The response of lif thermoluminescence dosemeters to photon beams in the energy range from 30 kV x rays to 60Co gamma rays

Heterogeneous physical phantom for I-125 dose measurements and dose-to-medium determination

PURPOSE

In this paper we present a further step in the implementation of a physical phantom designed to generate sets of "true" independent reference data as requested by TG-186, intending to address and mitigate the scarcity of experimental studies on brachytherapy (BT) validation in heterogeneous media. To achieve this, we incorporated well-known heterogeneous materials into the phantom in order to perform measurements of 125I dose distribution. The work aims to experimentally validate Monte Carlo (MC) calculations based on MBDCA and determine the conversion factors from LiF response to absorbed dose in different media, using cavity theory.

METHODS AND MATERIALS

The physical phantom was adjusted to incorporate tissue equivalent materials, such as: adipose tissue, bone, breast and lung with varying thickness. MC calculations were performed using MCNP6.2 code to calculate the absorbed dose in the LiF and the dose conversion factors (DCF).

RESULTS

The proposed heterogeneous phantom associated with the experimental procedure carried out in this work yielded accurate dose data that enabled the conversion of the LiF responses into absorbed dose to medium. The results showed a maximum uncertainty of 6.92 % (k = 1), which may be considered excellent for dosimetry with low-energy BT sources.

CONCLUSIONS

The presented heterogeneous phantom achieves the required precision in dose evaluations due to its easy reproducibility in the experimental setup. The obtained results support the dose conversion methodology for all evaluated media. The experimental validation of the DCF in different media holds great significance for clinical procedures, as it can be applied to other tissues, including water, which remains a widely utilized reference medium in clinical practice.

Comparison of absorbed doses and organ doses measured with thermoluminescent dosimeters and Gafchromic film for cone beam computed tomography examination of the posterior mandibular region in a head phantom

OBJECTIVES

We aimed to map the correlation between thermoluminescent dosimeters (TLDs) and Gafchromic film for measuring absorbed doses and to compare minimum, maximum, and mean absorbed doses over larger regions of interest and at various craniofacial organs and tissues during cone beam computed tomography (CBCT) exposure of the mandibular third molar region.

STUDY DESIGN

We positioned TLDs at 75 measurement points in a head phantom. Gafchromic film was cut to the same shape as the 5 levels of the phantom and was placed on top of the TLDs. Both dosimetry methods thus included the surface of each level simultaneously. CBCT scans were made using a 5 × 5 cm field of view and a rotation angle of 200°. Measurements included absorbed dose distributions, doses at all 75 points, and minimum, maximum, and mean doses within organs and tissues.

RESULTS

The correlation of point-dose measurements at all TLD sites with doses measured on film was strong (R2 = 0.9687), with greatest correlation at lower doses (<2 mGy). Large deviations between TLD and film measurements of minimum and maximum doses and absorbed doses to the organs occurred at all 5 levels. TLD positioning failed to cover several organ sites; for these, only absorbed dose measurements from the film were available.

CONCLUSIONS

TLDs were unable to sample dose distributions and gradients accurately. The characteristics of Gafchromic LD-V1 film make it a favorable alternative in dental CBCT dosimetry.

Use of Thermoluminescence Dosimetry for QA in High-Dose-Rate Skin Surface Brachytherapy with Custom-Flap Applicator

Surface brachytherapy (BT) lacks standard quality assurance (QA) protocols. Commercially available treatment planning systems (TPSs) are based on a dose calculation formalism that assumes the patient is made of water, resulting in potential deviations between planned and delivered doses. Here, a method for treatment plan verification for skin surface BT is reported. Chips of thermoluminescent dosimeters (TLDs) were used for dose point measurements. High-dose-rate treatments were simulated and delivered through a custom-flap applicator provided with four fixed catheters to guide the Iridium-192 (Ir-192) source by way of a remote afterloading system. A flat water-equivalent phantom was used to simulate patient skin. Elekta TPS Oncentra Brachy was used for planning. TLDs were calibrated to Ir-192 through an indirect method of linear interpolation between calibration factors (CFs) measured for 250 kV X-rays, Cesium-137, and Cobalt-60. Subsequently, plans were designed and delivered to test the reproducibility of the irradiation set-up and to make comparisons between planned and delivered dose. The obtained CF for Ir-192 was (4.96 ± 0.25) μC/Gy. Deviations between measured and TPS calculated doses for multi-catheter treatment configuration ranged from -8.4% to 13.3% with an average of 0.6%. TLDs could be included in clinical practice for QA in skin BT with a customized flap applicator.

MEASUREMENT OF ENTRANCE SKIN DOSE AND ABSORBED DOSE TO DIFFERENT ORGANS IN DUAL-ENERGY X-RAY ABSORPTIOMETRY SCANS USING THERMOLUMINESCENCE DOSIMETRY

Thermoluminescence dosimetry is considered as an effective method in estimating the absorbed doses to organs in different imaging modalities. The present study focuses on dosimetry in dual-energy X-ray absorptiometry scans, for patients, and phantoms in various imaging centres. The cubical LiF (Mg, Ti) thermoluminescence dosemeters were inserted inside the holes of the Rando phantom slabs, to measure the absorbed dose to different organs in the whole body and lumbar scans. According to the results the maximum entrance skin dose was found to be 202.06 μGy for Hologic discovery W, which uses the fan beam scanning mode. The Norland XR-800 device took the scans with a much lower dose, as it uses the pencil beam for scanning the patients. The results of the study show that the radiation beam type, patient thickness, imaging technique and scan time may affect the radiation dose received by patient.

A versatile physical phantom design and construction for I-125 dose measurements and dose-to-medium determination

PURPOSE

In this paper we present a phantom designed to provide conditions to generate set of "true" independent reference data as requested by TG-186, and mitigating the scarcity of experimental studies on brachytherapy validation. It was used to perform accurate experimental measurements of dose of ¹²⁵I brachytherapy seeds using LiF dosimeters, with the objective of experimentally validating Monte Carlo (MC) calculations with model-based dose calculation algorithm (MBDCA). In addition, this work intends to evaluate a methodology to convert the experimental values from LiF into dose in the medium.

METHODS AND MATERIALS

The proposed PMMA physical phantom features cavities to insert a LiF dosimeter and a ¹²⁵I seed, adjusted in different configurations with variable thickness. Monte Carlo calculations performed with MCNP6.2 code were used to score the absorbed dose in the LiF and the dose conversion parameters. A sensitivity analysis was done to verify the source of possible uncertainties and quantify their impact on the results.

RESULTS

The proposed phantom and experimental procedure developed in this work provided precise dose data within 5.68% uncertainty (k = 1). The achieved precision made it possible to convert the LiF responses into absorbed dose to medium and to validate the dose conversion factor methodology.

CONCLUSIONS

The proposed phantom is simple both in design and as in its composition, thus achieving the demanded precision in dose evaluations due to its easy reproducibility of experimental setup. The results derived from the phantom measurements support the dose conversion methodology. The phantom and the experimental procedure developed here can be applied for other materials and radiation sources.

