Air kerma reference field with high energy photons using a 15 MeV electron beam from a clinical linear accelerator.

In the medical and nuclear fields, there are environments where exposure to photons with energies above several MeV can result in problems. The National Metrology Institute of Japan has developed a high-energy photon field using a 15 MeV electron beam of a clinical linear accelerator with a copper target and an aluminium filter unit to facilitate dosimeter calibration in terms of air kerma. To determine the air kerma rate, the energy fluence distribution at a reference point was calculated, and both calculations and experiments evaluated the effective energy and spatial dose distribution. Moreover, to validate the air kerma measurement, two commercial cavity chambers were calibrated in a developed photon field. The results obtained exhibited a 4% difference compared with those in a Co-60γ-ray reference field.

DEVELOPMENT OF ABSOLUTE MEASUREMENT SYSTEM FOR 𝑾AIR IN 60CO GAMMA RAYS.

In the ICRU Report 90, the uncertainty of the recommendation for ${{W}}_{{air}}$ was changed from 0.15 to 0.35%. The purpose of this study is to develop an absolute measurement system for ${{W}}_{{air}}$ in electrons with lower uncertainty using 60Co gamma rays. ${{W}}_{{air}}$ was determined by the ratio of the energy deposition to the number of ion pairs created in a given volume of air using a graphite calorimeter and a graphite-wall ionisation chamber. The obtained value for ${{W}}_{{air}}$ was 33.91 eV with a relative standard uncertainty of 0.08 eV (k = 1), and was in good agreement with the recommended value of the ICRU Report 90 (33.97 eV). Additionally, the uncertainty for ${{W}}_{{air}}$ obtained in this investigation is 0.23% and is comparable with that reported by Burns et al., which is the lowest uncertainty in recent studies determining ${{W}}_{{air}}$ In the future, the proposed system can be used to measure ${{W}}_{{air}}$ in high-energy electron beams.

Technical note: The impact of storage humidity on the response of reference-class ionization chambers.

PURPOSE: A number of Farmer-type ionization chambers were tested against storage humidity to confirm whether they satisfied the criteria for the long-term stability of reference-class ionization chambers. METHODS: The ionization chambers were stored for several months in an environment with relative humidity adjustable from 20% to 80%. The ionization chambers were removed from the storage environment at variable intervals ranging from 1 to 70 days and irradiated in a Co-60 radiation beam. The responses for each ionization chamber were evaluated from the measured currents corrected for the atmospheric air density, and were compared with those predicted by the Co-60 half-life. RESULTS: Certain ionization chambers gave a constant relative response regardless of the storage humidity, while the relative responses of two types of ionization chambers changed as a function of the storage humidity. The difference between the relative responses for the low (20-30%) and high (70-80%) storage relative humidity was ∼ $\sim$ 0.7%. The response was larger for the high relative humidity storage. Immediately after the storage humidity changed, the relative response started to change by the day, and it took approximately 2 weeks to 2 months for the relative response to converge. For one type of the ionization chamber, the plastic outer wall and the outer electrode were replaced with those made of solid graphite, and it was confirmed that the remodeled ionization chamber did not exhibit the response change. CONCLUSIONS: The present results and previous reports by other authors indicate that the magnitude of the change depends on the magnitude of the water absorption of the plastic used for the outer wall and/or the electrode of the ionization chamber. Thus, it is important in the selection of the reference-class ionization chamber to note the material and structure of the outer wall and electrode of the ionization chamber. If the ionization chamber has a hygroscopic wall and electrode and it is used as a reference ionization chamber, it is necessary to pay additional attention to the humidity difference for the storage, daily irradiation, and yearly calibration especially in regions with large seasonal humidity fluctuations.

[Radiotherapy Dosimeter Calibration for Absorbed Dose to Water Using Medical Accelerators].

