The ICRU Proposal for New Operational Quantities for External Radiation.

Report Committee 26 of the ICRU proposes a set of operational quantities for radiation protection for external radiation, directly based on effective dose and for an extended range of particles and energies. It is accompanied by quantities for estimating deterministic effects to the eye lens and the local skin. The operational quantities are designed to overcome the conceptual and technical shortcomings of those presently in use. This paper describes the proposed operational quantities, and highlights the improvements with respect to the present, legal monitoring quantities.

Accuracy of a dose-area product compared to an absorbed dose to water at a point in a 2 cm diameter field.

PURPOSE: Graphite calorimeters with a core diameter larger than the beam can be used to establish dosimetric references in small fields. The dose-area product (DAP) measured can theoretically be linked to an absorbed dose at a point by the determination of a profile correction. This study aims at comparing the DAP-based protocol to the usual absorbed dose at a point protocol in a 2 cm diameter field for which both references exist. METHODS: Two calorimeters were used, respectively, with a sensitive volume of 0.6 cm (for the absorbed dose at a point measurement) and 3 cm diameter (for the DAP measurement). Profile correction was calculated from a 2D dose mapping using three detectors: a PinPoint chamber, a synthetic diamond, and EBT3 films. A specific protocol to read EBT3 films was implemented and the dose-rate and energy dependences were studied to assure a precise measurement, especially in the penumbra and out-of-field regions. RESULTS: EBT3 films were found independent on dose rates over the range studied but showed a strong under-response (18%) at low energies. Depending on the dosimeter used for calculating the profile correction, a deviation of 0.8% (PinPoint chamber), 0.9% (diamond), or 1.9% (EBT3 films) was observed between the calibration coefficient derived from DAP measurements and the one directly established in terms of absorbed dose to water at a point. CONCLUSIONS: The DAP method can currently be linked to the classical dosimetric reference system based in an absorbed dose at a point only with a confidence interval of 95% (k = 2). None of the detectors studied can be used to determine an absorbed dose to water at a point from a DAP measurement with an uncertainty smaller than 1.2%.

Using a dose-area product for absolute measurements in small fields: a feasibility study.

To extend the dosimetric reference system to field sizes smaller than 2 cm × 2 cm, the LNE-LNHB laboratory is studying an approach based on a new dosimetric quantity named the dose-area product instead of the commonly used absorbed dose at a point. A graphite calorimeter and a plane parallel ion chamber with a sensitive surface of 3 cm diameter were designed and built for measurements in fields of 2, 1 and 0.75 cm diameter. The detector surface being larger than the beam section, most of the issues linked with absolute dose measurements at a point could be avoided. Calibration factors of the plane parallel ionization chamber were established in terms of dose-area product in water for small fields with an uncertainty smaller than 0.9%.

The LNE-LNHB water calorimeter for primary measurement of absorbed dose at low depth in water: application to medium-energy x-rays.

Water calorimeters are used to establish absorbed dose standards in several national metrology laboratories involved in ionizing radiation dosimetry. These calorimeters have been first used in high-energy photons of (60)Co or accelerator beams, where the depth of measurement in water is large (5 or 10 cm). The LNE-LNHB laboratory has developed a specific calorimeter which makes measurements at low depth in water (down to 0.5 cm) easier, in order to fulfil the reference conditions required by the international dosimetry protocols for medium-energy x-rays. This new calorimeter was first used to measure the absorbed dose rate in water at a depth of 2 cm for six medium-energy x-ray reference beams with a tube potential from 80 to 300 kV. The relative combined standard uncertainty obtained on the absorbed dose rate to water is lower than 0.8%. An overview of the design of the calorimeter is given, followed by a detailed description of the calculation of the correction factors and the calorimetric measurements.

Comparison between absorbed dose to water standards established by water calorimetry at the LNE-LNHB and by application of international air-kerma based protocols for kilovoltage medium energy x-rays.

