Clinic based transfer of the N(D,W)(60Co) calibration coefficient using a linear accelerator.

Ionization chambers used for reference dosimetry require a local secondary standard ionization chamber with a 60Co absorbed dose to water calibration coefficient N(D,W)(60Co) traceable to a national primary standards dosimetry laboratory or an accredited secondary dosimetry calibration laboratory. Clinic based (in-house) transfer of this coefficient to tertiary reference ionization chambers has traditionally been accomplished with chamber cross calibration in water using a 60Co beam; however, access to 60Co teletherapy machines has become increasingly limited for clinic based physicists. In this work, the accuracy of alternative methods of transferring the N(D,W)(60Co) calibration coefficient using 6 and 18 MV photon beams from a linear accelerator in lieu of 60Co has been investigated for five different setups and four commonly used chamber types.

Development of a guarded liquid ionization chamber for clinical dosimetry.

Liquid ionization chambers are considered superior to air-filled chambers in terms of size, energy dependence and perturbation effects. We constructed and tested a liquid ionization chamber for clinical dosimetry, the GLIC-03, with a sensitive volume of approximately 2 mm3. We also examined two methods to correct for general ion recombination in pulsed photon beams: that of Johansson et al, which modifies Boag's theory for recombination in gases, and an empirical method relating recombination to dose per pulse. The second method can be used even in cases where the first method is not applicable. The response of the GLIC-03 showed a stable, linear and reproducible decrease of 1% over 10 h. The liquid-filled GLIC-03 had a 1.1 +/- 0.4% energy dependence while that of the air-filled GLIC-03 was 2.1 +/- 0.3% between the 6 and 18 MV beams from a Clinac 21EX. The two methods for recombination correction agreed within 0.2% for measurements at 18 MV, 700 V, 100 MU min(-1). Measurements with the GLIC-03 in Solid Water in the build-up region of an 18 MV beam agreed with extrapolation chamber measurements within 1.4%, indicating that the GLIC-03 causes minimal perturbation.

Commissioning of an NRC-type sealed water calorimeter at METAS using 60Co gamma-rays.

As part of a collaborative project between the National Research Council of Canada (NRC) and the Swiss Federal Office of Metrology and Accreditation (METAS), a sealed water calorimeter was built at NRC and transferred to METAS. The calorimeter is operated at 4 degrees C and uses two thermistor probes in a sealed glass vessel containing high-purity water to measure the radiation-induced temperature rise. The various correction factors have been evaluated and the estimated standard uncertainty on the absorbed dose to water is 0.41%. An extensive set of measurements using 60Co gamma-rays was carried out at NRC and two ionization chambers were calibrated against the absorbed dose determined calorimetrically. The chambers were also calibrated against the NRC standard for absorbed dose. After transferring the calorimeter to METAS, a similar set of measurements was carried out using their 60Co beam and the same two ionization chambers were calibrated against the absorbed dose to water established at METAS. The discrepancy between the three sets of calibration coefficients was smaller than the estimated standard uncertainty of 0.47% on the ratio of any pair of calibration coefficients.

Elimination of ghost markers during dual sensor-based infrared tracking of multiple individual reflective markers.

The accuracy of dose delivery in radiotherapy is affected by the uncertainty in tumor localization. Motion of internal anatomy due to physiological processes such as respiration may lead to significant displacements which compromise tumor coverage and generate irradiation of healthy tissue. Real-time tracking with infrared-based systems is often used for tracking thoracic motion in radiation therapy. We studied the origin of ghost markers ("crosstalk") which may appear during dual sensor-based infrared tracking of independent reflective markers. Ghost markers occur when two or more reflective markers are coplanar with each other and with the sensors of the two camera-based infrared tracking system. Analysis shows that sensors are not points but they have a finite extent and this extent determines for each marker a "ghost volume." If one reflective marker enters the ghost volume of another marker, ghost markers will be reported by the tracking system; if the reflective markers belong to a surface their "ghost volume" is reduced to a "ghost surface" (ghost zone). Appearance of ghost markers is predicted for markers taped on the torso of an anthropomorphic phantom. This study illustrates the dependence of the shape, extent, and location of the ghost zones on the shape of the anthropomorphic phantom, the angle of view of the tracking system, and the distance between the tracking system and the anthropomorphic phantom. It is concluded that the appearance of ghost markers can be avoided by positioning the markers outside the ghost zones of the other markers. However, if this is not possible and the initial marker configuration is ghost marker-free, ghost markers can be eliminated during real-time tracking by virtue of the fact that they appear in the coordinate data sequence only temporarily.

Comparing calibration methods of electron beams using plane-parallel chambers with absorbed-dose to water based protocols.