Monte Carlo characterization of high atomic number inorganic scintillators for in vivo dosimetry in 192 Ir brachytherapy

BACKGROUND

There is increased interest in vivo dosimetry for ¹⁹² Ir brachytherapy (BT) treatments using high atomic number (Z) inorganic scintillators. Their high light output enables construction of small detectors with negligible stem effect and simple readout electronics. Experimental determination of absorbed-dose energy dependence of detectors relative to water is prevalent, but it can be prone to high detector positioning uncertainties and does not allow for decoupling of absorbed-dose energy dependence from other factors affecting detector response.

PURPOSE

To investigate which measurement conditions and detector properties could affect their absorbed-dose energy dependence in BT in vivo dosimetry.

METHODS

We used a general-purpose MC code penelope for the characterization of high-Z inorganic scintillators with the focus on ZnSe (Z¯=32). Two other promising media CsI (Z¯=54) and Al₂ O₃ (Z¯=11) were included for comparison in selected scenarios. We determined absorbed-dose energy dependence of crystals relative to water under different scatter conditions (calibration phantom 12 × 12 × 30 cm³ , characterization phantoms 20 × 20 × 20 cm³ , 30 × 30 × 30 cm³ , 40 × 40 × 40 cm³ , and patient-like elliptic phantom 40 × 30 × 25 cm³ ). To mimic irradiation conditions during prostate treatments, we evaluated whether the presence of pelvic bones and calcifications affect ZnSe response. ZnSe detector design influence was also investigated.

RESULTS

In contrast to low-Z organic and medium-Z inorganic scintillators, ZnSe and CsI media have substantially greater absorbed-dose energy dependence relative to water. The response was phantom-size dependent and changed by 11 % between limited- and full-scatter conditions for ZnSe, but not for Al₂ O₃ . For a given phantom size, a part of the absorbed-dose energy dependence of ZnSe is caused not due to in-phantom scatter but due to source anisotropy. Thus, the absorbed-dose energy dependence of high-Z scintillators is a function of not only the radial distance but also the polar angle. Pelvic bones did not affect ZnSe response, whereas large and intermediate size calcifications reduced it by 9 % and 5 %, respectively, when placed midway between the source and the detector.

CONCLUSIONS

Unlike currently prevalent low- and medium-Z scintillators, high-Z crystals are sensitive to characterization and in vivo measurement conditions. However, good agreement between MC data for ZnSe in the present study and experimental data for ZnSe:O by Jørgensen et al (2021) suggest that detector signal is proportional to the average absorbed dose to the detector cavity. This enables an easy correction for non-TG43-like scenarios (e.g., patient sizes and calcifications) through MC simulations. Information that should be provided to the clinic by the detector vendors. This article is protected by copyright. All rights reserved.

A RADIOLUMINESCENCE STUDY OF DOSE CHARACTERISTICS OF LIF:MG,TI

A radioluminescence (RL) study of dose characteristics of tissue-equivalent LiF:Mg,Ti was carried out to determine the possible application as a real-time dosemeter. An RL measurements system based on LiF:Mg,Ti coupled with optical fiber was developed, and a blank fiber was set to remove the stem effect generated by the optical fiber due to direct radiation. A slight increase of RL sensitivity with accumulated dose and the afterglow effect due to shallow traps in LiF:Mg,Ti were observed, thus a set of algorithms was adopted to correct measured dose rate. A good linearity of dose-rate response using RL in LiF:Mg,Ti over more than four orders of magnitude (from 0.76 mGy/h to 8.02 Gy/h) was shown, and the deviation of calibrated dose rate is within 20%. Moreover, a satisfactory reproducibility (1.45%) of the measured dose rate after correction was represented. The results indicated that LiF:Mg,Ti might be promising for real-time dose monitoring.

Report of AAPM Task Group 155: Megavoltage photon beam dosimetry in small fields and non-equilibrium conditions

Small-field dosimetry used in advance treatment technologies poses challenges due to loss of lateral charged particle equilibrium (LCPE), occlusion of the primary photon source, and the limited choice of suitable radiation detectors. These challenges greatly influence dosimetric accuracy. Many high-profile radiation incidents have demonstrated a poor understanding of appropriate methodology for small-field dosimetry. These incidents are a cause for concern because the use of small fields in various specialized radiation treatment techniques continues to grow rapidly. Reference and relative dosimetry in small and composite fields are the subject of the International Atomic Energy Agency (IAEA) dosimetry code of practice that has been published as TRS-483 and an AAPM summary publication (IAEA TRS 483; Dosimetry of small static fields used in external beam radiotherapy: An IAEA/AAPM International Code of Practice for reference and relative dose determination, Technical Report Series No. 483; Palmans et al., Med Phys 45(11):e1123, 2018). The charge of AAPM task group 155 (TG-155) is to summarize current knowledge on small-field dosimetry and to provide recommendations of best practices for relative dose determination in small megavoltage photon beams. An overview of the issue of LCPE and the changes in photon beam perturbations with decreasing field size is provided. Recommendations are included on appropriate detector systems and measurement methodologies. Existing published data on dosimetric parameters in small photon fields (e.g., percentage depth dose, tissue phantom ratio/tissue maximum ratio, off-axis ratios, and field output factors) together with the necessary perturbation corrections for various detectors are reviewed. A discussion on errors and an uncertainty analysis in measurements is provided. The design of beam models in treatment planning systems to simulate small fields necessitates special attention on the influence of the primary beam source and collimating devices in the computation of energy fluence and dose. The general requirements for fluence and dose calculation engines suitable for modeling dose in small fields are reviewed. Implementations in commercial treatment planning systems vary widely, and the aims of this report are to provide insight for the medical physicist and guidance to developers of beams models for radiotherapy treatment planning systems.

Determination of the absorbed dose to water for medium-energy x-ray beams using Fricke dosimetry

PURPOSE

For x-ray beams in the low and medium energy range, reference dosimetry is established in terms of air kerma. Fricke dosimetry has shown great potential in the absolute measurements of the absorbed dose to water for high-energy ranges. Therefore, the main purpose of this work was to compare the absorbed dose to water for medium-energy x-ray beams obtained through Fricke dosimetry with that obtained from the air kerma rate.

METHODS

To determine the absorbed dose to water using Fricke dosimetry, the polyethylene bags methodology was chosen. Fricke solution was irradiated at four different beam qualities. The absorbed dose to water values obtained using Fricke dosimetry were compared to those obtained using the standard protocol, using the Z-score.

RESULTS

Values of the Z-score were <2 for all measurements of absorbed dose to water, which means that the values obtained using Fricke dosimetry are equivalent to those obtained using the reference protocol. The combined standard uncertainty for the absorbed dose to water obtained by Fricke dosimetry was lower than that obtained with the ionization chamber.

