The fast calibration model for dosimetry with an electronic portal imaging device.

PURPOSE: The aim of this study was to develop an algorithm that corrects the image of an electronic portal imaging device (EPID) of a linear accelerator so that it can be used for dosimetric purposes, such as in vivo dosimetry or quality assurance for photon radiotherapy. For that purpose, the impact of the field size, phantom thickness, and the varying spectral photon distribution within the irradiation field on the EPID image was investigated. METHODS: The EPID measurements were verified using reference measurements with ionization chambers. Therefore, absolute dose measurements with an ionization chamber and relative dose measurements with a detector array were performed. An EPID calibration and correction algorithm was developed to convert the EPID image to a dose distribution. The algorithm was validated by irradiating inhomogeneous phantoms using square fields as well as irregular IMRT fields. RESULTS: It was possible to correct the influence of the field size, phantom thickness on the EPID signal as well as the homogenization of the image profile by several correction factors within 0.6%. A gamma index analysis (3%, 3 mm) of IMRT fields showed a pass rate of above 99%, when comparing to the planning system. CONCLUSION: The developed algorithm enables an online dose measurement with the EPID during the radiation treatment. The algorithm is characterized by a robust, non-iterative, and thus real-time capable procedure with little measuring effort and does not depend on system-specific parameters. The EPID image is corrected by multiplying three independent correction factors. Therefore, it can easily be extent by further correction factors for other influencing variables, so it can be transferred to other linear accelerators and EPID configurations.

A phantom based evaluation of the dose prediction and effects in treatment plans, when calculating on a direct density CT reconstruction.

In radiation therapy, a Computed Tomography (CT) image is needed for an accurate dose calculation. To allow such a calculation, the CT image values have to be converted into relative electron densities. Thus, standard procedure is to calibrate the CT numbers to relative electron density (RED) by using a phantom with known composition inserts. This calibration curve is energy and CT dependent, therefore most radiotherapy CT acquisitions are obtained with 120 kVp, as each tube voltage needs an additional calibration curve. The commercially available DirectDensityTM (DD) reconstruction algorithm presents a reconstruction implementation without any dependence on the tube voltage. In comparison, it allows a calibration curve that is directly proportional to the RED, reducing the need of more than one calibration curve. This could potentially optimize CT acquisitions and reducing the dose given to the patient. Three different phantoms were used to evaluate the DirectDensityTM algorithm in simple and anthropomorphic geometries, as well as setups with metal implants. Scans with the DD algorithm were performed for 80, 100, 120, and 140 kVp. As reference a scan with the standard 120 kVp scan was used. Radiotherapy photon plans were optimized and calculated on the reference image and then transferred to the DD images, where they were recalculated. The dose distributions obtained this way were compared to the reference dose. Differences were found mainly in pure air and high density materials such as bones. The difference of the mean dose was below 0.7%, in most cases below 0.4%. No indication was found that the algorithm is corrupted by metal inserts, enabling the application for all clinical cases. This algorithm offers more variability in CT parameters for radiation therapy and thus a more personalized image acquisition with a high image quality and a lower dose exposure at a robust clinical workflow.

Technical note: Vendor-agnostic water phantom for 3D dosimetry of complex fields in particle therapy.

PURPOSE: Three-dimensional (3D) dosimetry is a necessity to validate patient-specific treatment plans in particle therapy as well as to facilitate the development of novel treatment modalities. Therefore, a vendor-agnostic water phantom was developed and verified to measure high resolution 3D dose distributions. METHODS: The system was experimentally validated at the Marburger Ionenstrahl-Therapiezentrum using two ionization chamber array detectors (PTW Octavius 1500XDR and 1000P) with 150.68 MeV proton and 285.35 MeV/u 12 C beams. The dose distribution of several monoenergetic and complex scanned fields were measured with different step sizes to assess the reproducibility, absolute positioning accuracy, and general performance of the system. RESULTS: The developed system was successfully validated and used to automatically measure high resolution 3D dose distributions. The reproducibility in depth was better than ±25 micron. The roll and tilt uncertainty of the detector was estimated to be smaller than ±3 mrad. CONCLUSIONS: The presented system performed fully automated, high resolution 3D dosimetry, suitable for the validation of complex radiation fields in particle therapy. The measurement quality is comparable to commercially available systems.

Scanned ion beam therapy for prostate carcinoma: Comparison of single plan treatment and daily plan-adapted treatment.

