Performance characteristics of a microMOSFET as anin vivodosimeter in radiation therapy

Compact and Real-Time Radiation Dosimeter Using Silicon Photomultipliers for In Vivo Dosimetry in Radiation Therapy

Existing dosimeters for radiation therapy are typically large, and their performance in in vivo system applications has not been assessed. This study develops a compact real-time dosimeter using silicon photomultipliers, plastic scintillators, and optical fibers and evaluates its in vivo applicability for radiation therapy. Dose calibration, dose-rate dependency and linearity, and short-term repeatability tests were conducted using solid water phantoms and bolus materials, and in vivo dosimetry was performed using an in-house phantom. The characterization evaluation results showed high linearity, with a coefficient of determination of 0.9995 for dose rates of 100-600 monitoring units (MU)/min, confirming an error rate within 2% when converted to dosage. In the short-term repeatability tests, the dosimeter exhibited good characteristics, with relative standard deviation (RSD) values lower than 2% for each beam delivery and an RSD value of 0.03% over ten beam deliveries. Dose measurements using the phantom indicated an average error rate of 3.83% compared to the values calculated using the treatment planning system. These results demonstrate a performance comparable to that of commercial metal-oxide-semiconductor field-effect transistors and plastic scintillator-based dosimeters. Based on these findings, the developed dosimeter has significant potential for in vivo radiation therapy applications.

P-channel MOSFET as ionizing radiation detector

In this study, the authors examine the responses of radiation-sensitive p-channel MOSFETs to irradiation and subsequent annealing at room temperature and higher temperatures to investigate their use as a dosimeter for measuring ionizing radiation. The response of these transistors to radiation was monitored based on the shift in the threshold voltage as a function of the absorbed dose of radiation. The results showed that the shift in the threshold voltage depended on the densities of traps formed during exposure to ionizing radiation in Si and at the Si-SiO₂ interface on which the charges were captured. We then analyzed the influence of these traps on the characteristics of the MOSFETs, and examined the influence of the gate bias, thickness of the gate oxide, energy of the ionizing radiation, and low doses on shifts in the threshold voltage. Moreover, we annealed the irradiated MOSFETs to determine their ability to preserve a certain dose of radiation over a long period as well as their potential for reuse. We explored the possibility of using commercial p-channel MOSFETs built into various electronic systems as sensors and dosimeters for measuring ionizing radiation. The results showed that they have approximately the same characteristics as radiation-sensitive MOSFETs with 100-nm-thick oxide layers.

Development of a real-time in vivo dosimetry tool for electron beam therapy using a flexible thin film solar cell coated with scintillator powder

PURPOSE

A real-time solar cell based in vivo dosimetry system (SC-IVD) was developed using a flexible thin film solar cell and scintillating powder. The present study evaluated the clinical feasibility of the SC-IVD in electron beam therapy.

METHODS

A thin film solar cell was coated with 100 mg of scintillating powder using an optical adhesive to enhance the sensitivity of the SC-IVD. Calibration factors were obtained by dividing the dose, measured at a reference depth for 6-20 MeV electron beam energy, by the signal obtained using the SC-IVD. Dosimetric characteristics of SC-IVDs containing variable quantities of scintillating powder (0-500 mg) were evaluated, including energy, dose rate, and beam angle dependencies, as well as dose linearity. To determine the extent to which the SC-IVD affected the dose to the medium, doses at R90 were compared depending on whether the SC-IVD was on the surface. Finally, the accuracy of surface doses measured using the SC-IVD was evaluated by comparison with surface doses measured using a Markus chamber.

RESULTS

Charge measured using the SC-IVD increased linearly with dose and was within 1% of the average signal according to the dose rate. The signal generated by the SC-IVD increased as the beam angle increased. The presence of the SC-IVD on the surface of a phantom resulted in a 0.5%-2.2% reduction in dose at R90 for 6-20 MeV electron beams compared with the bare phantom. Surface doses measured using the SC-IVD system and Markus chamber differed by less than 5%.

CONCLUSIONS

The dosimetric characteristics of the SC-IVD were evaluated in this study. The results showed that it accurately measured the surface dose without a significant difference of dose in the medium when compared with the Markus chamber. The flexibility of the SC-IVD allows it to be attached to a patient's skin, enabling real-time and cost-effective measurement.

Light-Dependent Resistors as Dosimetric Sensors in Radiotherapy

Safe quality control of radiotherapy treatments lies in reliable dosimetric sensors. Currently, ionization chambers and solid-state diodes along with electrometers as readout systems are accomplishing this task. In this work, we present a well-known and low-cost semiconductor sensor, the light-dependent resistor (LDR), as an alternative to the existing sensing devices for dosimetry. To demonstrate this, a complete characterization of the response to radiation of commercial LDRs has been conducted in terms of sensitivity, reproducibility and thermal correction under different bias voltages. Irradiation sessions have been applied under the common conditions in radiotherapy treatments using a hospital linear accelerator. Moreover, the same electrometer used for the ionization chamber has also been successfully used for LDRs. In comparison with the sensitivity achieved for the ionization chamber (0.2 nC/cGy at 400 V bias voltage), higher sensitivities have been measured for the proposed LDRs, ranging from 0.24 to 1.04 nC/cGy at bias voltages from 30 to 150 V, with a reproducibility uncertainty among samples of around 10%. In addition, LDR temperature dependence has been properly modeled using the simple thermistor model so that an easy thermal drift correction of dose measurements can be applied. Therefore, experimental results show that LDRs can be a reliable alternative to dosimetric sensors with the advantages of low size, affordable cost and the fact that it could be adopted with minimal changes in routine dosimetry quality control since the same readout system is fully compatible.

Characterization of microMOSFET detectors for in vivo dosimetry in high-dose-rate brachytherapy with 192 Ir

PURPOSE

The objective of this study was to characterize the Best Medical Canada microMOSFET detectors for their application in in vivo dosimetry for high-dose-rate brachytherapy (HDRBT) with ¹⁹² Ir. We also developed a mathematical model to correct dependencies under the measurement conditions of these detectors.

METHODS

We analyzed the linearity, reproducibility, and interdetector variability and studied the microMOSFET response dependence on temperature, source-detector distance, and angular orientation of the receptor with respect to the source. The correction model was applied to 19 measurements corresponding to five simulated treatments in a custom phantom specifically designed for this purpose.