CONCLUSIONS

Chemical dosimetry using a standard FeSO₄ solution has been demonstrated to be a potential option as a standard for the quantity absorbed dose to water for medium kV x-ray qualities.

Does dose optimisation in digital panoramic radiography affect diagnostic performance?

OBJECTIVES

To compare the overall diagnostic performance of digital panoramic radiographs obtained with low-dose protocols and to estimate the absorbed dose in the head and neck.

MATERIALS AND METHODS

Forty-eight panoramic radiographs were obtained from eight imaging phantoms using six exposure protocols of progressively lower tube voltages (kVp) and currents (mA), as follows: (1) 70 kVp and 12.5 mA, (2) 66 kVp and 10 mA, (3) 66 kVp and 8 mA, (4) 66 kVp and 5 mA, (5) 66 kVp and 4 mA and (6) 66 kVp and 3.2 mA. Five oral radiologists independently evaluated the images and reported all detectable radiographic findings. Intra-examiner reproducibility was assessed by re-evaluation of 25% of the images. The data were analysed using the McNemar and weighted Kappa tests. Absorbed doses of the six protocols were obtained from thermoluminescent dosimeters placed inside a Rando phantom and compared using one-way ANOVA with post hoc Tukey (α = 0.05).

RESULTS

The overall diagnostic performance of panoramic radiographs obtained with low-dose protocols did not differ from that of panoramic radiographs obtained with the highest dose (p > 0.05). Moreover, substantial agreement was observed between all protocols. Protocol 1 resulted in the highest absorbed dose and protocols 4, 5 and 6 in the lowest absorbed doses, with the difference being significant (p ≤ 0.05).

CONCLUSION

Although digital panoramic radiography is considered a relatively low-dose examination, the radiation dose can be further reduced without negatively affecting its overall diagnostic performance.

CLINICAL RELEVANCE

Considering the risks associated with X-rays, digital panoramic radiographs can be obtained at even lower exposure levels.

EGSnrc-based depth-dependent photon energy response and phantom scatter corrections for low-energy brachytherapy sources

In the present study, beam quality correction, [Formula: see text], and phantom scatter correction, k_phan(r), for low-energy brachytherapy sources, ¹³¹Cs, ¹²⁵I, and ¹⁰³Pd, are calculated using the Monte Carlo-based EGSnrc code system as a function of the distance along the transverse axis of the source. The solid-state detectors investigated are diamond, LiF, Li₂B₄O₇, Al₂O₃, and radiochromic films, such as HS, EBT, EBT2, EBT3, RTQA, XRT, and XRQA. The solid phantoms investigated are polystyrene, PMMA, virtual water, solid water, plastic water (LR), A150, RW1, RW3, and WE210. For a given detector and brachytherapy source, [Formula: see text] is independent of distance in the water phantom. Meanwhile, for a given detector, k_phan(r) depends on the distance from the source for the investigated solid phantoms. Moreover, the k_phan(r) values do not change with the detector type for sources ¹³¹Cs, ¹²⁵I, and ¹⁰³Pd at all distances. The LR and A150 phantoms are water equivalent for the investigated distances of 1-5 cm. The phantoms including solid water, virtual water, and WE210 are not water-equivalent for distances beyond 1 cm. Furthermore, PMMA, polystyrene, RW1, and RW3 are not water equivalent.

Technical Note: Robust individual thermoluminescence dosimeter tracking using optical fingerprinting

PURPOSE

The thermoluminescence dosimeter (TLD) has desirable features including low cost, reusability, small size, and relatively low energy dependence. However, the commonly available poly-crystal TLDs (e.g., TLD-100) exhibit high interdetector variability that requires individual calibration for high detection accuracy. To improve individual TLD tracking robustness, we developed an optical fingerprinting method to identify the TLD-100 chips.

METHODS

Seven hundred and fifty-two images were initially captured using a digital microscope camera to build a feature library for both facets of 376 TLD-100 chips. A median intensity thresholding method was used to segment images into foreground and background. The affine transformation was used to register the segmented images to the same position. The fingerprint of each image was calculated from its registered image. All fingerprints were then recorded in an Elasticsearch® search database. The TLD fingerprint match was tested three times when the library was established and repeated once 20 months later. All chips were irradiated at 0, 1, 4, and 8 Gy on a calibrated clinical MV linac to establish the individual calibration curve.

RESULTS

The true positive rate of identifying TLDs based on their optical fingerprints was 100% at initialization of the inventory. After 20 months and multiple deployments for characterization, calibration, and dose measurement, the true positive match rate dropped to 99% with zero false-positive matches. The TLDs exhibited high self-consistency in the dose-response test with R² between 0.988 and 1 with linear regression.

CONCLUSIONS

The TLD-100 chips surface textures are unique and sufficient to support accurate identification based on the optical fingerprinting. This method provides inexpensive and robust management of the TLDs for individual calibration and dosimetry.

Investigation of a synthetic diamond detector response in kilovoltage photon beams

PURPOSE

An important characteristic of radiation dosimetry detectors is their energy response which consists of absorbed-dose and intrinsic energy responses. The former can be characterized using Monte Carlo (MC) simulations, whereas the latter (i.e., detector signal per absorbed dose to detector) is extracted from experimental data. Such a characterization is especially relevant when detectors are used in nonrelative measurements at a beam quality that differs from the calibration beam quality. Having in mind the possible application of synthetic diamond detectors (microDiamond PTW 60019, Freiburg, Germany) for nonrelative dosimetry of low-energy brachytherapy (BT) beams, we determined their intrinsic and absorbed-dose energy responses in 25-250 kV beams relative to a ⁶⁰ Co beam, which is usually the reference beam quality for detector calibration in radiotherapy.

MATERIAL AND METHODS

Three microDiamond detectors and, for comparison, two silicon diodes (PTW 60017) were calibrated in terms of air-kerma free in air in six x-ray beam qualities (from 25 to 250 kV) and in terms of absorbed dose to water in a ⁶⁰ Co beam at the national metrology laboratory in Sweden. The PENELOPE/penEasy MC radiation transport code was used to calculate the absorbed-dose energy response of the detectors (modeled based on blueprints) relative to air and water depending on calibration conditions. The MC results were used to extract the relative intrinsic energy response of the detectors from the overall energy response. Measurements using an independent setup with a single ophthalmic BEBIG I25.S16 ¹²⁵ I BT seed (effective photon energy of 28 keV) were used as a qualitative check of the extracted intrinsic energy response correction factors. Additionally, the impact of the thickness of the active volume as well as the presence of extra-cameral components on the absorbed-dose energy response of a microDiamond detector was studied using MC simulations.

RESULTS

The relative intrinsic energy response of the microDiamond detectors was higher by a factor of 2 in 25 and 50 kV beams compared to the ⁶⁰ Co beam. The variation in the relative intrinsic energy response of silicon diodes was within 10% over the investigated photon energy range. The use of relative intrinsic energy response correction factors improved the agreement among the absorbed dose to water values determined using microDiamond detectors and silicon diodes, as well as with the TG-43 formalism-based calculations for the ¹²⁵ I seed. MC study of microDiamond detector design features provided a possible explanation for inter-detector response variation at low-energy photon beams by differences in the effective thickness of the active volume.