BACKGROUND AND PURPOSE: Intensity-modulated particle therapy (IMPT) for tumors showing interfraction motion is a topic of current research. The purpose of this work is to compare three treatment strategies for IMPT to determine potential advantages and disadvantages of ion prostate cancer therapy. MATERIALS AND METHODS: Simulations for three treatment strategies, conventional one-plan radiotherapy (ConvRT), image-guided radiotherapy (IGRT), and online adaptive radiotherapy (ART) were performed employing a dataset of 10 prostate cancer patients with six CT scans taken at one week intervals. The simulation results, using a geometric margin concept (7-2 mm) as well as patient-specific internal target volume definitions for IMPT were analyzed by target coverage and exposure of critical structures on single fraction dose distributions. RESULTS: All strategies led to clinically acceptable target coverage in patients exhibiting small prostate motion (mean displacement <4 mm), but IGRT and especially ART led to significant sparing of the rectum. In 20% of the patients, prostate motion exceeded 4 mm causing insufficient target coverage for ConvRT (V95mean = 0.86, range 0.63-0.99) and IGRT (V95mean = 0.91, range 0.68-1.00), while ART maintained acceptable target coverage. CONCLUSION: IMPT of prostate cancer demands consideration of rectal sparing and adaptive treatment replanning for patients exhibiting large prostate motion.

Effect of ROI filtering in 3D cone-beam rotational angiography on organ dose and effective dose in cerebral investigations.

The assessment of intracranial aneurysms is increasingly performed using three-dimensional cone-beam rotational angiography (3D CBRA). To reduce the dose to the patient during 3D CBRA procedures, filtered region-of-interest imaging (FROI) is presented in literature to be an effective technique as the dose in regions of low interest is reduced, while high image quality is preserved in the ROI. The purpose of this study was to quantify the benefit of FROI imaging during a typical 3D CBRA procedure in a patient's head region. A cone-beam rotational angiography unit (Infinix) was modeled in GMctdospp, an EGSnrc-based Monte Carlo software, which calculates patient dose distributions in rotational computed tomography. Kodak Lanex, a gadolinium compound, was chosen to be the ROI filter material. The adult female ICRP reference phantom was integrated in GMctdospp to calculate organ and effective doses in simulations of FROI-CBRA examinations. During the Monte Carlo simulations, different parameters as the ROI filter thickness, the ROI opening size, the tube voltage, and the isocenter position were varied. The results showed that the reduction in dose clearly depends on these parameters. Comparing the reduction in organ dose in standard 3D CBRA and FROI-CBRA, a maximum reduction of about 60%-80% could be achieved with a small sized ROI filter and about 40%-70% of the dose could be saved using a ROI filter with a large opening. Further we could show that dose reduction strongly depends on filter thickness, the location of the organ in the radiated area, and the position of the isocenter. As a consequence, dose reduction partially differs from theoretically calculated values by a factor up to 1.6. The effective dose could be reduced to a minimum of about 40%. Due to the fact that standard 3D CBRA is only used for the assessment of aneurysms at present and, thus, most of the patient dose originates from the aneurysm treatment (with 2D techniques) itself, the dose reduction effect of ROI filtering in 3D CBRA tends to be much smaller, if the patient dose of a whole aneurysm treatment procedure is considered.

Comparison of two methods simulating inter-track interactions using the radiobiological Monte Carlo toolkit TOPAS-nBio.

Objective.To compare two independently developed methods that enable modelling inter-track interactions in TOPAS-nBio by examining the yield of radiolytic species in radiobiological Monte Carlo track structure simulations. One method uses a phase space file to assign more than one primary to one event, allowing for inter-track interaction between these primary particles. This method has previously been developed by this working group and published earlier. Using the other method, chemical reactions are simulated based on a new version of the independent reaction time approach to allow inter-track interactions.Approach.G-values were calculated and compared using both methods for different numbers of tracks able to undergo inter-track interactions.Main results.Differences in theG-values simulated with the two methods strongly depend on the molecule type, and deviations can range up to 3.9% (H2O2), although, on average, the deviations are smaller than 1.5%.Significance.Both methods seem to be suitable for simulating inter-track interactions, as they provide comparableG-values even though both techniques were developed independently of each other.

Monte Carlo calculated beam quality correction factors for high energy electron beams.

