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Debnath SBC, Tonneau D, Fauquet C, Tallet A, Darréon J. Cerenkov free micro-dosimetry in small-field radiation therapy technique. Phys Med Biol 2024; 69:125018. [PMID: 38810619 DOI: 10.1088/1361-6560/ad51c6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/29/2024] [Indexed: 05/31/2024]
Abstract
Objective. Optical fiber-based scintillating dosimetry is a recent promising technique owing to the miniature size dosimeter and quality measurement in modern radiation therapy treatment. Despite several advantages, the major issue of using scintillating dosimeters is the Cerenkov effect and predominantly requires extra measurement corrections. Therefore, this work highlighted a novel micro-dosimetry technique to ensure Cerenkov-free measurement in radiation therapy treatment protocol by investigating several dosimetric characteristics.Approach.A micro-dosimetry technique was proposed with the performance evaluation of a novel infrared inorganic scintillator detector (IR-ISD). The detector essentially consists of a micro-scintillating head based on IR-emitting micro-clusters with a sensitive volume of 1.5 × 10-6mm3. The proposed system was evaluated under the 6 MV LINAC beam used in patient treatment. Overall measurements were performed using IBATMwater tank phantoms by following TRS-398 protocol for radiotherapy. Cerenkov measurements were performed for different small fields from 0.5 × 0.5 cm2to 10 × 10 cm2under LINAC. In addition, several dosimetric parameters such as percentage depth dose (PDD), high lateral resolution beam profiling, dose linearity, dose rate linearity, repeatability, reproducibility, and field output factor were investigated to realize the performance of the novel detector.Main results. This study highlighted a complete removal of the Cerenkov effect using a point-like miniature detector, especially for small field radiation therapy treatment. Measurements demonstrated that IR-ISD has acceptable behavior with dose rate variability (maximum standard deviation ∼0.18%) for the dose rate of 20-1000 cGy s-1. An entire linear response (R2= 1) was obtained for the dose delivered within the range of 4-1000 cGy, using a selected field size of 1 × 1 cm2. Perfect repeatability (max 0.06% variation from average) with day-to-day reproducibility (0.10% average variation) was observed. PDD profiles obtained in the water tank present almost identical behavior to the reference dosimeter with a build-up maximum depth dose at 1.5 cm. The small field of 0.5 × 0.5 cm2profiles have been characterized with a high lateral resolution of 100µm.Significance. Unlike recent plastic scintillation detector systems, the proposed micro-dosimetry system in this study requires no Cerenkov corrections and showed efficient performance for several dosimetric parameters. Therefore, it is expected that considering the detector correction factors, the IR-ISD system can be a suitable dose measurement tool, such as in small-field dose measurements, high and low gradient dose verification, and, by extension, in microbeam radiation and FLASH radiation therapy.
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Affiliation(s)
- Sree Bash Chandra Debnath
- Aix-Marseille University, CNRS, LP3 UMR 7341, 13288 Marseille, France
- Aix Marseille University, CNRS, CINaM UMR 7325, Marseille, 13288, France
| | - Didier Tonneau
- Aix Marseille University, CNRS, CINaM UMR 7325, Marseille, 13288, France
| | - Carole Fauquet
- Aix Marseille University, CNRS, CINaM UMR 7325, Marseille, 13288, France
| | - Agnes Tallet
- Institut Paoli-Calmettes, 13009 Marseille, France
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Failing T, Hartmann GH, Hensley FW, Keil B, Zink K. Enhancement of the EGSnrc code egs_chamber for fast fluence calculations of charged particles. Z Med Phys 2022; 32:417-427. [PMID: 35643800 PMCID: PMC9948836 DOI: 10.1016/j.zemedi.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Thomas Failing
- Department for Radiotherapy and Radiooncology, University Medical Center Göttingen, Göttingen 37075, Germany; Institute of Medical Physics and Radiation Protection (IMPS), University of Applied Sciences, Gießen 35390, Germany.
