Measuring output factors of small fields formed by collimator jaws and multileaf collimator using plastic scintillation detectors

Effect of Detector Orientation and Influence of Jaw Position in the Determination of Small-field Output Factor with Various Detectors for High-energy Photon Beams

Background

Accurate dose measurements are difficult in small fields due to charge particle disequilibrium, partial source occlusion, steep dose gradient, and the finite size of the detector.

Aim

The study aims to determine the output factor using various detectors oriented in parallel and perpendicular orientations for three different tertiary collimating systems using 15 MV photon beams. In addition, this study analyzes how the output factor could be affected by different configurations of X and Y jaws above the tertiary collimators.

Materials and Methods

Small field output factor measurements were carried out with three detectors for different tertiary collimating systems such as BrainLab stereotactic cones, BrainLab mMLC and Millennium MLC namely. To analyze the effect of jaw position on output factor, measurements have been carried out by positioning the jaws at the edge, 0.25, 0.5, and 1.0 cm away from the tertiary collimated field.

Results

The data acquired with 15 MV photon beams show significant differences in output factor obtained with different detectors for all collimating systems. For smaller fields when compared to microDiamond, the SRS diode underestimates the output by up to -1.7% ± 0.8% and -2.1% ± 0.3%, and the pinpoint ion chamber underestimates the output by up to -8.1% ± 1.4% and -11.9% ± 1.9% in their parallel and perpendicular orientation respectively. A large increase in output factor was observed in the small field when the jaw was moved 0.25 cm symmetrically away from the tertiary collimated field.

Conclusion

The investigated data on the effect of jaw position inferred that the position of the X and Y jaw highly influences the output factors of the small field. It also confirms that the output factor highly depends on the configuration of X and Y jaw settings, the tertiary collimating system as well as the orientation of the detectors in small fields.

Small field output factor measurement and verification for CyberKnife robotic radiotherapy and radiosurgery system using 3D polymer gel, ionization chamber, diode, diamond and scintillator detectors, Gafchromic film and Monte Carlo simulation

The dosimetry of small fields has become tremendously important with the advent of intensity-modulated radiation therapy (IMRT) and stereotactic radiosurgery, where small field segments or very small fields are used to treat tumors. With high dose gradients in the stereotactic radiosurgery or radiotherapy treatment, small field dosimetry becomes challenging due to the lack of lateral electronic equilibrium in the field, x-ray source occlusion, and detector volume averaging. Small volume and tissue-equivalent detectors are recommended to overcome the challenges. With the lack of a perfect radiation detector, studies on available detectors are ongoing with reasonable disagreement and uncertainties. The joint IAEA and AAPM international code of practice (CoP) for small field dosimetry, TRS 483 (Alfonso et al., 2017) provides guidelines and recommendations for the dosimetry of small static fields in external beam radiotherapy. The CoP provides a methodology for field output factor (FOF) measurements and use of field output correction factors for a series of small field detectors and strongly recommends additional measurements, data collection and verification for CyberKnife (CK) robotic stereotactic radiotherapy/radiosurgery system using the listed detectors and more new detectors so that the FOFs can be implemented clinically. The present investigation is focused on using 3D gel along with some other commercially available detectors for the measurement and verification of field output factors (FOFs) for the small fields available in the CK system. The FOF verification was performed through a comparison with published data and Monte Carlo simulation. The results of this study have proved the suitability of an in-house developed 3D polymer gel dosimeter, several commercially available detectors, and Gafchromic films as a part of small field dosimetric measurements for the CK system.

Influence of Jaw Setting in the Determination of Stereotactic Small-Field Output Factors with Different Detectors

Background

The experimental determination of relative output factors presents the greatest challenge, especially for small fields with different detectors. The aim of this study is to evaluate the influence of jaw positions on small-field output factors for the fields defined by micro-multileaf collimator and circular cones with different detectors.

Materials and Methods

The stereotactic output factors were measured on Primus linear accelerator with BrainLab micro-multileaf collimator (mMLC) and circular cones as add-on tertiary collimators. Square field sizes ranging from 0.6 cm × 0.6 cm to 9.8 cm × 9.8 cm and circular fields of diameter ranging from 1.0 cm to 4.0 cm were defined by mMLC and circular cones, respectively. The influence of jaw position on output factor was assessed for different geometric configurations with three different detectors.

Results

The values obtained with PinPoint ion chamber were consistent with microDiamond detector for fields greater than 24 mm × 24 mm, but an underestimation of 23.9% was noticed in 6 mm x 6 mm field size. For the mMLC defined field size of 6 mm × 6 mm, when the X-Y jaw was moved from 8 mm × 8 mm to 80 mm × 80 mm, an increase in the output by a factor of 1.7 was observed with both microDiamond and stereotactic radiosurgery diode, whereas an increase in output by a factor of 1.9 was noticed with PinPoint ion chamber.