PURPOSE: As the dosimetry protocol TRS 398 is being revised and the ICRU report 90 provides new recommendations for density correction as well as the mean ionization energies of water and graphite, updated beam quality correction factors kQ are calculated for reference dosimetry in electron beams and for independent validation of previously determined values. METHODS: Monte Carlo simulations have been performed using EGSnrc to calculate the absorbed dose to water and the dose to the active volumes of ionization chambers SNC600c, SNC125c and SNC350p (all Sun Nuclear, A Mirion Medical Company, Melbourne, FL). Realistic clinical electron beam spectra were used to cover the entire energy range of therapeutic electron accelerators. The Monte Carlo simulations were validated by measurements on a clinical linear accelerator. With regards to the cylindrical chambers, the simulations were performed according to the setup recommendations of TRS 398 and AAPM TG 51, i.e. with and without consideration of a reference point shift by rcav/2. RESULTS: kQ values as a function of the respective beam quality specifier R50 were fitted by recommended equations for electron beam dosimetry in the range of 5 MeV to 18 MeV. The fitting curves to the calculated values showed a root mean square deviation between 0.0016 and 0.0024. CONCLUSION: Electron beam quality correction factors kQ were calculated by Monte Carlo simulations for the cylindrical ionization chambers SNC600c and SNC125c as well as the plane parallel ionization chamber SNC350p to provide updated data for the TRS 398 and TG 51 dosimetry protocols.

Organization and operation of multi particle therapy facilities: the Marburg Ion-Beam Therapy Center, Germany (MIT).

Purpose: The Marburg Ion-Beam Therapy Center (MIT) is one of two particle therapy centers in Germany that enables the treatment of patients with both protons and carbon ions. The facility was build by Siemens Healthineers and is one of only two centers worldwide built by Siemens (Marburg, Germany and Shanghai, China). The present report provides an overview of technical and clinical operations as well as research activities at MIT. Methods: The MIT was completed in 2011 and uses a synchrotron for accelerating protons and carbon ions up to energies of 250 MeV/u and 430 MeV/u respectively. Three treatment rooms with a fixed horizontal beam-line and one room with a 45 degree beam angle are available. Results: Since the start of clinical operations in 2015, around 2.500 patients have been treated at MIT, about 40% with carbon ions and 60% with protons. Currently around 400 patients are treated each year. The majority of the patients suffered from benign and malign CNS tumors (around 40%) followed by head and neck tumors (around 23%). MIT is actively involved in clinical studies with its patients. In addition to clinical operations, there is active research at MIT in the fields of radiation biology and medical physics. The focus is on translational research to improve the treatment of H & N carcinomas and lung cancer (NSCLC). Moreover, intensive work is being carried out on the technical implementation of FLASH irradiation for research purposes. Conclusion: The MIT is one of two centers worldwide that were built by Siemens Healtineers and has been successfully in clinical operation since 2015. The service provided by Siemens is guaranteed until 2030, the future after 2030 is currently under discussion.

Analysis of hydrogen peroxide production in pure water: Ultrahigh versus conventional dose-rate irradiation and mechanistic insights.

BACKGROUND: Ultrahigh dose-rate radiation (UHDR) produces less hydrogen peroxide (H2O2) in pure water, as suggested by some experimental studies, and is used as an argument for the validity of the theory that FLASH spares the normal tissue due to less reactive oxygen species (ROS) production. In contrast, most Monte Carlo simulation studies suggest the opposite. PURPOSE: We aim to unveil the effect of UHDR on H2O2 production in pure water and its underlying mechanism, to serve as a benchmark for Monte Carlo simulation. We hypothesized that the reaction of solvated electrons ( e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ ) removing hydroxyl radicals (•OH), the precursor of H2O2, is the reason why UHDR leads to a lower G-value (molecules/100 eV) for H2O2 (G[H2O2]), because: 1, the third-order reaction between e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ and •OH is more sensitive to increased instantaneous ROS concentration by UHDR than a two-order reaction of •OH self-reaction producing H2O2; 2, e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ has two times higher diffusion coefficient and higher reaction rate constant than that of •OH, which means e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ would dominate the competition for •OH and benefit more from the inter-track effect of UHDR. Meanwhile, we also experimentally verify the theory of long-lived radicals causing lower G(H2O2) in conventional irradiation, which is mentioned in some simulation studies. METHODS AND MATERIALS: H2O2 was measured by Amplex UltraRed assay. 430.1 MeV/u carbon ions (50 and 0.1 Gy/s), 9 MeV electrons (600 and 0.62 Gy/s), and 200 kV x-ray tube (10 and 0.1 Gy/s) were employed. For three kinds of water (real hypoxic: 1% O2; hypoxic: 1% O2 and 5% CO2; and normoxic: 21% O2), unbubbled and bubbled samples with N2O, the scavenger of e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ , were irradiated by carbon ions and electrons with conventional and UHDR at different absolute dose levels. Normoxic water dissolved with sodium nitrate (NaNO3), another scavenger of e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ , and bubbled with N2O was irradiated by x-ray to verify the results of low-LET electron beam. RESULTS: UHDR leads to a lower G(H2O2) than conventional irradiation. O2 and CO2 can both increase G(H2O2). N2O increases G(H2O2) of both UHDR and conventional irradiation and eliminates the difference between them for carbon ions. However, N2O decreases G(H2O2) in electron conventional irradiation but increases G(H2O2) in the case of UHDR, ending up with no dose-rate dependency of G(H2O2). Three-spilled carbon UHDR does not have a lower G(H2O2) than one-spilled UHDR. However, the electron beam shows a lower G(H2O2) for three-spilled UHDR than for one-spilled UHDR. Normoxic water with N2O or NaNO3 can both eliminate the dose rate dependency of H2O2 production for x-ray. CONCLUSIONS: UHDR has a lower G(H2O2) than the conventional irradiation for both high LET carbon and low LET electron and x-ray beams. Both scavengers for e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ , N2O and NaNO3, eliminate the dose-rate dependency of G(H2O2), which suggests e aq - ${\mathrm{e}}_{{\mathrm{aq}}}^ - $ is the reason for decreased G(H2O2) for UHDR. Three-spilled UHDR versus one-spilled UHDR indicates that the assumption of residual radicals reducing G(H2O2) of conventional irradiation may only be valid for low LET electron beam.

