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Das IJ, Francescon P, Moran JM, Ahnesjö A, Aspradakis MM, Cheng CW, Ding GX, Fenwick JD, Saiful Huq M, Oldham M, Reft CS, Sauer OA. Report of AAPM Task Group 155: Megavoltage photon beam dosimetry in small fields and non-equilibrium conditions. Med Phys 2021; 48:e886-e921. [PMID: 34101836 DOI: 10.1002/mp.15030] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/06/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022] Open
Abstract
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.
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Affiliation(s)
- Indra J Das
- Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paolo Francescon
- Department of Radiation Oncology, Ospedale Di Vicenza, Vicenza, Italy
| | - Jean M Moran
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Anders Ahnesjö
- Medical Radiation Sciences, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Maria M Aspradakis
- Institute of Radiation Oncology, Cantonal Hospital of Graubünden, Chur, Switzerland
| | - Chee-Wai Cheng
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - George X Ding
- Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - John D Fenwick
- Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - M Saiful Huq
- Department of Radiation Oncology, University of Pittsburgh, School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Mark Oldham
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Chester S Reft
- Department of Radiation Oncology, University of Chicago, Chicago, IL, USA
| | - Otto A Sauer
- Department of Radiation Oncology, Klinik fur Strahlentherapie, University of Würzburg, Würzburg, Germany
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Narayanasamy G, Cruz W, Papanikolaou N, Stathakis S. Comparison between measured tissue phantom ratio values and calculated from percent depth doses with and without peak scatter correction factor in a 6 MV beam. INTERNATIONAL JOURNAL OF CANCER THERAPY AND ONCOLOGY 2015. [DOI: 10.14319/ijcto.0302.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lárraga-Gutiérrez JM, García-Hernández D, García-Garduño OA, Galván de la Cruz OO, Ballesteros-Zebadúa P, Esparza-Moreno KP. Evaluation of the Gafchromic® EBT2 film for the dosimetry of radiosurgical beams. Med Phys 2012; 39:6111-7. [DOI: 10.1118/1.4752211] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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