| | | | - Frank W Hensley
- Department for Radiotherapy and Radiooncology, University Medical Center Heidelberg, Heidelberg 69120, Germany
| | - Boris Keil
- Institute of Medical Physics and Radiation Protection (IMPS), University of Applied Sciences, Gießen 35390, Germany; Diagnostic and Interventional Radiology, Philipps-University Marburg, Marburg 35043, Germany
| | - Klemens Zink
- Institute of Medical Physics and Radiation Protection (IMPS), University of Applied Sciences, Gießen 35390, Germany; Department for Radiotherapy and Radiooncology, University Medical Center Giessen-Marburg, Marburg 35043, Germany; Marburg Iontherapy Center (MIT), Marburg 35043, Germany
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López-Sánchez M, Pérez-Fernández M, Pardo E, Fandiño JM, Teijeiro A, Gómez-Fernández N, Gómez F, González-Castaño DM. Small static radiosurgery field dosimetry with small volume ionization chambers. Phys Med 2022; 97:66-72. [DOI: 10.1016/j.ejmp.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/15/2022] [Accepted: 04/09/2022] [Indexed: 11/28/2022] Open
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Hartmann GH, Andreo P, Kapsch RP, Zink K. Cema-based formalism for the determination of absorbed dose for high-energy photon beams. Med Phys 2021; 48:7461-7475. [PMID: 34613620 DOI: 10.1002/mp.15266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/26/2021] [Accepted: 09/23/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Determination of absorbed dose is well established in many dosimetry protocols and considered to be highly reliable using ionization chambers under reference conditions. If dosimetry is performed under other conditions or using other detectors, however, open questions still remain. Such questions frequently refer to appropriate correction factors. A converted energy per mass (cema)-based approach to formulate such correction factors offers a good understanding of the specific response of a detector for dosimetry under various measuring conditions and thus an estimate of pros and cons of its application. METHODS Determination of absorbed dose requires the knowledge of the beam quality correction factor kQ,Qo , where Q denotes the quality of a user beam and Qo is the quality of the radiation used for calibration. In modern Monte Carlo (MC)-based methods, kQ,Qo is directly derived from the MC-calculated dose conversion factor, which is the ratio between the absorbed dose at a point of interest in water and the mean absorbed dose in the sensitive volume of an ion chamber. In this work, absorbed dose is approximated by the fundamental quantity cema. This approximation allows the dose conversion factor to be substituted by the cema conversion factor. Subsequently, this factor is decomposed into a product of cema ratios. They are identified as the stopping power ratio water to the material in the sensitive detector volume, and as the correction factor for the fluence perturbation of the secondary charged particles in the detector cavity caused by the presence of the detector. This correction factor is further decomposed with respect to the perturbation caused by the detector cavity and that caused by external detector properties. The cema-based formalism was subsequently tested by MC calculations of the spectral fluence of the secondary charged particles (electrons and positrons) under various conditions. RESULTS MC calculations demonstrate that considerable fluence perturbation may occur particularly under non-reference conditions. Cema-based correction factors to be applied in a 6-MV beam were obtained for a number of ionization chambers and for three solid-state detectors. Feasibility was shown at field sizes of 4 × 4 and 0.5 cm × 0.5 cm. Values of the cema ratios resulting from the decomposition of the dose conversion factor can be well correlated with detector response. Under the small field conditions, the internal fluence correction factor of ionization chambers is considerably dependent on volume averaging and thus on the shape and size of the cavity volume. CONCLUSIONS The cema approach is particularly useful at non-reference conditions including when solid-state detectors are used. Perturbation correction factors can be expressed and evaluated by cema ratios in a comprehensive manner. The cema approach can serve to understand the specific response of a detector for dosimetry to be dependent on (a) radiation quality, (b) detector properties, and (c) electron fluence changes caused by the detector. This understanding may also help to decide which detector is best suited for a specific measurement situation.
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Affiliation(s)
- Günther H Hartmann
- Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pedro Andreo
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Klemens Zink
- Institut fuer Medizinische Physik und Strahlenschutz (IMPS), University of Applied Sciences, Giessen, Giessen, Germany.,Department for Radiotherapy and Radiooncology, University Medical Center Giessen-Marburg, Marburg, Germany.,Marburg Iontherapy Center (MIT), Marburg, Germany
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Côté B, Keszti F, Bancheri J, Sarfehnia A, Seuntjens J, Renaud J. Feasibility of operating a millimeter-scale graphite calorimeter for absolute dosimetry of small-field photon beams in the clinic. Med Phys 2021; 48:7476-7492. [PMID: 34549805 DOI: 10.1002/mp.15244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 07/06/2021] [Accepted: 08/28/2001] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To characterize and build a cylindrically layered graphite calorimeter the size of a thimble ionization chamber for absolute dosimetry of small fields. This detector has been designed in a familiar probe format to facilitate integration into the clinical workflow. The feasibility of operating this absorbed dose calorimeter in quasi-adiabatic mode is assessed for high-energy accelerator-based photon beams. METHODS This detector, herein referred to as Aerrow MK7, is a miniaturized version of a previously validated aerogel-insulated graphite calorimeter known as Aerrow. The new model was designed and developed using numerical methods. Medium conversion factors from graphite to water, small-field output correction factors, and layer perturbation factors for this dosimeter were calculated using the EGSnrc Monte Carlo code system. A range of commercially available aerogel densities were studied for the insulating layers, and an optimal density was selected by minimizing the small-field output correction factors. Heat exchange within the detector was simulated using a five-body compartmental heat transfer model. In quasi-adiabatic mode, the sensitive volume (a 3 mm diameter cylindrical graphite core) experiences a temperature rise during irradiation on the order of 1.3 mK·Gy-1 . The absorbed dose is obtained by calculating the product of this temperature rise with the specific heat capacity of the graphite. The detector was irradiated with 6 MV ( % dd ( 10 ) x = 63.5%) and 10 MV ( % dd ( 10 ) x = 71.1%) flattening filter-free (FFF) photon beams for two field sizes, characterized by S clin dimensions of 2.16 and 11.0 cm. The dose readings were compared against a calibrated Exradin A1SL ionization chamber. All dose values are reported at d max in water. RESULTS The field output correction factors for this dosimeter design were computed for field sizes ranging from S clin = 0.54 to 11.0 cm. For all aerogel densities studied, these correction factors did not exceed 1.5%. The relative dose difference between the two dosimeters ranged between 0.3% and 0.7% for all beams and field sizes. The smallest field size experimentally investigated, S clin = 2.16 cm, which was irradiated with the 10 MV FFF beam, produced readings of 84.4 cGy (±1.3%) in the calorimeter and 84.5 cGy (±1.3%) in the ionization chamber. CONCLUSION The median relative difference in absorbed dose values between a calibrated A1SL ionization chamber and the proposed novel graphite calorimeter was 0.6%. This preliminary experimental validation demonstrates that Aerrow MK7 is capable of accurate and reproducible absorbed dose measurements in quasi-adiabatic mode.