RESULTS

The detectors (high bias applied in all measurements) showed excellent linearity up to 160 Gy. The response dependence on source-detector distance varied by (8.65 ± 0.06)% (k = 1) for distances between 1 and 7 cm, and the variation with temperature was (2.24 ± 0.05)% (k = 1) between 294 and 310 K. The response difference due to angular dependence can reach (10.3 ± 1.3)% (k = 1). For the set of measurements analyzed, regarding angular dependences, the mean difference between administered and measured doses was -4.17% (standard deviation of 3.4%); after application of the proposed correction model, the mean difference was -0.1% (standard deviation of 2.2%). For the treatments analyzed, the average difference between calculations and measures was 4.7% when only the calibration coefficient was used, but it is reduced to 0.9% when the correction model is applied.

CONCLUSION

Important response dependencies of microMOSFET detectors used for in vivo dosimetry in HDRBT treatments, especially the angular dependence, can be adequately characterized by a correction model that increases the accuracy of this system in clinical applications.

MOSFET dosimeter characterization in MR-guided radiation therapy (MRgRT) Linac

PURPOSE

With the increasing use of MR-guided radiation therapy (MRgRT), it becomes important to understand and explore accuracy of medical dosimeters in the presence of magnetic field. The purpose of this work is to characterize metal-oxide-semiconductor field-effect transistors (MOSFETs) in MRgRT systems at 0.345 T magnetic field strength.

METHODS

A MOSFET dosimetry system, developed by Best Medical Canada for in-vivo patient dosimetry, was used to study various commissioning tests performed on a MRgRT system, MRIdian^® Linac. We characterized the MOSFET dosimeter with different cable lengths by determining its calibration factor, monitor unit linearity, angular dependence, field size dependence, percentage depth dose (PDD) variation, output factor change, and intensity modulated radiation therapy quality assurance (IMRT QA) verification for several plans. MOSFET results were analyzed and compared with commissioning data and Monte Carlo calculations.

RESULTS

MOSFET measurements were not found to be affected by the presence of 0.345 T magnetic field. Calibration factors were similar for different cable length dosimeters either placed at the parallel or perpendicular direction to the magnetic field, with variations of less than 2%. The detector showed good linearity (R²  = 0.999) for 100-600 MUs range. Output factor measurements were consistent with ionization chamber data within 2.2%. MOSFET PDD measurements were found to be within 1% for 1-15 cm depth range in comparison to ionization chamber. MOSFET normalized angular response matched thermoluminescent detector (TLD) response within 5.5%. The IMRT QA verification data for the MRgRT linac showed that the percentage difference between ionization chamber and MOSFET was 0.91%, 2.05%, and 2.63%, respectively for liver, spine, and mediastinum.

CONCLUSION

MOSFET dosimeters are not affected by the 0.345 T magnetic field in MRgRT system. They showed physics parameters and performance comparable to TLD and ionization chamber; thus, they constitute an alternative to TLD for real-time in-vivo dosimetry in MRgRT procedures.

End-to-end test and MOSFET in vivo skin dosimetry for 192Ir high-dose-rate brachytherapy of chronic psoriasis

Purpose

This study was performed using end-to-end testing and real-time in vivo skin dose measurements, using metal oxide semiconductor field effect transistor (MOSFET) dosimeters on our first chronic psoriasis patient treated with iridium-192 (¹⁹²Ir) high-dose-rate (HDR) brachytherapy (BT).

Material and methods

Treatment delivery was planned with the prescription dose of 1.8 Gy to a 3 mm depth for 12 fractions, using our custom-fabricated surface mold and Varian soft catheters. The optimal technique to provide an adequate and acceptable skin dose as well as its feasibility were evaluated by an end-to-end exercise using a perspex finger phantom. The accuracy and reliability of MOSFET dose measurement was explored with a thermoluminescence dosimetry (TLD) before being used in vivo to monitor skin doses during treatment delivery for each BT fraction.

Results

Using custom-made surface mold (2.4 mm Med-Tec thermoplastic mask for hand fixation and 5 applicators attached to each finger for dose delivery), the optimal skin dose on the phantom was obtained without the need for additional bolus to increase thickness of applicator. We acquired mean skin doses at different skin depths from various dose-volume parameters of no-bolus and 3 mm-added bolus plans. They were 125% and 110% (1 mm), 120% and 108% (2 mm), and 114% and 106% (3 mm), respectively. There was excellent agreement between MOSFET and TLD for ¹⁹²Ir HDR-BT within ±3% (mean 2.65%, SD = 2.05%). With no energy correction, MOSFET overestimated the Acuros BV surface doses by up to 7% in the phantom study and in the clinical case.

Conclusions

We demonstrated achievable HDR-BT for our first case of nail bed psoriasis. The end-to-end exercise was an efficient methodology to evaluate new feasibility for this technique. Real-time dose monitoring using MOSFET was an effective and reliable tool to ensure treatment quality and patient safety.

Determining the energy spectrum of clinical linear accelerator using an optimized photon beam transmission protocol

PURPOSE

The complex beam delivery techniques for patient treatment using a clinical linear accelerator (linac) may result in variations in the photon spectra, which can lead to dosimetric differences in patients that cannot be accounted for by current treatment planning systems (TPSs). Therefore, precise knowledge of the fluence and energy spectrum (ES) of the therapeutic beam is very important. However, owing to the high energy and flux of the beam, the ES cannot be measured directly, and validation of the spectrum modeled in the TPS is difficult. The aim of this study is to develop an efficient beam transmission measurement procedure for accurately reconstructing the ES of a therapeutic x-ray beam generated by a clinical linac.

METHODS

The attenuation of a 6 MV photon beam from an Elekta Synergy Platform clinical linac through different thicknesses of graphite and lead was measured using an ion chamber. The response of the ion chamber as a function of photon energy was obtained using the Monte Carlo (MC) method in the Geant4 simulation code. Using the curves obtained in the photon beam transmission measurements and the ion chamber energy response, the ES was reconstructed using an iterative algorithm based on a mathematical model of the spectrum. To evaluate the accuracy of the spectrum reconstruction method, the reconstructed ES (ES_recon ) was compared to that determined by the MC simulation (ES_MC ).

RESULTS

The ion chamber model in the Geant4 simulation was well validated by comparing the ion chamber perturbation factors determined by the TRS-398 calibration protocol and EGSnrc; the differences were within 0.57%. The number of transmission measurements was optimized to 10 for efficient spectrum reconstruction according to the rate of increase in the spectrum reconstruction accuracy. The distribution of ES_recon obtained using the measured transmission curves was clearly similar to the reference, ES_MC , and the dose distributions in water calculated using ES_recon and ES_MC were similar within a 2% local difference. However, in a heterogeneous medium, the dose discrepancy between them was >5% when a complex beam delivery technique composed of 171 control points was used.