Investigation of Monte Carlo simulations of the electron transport in external magnetic fields using Fano cavity test.

PURPOSE: Monte Carlo simulations are crucial for calculating magnetic field correction factors kB for the dosimetry in external magnetic fields. As in Monte Carlo codes the charged particle transport is performed in straight condensed history (CH) steps, the curved trajectories of these particles in the presence of external magnetic fields can only be approximated. In this study, the charged particle transport in presence of a strong magnetic field B→ was investigated using the Fano cavity test. The test was performed in an ionization chamber and a diode detector, showing how the step size restrictions must be adjusted to perform a consistent charged particle transport within all geometrical regions. METHODS: Monte Carlo simulations of the charged particle transport in a magnetic field of 1.5 T were performed using the EGSnrc code system including an additional EMF-macro for the transport of charged particle in electro-magnetic fields. Detailed models of an ionization chamber and a diode detector were placed in a water phantom and irradiated with a so called Fano source, which is a monoenergetic, isotropic electron source, where the number of emitted particles is proportional to the local density. RESULTS: The results of the Fano cavity test strongly depend on the energy of charged particles and the density within the given geometry. By adjusting the maximal length of the charged particle steps, it was possible to calculate the deposited dose in the investigated regions with high accuracy (<0.1%). The Fano cavity test was performed in all regions of the detailed detector models. Using the default value for the step size in the external magnetic field, the maximal deviation between Monte Carlo based and analytical dose value in the sensitive volume of the ion chamber and diode detector was 8% and 0.1%, respectively. CONCLUSIONS: The Fano cavity test is a crucial validation method for the modeled detectors and the transport algorithms when performing Monte Carlo simulations in a strong external magnetic field. Special care should be given, when calculating dose in volumes of low density. This study has shown that the Fano cavity test is a useful method to adapt particle transport parameters for a given simulation geometry.

The influence of different versions of FLUKA and GEANT4 on the calculation of response functions of ionization chambers in clinical proton beams.

Objective.To investigate the influence of different versions of the Monte Carlo codesgeant4 andflukaon the calculation of overall response functionsfQof air-filled ionization chambers in clinical proton beams.Approach. fQfactors were calculated for six plane-parallel and four cylindrical ionization chambers withgeant4 andfluka. These factors were compared to already published values that were derived using older versions of these codes.Main results.Differences infQfactors calculated with different versions of the same Monte Carlo code can be up to ∼1%. Especially forgeant4, the updated version leads to a more pronounced dependence offQon proton energy and to smallerfQfactors for high energies.Significance.Different versions of the same Monte Carlo code can lead to differences in the calculation offQfactors of up to ∼1% without changing the simulation setup, transport parameters, ionization chamber geometry modeling, or employed physics lists. These findings support the statement that the dominant contributor to the overall uncertainty of Monte Carlo calculatedfQfactors are type-B uncertainties.