Nowadays, the absorbed dose to water for kilovoltage x-ray beams is determined from standards in terms of air-kerma by application of international dosimetry protocols. New standards in terms of absorbed dose to water has just been established for these beams at the LNE-LNHB, using water calorimetry, at a depth of 2 cm in water in accordance with protocols. The aim of this study is to compare these new standards in terms of absorbed dose to water, to the dose values calculated from the application of four international protocols based on air-kerma standards (IAEA TRS-277, AAPM TG-61, IPEMB and NCS-10). The acceleration potentials of the six beams studied are between 80 and 300 kV with half-value layers between 3.01 mm of aluminum and 3.40 mm of copper. A difference between the two methods smaller than 2.1% was reported. The standard uncertainty of water calorimetry being below 0.8%, and the one associated with the values from protocols being around 2.5%, the results are in good agreement. The calibration coefficients of some ionization chambers in terms of absorbed dose to water, established by application of calorimetry and air-kerma based dosimetry protocols, were also compared. The best agreement with the calibration coefficients established by water calorimetry was found for those established with the AAPM TG-61 protocol.

Air kerma to HP(3) conversion coefficients for photons from 10 keV to 10 MeV, calculated in a cylindrical phantom.

In the framework of the ORAMED project (Optimization of RAdiation protection for MEDical staff), funded by the European Union Seventh Framework Programme, different studies were aimed at improving the quality of radiation protection in interventional radiology and nuclear medicine. The main results of the project were presented during a final workshop held in Barcelona in January 2011, the proceedings of which are available in the open literature. One of the ORAMED tasks was focused on the problem of eye-lens photon exposure of the medical staff, a topic that gained more importance especially after the ICRP decision to lower the limiting equivalent dose to 20 mSv per year. The present technical note has the scope, besides briefly summarising the physical reasons of the proposal and the practical implications, to provide, in tabular form, a set of air kerma to Hp(3) conversion coefficients based on the adoption of a theoretical cylindrical model that is well suited for reproduction of the mass and the shape of a human head.

Assessment of small volume ionization chambers as reference dosimeters in high-energy photon beams.

LNE-LNHB is involved in a European project aiming at establishing absorbed dose-to-water standards for photon-radiation fields down to 2 × 2 cm². This requires the calibration of reference ionization chambers of small volume. Twenty-four ionization chambers of eight different types with volume ranging from 0.007 to 0.057 cm³ were tested in a 6°Co beam. For each chamber, two major characteristics were investigated: (1) the stability of the measured current as a function of the irradiation time under continuous irradiation. At LNE-LNHB, the variation of the current should be less than ±0.1% in comparison with its first value (over a 16 h irradiation time); (2) the variation of the ionization current with the applied polarizing voltage and polarity. Leakage currents were also measured. Results show that (1) every tested PTW (31015, 31016 and 31014) and Exradin A1SL chambers demonstrate a satisfying stability under irradiation. Other types of chambers have a stability complying with the stability criterion for some or none of them. (2) IBA CC01, IBA CC04 and Exradin A1SL show a proper response as a function of applied voltage for both polarities. PTW, Exradin A14SL and Exradin A16 do not. Only three types of chambers were deemed suitable as reference chambers according to LNE-LNHB requirements and specifications from McEwen (2010 Med. Phys. 37 2179-93): Exradin A1SL chambers (3/3), IBA CC04 (2/3) and IBA CC01 (1/3). The Exradin A1SL type with an applied polarizing voltage of 150 V was chosen as an LNE-LNHB reference chamber type in 2 × 2 cm² radiation fields.

Principles for the design and calibration of radiation protection dosemeters for operational and protection quantities for eye lens dosimetry.