CONCLUSIONS

The proposed measurement procedure required a total time of approximately 1 h to obtain and analyze 20 transmission measurements. In addition, it was confirmed that the transmission curve of high-Z materials influences the accuracy of spectrum reconstruction more than that of low-Z materials. A well-designed transmission measurement protocol suitable for clinical environments could be an essential tool for better dosimetric accuracy in patient treatment and for periodic verification of the beam quality.

Evaluation of the 4D RADPOS dosimetry system for dose and position quality assurance of CyberKnife

PURPOSE

The Synchrony respiratory motion tracking of the CyberKnife system purports to provide real-time tumor motion compensation during robotic radiosurgery. Such a complex delivery system requires thorough quality assurance. In this work, RADPOS applicability as a dose and position quality assurance tool for CyberKnife treatments is assessed quantitatively for different phantom types and breathing motions, which increase in complexity to more closely resemble clinical situations.

METHODS

Two radiotherapy treatment experiments were performed where dose and position were measured with the RADPOS probe housed within a Solid Water phantom. For the first experiment, a Solid Water breast phantom was irradiated using isocentric beam delivery while stationary or moving sinusoidally in the anterior/posterior direction. For the second experiment, a phantom consisting of a Solid Water tumor in lung equivalent material was irradiated using isocentric and non-isocentric beam delivery while either stationary or moving. The phantom movement was either sinusoidal or based on a real patient's breathing waveform. For each experiment, RADPOS dose measurements were compared to EBT3 GafChromic film dose measurements and the CyberKnife treatment planning system's (TPS) Monte Carlo and ray-tracing dose calculation algorithms. RADPOS position measurements were compared to measurements made by the CyberKnife system and to the predicted breathing motion models used by the Synchrony respiratory motion compensation.

RESULTS

For the static and dynamic (i.e., sinusoidal motion) cases of the breast experiment, RADPOS, film and the TPS agreed at the 2.0% level within 1.1 σ of estimated combined uncertainties. RADPOS position measurements were in good agreement with LED and fiducial position measurements, where the average standard deviation (SD) of the differences between any two of the three position datasets was ≤0.5 mm for all directions. For the 10 mm peak to peak amplitude sinusoidal motion of the breast experiment, the average Synchrony correlation errors were ≤0.2 mm, indicative of an accurate predictive model. For all the cases of the lung experiment, RADPOS and film measurements agreed with each other at the 2.0% level within 1.5 σ of estimated experimental uncertainties provided that the measurements were corrected for imaging dose. The measured dose for RADPOS and film were 4.0% and 3.4% higher, respectively, than the TPS for the most complex dynamic cases (i.e., irregular motion) considered for the lung experiment. Assessment of the Synchrony correlation models by RADPOS showed that model accuracy declined as motion complexity increased; the SD of the differences between RADPOS and model position data measurements was ≤0.8 mm for sinusoidal motion but increased to ≤2.6 mm for irregular patient waveform motion. These results agreed with the Synchrony correlation errors reported by the CyberKnife system.

CONCLUSIONS

RADPOS is an accurate and precise QA tool for dose and position measurements for CyberKnife deliveries with respiratory motion compensation.

Toward in vivo dosimetry in external beam radiotherapy using x-ray acoustic computed tomography: A soft-tissue phantom study validation

PURPOSE

To study, using phantoms made from biological tissues, the feasibility and practical challenges of monitoring the position of the radiation beam and the deposited dose by x-ray acoustic computed tomography (XACT) during external beam radiotherapy delivery.

MATERIAL AND METHODS

A prototype XACT system with a single immersion ultrasound transducer, which was positioned around the target sample driven by a motor-controlled rotation stage, was used to acquire the x-ray acoustic (XA) signals produced by a medical linear accelerator (Linac) to form an XACT image of the irradiated phantom. To investigate the feasibility of XACT in tracking the position of radiation dose, a large piece of veal liver with embedded fat tissue was imaged and beam misalignments were measured. Next, we explored the sensitivity of XACT in monitoring and quantifying the delivered dose, in which a block of porcine gel was embedded with equally spaced lard cylinders and imaged. The doses on the lard cylinders modulated by physical wedges were quantified from the XACT image and were verified by comparison to measurements from radiochromic films as the gold standard. Then, to simulate how XACT can perform in a targeted tissue in the human body, a porcine gel phantom with lard cylinders covered by different materials (bone, muscle, and air gap, respectively) was also imaged.

RESULTS

The reconstructed XACT images of the phantoms show congruence with the boundaries of the beam field and the interfaces between the different tissue materials. The beam displacement from the target was tracked properly by the reconstructed XACT images. An intensity difference as small as 2.9% in delivered dose region can be measured from XACT images P = 0.02. The intensities of XACT images were highly correlated to the film measurements with an R2 better than 0.986. The expected variances of dose delivered to different target regions as a result of the difference in attenuation were successfully captured by the XACT images.

CONCLUSIONS

This study validated the feasibility of XACT in accurately obtaining relative dose maps of tissue-mimicking phantoms. XACT offers a practical method for verifying the beam position against the target and quantifying the relative dose delivered to the target during external beam radiotherapy.

In vivo dosimetry in gynecological applications-A feasibility study

PURPOSE

To investigate the feasibility of in vivo dosimetry using microMOSFET dosimeters in patients treated with brachytherapy using two types of gynecological applicators.

METHODS AND MATERIALS

In this study, a microMOSFET was placed in an empty needle of an Utrecht Interstitial Fletcher applicator or MUPIT (Martinez Universal Perineal Interstitial Template) applicator for independent verification of treatment delivery. Measurements were performed in 10 patients, with one to three microMOSFETs per applicator and repeated for one to four fractions, resulting in 50 in vivo measurements. Phantom measurements were used to determine characteristics of the microMOSFETs.

RESULTS

Phantom measurements showed a linear relationship between dose and microMOSFET threshold voltage, and a calibration coefficient (mV/cGy) was determined. Reproducibility of repeated 50 cGy irradiations was 2% (1 standard deviation). Distance and angle dependencies were measured and correction factors were determined. Subsequently, three microMOSFETs were placed in a phantom to measure a validation plan. The difference between predicted and measured dose was less than the measurement uncertainty (±9%, 2 standard deviations). In vivo measurements were corrected for distance and angle dependencies. Differences between predicted and measured dose in the patients were smaller than the measurement uncertainty for the majority of the measurements.

CONCLUSIONS

In vivo dosimetry using microMOSFETs in MUPIT and Utrecht Interstitial Fletcher applicators has proved to be feasible. Reimaging should be performed after detection of differences larger than 10% between predicted and measured dose to verify the applicator configuration. Movement of the applicator relative to the target or organs at risk is undetectable with this method.