A calibration service using a medical accelerator has been launched to calibrate a radiotherapy dosimeter in terms of an absorbed dose to water. The radiotherapy dosimeter calibrated by the calibration service can measure the absorbed dose to water without a beam quality conversion factor. In this paper, an overview of the calibration service for a high-energy photon beam and a high-energy electron beam was described, as well as methods of absorbed dose measurement and cross-calibration using the calibrated radiotherapy dosimeter. And the development status of a dose standard for a particle beam was reported.

Dosimetric impacts of beam-hardening filter removal for the CyberKnife system.

PURPOSE: Equipment refurbishment was performed to remove the beam-hardening filter (BHF) from the CyberKnife system (CK). This study aimed to confirm the change in the beam characteristics between the conventional CK (present-BHF CK) and CK after the BHF was removed (absent-BHF CK) and evaluate the impact of BHF removal on the beam quality correction factors kQ. METHODS: The experimental measurements of the beam characteristics of the present- and absent-BHF CKs were compared. The CKs were modeled using Monte Carlo simulations (MCs). The energy fluence spectra were calculated using MCs. Finally, kQ were estimated by combining the MC results and analytic calculations based on the TRS-398 and TRS-483 approaches. RESULTS: All gamma values for percent depth doses and beam profiles between each CK were less than 0.5 following the 3%/1 mm criteria. The percentage differences for tissue-phantom ratios at depths of 20 and 10 cm and percentage depth doses at 10 cm between each CK were -1.20% and -0.97%, respectively. The MC results demonstrated that the photon energy fluence spectrum of the absent-BHF CK was softer than that of the present-BHF CK. The kQ values for the absent-BHF CK were in agreement within 0.02% with those for the present-BHF CK. CONCLUSIONS: The photon energy fluence spectrum was softened by the removal of BHF. However, no remarkable impact was observed for the measured beam characteristics and kQ. Therefore, the previous findings of the kQ values for the present-BHF CK can be directly used for the absent-BHF CK.

Examining electrometer performance checks with direct-current generator in a clinic: Assessment of generated charges and implementation of electrometer checks.

PURPOSE: Medical physicists use a suitable detector connected to an electrometer to measure radiotherapy beams. Each detector and electrometer has a lifetime (due to physical deterioration of detector components and electrical characteristic deterioration in electronic electrometer components), long-term stability [according to IEC 60731:2011, ≤0.5% (reference-class dosimeter)], and calibration frequency [according to Muir et al. (J Appl Clin Med Phys. 2017; 18:182-190), generally 2 years]; thus, physicists should check the electrometer and detector separately. However, to the best of our knowledge, only one study (Blad et al., Phys Med Biol. 1998; 43:2385-2391) has reported checking the electrometer independently from the detector. The present study conducts performance checks on electrometers separately from the detector in clinical settings, using an electrometer equipped with a direct current (DC) generator (EMF 521R) capable of injecting DC (effective range: ±20 pA to ±20 nA) into itself or another electrometer. METHODS: First, to check the nonlinearity of the generated currents from ±20 pA to ±20 nA, charges generated from the DC generator were measured with the EMF 521R electrometer. Next, six reference-class electrometers classified according to IEC 60731:2011 were checked for repeatability at a current of ±20 pA or a minimum effective indicated value meeting IEC 60731:2011, as well as for nonlinearity within the current range from ±20 pA to ±20 nA. RESULTS: The nonlinearities for the measured currents were less than ±0.05%. The repeatability for the six electrometers was < 0.1%. While the nonlinearity of one electrometer reached up to 0.22% at a current of -20 pA, all six electrometers displayed nonlinearities of less than ±0.1% at currents of ±100 pA or higher. CONCLUSIONS: This work suggests that it is possible to check the nonlinearity and repeatability of clinical electrometers with DCs above the ±30 pA level using a DC generator in a clinic.

Effect of Gold Nanoparticle Radiosensitization on Plasmid DNA Damage Induced by High-Dose-Rate Brachytherapy.