The work package two of the ORAMED project--Collaborative Project (2008-2011) supported by the European Commission within its seventh Framework Programme--is devoted to the study of the eye lens dosimetry. A first approach is to implement the use of H(p)(3) by providing new sets of conversion coefficients and well suited calibration and type test procedures. This approach is presented in other papers in the proceedings of this conference. Taking into account that the eye lens is an organ close to the surface of the body, another approach would be to directly estimate the absorbed dose to the eye lens, D(lens,est) through a special calibration procedure although this quantity is not directly measurable. This paper is a methodological paper that tries to identify the critical aspects of a dosimetry in terms of D(lens).

Eye lens dosimetry: task 2 within the ORAMED project.

The ORAMED (Optimization of RAdiation protection for MEDical staff) project is funded by EU-EURATOM within the 7° Framework Programme. Task 2 of the project is devoted to study the dose to the eye lens. The study was subdivided into various topics, starting from a critical revision of the operational quantity H(p)(3), with the corresponding proposal of a cylindrical phantom simulating as best as possible the head in which the eyes are located, the production of a complete set of air kerma to dose equivalent conversion coefficients for photons from 10 keV to 10 MeV, and finally, the optimisation of the design of a personal dosemeter well suited to respond in terms of H(p)(3). The paper presents some preliminary results.

ENEA extremity dosemeter based on LiF(Mg,Cu,P) to evaluate Hp(3,alpha).

Recent epidemiological studies suggest a rather low-dose threshold (<0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimised and current dose limits for the eye lens may be reduced in the future. ICRP Publication 103 on H(p)(d), in §(136), reads that '… a depth d = 3 mm has been proposed for the rare case of monitoring the dose to the lens of the eye. In practice, however, H(p)(3) has rarely been monitored and H(p)(0.07) can be used for the same monitoring purpose… '. As recommended on the EU 'Technical recommendations for monitoring individuals occupationally exposed to external radiation', a test on the ENEA TL extremity dosemeter is herein reported. The results within the actual EU founded Optimization of RAdiation protection for MEDical staff (ORAMED) Project, whose WP2 is aimed at the quantity H(p)(3) and eye lens dosimetry in practice, are taken into account. The paper summarises the main aspects of the study carried out at ENEA-Radiation Protection Institute (Bologna, Italy) to provide practical solutions (in the use and the design) to evaluate the response of the ENEA TL extremity dosemeter in terms of H(p)(3).

Monte Carlo determination of the conversion coefficients Hp(3)/Ka in a right cylinder phantom with 'PENELOPE' code. Comparison with 'MCNP' simulations.

This work has been performed within the frame of the European Union ORAMED project (Optimisation of RAdiation protection for MEDical staff). The main goal of the project is to improve standards of protection for medical staff for procedures resulting in potentially high exposures and to develop methodologies for better assessing and for reducing, exposures to medical staff. The Work Package WP2 is involved in the development of practical eye-lens dosimetry in interventional radiology. This study is complementary of the part of the ENEA report concerning the calculations with the MCNP-4C code of the conversion factors related to the operational quantity H(p)(3). In this study, a set of energy- and angular-dependent conversion coefficients (H(p)(3)/K(a)), in the newly proposed square cylindrical phantom made of ICRU tissue, have been calculated with the Monte-Carlo code PENELOPE and MCNP5. The H(p)(3) values have been determined in terms of absorbed dose, according to the definition of this quantity, and also with the kerma approximation as formerly reported in ICRU reports. At a low-photon energy (up to 1 MeV), the two results obtained with the two methods are consistent. Nevertheless, large differences are showed at a higher energy. This is mainly due to the lack of electronic equilibrium, especially for small angle incidences. The values of the conversion coefficients obtained with the MCNP-4C code published by ENEA quite agree with the kerma approximation calculations obtained with PENELOPE. We also performed the same calculations with the code MCNP5 with two types of tallies: F6 for kerma approximation and *F8 for estimating the absorbed dose that is, as known, due to secondary electrons. PENELOPE and MCNP5 results agree for the kerma approximation and for the absorbed dose calculation of H(p)(3) and prove that, for photon energies larger than 1 MeV, the transport of the secondary electrons has to be taken into account.