Practical issues regarding angular and energy response in in vivo intraoperative electron radiotherapy dosimetry

AIM

To estimate angular response deviation of MOSFETs in the realm of intraoperative electron radiotherapy (IOERT), review their energy dependence, and propose unambiguous names for detector rotations.

BACKGROUND

MOSFETs have been used in IOERT. Movement of the detector, namely rotations, can spoil results.

MATERIALS AND METHODS

We propose yaw, pitch, and roll to name the three possible rotations in space, as these unequivocally name aircraft rotations. Reinforced mobile MOSFETs (model TN-502RDM-H) and an Elekta Precise linear accelerator were used. Two detectors were placed in air for the angular response study and the whole set of five detectors was calibrated as usual to evaluate energy dependence.

RESULTS

The maximum readout was obtained with a roll of 90° and 4 MeV. With regard to pitch movement, a substantial drop in readout was achieved at 90°. Significant overresponse was measured at 315° with 4 MeV and at 45° with 15 MeV. Energy response is not different for the following groups of energies: 4, 6, and 9 MeV; and 12 MeV, 15 MeV, and 18 MeV.

CONCLUSIONS

Our proposal to name MOSFET rotations solves the problem of defining sensor orientations. Angular response could explain lower than expected results when the tip of the detector is lifted due to inadvertent movements. MOSFETs energy response is independent of several energies and differs by a maximum of 3.4% when dependent. This can limit dosimetry errors and makes it possible to calibrate the detectors only once for each group of energies, which saves time and optimizes lifespan of MOSFETs.

Performance characteristics of mobile MOSFET dosimeter for kilovoltage X-rays used in image guided radiotherapy

The main objective of this study was to investigate the characteristics of metal oxide semiconductor field effect transistor (MOSFET) dosimeter for kilovoltage (kV) X-ray beams in order to perform the in vivo dosimetry during image guidance in radiotherapy. The performance characteristics of high sensitivity MOSFET dosimeters were investigated for 80, 90, 100, 110, 120, and 125 kV X-ray beams used for imaging in radiotherapy. This study was performed using Clinac 2100 C/D medical electron linear accelerator with on-board imaging and kV cone beam computed tomography system. The characteristics studied in this work include energy dependence, angular dependence, and linearity. The X-ray beam outputs were measured as per American Association of Physicists in Medicine (AAPM) TG 61 recommendations using PTW parallel plate (PP) ionization chamber, which was calibrated in terms of air kerma (Nk) by the National Standard Laboratory. The MOSFET dosimeters were calibrated against the PP ionization chamber for all the kV X-ray beams and the calibration coefficient was found to be 0.11 cGy/mV with a standard deviation of about ±1%. The response of MOSFET was found to be energy independent for the kV X-ray energies used in this study. The response of the MOSFET dosimeter was also found independent of angle of incidence for the gantry angles in the range of 0° to 360° in-air as well as at 3 cm depth in tissue equivalent phantom.

Radioluminescence characterization of in situ x-ray nanodosimeters: Potential real-time monitors and modulators of external beam radiation therapy

Europium-doped yttrium oxide (Y₂O₃:Eu) has garnered considerable interest recently for its use as a highly efficient, red phosphor in a variety of lighting applications that include fluorescent lamps, plasma, and field emission display panels, light emitting diodes (LEDs), and lasers. In the present work, we describe the development of Y₂O₃:Eu nanoparticles for a very different application: in situ, in vivo x-ray dosimetry. Spectroscopic analyses of these nanoparticles during x-ray irradiation reveal surprisingly bright and stable radioluminescence at near-infrared wavelengths, with markedly linear response to changes in x-ray flux and energy. Monte Carlo modeling of incident flux and broadband, wide-field imaging of mouse phantoms bearing both Y₂O₃:Eu nanoparticles and calibrated LEDs of similar spectral emission demonstrated significant transmission of radioluminescence, in agreement with spectroscopic studies; with approximately 15 visible photons being generated for every x-ray photon incident. Unlike the dosimeters currently employed in clinical practice, these nanodosimeters can sample both dose and dose rate rapidly enough as to provide real-time feedback for x-ray based external beam radiotherapy (EBRT). The technique's use of remote sensing and absence of supporting structures enable perturbation-free dosing of the targeted region and complete sampling from any direction. With the conjugation of pathology-targeting ligands onto their surfaces, these nanodosimeters offer a potential paradigm shift in the real-time monitoring and modulation of delivered dose in the EBRT of cancer in situ.

Angular Dependence of the MOSFET Dosimeter and its Impact on In vivo Surface Dose Measurement in Breast Cancer Treatment

The focus of this study is the angular dependence of two types of Metal Oxide Semiconductor Field Effect Transistor (MOSFET) dosimeters (MOSFET20 and OneDose/OneDosePlus) when used for surface dose measurements. External beam radiationat different gantry angles were delivered to a cubic solid water phantom with a MOSFET placed on the top surface at CAX. The long axis of the MOSFET was oriented along the gantry axis of rotation, with the dosimeter (bubble side) facing the radiation source. MOSFET-measured surface doses were compared against calibrated radiochromic film readings. It was found that both types of MOSFET dosimeters exhibited larger than previously reported angular dependence when measuring surface dose in beams at large oblique angles. For the MOSFET20 dosimeter the measured surface dose deviation against film readings was as high as 17% when the incident angle was 72 degrees to the norm of the phantom surface. It is concluded that some MOSFET dosimeters may have a strong angular dependence when placed on the surface of water-equivalent material, even though they may have an isotropic angular response when surrounded by uniform medium. Extra on-surface calibration maybe necessary before using MOSFET dosimeters for skin dose measurement in tangential fields.

In-vivo dosimetry for field sizes down to 6 × 6 mm2 in shaped beam radiosurgery with microMOSFET

The aim of this study is to evaluate microMOSFET as in-vivo dosimeter in 6 MV shaped-beam radiosurgery for field sizes down to 6 × 6 mm2. A homemade build-up cap was developed and its use with microMOSFET was evaluated down to 6 × 6 mm2. The study with the homemade build-up cap was performed considering its influence on field size over-cover occurring at surface, achievement of the overall process of electronic equilibrium, dose deposition along beam axis and dose attenuation. An optimized calibration method has been validated using MOSFET in shaped-beam radiosurgery for field sizes from 98 × 98 down to 18 × 18 mm2. The method was detailed in a previous study and validated in irregular field shapes series measurements performed on a head phantom. The optimized calibration method was applied to microMOSFET equipped with homemade build-up cap down to 6 × 6 mm2. Using the same irregular field shapes, dose measurements were performed on head phantom. MicroMOSFET results were compared to previous MOSFET ones. Additional irregular field shapes down to 8.8 × 8.8 mm2 were studied with microMOSFET. Isocenter dose attenuation due to the homemade build-up cap over the microMOSFET was near 2% irrespective of field size. Our results suggested that microMOSFET equipped with homemade build-up cap is suitable for in-vivo dosimetry in shaped-beam radiosurgery for field sizes down to 6 × 6 mm2 and therefore that the required build-up cap dimensions to perform entrance in-vivo dosimetry in small-fields have to ensure only partial charge particle equilibrium.

