The measurement of backscatter factors of kilovoltage X-ray beams using Gafchromic™ EBT2 film

Evaluation of a novel patient-specific quality assurance phantom for robotic single-isocentre, multiple-target stereotactic radiosurgery, and stereotactic radiotherapy

OBJECTIVES

To evaluate patient-specific quality assurance (PSQA) of 3 targets in a single delivery using a novel film-based phantom.

METHODS

The phantom was designed to rotate freely as a sphere and could measure 3 targets with film in a single delivery. After identifying the coordinates of 3 targets in the skull, the rotation angles about the equator and meridian were computed for optimal phantom setup, ensuring the film plane intersected the 3 targets. The plans were delivered on the CyberKnife system using fiducial tracking. The irradiated films were scanned and processed. All films were analysed using 3 gamma criteria.

RESULTS

Fifteen CyberKnife test plans with 3 different modalities were delivered on the phantom. Both automatic and marker-based registration methods were applied when registering the irradiated film and dose plane. Gamma analysis was performed using a 3%/1 mm, 2%/1 mm, and 1%/1 mm criteria with a 10% threshold. For the automatic registration method, the passing rates were 98.2% ± 1.9%, 94.2% ± 3.7%, and 80.9% ± 6.3%, respectively. For the marker-based registration approach, the passing rates were 96.4% ± 2.7%, 91.7% ± 4.3%, and 78.4% ± 6.2%, respectively.

CONCLUSIONS

A novel spherical phantom was evaluated for the CyberKnife system and achieved acceptable PSQA passing rates using TG218 recommendations. The phantom can measure true-composite dose and offers high-resolution results for PSQA, making it a valuable device for robotic radiosurgery.

ADVANCES IN KNOWLEDGE

This is the first study on PSQA of 3 targets concurrently on the CyberKnife system.

Characterization of GafChromic EBT2 film dose measurements using a tissue-equivalent water phantom for a Theratron® Equinox Cobalt-60 teletherapy machine

PURPOSE

In vivo dosimetry is a quality assurance tool that provides post-treatment measurement of the absorbed dose as delivered to the patient. This dosimetry compares the prescribed and measured dose delivered to the target volume. In this study, a tissue-equivalent water phantom provided the simulation of the human environment. The skin and entrance doses were measured using GafChromic EBT2 film for a Theratron® Equinox Cobalt-60 teletherapy machine.

METHODS

We examined the behaviors of unencapsulated films and custom-made film encapsulation. Films were cut to 1 cm × 1 cm, calibrated, and used to assess skin dose depositions and entrance dose. We examined the response of the film for variations in field size, source to skin distance (SSD), gantry angle and wedge angle.

RESULTS

The estimated uncertainty in EBT2 film for absorbed dose measurement in phantom was ±1.72%. Comparison of the measurements of the two film configurations for the various irradiation parameters were field size (p = 0.0193, α = 0.05, n = 11), gantry angle (p = 0.0018, α = 0.05, n = 24), SSD (p = 0.1802, α = 0.05, n = 11) and wedge angle (p = 0.6834, α = 0.05, n = 4). For a prescribed dose of 200 cGy and at reference conditions (open field 10 cm x 10 cm, SSD = 100 cm, and gantry angle = 0º), the measured skin dose using the encapsulation material was 70% while that measured with the unencapsulated film was 24%. At reference irradiation conditions, the measured skin dose using the unencapsulated film was higher for open field configurations (24%) than wedged field configurations (19%). Estimation of the entrance dose using the unencapsulated film was within 3% of the prescribed dose.

CONCLUSIONS

GafChromic EBT2 film measurements were significantly affected at larger field sizes and gantry angles. Furthermore, we determined a high accuracy in entrance dose estimations using the film.

Review of backscatter measurement in kilovoltage radiotherapy using novel detectors and reduction from lack of underlying scattering material

Lack of underlying material can lead to dose reduction in kilovoltage radiotherapy treatments because of backscatter reduction. Conversely, the use of lead shielding can lead to large dose enhancement close to the lead interface. GAFCHROMIC film has been shown to be of use in verification of local backscatter factors compared to reference data in codes of practice, but careful handling and multiple readings are required to reduce systematic uncertainties to between 3% and 4%. Monte Carlo modeling of the specific treatment unit should be performed in cases which are found to differ from reference values before alternative values are adopted clinically, but these cases are expected to be few. GAFCHROMIC film may also be used to estimate backscatter reduction more readily than customized ionization chambers, for a range of beam qualities, applicator sizes and depth, with and without lead shielding. Differences were found between different studies, and it is not clear to what extent these are due to variation in equipment and/or technique. However, a layer of wax around lead shielding of 1 mm thickness should be sufficient to eliminate lead enhancement effects for all kilovoltage energies from 40 kV to 300 kV.

A study of surface dosimetry for breast cancer radiotherapy treatments using Gafchromic EBT2 film

The present study quantified surface doses on several rectangular phantom setups and on curved surface phantoms for a 6 MV photon field using the Attix parallel‐plate chamber and Gafchromic EBT2 film. For the rectangular phantom setups, the surface doses on a homogenous water equivalent phantom and a water equivalent phantom with 60 mm thick lung equivalent material were measured. The measurement on the homogenous phantom setup showed consistency in surface and near‐surface doses between an open field and enhanced dynamic wedge (EDW) fields, whereas physical wedged fields showed small differences. Surface dose measurements made using the EBT2 film showed good agreement with results of the Attix chamber and results obtained in previous studies which used other dosimeters within the measurement uncertainty of 3.3%. The surface dose measurements on the phantom setup with lung equivalent material showed a small increase without bolus and up to 6.9% increase with bolus simulating the increase of chest wall thickness. Surface doses on the cylindrical CT phantom and customized Perspex chest phantom were measured using the EBT2 film with and without bolus. The results indicate the important role of the presence of bolus if the clinical target volume (CTV) is quite close to the surface. Measurements on the cylindrical phantom suggest that surface doses at the oblique positions of 60° and 90° are mainly caused by the lateral scatter from the material inside the phantom. In the case of a single tangential irradiation onto Perspex chest phantom, the distribution of the surface dose with and without bolus materials showed opposing inclination patterns, whereas the dose distribution for two opposed tangential fields gave symmetric dose distribution. This study also demonstrates the suitability of Gafchromic EBT2 film for surface dose measurements in megavoltage photon beams.

PACS number: 87.53.Bn