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Affiliation(s)
- Benjamin Côté
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Federico Keszti
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Julien Bancheri
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Arman Sarfehnia
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Jan Seuntjens
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - James Renaud
- Medical Physics Unit, Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Metrology Research Centre, National Research Council Canada, Ottawa, Ontario, Canada
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Younes T, Chauvin M, Delbaere A, Labour J, Fonteny V, Simon L, Fares G, Vieillevigne L. Towards the standardization of the absorbed dose report mode in high energy photon beams. Phys Med Biol 2021; 66:045009. [PMID: 33296874 DOI: 10.1088/1361-6560/abd22c] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The benefits of using an algorithm that reports absorbed dose-to-medium have been jeopardized by the clinical experience and the experimental protocols that have mainly relied on absorbed dose-to-water. The aim of the present work was to investigate the physical aspects that govern the dosimetry in heterogeneous media using Monte Carlo method and to introduce a formalism for the experimental validation of absorbed dose-to-medium reporting algorithms. Particle fluence spectra computed within the sensitive volume of two simulated detectors (T31016 Pinpoint 3D ionization chamber and EBT3 radiochromic film) placed in different media (water, RW3, lung and bone) were compared to those in the undisturbed media for 6 MV photon beams. A heterogeneity correction factor that takes into account the difference between the detector perturbation in medium and under reference conditions as well as the stopping-power ratios was then derived for all media using cema calculations. Furthermore, the different conversion approaches and Eclipse treatment planning system algorithms were compared against the Monte Carlo absorbed dose reports. The detectors electron fluence perturbation in RW3 and lung media were close to that in water (≤1.5%). However, the perturbation was greater in bone (∼4%) and impacted the spectral shape. It was emphasized that detectors readings should be corrected by the heterogeneity correction factor that ranged from 0.932 in bone to 0.985 in lung. Significant discrepancies were observed between all the absorbed dose reports and conversions, especially in bone (exceeding 10%) and to a lesser extent in RW3. Given the ongoing advances in dose calculation algorithms, it is essential to standardize the absorbed dose report mode with absorbed dose-to-medium as a favoured choice. It was concluded that a retrospective conversion should be avoided and switching from absorbed dose-to-water to absorbed dose-to-medium reporting algorithm should be carried out by a direct comparison of both algorithms.