Active personal dosemeters in interventional radiology: tests in laboratory conditions and in hospitals.

The work package 3 of the ORAMED project, Collaborative Project (2008-11) supported by the European Commission within its seventh Framework Programme, is focused on the optimisation of the use of active personal dosemeters (APDs) in interventional radiology and cardiology (IR/IC). Indeed, a lack of appropriate APD devices is identified for these specific fields. Few devices can detect low-energy X rays (20-100 keV), and none of them are specifically designed for working in pulsed radiation fields. The work presented in this paper consists in studying the behaviour of some selected APDs deemed suitable for application in IR/IC. For this purpose, measurements under laboratory conditions, both with continuous and pulsed X-ray beams, and tests in real conditions on site in different European hospitals were performed. This study highlights the limitations of APDs for this application and the need of improving the APD technology so as to fulfil all needs in the IR/IC field.

Analysis of the CONRAD computational problems expressing only stochastic uncertainties: neutrons and protons.

Within the scope of CONRAD (A Coordinated Action for Radiation Dosimetry) Work Package 4 on Computational Dosimetry jointly collaborated with the other research actions on internal dosimetry, complex mixed radiation fields at workplaces and medical staff dosimetry. Besides these collaborative actions, WP4 promoted an international comparison on eight problems with their associated experimental data. A first set of three problems, the results of which are herewith summarised, dealt only with the expression of the stochastic uncertainties of the results: the analysis of the response function of a proton recoil telescope detector, the study of a Bonner sphere neutron spectrometer and the analysis of the neutron spectrum and dosimetric quantity H(p)(10) in a thermal neutron facility operated by IRSN Cadarache (the SIGMA facility). A second paper will summarise the results of the other five problems which dealt with the full uncertainty budget estimate. A third paper will present the results of a comparison on in vivo measurements of the (241)Am bone-seeker nuclide distributed in the knee. All the detailed papers will be presented in the WP4 Final Workshop Proceedings.

Extremity ring dosimetry intercomparison in reference and workplace fields.

An intercomparison of ring dosemeters has been organised with the aim of assessing the technical capabilities of available extremity dosemeters and focusing on their performance at clinical workplaces with potentially high extremity doses. Twenty-four services from 16 countries participated in the intercomparison. The dosemeters were exposed to reference photon ((137)Cs) and beta ((147)Pm, (85)Kr and (90)Sr/(90)Y) fields together with fields representing realistic exposure situations in interventional radiology (direct and scattered radiation) and nuclear medicine ((99 m)Tc and (18)F). It has been found that most dosemeters provided satisfactory measurements of H(p)(0.07) for photon radiation, both in reference and realistic fields. However, only four dosemeters fulfilled the established requirements for all radiation qualities. The main difficulties were found for the measurement of low-energy beta radiation. Finally, the results also showed a general under-response of detectors to (18)F, which was attributed to the difficulties of the dosimetric systems to measure the positron contribution to the dose.

Evaluation of the calibration procedure of active personal dosemeters for interventional radiology.

An overview of the use of active personal dosemeters (APD) in interventional radiology is presented. It is based on the work done by the working package 7 of the CONRAD coordinated action supported by the EC within the frame of the 6th FP. This study was done in collaboration with the working package 4 of CONRAD to deal with the calculations required for studying the new calibration facility. The main requirements of the standard for the APD and the difficulties caused by the use of pulsed radiations are presented through the results of an intercomparison organised in a realistic calibration facility similar to the workplace situation in interventional radiology. The main characteristics of this facility are presented.

Multichannel dosemeter and Al2O3:C optically stimulated luminescence fibre sensors for use in radiation therapy: evaluation with electron beams.