PURPOSE: Gold nanoparticles (AuNPs) are candidate radiosensitizers for medium-energy photon treatment, such as γ-ray radiation in high-dose-rate (HDR) brachytherapy. However, high AuNP concentrations are required for sufficient dose enhancement for clinical applications. Here, we investigated the effect of positively (+) charged AuNP radiosensitization of plasmid DNA damage induced by 192Ir γ-rays, and compared it with that of negatively (-) charged AuNPs. METHODS: We observed DNA breaks and reactive oxygen species (ROS) generation in the presence of AuNPs at low concentrations. pBR322 plasmid DNA exposed to 64 ng/mL AuNPs was irradiated with 192Ir γ-rays via HDR brachytherapy. DNA breaks were detected by observing the changes in the form of the plasmid and quantified by agarose gel electrophoresis. The ROS generated by the AuNPs were measured with the fluorescent probe sensitive to ROS. The effects of positively (+) and negatively (-) charged AuNPs were compared to study the effect of surface charge on dose enhancement. RESULTS: +AuNPs at lower concentrations promoted a comparable level of radiosensitization by producing both single-stranded breaks (SSBs) and double-stranded breaks (DSBs) than those used in cell assays and Monte Carlo simulation experiments. The dose enhancement factor (DEF) for +AuNPs was 1.3 ± 0.2 for SSBs and 1.5 ± 0.4 for DSBs. The ability of +AuNPs to augment plasmid DNA damage is due to enhanced ROS generation. While -AuNPs generated similar ROS levels, they did not cause significant DNA damage. Thus, dose enhancement using low concentrations of +AuNPs presumably occurred via DNA binding or increasing local +AuNP concentration around the DNA. CONCLUSION: +AuNPs at low concentrations displayed stronger radiosensitization compared to -AuNPs. Combining +AuNPs with 192Ir γ-rays in HDR brachytherapy is a candidate method for improving clinical outcomes. Future development of cancer cell-specific +AuNPs would allow their wider application for HDR brachytherapy.

Experimental study of humidity effect on charge measurement of reference ionization chambers in clinical high-energy photon beams.

PURPOSE: In the practice code of dosimetry, humidity effect is assumed to be constant as far as the measurements are performed in the relative humidity (RH) range of (20-80)%; thus, the humidity effect can be ignored with a dose uncertainty of 0.15%. This assumption is based on the previous experimental results by Niatel and Guiho. Rogers and Ross calculated the stopping power ratio of humid air and dry air for high-energy electron beams by using a Monte Carlo code. They demonstrate that the W value, the mean energy required to create an ion pair in air, is independent of the beam quality when the air is dry, and that the traditional humidity correction can be used also for high-energy photon and electron beams; however, this was only a computational study. In the present study, we measured the humidity correction of Farmer-type ionization chambers in high-energy photon beams and determined the W values of humid air using the calculated energy deposition of humid air with a Monte Carlo code. Furthermore, we proposed an analytical expression to determine a practical humidity correction for an ionization chamber as a function of absolute humidity. METHOD: Experiments were carried out using a clinical linear accelerator (linac, Elekta Precise) at the National Metrology Institute of Japan (NMIJ). A shield box was constructed downstream of the linac and connected to an air processor, which maintained the temperature around 22°C and controlled the humidity in the range of (10-70)% inside the box. We prepared two Farmer-type ionization chambers: PTW 30013 and Exradin A19. Each ionization chamber was placed inside the box and irradiated with 6-, 10-, and 15-MV high-energy photon beams from the clinical linac. The energy deposition to the humid air inside the ionization chamber was calculated using the Electron Gamma Shower Version 5 (EGS5) code system. RESULTS: Stabilization for the humidity of the ionization chamber was completed within 3 h. The polarity and ion recombination corrections did not show any change in the humidity range studied. The measured humidity correction and the evaluated W values of humid air in high-energy photon beams were in good agreement with those by Rogers in TG-21 and by Niatel in the range of RH (10-70)%. CONCLUSION: Humidity correction of ionization chambers in high-energy photon beams from the clinical linac was determined experimentally. Using the analytical expression for the energy depositions by EGS5, the analytical expression for the W values was also derived.