CONCLUSIONS

MicroDiamond detectors had a non-negligible variation in the relative intrinsic energy response (factor of 2) which was comparable to that in the absorbed-dose energy response relative to water at low-energy photon beams. Silicon diodes, in contrast, had an absorbed-dose energy dependence on photon energy that varied by a factor of 6, whereas the intrinsic energy dependence on beam quality was within 10%. It is important to decouple these two responses for a full characterization of detector energy response especially when the user and reference beam qualities differ significantly, and MC alone is not enough.

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.

Dosimetric validation of the Theragenics AgX-100® I-125 seed for ROPES eye plaque brachytherapy

With the discontinued distribution of the I-125 Oncura Onco seed (model 6711), the Theragenics AgX100® I-125 seeds were considered as a suitable alternative for eye plaque brachytherapy as their physical properties matched the requirements for use with the ROPES eye plaques. The purpose of this study aims at validating the dosimetry of the AgX-100 loaded ROPES plaques (11 mm diameter, 15 mm diameter with flange, 15 mm diameter with notch, 18 mm diameter) and assess the differences with the discontinued I-125 6711 model. To independently verify the plaque dosimetry, the brachytherapy module of RADCALC® version 6.2.3.6 was commissioned for the new AgX-100 I-125 seed using the published AAPM TG43 data from the literature. Experimental dosimetry verification was performed using EBT3 Gafchromic™ film and TLD-100 micro-cubes in a specially designed Solid Water® phantom. Both RADCALC® and film confirmed the dosimetry calculated by Plaque Simulator (PS) version 6.4.6 The dose calculated by PS agrees with RADCALC® to within 2% for depths of 1-15 mm for the 4 available ROPES plaques. The dosimetric measurements agreed with the calculations of PS for clinically relevant depths (4 mm to 6 mm) within the evaluated uncertainties of 4.7% and 7.2% for EBT3 film and TLDs respectively. The AgX-100 I-125 seed was a suitable replacement for the 6711 I-125 seed. Due to the introduction of the stainless-steel backscatter factor in PS v6.4.6, the department has decided to report both the homogenous dose and heterogeneity corrected dose for each eye plaque patient.

Whole-body dose equivalent including neutrons is similar for 6 MV and 15 MV IMRT, VMAT, and 3D conformal radiotherapy

PURPOSE

This study investigates the difference in whole-body dose equivalent between 6 and 15 MV image-guided radiotherapy (IGRT) for the treatment of a rhabdomyosarcoma in the prostate.

METHODS

A previously developed model for stray radiation of the primary beam was improved and used to calculate the photon dose and photon energy in the out-of-field region for a radiotherapy patient. The dose calculated by the treatment planning system was fused with the model-calculated out-of-field dose, resulting in a whole-body photon dose distribution. The peripheral neutron dose equivalent was calculated using an analytical model from the literature. A daily cone beam CT dose was added to the neutron and photon dose equivalents. The calculated 3D dose distributions were compared to independent measurements conducted with thermoluminescence dosimeters and an anthropomorphic phantom. The dose contributions from the IGRT treatments of three different techniques applied with two nominal X-ray energies were compared using dose equivalent volume histograms (DEVHs).

RESULTS

The calculated and measured out-of-field whole-body dose equivalents for the IGRT treatments agreed within (9 ± 10) % (mean and type A SD). The neutron dose equivalent was a minor contribution to the total out-of-field dose up to 50 cm from the isocenter. Further from the isocenter, head leakage was dominating inside the patient body, whereas the neutron dose equivalent contribution was important close to the surface. There were small differences between the whole-body DEVHs of the 6 and 15 MV treatments applied with the same technique, although the single scatter contributions showed large differences. Independent of the beam energy, the out-of-field dose of the volumetric-modulated arc therapy (VMAT) treatment was significantly lower than the dynamic intensity-modulated radiation therapy (IMRT) treatment.

CONCLUSION

The calculated whole-body dose helped to understand the importance of the dose contributions in different areas of the patient. Regarding radiation protection of the patient for IGRT treatments, the choice of beam energy is not important, whereas the treatment technique has a large influence on the out-of-field dose. If the patient is treated with intensity-modulated beams, VMAT should be used instead of dynamic IMRT in terms of radiation protection of the patient. In general, the developed models for photon and neutron dose equivalent calculation can be used for any patient geometry, tumor location, and linear accelerator.

Energy dependence of a radiophotoluminescent glass dosimeter for HDR 192 Ir brachytherapy source

PURPOSE

We determined correction factors for absorbed dose energy dependence and intrinsic energy dependence for measurements of absorbed dose to water around an ¹⁹² Ir source using a radiophotoluminescent glass dosimeter (RPLD) calibrated with a 4-MV photon beam.

METHODS

The ratio of the absorbed dose to the water and the average absorbed dose to RPLD for the ¹⁹² Ir beam relative to the same ratio in a 4 MV photon beam defines the absorbed dose energy dependence and was determined at distances of 2-10 cm (at intervals of 1 cm) from the ¹⁹² Ir source in a water phantom using the egs_chamber user code. The RPLD was calibrated to measure absorbed dose to water, D_w , in a 4 MV photon beam using an ionization chamber, which was also used to measure absorbed dose to water, D_w , in a water phantom using the ¹⁹² Ir source. The detector response radiophotoluminescence (RPL signal per average absorbed dose in the detector) in the ¹⁹² Ir beam relative to that in the 4 MV photon beam (the relative intrinsic efficiency) was determined experimentally. Finally, the beam quality correction factor was obtained as the quotient between the absorbed dose energy dependence and the relative intrinsic efficiency and corrects for the difference between the beam quality Q₀ used at calibration and the beam quality Q used in the measurements.

RESULTS

The relative dose ratio of the average absorbed dose to water relative to RPLD ranged from 0.930 to 0.746, and the beam quality correction factor ranged from 0.999 to 0.794 for distances of 2-10 cm from the ¹⁹² Ir source. The relative detector response to an ¹⁹² Ir source and a 4-MV photon beam was 0.930, and it did not vary significantly with distance.

CONCLUSIONS

These results demonstrate that corrections for absorbed dose energy dependence and intrinsic energy dependence are required when using an RPLD to measure with sources different from the reference source providing the primary calibration.