Potential reduction of contralateral second breast-cancer risks by prophylactic mammary irradiation: validation in a breast-cancer-prone mouse model

Background

Long-term breast-cancer survivors have a highly elevated risk (1 in 6 at 20 years) of contralateral second breast cancer. This high risk is associated with the presence of multiple pre-malignant cell clones in the contralateral breast at the time of primary breast cancer diagnosis. Mechanistic analyses suggest that a moderate dose of X-rays to the contralateral breast can kill these pre-malignant clones such that, at an appropriate Prophylactic Mammary Irradiation (PMI) dose, the long-term contralateral breast cancer risk in breast cancer survivors would be considerably decreased.

Aims

To test the predicted relationship between PMI dose and cancer risk in mammary glands that have a high risk of developing malignancies.

Methods

We tested the PMI concept using MMTV-PyVT mammary-tumor-prone mice. Mammary glands on one side of each mouse were irradiated with X-rays, while those on the other side were shielded from radiation. The unshielded mammary glands received doses of 0, 4, 8, 12 and 16Gy in 4-Gy fractions.

Results

In high-risk mammary glands exposed to radiation doses designed for PMI (12 and 16 Gy), tumor incidence rates were respectively decreased by a factor of 2.2 (95% CI, 1.1-5.0) at 12 Gy, and a factor of 3.1 (95% CI, 1.3-8.3) at 16 Gy, compared to those in the shielded glands that were exposed to very low radiation doses. The same pattern was seen for PMI-exposed mammary glands relative to zero-dose controls.

Conclusions

The pattern of cancer risk reduction by PMI was consistent with mechanistic predictions. Contralateral breast PMI may thus have promise as a spatially targeted breast-conserving option for reducing the current high risk of contralateral second breast cancers. For estrogen-receptor positive primary tumors, PMI might optimally be used concomitantly with systemically delivered chemopreventive drugs such as tamoxifen or aromatase inhibitors, while for estrogen-receptor negative tumors, PMI might be used alone.

An optimized calibration method for surface measurements with MOSFETs in shaped-beam radiosurgery

Nowadays MOSFET dosimeters are widely used for dose verification in radiotherapy procedures. Although their sensitive area satisfies size requirements for small field dosimetry, their use in radiosurgery has rarely been reported. The aim of this study is to propose and optimize a calibration method to perform surface measurements in 6 MV shaped-beam radiosurgery for field sizes down to 18 × 18 mm(2). The effect of different parameters such as recovery time between 2 readings, batch uniformity and build-up cap attenuation was studied. Batch uniformity was found to be within 2% and isocenter dose attenuation due to the build-up cap over the MOSFET was near 2% irrespective of field size. Two sets of sensitivity coefficients (SC) were determined for TN-502RD MOSFET dosimeters using experimental and calculated calibration; the latter being developed using an inverse square law model. Validation measurements were performed on a realistic head phantom in irregular fields. MOSFET dose values obtained by applying either measured or calculated SC were compared. For calibration, optimal results were obtained for an inter-measurement time lapse of 5 min. We also found that fitting the SC values with the inverse square law reduced the number of measurements required for calibration. The study demonstrated that combining inverse square law and Sterling-Worthley formula resulted in an underestimation of up to 4% of the dose measured by MOSFETs for complex beam geometries. With the inverse square law, it is possible to reduce the number of measurements required for calibration for multiple field-SSD combinations. Our results suggested that MOSFETs are suitable sensors for dosimetry when used at the surface in shaped-beam radiosurgery down to 18 × 18 mm(2).

Dosimetry investigation of MOSFET for clinical IMRT dose verification

In IMRT, patient-specific dose verification is followed regularly at each centre. Simple and efficient dosimetry techniques play a very important role in routine clinical dosimetry QA. The MOSFET dosimeter offers several advantages over the conventional dosimeters such as its small detector size, immediate readout, immediate reuse, multiple point dose measurements. To use the MOSFET as routine clinical dosimetry system for pre-treatment dose verification in IMRT, a comprehensive set of experiments has been conducted, to investigate its linearity, reproducibility, dose rate effect and angular dependence for 6 MV x-ray beam. The MOSFETs shows a linear response with linearity coefficient of 0.992 for a dose range of 35 cGy to 427 cGy. The reproducibility of the MOSFET was measured by irradiating the MOSFET for ten consecutive irradiations in the dose range of 35 cGy to 427 cGy. The measured reproducibility of MOSFET was found to be within 4% up to 70 cGy and within 1.4% above 70 cGy. The dose rate effect on the MOSFET was investigated in the dose rate range 100 MU/min to 600 MU/min. The response of the MOSFET varies from -1.7% to 2.1%. The angular responses of the MOSFETs were measured at 10 degrees intervals from 90 to 270 degrees in an anticlockwise direction and normalized at gantry angle zero and it was found to be in the range of 0.98 ± 0.014 to 1.01 ± 0.014. The MOSFETs were calibrated in a phantom which was later used for IMRT verification. The measured calibration coefficients were found to be 1 mV/cGy and 2.995 mV/cGy in standard and high sensitivity mode respectively. The MOSFETs were used for pre-treatment dose verification in IMRT. Nine dosimeters were used for each patient to measure the dose in different plane. The average variation between calculated and measured dose at any location was within 3%. Dose verification using MOSFET and IMRT phantom was found to quick and efficient and well suited for a busy radiotherapy department.

In vivo dosimetry for gynaecological brachytherapy using a novel position sensitive radiation detector: feasibility study

PURPOSE

In gynecological radiotherapy with high dose rate (HDR)(192)Ir brachytherapy, the treatment complexity has increased due to improved optimization techniques and dose constraints. As a consequence, it has become more important to verify the dose delivery to the target and also to the organs at risk (e.g., the bladder). In vivo dosimetry, where dosimeters are placed in or on the patient, is one way of verifying the dose but until recently this was hampered by motion of the radiation detectors with respect to the source. The authors present a novel dosimetry method using a position sensitive radiation detector.

