ACCURATE KAP METER CALIBRATION AS A PREREQUISITE FOR OPTIMISATION IN PROJECTION RADIOGRAPHY.

Modern X-ray units register the air kerma-area product, PKA, with a built-in KAP meter. Some KAP meters show an energy-dependent bias comparable with the maximum uncertainty articulated by the IEC (25 %), adversely affecting dose-optimisation processes. To correct for the bias, a reference KAP meter calibrated at a standards laboratory and two calibration methods described here can be used to achieve an uncertainty of <7 % as recommended by IAEA. A computational model of the reference KAP meter is used to calculate beam quality correction factors for transfer of the calibration coefficient at the standards laboratory, Q0, to any beam quality, Q, in the clinic. Alternatively, beam quality corrections are measured with an energy-independent dosemeter via a reference beam quality in the clinic, Q1, to beam quality, Q Biases up to 35 % of built-in KAP meter readings were noted. Energy-dependent calibration factors are needed for unbiased PKA Accurate KAP meter calibration as a prerequisite for optimisation in projection radiography.

In-situ calibration of clinical built-in KAP meters with traceability to a primary standard using a reference KAP meter.

The air kerma-area product (KAP) is used for settings of diagnostic reference levels. The International Atomic Energy Agency (IAEA) recommends that doses in diagnostic radiology (including the KAP values) be estimated with an accuracy of at least ± 7% (k = 2). Industry standards defined by the International Electrotechnical Commission (IEC) specify that the uncertainty of KAP meter measurements should be less than ± 25% (k = 2). Medical physicists willing to comply with the IAEA's recommendation need to apply correction factors to KAP values reported by x-ray units. The aim of this work is to present and evaluate a calibration method for built-in KAP meters on clinical x-ray units. The method is based on (i) a tandem calibration method, which uses a reference KAP meter calibrated to measure the incident radiation, (ii) measurements using an energy-independent ionization chamber to correct for the energy dependence of the reference KAP meter, and (iii) Monte Carlo simulations of the beam quality correction factors that correct for differences between beam qualities at a standard laboratory and the clinic. The method was applied to the KAP meter in a Siemens Aristos FX plus unit. It was found that values reported by the built-in KAP meter differed from the more accurate values measured by the reference KAP meter by more than 25% for high tube voltages (more than 140 kV) and heavily filtered beams (0.3 mm Cu). Associated uncertainties were too high to claim that the IEC's limit of 25% was exceeded. Nevertheless the differences were high enough to justify the need for a more accurate calibration of built-in KAP meters.

The potential of dual-energy computed tomography for quantitative decomposition of soft tissues to water, protein and lipid in brachytherapy.

Dosimetric accuracy of radiation treatment planning in brachytherapy depends on knowledge of tissue composition. It has been speculated that soft tissues can be decomposed to water, lipid and protein. The aim of our work is to evaluate the accuracy of such tissue decomposition. Selected abdominal soft tissues, whose average elemental compositions were taken from literature, were decomposed using dual energy computed tomography to water, lipid and protein via the three-material decomposition method. The quality of the decomposition was assessed using relative differences between (i) mass energy absorption and (ii) mass energy attenuation coefficients of the analyzed and approximated tissues. It was found that the relative differences were less than 2% for photon energies larger than 10 keV. The differences were notably smaller than the ones for water as the transport and dose scoring medium. The choice of the water, protein and lipid triplet resulted in negative elemental mass fractions for some analyzed tissues. As negative elemental mass fractions cannot be used in general purpose particle transport computer codes using the Monte Carlo method, other triplets should be used for the decomposition. These triplets may further improve the accuracy of the approximation as the differences were mainly caused by the lack of high-Z materials in the water, protein and lipid triplet.

Nanodosimetry in a clinical neutron therapy beam using the variance-covariance method and Monte Carlo simulations.

Nanodosimetric single-event distributions or their mean values may contribute to a better understanding of how radiation induced biological damages are produced. They may also provide means for radiation quality characterization in therapy beams. Experimental nanodosimetry is however technically challenging and Monte Carlo simulations are valuable as a complementary tool for such investigations. The dose-mean lineal energy was determined in a therapeutic p(65)+Be neutron beam and in a (60)Co gamma beam using low-pressure gas detectors and the variance-covariance method. The neutron beam was simulated using the condensed history Monte Carlo codes MCNPX and SHIELD-HIT. The dose-mean lineal energy was calculated using the simulated dose and fluence spectra together with published data from track-structure simulations. A comparison between simulated and measured results revealed some systematic differences and different dependencies on the simulated object size. The results show that both experimental and theoretical approaches are needed for an accurate dosimetry in the nanometer region. In line with previously reported results, the dose-mean lineal energy determined at 10 nm was shown to be related to clinical RBE values in the neutron beam and in a simulated 175 MeV proton beam as well.

Nanodosimetric measurements and calculations in a neutron therapy beam.

A comparison of calculated and measured values of the dose mean lineal energy (y(D)) for the former neutron therapy beam at Louvain-la-Neuve is reported. The measurements were made with wall-less tissue-equivalent proportional counters using the variance-covariance method and simulating spheres with diameters between 10 nm and 15 microm. The calculated y(D)-values were obtained from simulated energy distributions of neutrons and charged particles inside an A-150 phantom and from published y(D)-values for mono-energetic ions. The energy distributions of charged particles up to oxygen were determined with the SHIELD-HIT code using an MCNPX simulated neutron spectrum as an input. The mono-energetic ion y(D)-values in the range 3-100 nm were taken from track-structure simulations in water vapour done with PITS/KURBUC. The large influence on the dose mean lineal energy from the light ion (A > 4) absorbed dose fraction, may explain an observed difference between experiment and calculation. The latter being larger than earlier reported result. Below 50 nm, the experimental values increase while the calculated decrease.

Monte Carlo study of the dependence of the KAP-meter calibration coefficient on beam aperture, x-ray tube voltage and reference plane.

The Monte Carlo method was used to study the dependence of the calibration coefficient on the tube voltage, beam aperture and reference plane in simplified over-couch geometries modelling VacuTec's type 70157 KAP-meter both with and without an additional filter. The MCNP5 code was used to calculate (i) energy imparted to air cavities of the KAP-meter and (ii) spatial distribution of air collision kerma at entrance and exit planes of the KAP-meter and at a plane close to the patient. From these data, the air kerma area product and calibration coefficient were calculated and their dependence on the tube voltage and beam aperture was analysed. It was found that the variation of the calibration coefficient as a function of tube voltage was up to 40% when the additional filter was used. The additional filter placed closely in front of the KAP-meter decreased the calibration coefficient for the patient plane by about 10% compared to the ideal additional filter. The effect of the beam aperture was small at the patient plane and negligible for the exit plane.