OPTIMIZATION OF A RADIOPHOTOLUMINESCENT GLASS DOSEMETER FOR OCCUPATIONAL EYE LENS DOSIMETRY IN INTERVENTIONAL RADIOLOGY/CARDIOLOGY

Hospital based workers that perform interventional radiology are at risk of reaching the eye lens dose limit of 20 mSv/y. These workers are exposed to the radiation scattered by the patient, which creates a complex field, with low radiation energy reaching the eyes of the medical staff from wide angles. Therefore, the dosemeter used in the assessment of the eye lens dose of interventional radiologists needs to respond accurately in such conditions. In this study, the angular response of a commercially available radiophotoluminescent glass dosemeter, GD-352M, was optimized via Monte Carlo simulations, aiming at its use as eye lens dosemeter in interventional radiology. The improved dosemeter was manufactured and then characterized in terms of Hp(3), the quantity recommended for eye lens dosimetry. Its response was compared to the IEC 62387:2012 requirements for Hp(3) and to requirements proposed specifically for eye lens dosemeters used in interventional radiology. The improved dosemeter meets the IEC 62387:2012 requirements for energy and angular response for Hp(3) and also shows good agreement with the more strict requisites proposed for eye lens dosemeters to be used in interventional radiology.

Suitability of microDiamond detectors for the determination of absorbed dose to water around high-dose-rate 192 Ir brachytherapy sources

PURPOSE

Experimental dosimetry of high-dose-rate (HDR) ¹⁹² Ir brachytherapy (BT) sources is complicated due to high dose and dose-rate gradients, and softening of photon energy spectrum with depth. A single crystal synthetic diamond detector microDiamond (PTW 60019, Freiburg, Germany) has a small active volume, high sensitivity, direct readout, and nearly water-equivalent active volume. The purpose of this study was to evaluate the suitability of microDiamond detectors for the determination of absorbed dose to water around HDR ¹⁹² Ir BT sources. Three microDiamond detectors were used, allowing for the comparison of their properties.

METHODS

In-phantom measurements were performed using microSelectron and VariSource iX HDR ¹⁹² Ir BT treatment units. Their treatment planning systems (TPSs), Oncentra (v. 4.3) and BrachyVision (v. 13.6), respectively, were used to create irradiation plans for a cubic PMMA phantom with the microDiamond positioned at one of three source-to-detector distances (SDDs) (1.5, 2.5, and 5.5 cm) at a time. The source was stepped in increments of 0.5 cm over a total length of 6 cm to yield absorbed dose of 2 Gy at the nominal reference-point of the detector. Detectors were calibrated in ⁶⁰ Co beam in terms of absorbed dose to water, and Monte Carlo (MC) calculated beam quality correction factors were applied to account for absorbed-dose energy dependence. Phantom correction factors were applied to account for differences in dimensions between the measurement phantom and a water phantom used for absorbed dose calculations made with a TPS. The same measurements were made with all three of the detectors. Additionally, dose-rate dependence and stability of the detectors were evaluated in ⁶⁰ Co beam.

RESULTS

The percentage differences between experimentally determined and TPS-calculated absorbed doses to water were from -1.3% to +2.9%. The values agreed to within experimental uncertainties, which were from 1.9% to 4.3% (k = 2) depending on the detector, SDD and treatment delivery unit. No dose-rate or intrinsic energy dependence corrections were applied. All microDiamonds were comparable in terms of preirradiation dose, stability of the readings and energy response, and showed a good agreement.

CONCLUSIONS

The results indicate that the microDiamond is potentially suitable for the determination of absorbed dose to water around HDR ¹⁹² Ir BT sources and may be used for independent verification of TPS's calculations, as well as for QA measurements of HDR ¹⁹² Ir BT treatment delivery units at clinical sites.

Whole-body dose and energy measurements in radiotherapy by a combination of LiF:Mg,Cu,P and LiF:Mg,Ti

PURPOSE

Long-term survivors of cancer who were treated with radiotherapy are at risk of a radiation-induced tumor. Hence, it is important to model the out-of-field dose resulting from a cancer treatment. These models have to be verified with measurements, due to the small size, the high sensitivity to ionizing radiation and the tissue-equivalent composition, LiF thermoluminescence dosimeters (TLD) are well-suited for out-of-field dose measurements. However, the photon energy variation of the stray dose leads to systematic dose errors caused by the variation in response with radiation energy of the TLDs. We present a dosimeter which automatically corrects for the energy variation of the measured photons by combining LiF:Mg,Ti (TLD100) and LiF:Mg,Cu,P (TLD100H) chips.

METHODS

The response with radiation energy of TLD100 and TLD100H compared to ⁶⁰Co was taken from the literature. For the measurement, a TLD100H was placed on top of a TLD100 chip. The dose ratio between the TLD100 and TLD100H, combined with the ratio of the response curves was used to determine the mean energy. With the energy, the individual correction factors for TLD100 and TLD100H could be found. The accuracy in determining the in- and out-of-field dose for a nominal beam energy of 6MV using the double-TLD unit was evaluated by an end-to-end measurement. Furthermore, published Monte Carlo (M.C.) simulations of the mean photon energy for brachytherapy sources, stray radiation of a treatment machine and cone beam CT (CBCT) were compared to the measured mean energies. Finally, the photon energy distribution in an Alderson phantom was measured for different treatment techniques applied with a linear accelerator. Additionally, a treatment plan was measured with a cobalt machine combined with an MRI.

RESULTS

For external radiotherapy, the presented double-TLD unit showed a relative type A uncertainty in doses of -1%±2% at the two standard deviation level compared to an ionization chamber. The type A uncertainty in dose was in agreement with the theoretically calculated type B uncertainty. The measured energies for brachytherapy sources, stray radiation of a treatment machine and CBCT imaging were in agreement with M.C. simulations. A shift in energy with increasing distance to the isocenter was noticed for the various treatment plans measured with the Alderson phantom. The calculated type B uncertainties in energy were in line with the experimentally evaluated type A uncertainties.

CONCLUSION

The double-TLD unit is able to predict the photon energy of scatter radiation in external radiotherapy, X-ray imagine and brachytherapy sources. For external radiotherapy, the individual energy correction factors enabled a more accurate dose determination compared to conventional TLD measurements.

Technical note: No increase in effective dose from half compared to full rotation pelvis cone beam CT

PURPOSE

To image the abdomen of a patient with a gantry mounted imaging system of a linear accelerator, different cone beam computed tomography (CBCT) protocols are available. The whole-body dose of a full rotation abdomen CBCT and a half rotation CBCT was compared. In our clinic, both CBCT protocols are used in daily routine work.

METHODS

With an adult anthropomorphic Alderson phantom, the whole-body dose per CBCT scan was measured with thermoluminescence dosimeters. The half rotation CBCT was applied such that the gantry mounted X-ray source rotated around the right side of the phantom. The 183 measurement locations covered all ICRP recommended critical organs (except the gonads). The effective dose was calculated with the mean organ dose and the corresponding tissue weighting factors. A point-by-point dose comparison of both protocols was conducted.

RESULTS

The effective dose was 5.4 mSv ±5% and 5.0 mSv ±5% (estimated type B 1σ) for the full and the half rotation CBCT respectively. There was no significant difference (α = 0.05) in the effective dose within the precision of the measurement (1σ = 5%). The half rotation CBCT displayed an inhomogeneous dose distribution in a transversal phantom slice in contrast with the full rotation CBCT. In the imaging region, the mean dose was (20.5 ± 3.4) mGy and (19.2 ± 7.4) mGy (measured type A 1σ) for the full and the half rotation CBCT respectively.

