by Monte Carlo calculations. The average associated uncertainty of the calibration coefficients is around 0.6% at k=1. CONCLUSIONS: For the first time, primary standards in terms of DAP were established by graphite calorimetry for an extended range of small field sizes. These promising results open the door for an alternative approach in small fields dosimetry.

Feasibility of using a dose-area product ratio as beam quality specifier for photon beams with small field sizes.

PURPOSE: To investigate the feasibility of using the ratio of dose-area product at 20 cm and 10 cm water depths (DAPR20,10) as a beam quality specifier for radiotherapy photon beams with field diameter below 2 cm. METHODS: Dose-area product was determined as the integral of absorbed dose to water (Dw) over a surface larger than the beam size. 6 MV and 10 MV photon beams with field diameters from 0.75 cm to 2 cm were considered. Monte Carlo (MC) simulations were performed to calculate energy-dependent dosimetric parameters and to study the DAPR20,10 properties. Aspects relevant to DAPR20,10 measurement were explored using large-area plane-parallel ionization chambers with different diameters. RESULTS: DAPR20,10 was nearly independent of field size in line with the small differences among the corresponding mean beam energies. Both MC and experimental results showed a dependence of DAPR20,10 on the measurement setup and the surface over which Dw is integrated. For a given setup, DAPR20,10 values obtained using ionization chambers with different air-cavity diameters agreed with one another within 0.4%, after the application of MC correction factors accounting for effects due to the chamber size. DAPR20,10 differences among the small field sizes were within 1% and sensitivity to the beam energy resulted similar to that of established beam quality specifiers based on the point measurement of Dw. CONCLUSIONS: For a specific measurement setup and integration area, DAPR20,10 proved suitable to specify the beam quality of small photon beams for the selection of energy-dependent dosimetric parameters.

Comparison of air kerma standards of LNE-LNHB and NPL for 192Ir HDR brachytherapy sources: EUROMET project no 814.

An indirect comparison has been made in the air kerma standards for high dose rate (HDR) 192Ir brachytherapy sources at the Laboratoire National Henri Becquerel (LNHB) and the National Physical Laboratory (NPL). The measurements were carried out at both laboratories between November and December 2004. The comparison was based on measurements using well-type transfer ionization chambers and two different source types, Nucletron microSelectron HDR Classic and version 2. The results show the reported calibration coefficients to agree within 0.47% to 0.63%, which is within the overall standard uncertainty of 0.65% reported by both laboratories at the time of this comparison. Following this comparison, some of the NPL primary standard correction factors were re-evaluated resulting in a change of +0.17% in the overall correction factor. The new factor was implemented in May 2006. Applying the revised chamber factor to the measurements reported in this comparison report will reduce the difference between the two standards by 0.17%.

Comparison of dosimetric standards of USA and France for HDR brachytherapy.

A bilateral comparison of national dosimetric standards for high dose rate brachytherapy has been conducted between the Laboratoire National Henri Becquerel and the University of Wisconsin Accredited Dosimetry Calibration Laboratory. A complete overview of the methods that are currently in use to establish the two national standards is given. The comparison has been carried out using well-type transfer ionization chambers. Three units have been calibrated in both laboratories, and calibration coefficients have been compared. The discrepancies between the two measurements are within 0.3%.