Recent absorbed-dose-based protocols allow for two methods of calibrating electron beams using plane-parallel chambers, one using the N(Co)D,w for a plane-parallel chamber, and the other relying on cross-calibration of the plane-parallel chamber in a high-energy electron beam against a cylindrical chamber which has an N(Co)D,w factor. The second method is recommended as it avoids problems associated with the Pwall correction factors at 60Co for plane-parallel chambers which are used in the determination of the beam quality conversion factors. In this article we investigate the consistency of these two methods for the PTW Roos, Scanditronics NACP02, and PTW Markus chambers. We processed our data using both the AAPM TG-51 and the IAEA TRS-398 protocols. Wall correction factors in 60Co beams and absorbed-dose beam quality conversion factors for 20 MeV electrons were derived for these chambers by cross-calibration against a cylindrical ionization chamber. Systematic differences of up to 1.6% were found between our values of Pwall and those from the Monte Carlo calculations underlying AAPM TG-51, and up to 0.6% when comparing with the IAEA TRS-398 protocol. The differences in Pwall translate directly into differences in the beam quality conversion factors in the respective protocols. The relatively large spread in the experimental data of Pwall, and consequently the absorbed-dose beam quality conversion factor, confirms the importance of the cross-calibration technique when using plane-parallel chambers for calibrating clinical electron beams. We confirmed that for well-guarded plane-parallel chambers, the fluence perturbation correction factor at d(max) is not significantly different from the value at d(ref). For the PTW Markus chamber the variation in the latter factor is consistent with published fits relating it to average energy at depth.

Electron fluence correction factors for various materials in clinical electron beams.

Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone, lung, aluminum, and copper for nominal electron beam energies of 9 MeV and 15 MeV of the Clinac 18 accelerator have been determined experimentally and by Monte Carlo calculation. Thermoluminescent dosimeters were used to measure depth doses in these materials. The measured relative dose at dmax in the various materials versus that of solid water, when irradiated with the same number of monitor units, has been used to calculate the ratio of electron fluence for the various materials to that of solid water. The beams of the Clinac 18 were fully characterized using the EGS4/BEAM system. EGSnrc with the relativistic spin option turned on was used to optimize the primary electron energy at the exit window, and to calculate depth doses in the five phantom materials using the optimized phase-space data. Normalizing all depth doses to the dose maximum in solid water stopping power ratio corrected, measured depth doses and calculated depth doses differ by less than +/- 1% at the depth of dose maximum and by less than 4% elsewhere. Monte Carlo calculated ratios of doses in each material to dose in LiF were used to convert the TLD measurements at the dose maximum into dose at the center of the TLD in the phantom material. Fluence perturbation correction factors for a LiF TLD at the depth of dose maximum deduced from these calculations amount to less than 1% for 0.15 mm thick TLDs in low Z materials and are between 1% and 3% for TLDs in Al and Cu phantoms. Electron fluence ratios of the studied materials relative to solid water vary between 0.83+/-0.01 and 1.55+/-0.02 for materials varying in density from 0.27 g/cm3 (lung) to 8.96 g/cm3 (Cu). The difference in electron fluence ratios derived from measurements and calculations ranges from -1.6% to +0.2% at 9 MeV and from -1.9% to +0.2% at 15 MeV and is not significant at the 1sigma level. Excluding the data for Cu, electron fluence correction factors for open electron beams are approximately proportional to the electron density of the phantom material and only weakly dependent on electron beam energy.

AAPM protocol for 40-300 kV x-ray beam dosimetry in radiotherapy and radiobiology.

The American Association of Physicists in Medicine (AAPM) presents a new protocol, developed by the Radiation Therapy Committee Task Group 61, for reference dosimetry of low- and medium-energy x rays for radiotherapy and radiobiology (40 kV < or = tube potential < or = 300 kV). It is based on ionization chambers calibrated in air in terms of air kerma. If the point of interest is at or close to the surface, one unified approach over the entire energy range shall be used to determine absorbed dose to water at the surface of a water phantom based on an in-air measurement (the "in-air" method). If the point of interest is at a depth, an in-water measurement at a depth of 2 cm shall be used for tube potentials > or = 100 kV (the "in-phantom" method). The in-phantom method is not recommended for tube potentials < 100 kV. Guidelines are provided to determine the dose at other points in water and the dose at the surface of other biological materials of interest. The protocol is based on an up-to-date data set of basic dosimetry parameters, which produce consistent dose values for the two methods recommended. Estimates of uncertainties on the final dose values are also presented.

Comparison of measured and Monte Carlo calculated dose distributions from the NRC linac.