CONCLUSION

The half compared to the full rotation CBCT displays a smaller field-of-view in a transversal slice and no significant difference in the effective dose. Hence, the full rotation CBCT is favorable compared to the half rotation CBCT. However, by using the half rotation protocol, critical volumes in the patient can be spared compared to the full rotation protocol.

Technical Note: Comparison of peripheral patient dose from MR-guided 60 Co therapy and 6 MV linear accelerator IGRT

PURPOSE

The use of X-ray imaging in radiation therapy can give a substantial dose to the patient. A Cobalt machine combined with an magnetic resonance imaging (MRI) was recently introduced to clinical work. One positive aspect of using non-ionizing imaging devices is the reduction of the patient exposure. The purpose of this study was to quantify the difference in out-of-field dose to the patient between the image guided radiation therapy (IGRT) treatment applied with a linear accelerator with cone beam CT (CBCT) equipment and a Cobalt machine combined with an MRI.

METHODS

The treatment of a rhabdomyosarcoma in the prostate was planned and irradiated using different modalities and radiation therapy machines. The whole-body dose was measured for a 3D-conformal radiation therapy (3DCRT), an intensity-modulated radiation therapy (IMRT), and a volumetric-modulated arc therapy plan applied with a conventional linear accelerator operated at 6 MV beam energy. Additionally, the dose of an IMRT plan applied with a ⁶⁰ Co machine combined with an MRI was measured. Furthermore, the dose of one CBCT scan using the linear accelerator's on-board imaging system was determined. The 3D dose measurements were performed in an anthropomorphic phantom containing 168 slots for thermoluminescence dosimeters (TLDs). A combination of LiF:Mg,Ti (TLD100) and LiF:Mg,Cu,P (TLD100H) was used to accurately determine the in- and out-of-field dose. The plans were rescaled to different fractionation schemes (2 Gy, 3 Gy, and 5 Gy fraction dose) and the dose of one CBCT scan was additionally added to the treatment dose per fraction applied with the linear accelerator. The resulting absorbed doses per fraction of the two machines were compared.

RESULTS

In the target region, all measured treatment plans presented the same magnitude of dose, while the CBCT dose was a factor of 100 smaller. Close to the planned target volume (PTV), the dose from the ⁶⁰ Co machine was a factor of two higher compared with the 3DCRT + CBCT dose. Up to 45 cm from the PTV, the treatment applied with the ⁶⁰ Co-sources showed an increased out-of-field dose compared to the linear accelerator + CBCT IGRT treatments. Further away from the PTV in the region where leakage from the gantry head is dominating, the out-of-field dose of the Cobalt machine was smaller compared to the linear accelerator + CBCT.

CONCLUSION

The peripheral dose of the ⁶⁰ Co machine combined with an MRI is larger up to 45 cm from the PTV and further away, it is lower than the dose from a linear accelerator + CBCT treatment. The presented fractionation schemes had a marginal impact on the results.

Out-of-field doses from pediatric craniospinal irradiations using 3D-CRT, IMRT, helical tomotherapy and electron-based therapy

Medulloblastoma treatment involves irradiation of the entire central nervous system, i.e. craniospinal irradiation (CSI). This is associated with the significant exposure of large volumes of healthy tissue and there is growing concern regarding treatment-associated side effects. The current study compares out-of-field organ doses in children receiving CSI through 3D-conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), helical tomotherapy (HT) and an electron-based technique, and includes radiation doses resulting from imaging performed during treatment. An extensive phantom study is performed, using an anthropomorphic phantom corresponding to a five year old child, in which organ absorbed doses are measured using thermoluminescent detectors. Additionally, the study evaluates and explores tools for calculating out-of-field patient doses using the treatment planning system (TPS) and analytical models. In our study, 3D-CRT resulted in very high doses to a limited number of organs, while it was able to spare organs such as the lungs and breast when compared to IMRT and HT. Both IMRT and HT spread the dose over more organs and were able to spare the heart, thyroid, bladder, uterus and testes when compared to 3D-CRT. The electron-based technique considerably decreased the out-of-field doses in deep-seated organs but could not avoid nearby out-of-field organs such as the lungs, ribs, adrenals, kidneys and uterus. The daily imaging dose is small compared to the treatment dose burden. The TPS error for out-of-field doses was most pronounced for organs further away from the target; nevertheless, no systematic underestimation was observed for any of the studied TPS systems. Finally, analytical modeling was most optimal for 3D-CRT although the number of organs that could be modeled was limited. To conclude, none of the techniques studied was capable of sparing all organs from out-of-field doses. Nevertheless, the electron-based technique showed the most promise for out-of-field organ dose reduction during CSI when compared to photon techniques.

A review of uncertainties in radiotherapy dose reconstruction and their impacts on dose-response relationships

Proper understanding of the risk of radiation-induced late effects for patients receiving external photon beam radiotherapy requires the determination of reliable dose-response relationships. Although significant efforts have been devoted to improving dose estimates for the study of late effects, the most often questioned explanatory variable is still the dose. In this work, based on a literature review, we provide an in-depth description of the radiotherapy dose reconstruction process for the study of late effects. In particular, we focus on the identification of the main sources of dose uncertainty involved in this process and summarise their impacts on the dose-response relationship for radiotherapy late effects. We provide a number of recommendations for making progress in estimating the uncertainties in current studies of radiotherapy late effects and reducing these uncertainties in future studies.

Track-average LET of secondary electrons generated in LiF:Mg,Ti and liquid water by 20-300 kV x-ray, 137Cs and 60Co beams

Electrons generated in matter by photons could be a fundamental basis for an adequate analysis of radiation effects and damage. We have studied separately the 'primary electrons' generated directly by photons from the 'secondary electrons' (SE) produced by electron-electron interactions. In this work, track-average linear energy transfer, [Formula: see text], of SE in LiF:Mg,Ti and liquid water produced by twelve photon energy beams from 20 kV x-ray to ⁶⁰Co gamma rays have been investigated using the EGSnrc Monte Carlo Code. The exposure of LiF:Mg,Ti in different phantom materials has been considered. Depending on the photon energy, SE represent 40%-90% of the total electron fluence (TEF) between 1 keV and 10 keV, being higher when the photon energy increases. Independent of the medium, [Formula: see text] versus mean photon energy displays a local minimum at around 40 keV, followed by a local maximum at ~80 keV-100 keV. The [Formula: see text] of SE generated by the x-ray beams are of order of 11 keV µm^-1 to 19 keV µm^-1 in LiF:Mg,Ti and 5 keV µm^-1 to 9 keV µm^-1 in liquid water which represent 3-5 times those produced by ⁶⁰Co gamma rays in both media. These values were considerably greater than those of TEF, by factors of 3-8. Furthermore, [Formula: see text] of SE generated in liquid water by 20 kV-200 kV x-rays are similar to those of 76 MeV-120 MeV ³He ions. Contrary to the TEF, where [Formula: see text] were independent of the phantom material, at low photon energies [Formula: see text] of SE was found to be sensitive to the surrounding medium showing higher values within the phantom than in air. This result, which agrees with published experimental results, implies the importance of the SE ionization density for an understanding of dosimeter response induced by photon beams.