This article proposes an innovative multichannel optically stimulated luminescence (OSL) dosemeter for on-line in vivo dose verification in radiation therapy. OSL fibre sensors incorporating small Al(2)O(3):C fibre crystals (TLD(500)) have been tested with an X-ray generator. A reproducible readout procedure should reduce the fading-induced uncertainty ( approximately - 1% per decade). OSL readouts are temperature-dependent [ approximately 0.3% K(-1) when OSL stimulation is performed at the same temperature as irradiation; approximately 0.16% K(-1) after thermalisation (20 degrees C)]. Sensor calibration and depth-dose measurements with electron beams have been performed with a Saturne 43 linear accelerator in reference conditions at CEA-LNHB (ionising radiation reference laboratory in France). Predosed OSL sensors show a good repeatability in multichannel operation and independence versus electron energy in the range (9, 18 MeV). The difference between absorbed doses measured by OSL and an ionisation chamber were within +/-0.9% (for a dose of about 1 Gy) despite a sublinear calibration curve.

Comparison of PENELOPE Monte Carlo dose calculations with Fricke dosimeter and ionization chamber measurements in heterogeneous phantoms (18 MeV electron and 12 MV photon beams).

Different measurements of depth-dose curves and dose profiles were performed in heterogeneous phantoms and compared to dose distributions calculated by a Monte Carlo code. These heterogeneous phantoms consisted of lung and/or bone heterogeneities. Irradiations and simulations were carried out for an 18 MeV electron beam and a 12 MV photon beam. Depth-dose curves were measured with Fricke dosimeters and with plane and cylindrical ionization chambers. Dose profiles were measured with a small cylindrical ionization chamber at different depths. The LINAC was modelled using the PENELOPE code and phase space files were used as input data for the calculations of the dose distributions in every simulation. The detectors (Fricke dosimeters and ionization chambers) were not modelled in the geometry. There is generally a good agreement between the measurements and PENELOPE. Some discrepancies exist, near interfaces, between the ionization chamber and PENELOPE due to the attenuation of the lower energy electrons by the wall of the ionization chamber.

A review of the properties of the dosimetric systems and the quality assurance programmes of 48 dosimetric services in the European Union and Switzerland.

This paper summarises the evaluation of the 1997 EURADOS questionnaire on dosimetric systems able to assess personal dose equivalent. In total, 56 approved dosimetric services in the European Union and Switzerland responded, together monitoring approximately 615,000 occupationally exposed persons. Of these services, 48 stated they were able to assess the external doses in terms of personal dose equivalent. The general aspects of the dosimetric systems and the quality assurance programmes of these services are discussed.

EURADOS trial performance test for photon dosimetry.

Within the framework of the EURADOS Action entitled Harmonisation and Dosimetric Quality Assurance in Individual Monitoring for External Radiation, trial performance tests for whole-body and extremity personal dosemeters were carried out. Photon, beta and neutron dosemeters were considered. This paper summarises the results of the whole-body photon dosemeter test. Twenty-six dosimetry services from all EU Member States and Switzerland participated. Twelve different radiation fields were used to simulate various workplace irradiation fields. Dose values from 0.4 mSv to 80 mSv were chosen. From 312 single results, 26 fell outside the limits of the trumpet curve and 32 were outside the range 1/1.5 to 1.5. Most outliers resulted from high energy R-F irradiations without electronic equilibrium. These fields are not routinely encountered by many of the participating dosimetry services. If the results for this field are excluded, most participating services satisfied the evaluation criteria.

EURADOS trial performance test for neutron personal dosimetry.

This paper reports on the results of a neutron trial performance test sponsored by the European Commission and organised by EURADOS. As anticipated, neutron dosimetry results were very dependent on the dosemeter type and the dose calculation algorithm. Fast neutron fields were generally well measured, but particular problems were noted in the determination of intermediate energy fields and large incident angles, demonstrating the difficulties of neutron personal dosimetry. Of particular concern from a radiological protection point of view was the large number of results underestimating personal dose equivalent. A considerable over-response was noted in a few cases.