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Affiliation(s)
- Tony Younes
- Department of Medical Physics, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse Oncopole, 1 avenue Irène Joliot Curie, F-31059 Toulouse Cedex 9, France. Centre de Recherche et de Cancérologie de Toulouse, UMR1037 INSERM-Université Toulouse 3-ERL5294 CNRS, 2 avenue Hubert Curien, F-31037 Toulouse Cedex 1, France. Laboratoire de 'Mathématiques et Applications', Unité de recherche 'Mathématiques et Modélisation', Centre d'analyses et de recherche, Faculté des sciences, Université Saint-Joseph, Beyrouth 1104 2020, Lebanon
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Rossi G, Gainey M, Kollefrath M, Hofmann E, Baltas D. Suitability of the microDiamond detector for experimental determination of the anisotropy function of High Dose Rate 192 Ir brachytherapy sources. Med Phys 2020; 47:5838-5851. [PMID: 32970875 DOI: 10.1002/mp.14488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 09/07/2020] [Accepted: 09/13/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To investigate the suitability of the microDiamond detector (mDD) type 60019 (PTW-Freiburg, Germany) to measure the anisotropy function F(r,θ) of High Dose Rate (HDR) 192 Ir brachytherapy sources. METHODS The HDR 192 Ir brachytherapy source, model mHDR-v2r (Elekta AB, Sweden), was placed inside a water tank within a 4F plastic needle. Four mDDs (mDD1, mDD2, mDD3, and mDD4) were investigated. Each mDD was placed laterally with respect to the source, and measurements were performed at radial distances r = 1 cm, 3 and 5 cm, and polar angles θ from 0° to 168°. The Monte Carlo (MC) system EGSnrc was used to simulate the measurements and to calculate phantom effect, energy dependence and volume-averaging correction factors. F(r,θ) was determined according to TG-43 formalism from the detector reading corrected with the MC-based factors and compared to the consensus anisotropy function CON F(r,θ). RESULTS At 1 cm, the differences between measurements and MC simulations ranged from -0.8% to +0.8% for θ = 0° and from -2.1% to + 2.3% for θ ≠ 0°. At 3 and 5 cm, the differences ranged from +1.4% to +3.9% for θ = 0°, and from -0.4% to +2.9% for θ ≠ 0°. All differences were within the uncertainties (k = 2). At small angles, the phantom effect correction was up to -1.9%. This effect was mainly caused by the air between source and needle tip. The energy correction was angle-independent everywhere. For small angles at 1 cm, the volume-averaging correction was up to -2.9% and became less important for larger angles and distances. The differences of the measured F(r,θ) corrected with the MC-based factors to CON F(r,θ) ranged from -1.0% to +3.4% for mDD1, -2.2% to +4.2% for mDD2, -2.5% to +4.0% for mDD3, and -2.6% to +3.4% for mDD4. All differences were within the uncertainties (k = 2) except one at (3 cm, 0°). For all the mDDs, F(r,0°) was always higher than CON F(r,0°), with average differences of +3.1% (1 cm), +3.6% (3 cm), and +1.9% (5 cm). The inter-detector variability was within 2.9% (1 cm), 1.8% (3 cm), and 3.4% (5 cm). CONCLUSIONS A reproducible method and experimental setup were presented for measuring and validating F(r,θ) of an HDR 192 Ir brachytherapy source in a water phantom using the mDD. The phantom effect and the volume-averaging need to be taken into account, especially for the smaller distances and angles. Good agreement to CON F(r,θ) was obtained. The discrepancies at (1 cm, 0°), accurately predicted by the MC results, may suggest a reconsideration of CON F(r,θ), at least for this position. The slight overestimations at (3 cm,0°) and (5 cm,0°), both in comparison to CON F(r,θ) and MC results, may be due to an underestimation of the air volume between source and needle tip, dark current, intrinsic over-response of the mDDs, or radiation-induced charge imbalance in the detector's components. The results indicate that the mDD is a valuable tool for measurements with HDR 192 Ir brachytherapy sources and support its employment for the determination and validation of TG-43 parameters of such sources.
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Affiliation(s)
- Giulio Rossi
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mark Gainey
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Kollefrath
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elena Hofmann
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dimos Baltas
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Hartmann GH, Hensley F, Kapsch RP, Poppe B, Sauer O, Würfel J, Zink K. [Detector Based Determination of Water Absorbed Dose According to DIN 6800 Teil 1: Suggestion for an Extension of the Fundamental Formalism]. Z Med Phys 2019; 30:24-39. [PMID: 31585786 DOI: 10.1016/j.zemedi.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/13/2019] [Accepted: 05/20/2019] [Indexed: 10/25/2022]
Abstract
For any detector to be used for the determination of absorbed dose at the point of measurement in water a basic equation is required to convert the reading of the detector into absorbed dose in water. The German DIN 6800 part 1 provides a general formalism for that. A further differentiated formalism applicable to photon dosimetry is suggested in this work. This modified formalism presents the two following still general and at the same time fundamental properties of any dosimetry detector: a) a clear distinction of correction factors with respect to the physical processes involved during the measurement, and b) the fact that the process of energy absorption in the detector is determined by the spectral distribution of the fluence of the secondary charged particles. It is concluded that based on the modified formalism and knowing this spectral distribution within the detector a general method is available with benefits for ionization chambers as well as for any other dosimetry detector and which is applicable at reference as well as non-reference conditions without any preconditions.
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Affiliation(s)
| | | | - Ralf-Peter Kapsch
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Deutschland
| | - Bjoern Poppe
- Carl von Ossietzky Universität, Oldenburg, Deutschland
| | - Otto Sauer
- Universitätsklinikum, Würzburg, Deutschland
| | - Jan Würfel
- Physikalisch-Technische Werkstätten (PTW), Freiburg, Deutschland
| | - Klemens Zink
- Technische Hochschule Mittelhessen, Gießen, Deutschland
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