A method to implement inter-track interactions in Monte Carlo simulations with TOPAS-nBio and their influence on simulated radical yields following water radiolysis.

Objective.In FLASH radiotherapy (dose rates ≥40 Gy s-1), a reduced normal tissue toxicity has been observed, while maintaining the same tumor control compared to conventional radiotherapy (dose rates ≤0.03 Gy s-1). This protecting effect could not be fully explained yet. One assumption is that interactions between the chemicals of different primary ionizing particles, so-called inter-track interactions, trigger this outcome. In this work, we included inter-track interactions in Monte Carlo track structure simulations and investigated the yield of chemicals (G-value) produced by ionizing particles.Approach.For the simulations, we used the Monte Carlo toolkit TOPAS, in which inter-track interactions cannot be implemented without further effort. Thus, we developed a method enabling the simultaneous simulation ofNoriginal histories in one event allowing chemical species to interact with each other. To investigate the effect of inter-track interactions we analyzed theG-value of different chemicals using various radiation sources. We used electrons with an energy of 60 eV in different spatial arrangements as well as a 10 MeV and 100 MeV proton source. For electrons we setNbetween 1 and 60, for protons between 1 and 100.Main results.In all simulations, the totalG-value decreases with increasingN. In detail, theG-value for•OH , H3O and eaqdecreases with increasingN, whereas theG-value of OH-, H2O2and H2increases slightly. The reason is that with increasingN, the concentration of chemical radicals increases allowing for more chemical reactions between the radicals resulting in a change of the dynamics of the chemical stage.Significance.Inter-track interactions resulting in a variation of the yield of chemical species, may be a factor explaining the FLASH effect. To verify this hypothesis, further simulations are necessary in order to evaluate the impact of varyingG-values on the yield of DNA damages.

Monte Carlo calculated ionization chamber correction factors in clinical proton beams - deriving uncertainties from published data.

For the update of the IAEA TRS-398 Code of Practice (CoP), global ionization chamber factors (fQ) and beam quality correction factors (kQ) for air-filled ionization chambers in clinical proton beams have been calculated with different Monte Carlo codes. In this study, average Monte Carlo calculated fQ and kQ factors are provided and the uncertainty of these factors is estimated. Average fQ factors in monoenergetic proton beams with energies between 60 MeV and 250 MeV were derived from Monte Carlo calculated fQ factors published in the literature. Altogether, 195 fQ factors for six plane-parallel and three cylindrical ionization chambers calculated with penh, fluka and geant4 were incorporated. Additionally, a weighted standard deviation of fQ factors was calculated, where the same weight was assigned to each Monte Carlo code. From average fQ factors, kQ factors were derived and compared to the values from the IAEA TRS-398 CoP published in 2000 as well as to the values of the upcoming version. Average Monte Carlo calculated fQ factors are constant within 0.6% over the energy range investigated. In general, the different Monte Carlo codes agree within 1% for low energies and show larger differences up to 2% for high energies. As a result, the standard deviation of fQ factors increases with energy and is ∼0.3% for low energies and ∼0.8% for high energies. kQ factors derived from average Monte Carlo calculated fQ factors differ from the values presented in the IAEA TRS-398 CoP by up to 2.4%. The overall estimated uncertainty of Monte Carlo calculated kQ factors is ∼0.5%-1% smaller than the uncertainties estimated in IAEA TRS-398 CoP since the individual ionization chamber characteristics (e.g. fluence perturbations) are considered in detail in Monte Carlo calculations. The agreement between Monte Carlo calculated kQ factors and the values of the upcoming version of IAEA TRS-398 CoP is better with deviations smaller than 1%.

Determination of the dose rate around a HDR 192Ir brachytherapy source with the microDiamond and the microSilicon detector.