Radiation exposure of the investigator's hand during fusion imaging of the thyroid with 99mTcO4-free-hand SPECT and ultrasound

The objective of this study was to assess the radiation exposure of the investigators' hand during free-hand single photon emission tomography/ultrasound ((99m)TcO4-fhSPECT/US) of the thyroid. Conventional dosimetry by rings with thermoluminescent detectors (TLDs) was performed in 32 patients (Group A), followed by TLD-chipstrate dosimetry in further 20 patients (Group B). In both the groups, the ambient dose rate was measured by dose rate meter (DRM). The applied activity was in the range of 60-80 MBq (99m)TcO4. In Group A, the exposure per investigation was 7.53 µSv (calculated average) by ring dosimetry and 9.02±5.64 µSv by DRM; in Group B, 10.93 and 9.51 ± 1.76 µSv, respectively. Based on estimated 1224 yearly thyroid investigations per nuclear medicine specialist in Germany, the estimated cumulative yearly exposure of the hand was 11.32 mSv. The hand exposure during a thyroid (99m)TcO4-fhSPECT/US of 20-min duration proved modest and comparable with different methods. Yearly examinations in excess of 1000 per investigator are not expected to add a relevant cumulative risk.

Contralateral breast dose from partial breast brachytherapy

The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam-published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single-entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high-dose-rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium-192 as the treatment source. Post-treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI.

The mean photon energy ĒF at the point of measurement determines the detector-specific radiation quality correction factor kQ,M in (192)Ir brachytherapy dosimetry

The application of various radiation detectors for brachytherapy dosimetry has motivated this study of the energy dependence of radiation quality correction factor kQ,M, the quotient of the detector responses under calibration conditions at a (60)Co unit and under the given non-reference conditions at the point of measurement, M, occurring in photon brachytherapy. The investigated detectors comprise TLD, radiochromic film, ESR, Si diode, plastic scintillator and diamond crystal detectors as well as ionization chambers of various sizes, whose measured response-energy relationships, taken from the literature, served as input data. Brachytherapy photon fields were Monte-Carlo simulated for an ideal isotropic (192)Ir point source, a model spherical (192)Ir source with steel encapsulation and a commercial HDR GammaMed Plus source. The radial source distance was varied within cylindrical water phantoms with outer radii ranging from 10 to 30cm and heights from 20 to 60cm. By application of this semiempirical method - originally developed for teletherapy dosimetry - it has been shown that factor kQ,M is closely correlated with a single variable, the fluence-weighted mean photon energy ĒF at the point of measurement. The radial profiles of ĒF obtained with either the commercial (192)Ir source or the two simplified source variants show little variation. The observed correlations between parameters kQ,M and ĒF are represented by fitting formulae for all investigated detectors, and further variation of the detector type is foreseen. The herewith established close correlation of radiation quality correction factor kQ,M with local mean photon energy ĒF can be regarded as a simple regularity, facilitating the practical application of correction factor kQ,M for in-phantom dosimetry around (192)Ir brachytherapy sources. ĒF values can be assessed by Monte Carlo simulation or measurement. A technique describing the local measurement of ĒF will be published separately.

Effect of improved TLD dosimetry on the determination of dose rate constants for (125)I and (103)Pd brachytherapy seeds

PURPOSE

To more accurately account for the relative intrinsic energy dependence and relative absorbed-dose energy dependence of TLDs when used to measure dose rate constants (DRCs) for (125)I and (103)Pd brachytherapy seeds, to thereby establish revised "measured values" for all seeds and compare the revised values with Monte Carlo and consensus values.

METHODS

The relative absorbed-dose energy dependence, f(rel), for TLDs and the phantom correction, Pphant, are calculated for (125)I and (103)Pd seeds using the EGSnrc BrachyDose and DOSXYZnrc codes. The original energy dependence and phantom corrections applied to DRC measurements are replaced by calculated (f(rel))(-1) and Pphant values for 24 different seed models. By comparing the modified measured DRCs to the MC values, an appropriate relative intrinsic energy dependence, kbq (rel), is determined. The new Pphant values and relative absorbed-dose sensitivities, SAD (rel), calculated as the product of (f(rel))(-1) and (kbq (rel))(-1), are used to individually revise the measured DRCs for comparison with Monte Carlo calculated values and TG-43U1 or TG-43U1S1 consensus values.

RESULTS

In general, f(rel) is sensitive to the energy spectra and models of the brachytherapy seeds. Values may vary up to 8.4% among (125)I and (103)Pd seed models and common TLD shapes. Pphant values depend primarily on the isotope used. Deduced (kbq (rel))(-1) values are 1.074 ± 0.015 and 1.084 ± 0.026 for (125)I and (103)Pd seeds, respectively. For (1 mm)(3) chips, this implies an overall absorbed-dose sensitivity relative to (60)Co or 6 MV calibrations of 1.51 ± 1% and 1.47 ± 2% for (125)I and (103)Pd seeds, respectively, as opposed to the widely used value of 1.41. Values of Pphant calculated here have much lower statistical uncertainties than literature values, but systematic uncertainties from density and composition uncertainties are significant. Using these revised values with the literature's DRC measurements, the average discrepancies between revised measured values and Monte Carlo values are 1.2% and 0.2% for (125)I and (103)Pd seeds, respectively, compared to average discrepancies for the original measured values of 4.8%. On average, the revised measured values are 4.3% and 5.9% lower than the original measured values for (103)Pd and (125)I seeds, respectively. The average of revised DRCs and Monte Carlo values is 3.8% and 2.8% lower for (125)I and (103)Pd seeds, respectively, than the consensus values in TG-43U1 or TG-43U1S1.

CONCLUSIONS

This work shows that f(rel) is TLD shape and seed model dependent suggesting a need to update the generalized energy response dependence, i.e., relative absorbed-dose sensitivity, measured 25 years ago and applied often to DRC measurements of (125)I and (103)Pd brachytherapy seeds. The intrinsic energy dependence for LiF TLDs deduced here is consistent with previous dosimetry studies and emphasizes the need to revise the DRC consensus values reported by TG-43U1 or TG-43U1S1.