METHODS

The prototype RADPOS system (Best Medical Canada) consists of a metal oxide field effect transistor (MOSFET) dosimeter coupled to a position-sensor, which deduces its 3D position in a magnetic field. To assess the feasibility of in vivo dosimetry based on the RADPOS system, different characteristics of the detector need to be investigated. Using a PMMA phantom, the positioning accuracy of the RADPOS system was quantified by comparing position readouts with the known position of the detector along the x and y-axes. RADPOS dose measurements were performed at various distances from a Nucletron(192)Ir source in a PMMA phantom to evaluate the energy dependence of the MOSFET. A sensitivity analysis was performed by calculating the dose after varying (1) the position of the RADPOS detector to simulate organ motion and (2) the position of the first dwell position to simulate errors in delivery. The authors also performed an uncertainty analysis to determine the action level (AL) that should be used during in vivo dosimetry.

RESULTS

Positioning accuracy is found to be within 1 mm in the 1-10 cm range from the origin along the x-axis (away from the transmitter), meeting the requirements for in vivo dosimetry. Similar results are obtained for the other axes. The ALs are chosen to take into account the total uncertainty on the measurements. As a consequence for in vivo dosimetry, it is determined that the RADPOS sensor, if placed, for example, in the bladder Foley balloon, would detect a 2 mm motion of the bladder, at a 5% chance of a false positive, with an AL limit of 9% of the dose delivered. The authors found that source position errors, caused by, e.g., a wrong first dwell position, are more difficult to detect; indeed, with our single RADPOS detector, positioned in the bladder, dwell position errors below 5 mm and resulting in a dose error within 10%, could be detected in the tandem but not in the colpostats. A possible solution to improve error detection is to use multiple MOSFETs to obtain multiple dose values.

CONCLUSIONS

In this study, the authors proposed a dosimetry procedure, based on the novel RADPOS system, to accurately determine the position of the radiation dosimeter with respect to the applicator. The authors found that it is possible to monitor the delivered dose in a point and compare it to the predetermined dose. This allows in principle the detection of problems such as bladder motion/filling or source mispositioning. Further clinical investigation is warranted.

In vivo proton dosimetry using a MOSFET detector in an anthropomorphic phantom with tissue inhomogeneity

When in vivo proton dosimetry is performed with a metal‐oxide semiconductor field‐effect transistor (MOSFET) detector, the response of the detector depends strongly on the linear energy transfer. The present study reports a practical method to correct the MOSFET response for linear energy transfer dependence by using a simplified Monte Carlo dose calculation method (SMC). A depth‐output curve for a mono‐energetic proton beam in polyethylene was measured with the MOSFET detector. This curve was used to calculate MOSFET output distributions with the SMC (SMCMOSFET). The SMCMOSFET output value at an arbitrary point was compared with the value obtained by the conventional SMCPPIC, which calculates proton dose distributions by using the depth‐dose curve determined by a parallel‐plate ionization chamber (PPIC). The ratio of the two values was used to calculate the correction factor of the MOSFET response at an arbitrary point. The dose obtained by the MOSFET detector was determined from the product of the correction factor and the MOSFET raw dose. When in vivo proton dosimetry was performed with the MOSFET detector in an anthropomorphic phantom, the corrected MOSFET doses agreed with the SMCPPIC results within the measurement error. To our knowledge, this is the first report of successful in vivo proton dosimetry with a MOSFET detector.

PACS number: 87.56.‐v

On-line optimization of intraoperative electron beam radiotherapy of the breast

PURPOSE

To optimize the dose delivery to the breast lumpectomy target treated with intraoperative electron beam radiotherapy (IOERT).

MATERIALS AND METHODS

Two tools have been developed in our MU calculation software NEMO X to improve the dose homogeneity and the in-vivo dosimetry effectiveness for IOERT treatments. Given the target (tumor bed) thickness measured by the surgeon, NEMO X can provide auto dose normalization to cover 95% of the target volume with 95% of the prescription dose (PD) and a "best guess" of the expected dosimeter dose (EDD) for a deep seated in-vivo dosimeter. The tools have been validated with the data of 91 patients treated with IOERT on a LIAC mobile accelerator. In-vivo dosimetry has been performed with microMOSFETs positioned on the shielding disk inserted between the tumor bed and the chest wall.

RESULTS

On average the auto normalization showed to provide better results if compared to conventional normalization rules in terms of mean target dose (|MTD-PD|/PD ≤ 5% in 95% vs. 53% of pts) and V107 percentage (left angle bracket V107 right angle bracket =19% vs. 32%). In-vivo dosimetry MOSFET dose (MD) showed a better correlation with the EDD guessed by our tool than just by assuming that EDD=PD (|MD-EDD|/EDD ≤ 5% in 57 vs. 26% of pts).

CONCLUSIONS

NEMO X provides two useful tools for the on-line optimization of the dose delivery in IOERT. This optimization can help to reduce unnecessary large over-dosage regions and allows introducing reliable action levels for in-vivo dosimetry.

Calculation of midplane dose for total body irradiation from entrance and exit dose MOSFET measurements

This work is the development of a MOSFET based surface in vivo dosimetry system for total body irradiation patients treated with bilateral extended SSD beams using PMMA missing tissue compensators adjacent to the patient. An empirical formula to calculate midplane dose from MOSFET measured entrance and exit doses has been derived. The dependency of surface dose on the air-gap between the spoiler and the surface was investigated by suspending a spoiler above a water phantom, and taking percentage depth dose measurements (PDD). Exit and entrances doses were measured with MOSFETs in conjunction with midplane doses measured with an ion chamber. The entrance and exit doses were combined using an exponential attenuation formula to give an estimate of midplane dose and were compared to the midplane ion chamber measurement for a range of phantom thicknesses. Having a maximum PDD at the surface simplifies the prediction of midplane dose, which is achieved by ensuring that the air gap between the compensator and the surface is less than 10 cm. The comparison of estimated midplane dose and measured midplane dose showed no dependence on phantom thickness and an average correction factor of 0.88 was found. If the missing tissue compensators are kept within 10 cm of the patient then MOSFET measurements of entrance and exit dose can predict the midplane dose for the patient.