We have benchmarked photon beam simulations with the EGS4 user code BEAM [Rogers et al., Med. Phys. 22, 503-524 (1995)] by comparing calculated and measured relative ionization distributions in water from the 10 and 20 MV photon beams of the NRC linac. Unlike previous calculations, the incident electron energy is known independently to 1%, the entire extra-focal radiation is simulated, and electron contamination is accounted for. The full Monte Carlo simulation of the linac includes the electron exit window, target, flattening filter, monitor chambers, collimators, as well as the PMMA walls of the water phantom. Dose distributions are calculated using a modified version of the EGS4 user code DOSXYZ which additionally allows scoring of average energy and energy fluence in the phantom. Dose is converted to ionization by accounting for the (L/rho)water(air) variation in the phantom, calculated in an identical geometry for the realistic beams using a new EGS4 user code, SPRXYZ. The variation of (L/rho)water(air) with depth is a 1.25% correction at 10 MV and a 2% correction at 20 MV. At both energies, the calculated and the measured values of ionization on the central axis in the buildup region agree within 1% of maximum ionization relative to the ionization at 10 cm depth. The agreement is well within statistics elsewhere. The electron contamination contributes 0.35(+/- 0.02) to 1.37(+/- 0.03)% of the maximum dose in the buildup region at 10 MV and 0.26(+/- 0.03) to 3.14(+/- 0.07)% of the maximum dose at 20 MV. The penumbrae at 3 depths in each beam (in g/cm2), 1.99 (dmax, 10 MV only), 3.29 (dmax, 20 MV only), 9.79 and 19.79, agree with ionization chamber measurements to better than 1 mm. Possible causes for the discrepancy between calculations and measurements are analyzed and discussed in detail.

Monte Carlo study of correction factors for Spencer-Attix cavity theory at photon energies at or above 100 keV.

To develop a primary standard for 192Ir sources, the basic science on which this standard is based, i.e., Spencer-Attix cavity theory, must be established. In the present study Monte Carlo techniques are used to investigate the accuracy of this cavity theory for photons in the energy range from 20 to 1300 keV, since it is usually not applied at energies below that of 137Cs. Ma and Nahum [Phys. Med. Biol. 36, 413-428 (1991)] found that in low-energy photon beams the contribution from electrons caused by photons interacting in the cavity is substantial. For the average energy of the 192Ir spectrum they found a departure from Bragg-Gray conditions of up to 3% caused by photon interactions in the cavity. When Monte Carlo is used to calculate the response of a graphite ion chamber to an encapsulated 192Ir source it is found that it differs by less than 0.3% from the value predicted by Spencer-Attix cavity theory. Based on these Monte Carlo calculations, for cavities in graphite it is concluded that the Spencer-Attix cavity theory with delta = 10 keV is applicable within 0.5% for photon energies at 300 keV or above despite the breakdown of the assumption that there is no interaction of photons within the cavity. This means that it is possible to use a graphite ion chamber and Spencer-Attix cavity theory to calibrate an 192Ir source. It is also found that the use of delta related to the mean chord length instead of delta = 10 keV improves the agreement with Spencer-Attix cavity theory at 60Co from 0.2% to within 0.1% of unity. This is at the level of accuracy of which the Monte Carlo code EGSnrc calculates ion chamber responses. In addition, it is shown that the effects of other materials, e.g., insulators and holders, have a substantial effect on the ion chamber response and should be included in the correction factors for a primary standard of air kerma.

Absorbed-dose beam quality conversion factors for cylindrical chambers in high energy photon beams.

Recent working groups of the AAPM [Almond et al., Med. Phys. 26, 1847 (1999)] and the IAEA (Andreo et al., Draft V.7 of "An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water," IAEA, 2000) have described guidelines to base reference dosimetry of high energy photon beams on absorbed dose to water standards. In these protocols use is made of the absorbed-dose beam quality conversion factor, kQ which scales an absorbed-dose calibration factor at the reference quality 60Co to a quality Q, and which is calculated based on state-of-the-art ion chamber theory and data. In this paper we present the measurement and analysis of beam quality conversion factors kQ for cylindrical chambers in high-energy photon beams. At least three chambers of six different types were calibrated against the Canadian primary standard for absorbed dose based on a sealed water calorimeter at 60Co [TPR10(20)=0.572, %dd(10)x=58.4], 10 MV [TPR10(20)=0.682, %dd(10)x=69.6), 20 MV (TPR10(20)=0.758, %dd(10)x= 80.5] and 30 MV [TPR10(20) = 0.794, %dd(10)x= 88.4]. The uncertainty on the calorimetric determination of kQ for a single chamber is typically 0.36% and the overall 1sigma uncertainty on a set of chambers of the same type is typically 0.45%. The maximum deviation between a measured kQ and the TG-51 protocol value is 0.8%. The overall rms deviation between measurement and the TG-51 values, based on 20 chambers at the three energies, is 0.41%. When the effect of a 1 mm PMMA waterproofing sleeve is taken into account in the calculations, the maximum deviation is 1.1% and the overall rms deviation between measurement and calculation 0.48%. When the beam is specified using TPR10(20), and measurements are compared with kQ values calculated using the version of TG-21 with corrected formalism and data, differences are up to 1.6% when no sleeve corrections are taken into account. For the NE2571 and the NE2611A chamber types, for which the most literature data are available, using %dd(10)x, all published data show a spread of 0.4% and 0.6%, respectively, over the entire measurement range, compared to spreads of up to 1.1% for both chambers when the kQ values are expressed as a function of TPR10(20). For the PR06-C chamber no clear preference of beam quality specifier could be identified. When comparing the differences of our kQ measurements and calculations with an analysis in terms of air-kerma protocols with the same underlying calculations but expressed in terms of a compound conversion factor CQ, we observe that a system making use of absorbed-dose calibrations and calculated kQ values, is more accurate than a system based on air-kerma calibrations in combination with calculated CQ (rms deviation of 0.48% versus 0.67%, respectively).