PURPOSE: To employ the microDiamond and the microSilicon detector (mDD and mSD, both PTW-Freiburg, Germany) to determine the dose rate around a HDR 192Ir brachytherapy source (model mHDR-v2r, Elekta AB, Sweden). METHODS: The detectors were calibrated with a 60Co beam at the PTW Calibration Laboratory. Measurements around the 192Ir source were performed inside a PTW MP3 water phantom. The detectors were placed at selected points of measurement at radial distances r, ranging from 0.5 to 10 cm, keeping the polar angle θ = 90°. Additional measurements were performed with the mSD at fixed distances r = 1, 3 and 5 cm, with θ varying from 0 to 150°, 0 to 166°, and 0 to 168°, respectively. The corresponding mDD readings were already available from a previous work (Rossi et al., 2020). The beam quality correction factor of both detectors, as well as a phantom effect correction factor to account for the difference between the experimental geometry and that assumed in the TG-43 formalism, were determined using the Monte Carlo (MC) toolkit EGSnrc. The beam quality correction factor was factorized into energy dependence and volume-averaging correction factors. Using the abovementioned MC-based factors, the dose rate to water at the different points of measurement in TG-43 conditions was obtained from the measured readings, and was compared to the dose rate calculated according to the TG-43 formalism. RESULTS: The beam quality correction factor was considerably closer to unity for the mDD than for the mSD. The energy dependence of the mDD showed a very weak radial dependence, similar to the previous findings showing a weak angular dependence as well (Rossi et al., 2020). Conversely, the energy dependence of the mSD decreased significantly with increasing distances, and also showed a considerably more pronounced angular dependence, especially for the smallest angles. The volume-averaging showed a similar radial dependence for both detectors: the correction had a maximal impact at 0.5 cm and then approached unity for larger distances, as expected. Concerning the angular dependence, the correction for the mSD was also similar to the one previously determined for the mDD (Rossi et al., 2020): a maximal impact was observed at θ = 0°, with values tending to unity for larger angles. In general, the volume-averaging was less pronounced for the mSD due to the smaller sensitive volume radius. After the application of the MC-based factors, differences between mDD dose rate measurements and TG-43 dose rate calculations ranged from -2.6% to +4.3%, with an absolute average difference of 1.0%. For the mSD, the differences ranged from -3.1% to +5.2%, with an absolute average difference of 1.0%. For both detectors, all differences but one were within the combined uncertainty (k = 2). The differences of the mSD from the mDD ranged from -3.9% to +2.6%, with the vast majority of them being within the combined uncertainty (k = 2). For θ ≠ 0°, the mDD was able to provide sufficiently accurate results even without the application of the MC-based beam quality correction factor, with differences to the TG-43 dose rate calculations from -1.9% to +3.4%, always within the combined uncertainty (k = 2). CONCLUSION: The mDD and the mSD showed consistent results and appear to be well suitable for measuring the dose rate around HDR 192Ir brachytherapy sources. MC characterization of the detectors response is needed to determine the beam quality correction factor and to account for energy dependence and/or volume-averaging, especially for the mSD. Our findings support the employment of the mDD and mSD for source QA, TPS verification and TG-43 parameters determination.

Validation of an EGSnrc-based Monte Carlo model for a complex 2D-array for technical QA measurements of a linear accelerator.

PURPOSE: Multi-axis ionization chamber arrays can be used for quality assurance (QA) and measurement of linear accelerator (linac) specific data. In this work, the ability of the IC Profiler (Sun Nuclear Corp., Melbourne, Florida) detector array to measure the photon beam quality specifier %dd(10) x $_\textrm {{\it x}}$ and TPR20, 10 was investigated. To investigate the method for beam energy QA using a two-dimensional detector array, a Monte Carlo-based model of the detector array was developed and validated. METHODS: A Monte Carlo-based model of the IC Profiler detector array with Quad Wedge accessories was developed in detail from drawings provided by the manufacturer using the egs++ class library from the EGSnrc code system. Monte Carlo simulations were used to calculate the absorbed dose in the 251 ionization chambers of the IC profiler in the 6 MV Elekta Precise radiation field. To validate the results from the Monte Caro simulations, measurements were performed on clinical 6 MV linacs. To vary the photon beam quality of the Elekta 6 MV linac, the current of the bending magnet was varied. Furthermore, the area ratio A R $AR$ was calculated from IC Profiler measurements with the Quad Wedge accessories. RESULTS: Measurements as well as Monte Carlo simulations confirmed the linear relationship between the area ratio A R $AR$ and the investigated photon beam quality specifier %dd(10) x $_\textrm {{\it x}}$ and TPR20, 10 for the investigated radiation source. Furthermore, the Monte Carlo-simulated data were within the 95% confidence interval of the linear fit to the measured data. This enabled the Monte Carlo-based IC Profiler model to be used for further investigations. The A R $AR$ values were calculated for various electron beam sizes and the angle of incidence on the target of the linac. CONCLUSIONS: A Monte-Carlo-based model of the detector array was developed, which could successfully reproduce measurements, demonstrating that even very complex geometries can be modeled in EGSnrc. Moreover, the study showed that the validated Monte Carlo model has the potential to investigate variations in beam parameters and their effects on AR ratios and %dd(10) x $_\textrm {{\it x}}$ that may not be investigated experimentally. While these findings may help users gain a deeper understanding of the QA method, the Monte Carlo model enables other complex investigations, such as the simulation of measurements in the presence of magnetic fields, or the simulation of measurements on novel treatment delivery techniques and devices.