Proton dose distribution measurements using a MOSFET detector with a simple dose-weighted correction method for LET effects

We experimentally evaluated the proton beam dose reproducibility, sensitivity, angular dependence and depth-dose relationships for a new Metal Oxide Semiconductor Field Effect Transistor (MOSFET) detector. The detector was fabricated with a thinner oxide layer and was operated at high-bias voltages. In order to accurately measure dose distributions, we developed a practical method for correcting the MOSFET response to proton beams. The detector was tested by examining lateral dose profiles formed by protons passing through an L-shaped bolus. The dose reproducibility, angular dependence and depth-dose response were evaluated using a 190 MeV proton beam. Depth-output curves produced using the MOSFET detectors were compared with results obtained using an ionization chamber (IC). Since accurate measurements of proton dose distribution require correction for LET effects, we developed a simple dose-weighted correction method. The correction factors were determined as a function of proton penetration depth, or residual range. The residual proton range at each measurement point was calculated using the pencil beam algorithm. Lateral measurements in a phantom were obtained for pristine and SOBP beams. The reproducibility of the MOSFET detector was within 2%, and the angular dependence was less than 9%. The detector exhibited a good response at the Bragg peak (0.74 relative to the IC detector). For dose distributions resulting from protons passing through an L-shaped bolus, the corrected MOSFET dose agreed well with the IC results. Absolute proton dosimetry can be performed using MOSFET detectors to a precision of about 3% (1 sigma). A thinner oxide layer thickness improved the LET in proton dosimetry. By employing correction methods for LET dependence, it is possible to measure absolute proton dose using MOSFET detectors.

Consistency and reproducibility of the VMAT plan delivery using three independent validation methods

The complexity of VMAT delivery requires new methods and potentially new tools for the commissioning of these systems. It appears that great consideration is needed for quality assurance (QA) of these treatments since there are limited devices that are dedicated to the QA of rotational delivery. In this present study, we have evaluated the consistency and reproducibility of one prostate and one lung VMAT plans for 31 consecutive days using three different approaches: 1) MLC DynaLog files, 2) in vivo measurements using the multiwire ionization chamber DAVID, and 3) using PTWseven29 2D ARRAY with the OCTAVIUS phantom at our Varian Clinac linear accelerator. Overall, the three methods of testing the reproducibility and consistency of the VMAT delivery were in agreement with each other. All methods showed minimal daily deviations that contributed to clinically insignificant dose variations from day to day. Based on our results, we conclude that the VMAT delivery using a Varian 2100CD linear accelerator equipped with 120 MLC is highly reproducible.

PACS numbers: 87.55.Qr and 87.56.Fc

Small field electron beam dosimetry using MOSFET detector

The dosimetry of very small electron fields can be challenging due to relative shifts in percent depth‐dose curves, including the location of dmax, and lack of lateral electronic equilibrium in an ion chamber when placed in the beam. Conventionally a small parallel plate chamber or film is utilized to perform small field electron beam dosimetry. Since modern radiotherapy departments are becoming filmless in favor of electronic imaging, an alternate and readily available clinical dosimeter needs to be explored. We have studied the performance of MOSFET as a relative dosimeter in small field electron beams. The reproducibility, linearity and sensitivity of a high‐sensitivity microMOSFET were investigated for clinical electron beams. In addition, the percent depth doses, output factors and profiles have been measured in a water tank with MOSFET and compared with those measured by an ion chamber for a range of field sizes from 1 cm diameter to 10 cm× 10 cm for 6, 12, 16 and 20 MeV beams. Similar comparative measurements were also performed with MOSFET and films in solid water phantom. The MOSFET sensitivity was found to be practically constant over the range of field sizes investigated. The dose response was found to be linear and reproducible (within ±1% for 100 cGy). An excellent agreement was observed among the central axis depth dose curves measured using MOSFET, film and ion chamber. The output factors measured with MOSFET for small fields agreed to within 3% with those measured by film dosimetry. Overall results indicate that MOSFET can be utilized to perform dosimetry for small field electron beam.

PACS number: 87.55.Qr

Monte carlo study of MOSFET packaging, optimised for improved energy response: single MOSFET filtration

Monte Carlo simulations of the energy response of a conventionally packaged single metal-oxide field effect transistors (MOSFET) detector were performed with the goal of improving MOSFET energy dependence for personal accident or military dosimetry. The MOSFET detector packaging was optimised. Two different 'drop-in' design packages for a single MOSFET detector were modelled and optimised using the GEANT4 Monte Carlo toolkit. Absorbed photon dose simulations of the MOSFET dosemeter placed in free-air response, corresponding to the absorbed doses at depths of 0.07 mm (D(w)(0.07)) and 10 mm (D(w)(10)) in a water equivalent phantom of size 30 x 30 x 30 cm(3) for photon energies of 0.015-2 MeV were performed. Energy dependence was reduced to within + or - 60 % for photon energies 0.06-2 MeV for both D(w)(0.07) and D(w)(10). Variations in the response for photon energies of 15-60 keV were 200 and 330 % for D(w)(0.07) and D(w)(10), respectively. The obtained energy dependence was reduced compared with that for conventionally packaged MOSFET detectors, which usually exhibit a 500-700 % over-response when used in free-air geometry.

MOSFET dosimetry mission inside the ISS as part of the Matroshka-R experiment

Radiation measurements of surface and deep organ doses were performed aboard the International Space Station, for the period of January 2006 to April 2007, using a MOSFET dosimetry system combined with the Matroshka-R spherical phantom. The averaged internal and surface dose rates are found to be 0.19 and 0.29 mGy d(-1), respectively. The levels of radiation dose to blood-forming organs (BFO) and to surface organs are compared with recommended safe limits. The maximum measured BFO dose has an average dose rate of 0.23 mGy d(-1) (84 mGy y(-1)), corresponding to 44 % of the recommended annual limit of 0.5 Sv, for a space radiation quality factor of 2.6. The annual surface dose is found to be higher at 126 mGy, corresponding to 16 % of the eye dose limit and to 11 % of the skin dose limit. Doses calculated using the Spenvis software showed deviations of up to 37 % from measurements.

Evaluation of the usefulness of a MOSFET detector in an anthropomorphic phantom for 6-MV photon beam

In order to evaluate the usefulness of a metal oxide-silicon field-effect transistor (MOSFET) detector as a in vivo dosimeter, we performed in vivo dosimetry using the MOSFET detector with an anthropomorphic phantom. We used the RANDO phantom as an anthropomorphic phantom, and dose measurements were carried out in the abdominal, thoracic, and head and neck regions for simple square field sizes of 10 x 10, 5 x 5, and 3 x 3 cm(2) with a 6-MV photon beam. The dose measured by the MOSFET detector was verified by the dose calculations of the superposition (SP) algorithm in the XiO radiotherapy treatment-planning system. In most cases, the measured doses agreed with the results of the SP algorithm within +/-3%. Our results demonstrated the utility of the MOSFET detector for in vivo dosimetry even in the presence of clinical tissue inhomogeneities.