Monte Carlo modeling of a 60Co MRI-guided radiotherapy system on Geant4 and experimental verification of dose calculation under a magnetic field of 0.35 T.

Our purpose was to establish the commissioning procedure of Monte Carlo modeling on a magnetic resonance imaging-guided radiotherapy system (MRIdian, Viewray Inc.) under a magnetic field of 0.345 T through experimental measurements. To do this, we sought (i) to assess the depth-dose and lateral profiles generated by the Geant4 using either EBT3 film or the BJR-25 data; (ii) to assess the calculation accuracy under a magnetic field of 0.345 T. The radius of the electron trajectory caused by the electron return effect (ERE) in a vacuum was obtained both by the Geant4 and the theoretical methods. The surface dose on the phantom was calculated and compared with that obtained from the film measurements. The dose distribution in a phantom having two air gaps was calculated and measured with EBT 3 film. (i) The difference of depth-dose profile generated by the Geant4 from the BJR-25 data was 0.0 ± 0.8% and 0.3 ± 1.5% for field sizes of 4.5 and 27.3 cm2, respectively. Lateral dose profiles generated by Geant4 agreed well with those generated from the EBT3 film data. (ii) The radius of the electron trajectory generated by Geant4 agreed well with the theoretical values. A maximum of ~50% reduction of the surface dose under a magnetic field of 0.345 T was observed due to elimination of the electron contamination caused by the magnetic field, as determined by both the film measurements and the Geant4. Changes in the dose distributions in the air gaps caused by the ERE were observed on the Geant4 and in the film measurements. Gamma analysis (3%/3 mm) showed a pass rate of 95.1%. Commissioning procedures for the MRI-guided radiotherapy system on the Geant4 were established, and we concluded that the Geant4 had provided high calculation accuracy under a magnetic field of 0.345 T.

A Comparative Study of Reference Dosimetries in Japan and Canada.

In Japan and North America, different dosimetry protocols have been implemented to determine the absorbed dose to water: JSMP Standard Dosimetry 12 and AAPM TG-51 addendum. In this study, Japanese and Canadian reference dosimetries for high energy photon beams were compared theoretically, and then they were verified experimentally. We estimated the theoretical differences of the ion recombination correction factors, the leakage correction factors, the radial dose distribution correction factors, the calibration factors, the beam quality correction factors and the absorbed dose to water. When an influence of the radial dose distribution is negligible, the ratios of Canadian to Japanese absorbed dose in reference dosimetries ranged from 0.995 to 1.007 for all the reference-class-Farmer-type ionization chambers. This discrepancy was mainly caused by the wall correction factor included in the beam quality correction factor. Subsequently, to verify the theoretical approaches, we calibrated the same ionization chamber in 60Co gamma ray of Japanese primary and secondary standard dosimetry laboratories (PSDL and SSDL) and measured the absorbed dose of a clinical linear accelerator. It followed that the ratios of Canadian to Japanese absorbed dose in reference dosimetries increased up to 1.015 for PTW 30013 reference-class-Farmer-type ionization chamber. This increase was mainly caused by a discrepancy in the calibration factors (ND,w) observed between Japanese PSDL and SSDL. In conclusion, in order to improve the international consistency of the absorbed dose to water determined by JSMP Standard Dosimetry 12, we should reevaluate the accuracy of the wall correction factors and implement a periodic comparative test of the ND,w between Japanese PSDL and SSDL.

[Primary Standard of Absorbed Dose to Water in High-energy Photon Beam Irradiation].

With the aim of improving the accuracy of photon dosimetry, the primary standard of absorbed dose to water for high-energy photon beams had been established using a graphite calorimeter. The relative expanded uncertainty (k = 2) of the calibration coefficient of absorbed dose to water for high-energy photon beams is 0.8%. The National Metrology Institute of Japan has launched a calibration service for high-energy photon beams in terms of absorbed dose to water in November 2013.