Induced luminescence in water and PMMA - spectral analysis for irradiations with proton beams within the clinical energy range.

It was recently discovered that water and PMMA emit a weak luminescence signal when irradiated with protons within the clinically used energy range. This could offer a fast approach for range measurements in water. However, a complete explanation or investigation on the origin of the signal has not been published. In this work, a setup for the high-resolution spectral measurement of the weak luminescence signal in water and PMMA was designed. The measurement environment in the vicinity of a proton accelerator represented a major challenge for the sensitive optical measurements due to the presence of ionizing scattered radiation. A high-sensitive spectrometer in combination with a custom-made fiber was used to build a foundation for further analysis of the luminescence signal by providing accurate spectral information. For water, a broad distribution in the range from 240 to 900 nm with a maximum at 480 nm was obtained. A comparison of the spectra with previously published work indicates that the signal originates from excited states produced during the radiolysis of water. In comparison, differences between the water and the PMMA spectrum were observed. When examining the signal in PMMA, spectral differences were found compared to the measurements in water. The signal in PMMA was approximately 10 times stronger, had a narrower distribution and was shifted to lower wavelengths. Nevertheless, for the investigated proton energies, no spectral energy dependence was detected. In addition to the results for water and PMMA, a further luminescence signal was measured when the silica fiber used was directly irradiated with primary protons. All spectra, obtained in this work, describe the signal of proton-induced luminescence in water and PMMA with a high resolution of 3.4 nm and thus form a basis for further research, which could be a powerful tool in proton range verification.

Experimental and Monte Carlo-based determination of magnetic field correction factors k B , Q $k_{B,Q}$ in high-energy photon fields for two ionization chambers.

BACKGROUND: The integration of magnetic resonance tomography into clinical linear accelerators provides high-contrast, real-time imaging during treatment and facilitates online-adaptive workflows in radiation therapy treatments. The associated magnetic field also bends the trajectories of charged particles via the Lorentz force, which may alter the dose distribution in a patient or a phantom and affects the dose response of dosimetry detectors. PURPOSE: To perform an experimental and Monte Carlo-based determination of correction factors k B , Q $k_{B,Q}$ , which correct the response of ion chambers in the presence of external magnetic fields in high-energy photon fields. METHODS: The response variation of two different types of ion chambers (Sun Nuclear SNC125c and SNC600c) in strong external magnetic fields was investigated experimentally and by Monte Carlo simulations. The experimental data were acquired at the German National Metrology Institute, PTB, using a clinical linear accelerator with a nominal photon energy of 6 MV and an external electromagnet capable of generating magnetic flux densities of up to 1.5 T in opposite directions. The Monte Carlo simulation geometries corresponded to the experimental setup and additionally to the reference conditions of IAEA TRS-398. For the latter, the Monte Carlo simulations were performed with two different photon spectra: the 6 MV spectrum of the linear accelerator used for the experimental data acquisition and a 7 MV spectrum of a commercial MRI-linear accelerator. In each simulation geometry, three different orientations of the external magnetic field, the beam direction and the chamber orientation were investigated. RESULTS: Good agreement was achieved between Monte Carlo simulations and measurements with the SNC125c and SNC600c ionization chambers, with a mean deviation of 0.3% and 0.6%, respectively. The magnitude of the correction factor k B , Q $k_{B,Q}$ strongly depends on the chamber volume and on the orientation of the chamber axis relative to the external magnetic field and the beam directions. It is greater for the SNC600c chamber with a volume of 0.6 cm3 than for the SNC125c chamber with a volume of 0.1 cm3 . When the magnetic field direction and the chamber axis coincide, and they are perpendicular to the beam direction, the ion chambers exhibit a calculated overresponse of less than 0.7(6)% (SNC600c) and 0.3(4)% (SNC125c) at 1.5 T and less than 0.3(0)% (SNC600c) and 0.1(3)% (SNC125c) for 0.35 T for nominal beam energies of 6 MV and 7 MV. This chamber orientation should be preferred, as k B , Q $k_{B,Q}$ may increase significantly in other chamber orientations. Due to the special geometry of the guard ring, no dead-volume effects have been observed in any orientation studied. The results show an intra-type variation of 0.17% and 0.07% standard uncertainty (k=1) for the SNC125c and SNC600c, respectively. CONCLUSION: Magnetic field correction factors k B , Q $k_{B,Q}$ for two different ion chambers and for typical clinical photon beam qualities were presented and compared with the few data existing in the literature. The correction factors may be applied in clinical reference dosimetry for existing MRI-linear accelerators.