Measurement of absorbed dose to water around an electronic brachytherapy source. Comparison of two dosimetry systems: lithium formate EPR dosimeters and radiochromic EBT2 film

Interest in high dose rate (HDR) electronic brachytherapy operating at 50 kV is increasing. For quality assurance it is important to identify dosimetry systems that can measure the absorbed doses in absolute terms which is difficult in this energy region. In this work a comparison is made between two dosimetry systems, EPR lithium formate dosimeters and radiochromic EBT2 film. Both types of dosimeters were irradiated simultaneously in a PMMA phantom using the Axxent EBS. Absorbed dose to water was determined at distances of 10 mm, 30 mm and 50 mm from the EBS. Results were traceable to different primary standards as regards to absorbed dose to water (EPR) and air kerma (EBT2). Monte Carlo simulations were used in absolute terms as a third estimate of absorbed dose to water. Agreement within the estimated expanded (k = 2) uncertainties (5% (EPR), 7% (EBT2)) was found between the results at 30 mm and 50 mm from the x-ray source. The same result was obtained in 4 repetitions of irradiation, indicating high precision in the measurements with both systems. At all distances, agreement between EPR and Monte Carlo simulations was shown as was also the case for the film measurements at 30mm and 50mm. At 10mm the geometry for the film measurements caused too large uncertainty in measured values depending on the exact position (within sub-mm distances) of the EBS and the 10 mm film results were exculded from comparison. This work has demonstrated good performance of the lithium formate EPR dosimetry system in accordance with earlier experiments at higher photon energies ((192)Ir HDR brachytherapy). It was also highlighted that there might be issues regarding the energy dependence and intrinsic efficiency of the EBT2 film that need to be considered for measurements using low energy sources.

Calculation of the TLD700:LiF energy response from Ir-192 using novel Monte Carlo and empirical methods

Lithium fluoride thermoluminescent dosimeters (TLDs) exhibit a dependence on the energy of the radiation beam of interest so need to be carefully calibrated for different energy spectra if used for clinical radiation oncology beam dosimetry and quality assurance. TLD energy response was investigated for a specific set of TLD700:LiF(Mg,Ti) chips for a high dose rate (192)Ir brachytherapy source. A novel method of energy response calculation for (192)Ir was developed where dose was determined through Monte Carlo modelling in Geant4. The TLD response was then measured experimentally. Results showed that TLD700 has a depth dependent response in water ranging from 1.170 ± 0.125 at 20 mm to 0.976 ± 0.043 at 50 mm (normalised to a nominal 6 MV beam response). The method of calibration and Monte Carlo data developed through this study could be easily applied by other Medical Physics departments seeking to use TLDs for (192)Ir patient dosimetry or treatment planning system experimental verification.

Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study

OBJECTIVES

The objective of this study was to compare the performance of metal oxide semiconductor field-effect transistor (MOSFET) technology dosemeters with thermoluminescent dosemeters (TLDs) (TLD 100; Thermo Fisher Scientific, Waltham, MA) in the maxillofacial area.

METHODS

Organ and effective dose measurements were performed using 40 TLD and 20 MOSFET dosemeters that were alternately placed in 20 different locations in 1 anthropomorphic RANDO(®) head phantom (the Phantom Laboratory, Salem, NY). The phantom was exposed to four different CBCT default maxillofacial protocols using small (4 × 5 cm) to full face (20 × 17 cm) fields of view (FOVs).

RESULTS

The TLD effective doses ranged between 7.0 and 158.0 µSv and the MOSFET doses between 6.1 and 175.0 µSv. The MOSFET and TLD effective doses acquired using four different (FOV) protocols were as follows: face maxillofacial (FOV 20 × 17 cm) (MOSFET, 83.4 µSv; TLD, 87.6 µSv; -5%); teeth, upper jaw (FOV, 8.5 × 5.0 cm) (MOSFET, 6.1 µSv; TLD, 7.0 µSv; -14%); tooth, mandible and left molar (FOV, 4 × 5 cm) (MOSFET, 10.3 µSv; TLD, 12.3 µSv; -16%) and teeth, both jaws (FOV, 10 × 10 cm) (MOSFET, 175 µSv; TLD, 158 µSv; +11%). The largest variation in organ and effective dose was recorded in the small FOV protocols.

CONCLUSIONS

Taking into account the uncertainties of both measurement methods and the results of the statistical analysis, the effective doses acquired using MOSFET dosemeters were found to be in good agreement with those obtained using TLD dosemeters. The MOSFET dosemeters constitute a feasible alternative for TLDs for the effective dose assessment of CBCT devices in the maxillofacial region.

Using LiF:Mg,Cu,P TLDs to estimate the absorbed dose to water in liquid water around an 192Ir brachytherapy source

PURPOSE

The absorbed dose to water is the fundamental reference quantity for brachytherapy treatment planning systems and thermoluminescence dosimeters (TLDs) have been recognized as the most validated detectors for measurement of such a dosimetric descriptor. The detector response in a wide energy spectrum as that of an (192)Ir brachytherapy source as well as the specific measurement medium which surrounds the TLD need to be accounted for when estimating the absorbed dose. This paper develops a methodology based on highly sensitive LiF:Mg,Cu,P TLDs to directly estimate the absorbed dose to water in liquid water around a high dose rate (192)Ir brachytherapy source.

METHODS

Different experimental designs in liquid water and air were constructed to study the response of LiF:Mg,Cu,P TLDs when irradiated in several standard photon beams of the LNE-LNHB (French national metrology laboratory for ionizing radiation). Measurement strategies and Monte Carlo techniques were developed to calibrate the LiF:Mg,Cu,P detectors in the energy interval characteristic of that found when TLDs are immersed in water around an (192)Ir source. Finally, an experimental system was designed to irradiate TLDs at different angles between 1 and 11 cm away from an (192)Ir source in liquid water. Monte Carlo simulations were performed to correct measured results to provide estimates of the absorbed dose to water in water around the (192)Ir source.

RESULTS

The dose response dependence of LiF:Mg,Cu,P TLDs with the linear energy transfer of secondary electrons followed the same variations as those of published results. The calibration strategy which used TLDs in air exposed to a standard N-250 ISO x-ray beam and TLDs in water irradiated with a standard (137)Cs beam provided an estimated mean uncertainty of 2.8% (k = 1) in the TLD calibration coefficient for irradiations by the (192)Ir source in water. The 3D TLD measurements performed in liquid water were obtained with a maximum uncertainty of 11% (k = 1) found at 1 cm from the source. Radial dose values in water were compared against published results of the American Association of Physicists in Medicine and the European Society for Radiotherapy and Oncology and no significant differences (maximum value of 3.1%) were found within uncertainties except for one position at 9 cm (5.8%). At this location the background contribution relative to the TLD signal is relatively small and an unexpected experimental fluctuation in the background estimate may have caused such a large discrepancy.

CONCLUSIONS

This paper shows that reliable measurements with TLDs in complex energy spectra require a study of the detector dose response with the radiation quality and specific calibration methodologies which model accurately the experimental conditions where the detectors will be used. The authors have developed and studied a method with highly sensitive TLDs and contributed to its validation by comparison with results from the literature. This methodology can be used to provide direct estimates of the absorbed dose rate in water for irradiations with HDR (192)Ir brachytherapy sources.