Evaluation of a novel 4D in vivo dosimetry system

A prototype of a new 4D in vivo dosimetry system capable of simultaneous real-time position monitoring and dose measurement has been developed. The radiation positioning system (RADPOS) is controlled by a computer and combines two technologies: MOSFET radiation detector coupled with an electromagnetic positioning device. Special software has been developed that allows sampling position and dose either manually or automatically in user-defined time intervals. Preliminary tests of the new device include a dosimetric evaluation of the detector in 60Co, 6 MV, and 18 MV beams and measurements of spatial position stability and accuracy. In addition, the effect of metals and other materials on the performance of the positioning system has been investigated. Results show that the RADPOS system can measure in-air dose profiles that agree, on average, within 3%-5% of diode measurements for the energies tested. The response of the detector is isotropic within 1.6% (1 SD) with a maximum deviation of +/- 4.0% over 360 degrees. The maximum variation in the calibration coefficient over field sizes from 6 x 6 to 25 x 25 cm2 was 2.3% for RADPOS probe with the high sensitivity MOSFET and 4.6% for the probe with the standard sensitivity MOSFET. Of the materials tested, only aluminum, lead, and brass caused shifts in the RADPOS read position. The magnitude of the shift varied between materials and size of the material sample. Nonmagnetic stainless steel (Grade 304) caused a distortion of less than 2 mm when placed within 10 mm of the detector; therefore, it can provide a reasonable alternative to other metals if required. The results of the preliminary tests indicate that the device can be used for in vivo dosimetry in 60Co and high-energy beams from linear accelerators.

In vivo dose verification of IMRT treated head and neck cancer patients

An independent in vivo dose verification procedure for IMRT treatments of head and neck cancers was developed. Results of 177 intracavitary TLD measurements from 10 patients are presented. The study includes data from 10 patients with cancer of the rhinopharynx or the thyroid treated with dynamic IMRT. Dose verification was performed by insertion of a flexible naso-oesophageal tube containing TLD rods and markers for EPID and simulator image detection. Part of the study focussed on investigating the accuracy of the TPS calculations in the presence of inhomogeneities. Phantom measurements and Monte Carlo simulations were performed for a number of geometries involving lateral electronic disequilibrium and steep density shifts. The in vivo TLD measurements correlated well with the predictions of the treatment planning system with a measured/calculated dose ratio of 1.002+/-0.051 (1 SD, N=177). The measurements were easily performed and well tolerated by the patients. We conclude that in vivo intracavitary dosimetry with TLD is suitable and accurate for dose determination in intensity-modulated beams.

In vivo verification of superficial dose for head and neck treatments using intensity-modulated techniques

Skin dose is one of the key issues for clinical dosimetry in radiation therapy. Currently planning computer systems are unable to accurately predict dose in the buildup region, leaving ambiguity as to the dose levels actually received by the patient's skin during radiotherapy. This is one of the prime reasons why in vivo measurements are necessary to estimate the dose in the buildup region. A newly developed metal-oxide-semiconductor-field-effect-transistor (MOSFET) detector designed specifically for dose measurements in rapidly changing dose gradients was introduced for accurate in vivo skin dosimetry. The feasibility of this detector for skin dose measurements was verified in comparison with plane parallel ionization chamber and radiochromic films. The accuracy of a commercial treatment planning system (TPS) in skin dose calculations for intensity-modulated radiation therapy treatment of nasopharyngeal carcinoma was evaluated using MOSFET detectors in an anthropomorphic phantom as well as on the patients. Results show that this newly developed MOSFET detector can provide a minimal but highly reproducible intrinsic buildup of 7 mg cm(-2) corresponding to the requirements of personal surface dose equivalent Hp (0.07). The reproducibility of the MOSFET response, in high sensitivity mode, is found to be better than 2% at the phantom surface for the doses normally delivered to the patients. The MOSFET detector agrees well with the Attix chamber and the EBT Gafchromic film in terms of surface and buildup region dose measurements, even for oblique incident beams. While the dose difference between MOSFET measurements and TPS calculations is within measurement uncertainty for the depths equal to or greater than 0.5 cm, an overestimation of up to 8.5% was found for the surface dose calculations in the anthropomorphic phantom study. In vivo skin dose measurements reveal that the dose difference between the MOSFET results and the TPS calculations was on average -7.2%, ranging from -4.3% to -9.2%. The newly designed MOSFET detector encapsulated into a thin water protective film has a minimal reproducible intrinsic buildup recommended for skin dosimetry. This feature makes it very suitable for routine IMRT QA and accurate in vivo skin dosimetry.

Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy

The purpose of this work was to estimate skin dose for the patients treated with tomotherapy using metal oxide semiconductor field-effect transistors (MOSFETs) and thermoluminescent dosimeters (TLDs). In vivo measurements were performed for two head and neck patients treated with tomotherapy and compared to TLD measurements. The measurements were subsequently carried out for five days to estimate the inter-fraction deviations in MOSFET measurements. The variation between skin dose measured with MOSFET and TLD for first patient was 2.2%. Similarly, the variation of 2.3% was observed between skin dose measured with MOSFET and TLD for second patient. The tomotherapy treatment planning system overestimated the skin dose as much as by 10-12% when compared to both MOSFET and TLD. However, the MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1% to 1.4%. MOSFETs may be used as a viable dosimeter for measuring skin dose in areas where the treatment planning system may not be accurate.

Dosimetric characteristics of a MOSFET dosimeter for clinical electron beams

The fundamental dosimetric characteristics of commercially available metal oxide semiconductor field effect transistor (MOSFET) detectors were studied for clinical electron beam irradiations. MOSFET showed excellent linearity against doses measured using an ion chamber in the dose range of 20-630cGy. MOSFET reproducibility is better at high doses compared to low doses. The output factors measured with the MOSFET were within +/-3% when compared with those measured with a parallel plate chamber. From 4 to 12MeV, MOSFETs showed a large angular dependence in the tilt directions and less in the axial directions. MOSFETs do not show any dose-rate dependence between 100 and 600MU/min. However, MOSFETs have shown under-response when the dose per pulse of the beam is decreased. No measurable effect in MOSFET response was observed in the temperature range of 23-40 degrees C. The energy dependence of a MOSFET dosimeter was within +/-3.0% for 6-18MeV electron beams and 5.5% for 4MeV ones. This study shows that MOSFET detectors are suitable for dosimetry of electron beams in the energy range of 4-18MeV.