Monte Carlo calculated beam quality correction factors for two cylindrical ionization chambers in photon beams.

PURPOSE: Although several studies provide data for reference dosimetry, the SNC600c and SNC125c ionization chambers (Sun Nuclear Corporation, Melbourne, FL) are in clinical use worldwide for which no beam quality correction factors kQ are available. The goal of this study was to calculate beam quality correction factors kQ for these ionization chambers according to dosimetry protocols TG-51, TRS 398 and DIN 6800-2. METHODS: Monte Carlo simulations using EGSnrc have been performed to calculate the absorbed dose to water and the dose to air within the active volume of ionization chamber models. Both spectra and simulations of beam transport through linear accelerator head models were used as radiation sources for the Monte Carlo calculations. RESULTS: kQ values as a function of the respective beam quality specifier Q were fitted against recommended equations for photon beam dosimetry in the range of 4 MV to 25 MV. The fitting curves through the calculated values showed a root mean square deviation between 0.0010 and 0.0017. CONCLUSIONS: The investigated ionization chamber models (SNC600c, SNC125c) are not included in above mentioned dosimetry protocols, but are in clinical use worldwide. This study covered this knowledge gap and compared the calculated results with published kQ values for similar ionization chambers. Agreements with published data were observed in the 95% confidence interval, confirming the use of data for similar ionization chambers, when there are no kQ values available for a given ionization chamber.

Enhancement of the EGSnrc code egs_chamber for fast fluence calculations of charged particles.

PURPOSE: Simulation of absorbed dose deposition in a detector is one of the key tasks of Monte Carlo (MC) dosimetry methodology. Recent publications (Hartmann and Zink, 2018; Hartmann and Zink, 2019; Hartmann et al., 2021) have shown that knowledge of the charged particle fluence differential in energy contributing to absorbed dose is useful to provide enhanced insight on how response depends on detector properties. While some EGSnrc MC codes provide output of charged particle spectra, they are often restricted in setup options or limited in calculation efficiency. For detector simulations, a promising approach is to upgrade the EGSnrc code egs_chamber which so far does not offer charged particle calculations. METHODS: Since the user code cavity offers charged particle fluence calculation, the underlying algorithm was embedded in egs_chamber. The modified code was tested against two EGSnrc applications and DOSXYZnrc which was modified accordingly by one of the authors. Furthermore, the gain in efficiency achieved by photon cross section enhancement was determined quantitatively. RESULTS: Electron and positron fluence spectra and restricted cema calculated by egs_chamber agreed well with the compared applications thus demonstrating the feasibility of the new code. Additionally, variance reduction techniques are now applicable also for fluence calculations. Depending on the simulation setup, considerable gains in efficiency were obtained by photon cross section enhancement. CONCLUSION: The enhanced egs_chamber code represents a valuable tool to investigate the response of detectors with respect to absorbed dose and fluence distribution and the perturbation caused by the detector in a reasonable computation time. By using intermediate phase space scoring, egs_chamber offers parallel calculation of charged particle fluence spectra for different detector configurations in one single run.

Development, Monte Carlo simulations and experimental evaluation of a 3D range-modulator for a complex target in scanned proton therapy.

The purpose of this work was to develop and manufacture a 3D range-modulator (3D RM) for a complex target contour for scanned proton therapy. The 3D RM is considered to be a viable technique for the very fast dose application in patient-specific tumors with only one fixed energy. The RM was developed based on a tumor from a patient CT and manufactured with high-quality 3D printing techniques with both polymer resin and aluminum. Monte Carlo simulations were utilized to investigate its modulating properties and the resulting dose distribution. Additionally, the simulation results were validated with measurements at the Marburg Ion-Beam Therapy Centre. For this purpose, a previously developed water phantom was used to conduct fast, automated high-resolution dose measurements. The results show a very good agreement between simulations and measurements and indicate that highly homogeneous dose distributions are possible. The delivered dose is conformed to the distal as well as to the proximal edge of the target. The 3D range-modulator concept combines a high degree of dose homogeneity and conformity, comparable to standard IMPT with very short irradiation times, promising clinically applicable dose distributions for lung and/or FLASH treatment, comparable and competitive to those from conventional irradiation techniques.