Mass-energy absorption coefficient and backscatter factor ratios for kilovoltage x-ray beams.

For low-energy (up to 150 kV) x-rays, the ratio of mass-energy absorption coefficients for water to air, (mu(en)/rho)w.air, and the backscatter factor B are used in the conversion of air kerma, measured free-in-air, to water kerma on the surface of a water phantom. For clinical radiotherapy, similar conversion factors are needed for the determination of the absorbed dose to biological tissues on (or near) the surface of a human body. We have computed the mu(en)/rho ratios and B factor ratios for different biological tissues including muscle, soft tissue, lung, skin and bone relative to water. The mu(en)/rho ratios were obtained by integrating the respective mass-energy absorption coefficients over the in-air primary photon spectra. We have also calculated the mu(en)/rho ratios at different depths in a water phantom in order to convert the measured in-phantom water kerma to the absorbed dose to various biological tissues. The EGS4/DOSIMETER Monte Carlo code system has been used for the simulation of the energy fluence at different depths in a water phantom irradiated by a kilovoltage x-ray beam of variable beam quality (HVL: 0.1 mm Al-5 mm Cu), field size and source-surface distance (SSD). The same code was also used in the calculation of the B factor ratios, soft tissue to water and bone to water. The results show that the B factor for bone differs from the B factor for water by up to 20% for a 100 kV beam (HVL: 2.65 mm Al) with a 100 cm2 field. On the other hand, the difference in the B factor between water and soft tissue is insignificant (well within 1% generally). This means that the B factors for water may be directly used to convert the 'in-air' water kerma to surface kerma for human soft tissues.

Study of dosimetry consistency for kilovoltage x-ray beams.

In this paper, the consistency of kilovoltage (tube potentials between 40 and 300 kV) x-ray beam dosimetry using the "in-air" method and the in-phantom measurement has been studied. The procedures for the measurement of the central-axis depth-dose curve, which serve as a link between the dose at the reference depth to the dose elsewhere in a phantom, were examined. The uncertainties on the measured dose distributions were analyzed with the emphasis on the surface dose measurement. The Monte Carlo method was used to calculate the perturbation correction factors for a photon diode and a NACP plane-parallel ionization chamber at different depths in a water phantom irradiated by 100-300 kV (2.43 mm Al-3.67 mm Cu half-value layer) x-ray beams. The depth-dose curves measured with these two detectors, after correcting for the perturbation effect (up to 15% corrections), agreed with each other to within 1.5%. Comparisons of the doses at the phantom surface and at 2 cm depth in water for photon beams of 100-300 kV tube potential obtained using the "backscatter" method and those using the "in-phantom" measurement have shown that the "in-air" method can be equally applied to this energy range if the depth-dose curve can be measured accurately. To this end, measured depth ionization curves require depth-dependent correction factors.

Correction factors for water-proofing sleeves in kilovoltage x-ray beams.

This paper investigates the effect of the waterproofing sleeve on the calibration of kilovoltage photon beams (50-300 kV). The sleeve effect correction factor, ps has been calculated using the Monte Carlo method as the ratios of the air kerma in an air cavity of a cylindrical chamber without the waterproofing sleeve to that with a sleeve. Three sleeve materials have been studied, PMMA, nylon and polystyrene. The calculations were carried out using the EGS4 (Electron Gamma Shower version 4) code system with the application of a correlated-sampling variance-reduction technique. The results show that the sleeve correction factor for 1-mm thick nylon and polystyrene sleeves, ps varies from 0.992 to 1.000 and from 0.981 to 1.000, respectively, for the same beam quality range. The ps factor varies with sleeve thickness, beam quality and phantom depth. No significant dependence of the ps factor on field size and source-surface distance has been found. Measurements for PMMA, nylon and polystyrene sleeves of various thicknesses have also been carried out and show excellent agreement with Monte Carlo calculations.