Conclusion

Output factors obtained with different detectors show high differences in the smallest field size for all collimating systems. This study confirms that the position of X and Y jaw above the tertiary collimator significantly influences the small-field output factor.

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.

SciFi detector and associated method for real-time determination of profile and output factor for small fields in stereotactic radiotherapy

PURPOSE

For determining small-field profile and output factor during stereotactic radiotherapy quality assurance (QA) procedures, we propose a novel system based on the scintillating fiber (SciFi) detector with output image acquisition and processing to allow real-time monitoring of profile and output factor.

MATERIALS AND METHODS

The employed detector is a SciFi detector made of tissue-equivalent scintillating plastic fibers arranged in 6-layer fiber ribbons with a fiber pitch of 275 μm in each layer. The scintillating signal at the detector output is acquired by a sCMOS (scientific complementary metal-oxide-semiconductor) camera and represents the projected field profile along the fibers axis. An iterative reconstruction method of the field from its projected profile based on a priori knowledge of some features of the radiation field defined by the stereotactic cones is suggested. The detector with implemented data processing has been tested in clinical conditions, for determining beam profiles and output factors, using cone collimators of different sizes from 4 to 15 mm diameter. The detector under test was placed at 1.4 cm depth and 98.6 cm source to surface distance (SSD) in a water-equivalent phantom and irradiated by a 6 MV photon beam.

RESULTS

The reconstructed field profiles obtained from the detector are coherent with data from EBT3 radiochromic films, with differences within ±0.32 mm for both the FWHM and the penumbra region. For real-time determination of the field output factor, the measured data are also in good agreement with data independently determined by the French Institute for Radiological Protection and Nuclear Safety (IRSN) based on radiochromic films and thermoluminescent 1 × 1 mm2 micro-cubes dosimeters (TLD). The differences are within ±1.6% for all the tested cone sizes.

CONCLUSIONS

We propose and have tested a SciFi plastic scintillating detector with an optimized signal processing method to characterize small fields defined by cone collimators. It allows the determination of key field parameters such as full width at half maximum (FWHM) and field output factors. The results are consistent with those independently measured using TLD and radiochromic films. As the SciFi detector does not require a correction factor, it is in line with the International Atomic Energy Agency (IAEA) and the American Association of Physicists in Medicine (AAPM) TRS-483 recommendations, and can be suitable for online QA of small radiation fields used in photon beam radiotherapy, and is compatible with MRI-LINAC.

Quality assurance for Gamma Knife Perfexion using the Exradin W1 plastic scintillation detector and Lucy phantom

The goal of this work is to validate the use of the Exradin W1 plastic scintillation detector (PSD) to measure profiles and output factors from Gamma Knife Perfexion collimators in a Lucy phantom. The Exradin W1 PSD has a small-volume, near-water-equivalent, energy-independent sensitive element. Output measurements were performed for all 3 collimators (4 mm, 8 mm, and 16 mm) of the Gamma Knife Perfexion system, and these measurements were compared to measurements made with an A16 ion chamber and an EBT3 film and to the nominal values. We showed that a configuration in which the focus or 'shot' moves while the detector remains fixed is essentially equivalent to a configuration in which the focus is fixed while the detector moves. A Lucy phantom containing a PSD was moved in small steps to acquire profiles in all three dimensions. EBT3 film was inserted in the Lucy phantom and exposed to a single shot for each collimator. The relative values for output factors measured with the PSD were 1.000, 0.892, and 0.795, for the 16 mm, 8 mm, and 4 mm collimators, respectively. The values measured with EBT3 film were 1.000, 0.881, and 0.793, and the values measured with the A16 ion chamber were 1.000, 0.883, and 0.727. The nominal output factors for the Gamma Knife Perfexion are 1.000, 0.900, and 0.814, respectively. There was excellent agreement between all profiles measured with the PSD and EBT3 as well as with the treatment planning system data provided by the vendor. In light of our results, the Exradin W1 PSD is well suited for beam quality assurance of a Gamma Knife Perfexion irradiator.

In vivo surface dosimetry with a scintillating fiber dosimeter in preclinical image-guided radiotherapy

PURPOSE

New preclinical image-guided irradiators and treatment planning systems represent a huge progress in radiobiology. Nevertheless, quality control of preclinical treatments is not as advanced as in clinical radiotherapy and in vivo dosimetry is less developed. In this study, we evaluate the use of a scintillating fiber dosimeter called DosiRat to verify the agreement between the doses planned with SmART-Plan and the measured doses during small animal irradiations.

METHODS

In vivo dosimetry was first evaluated with DosiRat through dose measurements performed at the surface of a 3 × 9 × 3 cm³ phantom. Measured and planned doses were compared for different irradiation conditions (prescription point, anterior, and posterior beams, 5 mm and 10 mm irradiation fields). In a second phase, measured and planned doses were compared for rat brain irradiations performed with anterior beams, with DosiRat positioned at the beam entrance. Comparisons were performed for different tube currents (1.3 and 13 mA), collimations (5, 10 and 25 mm diameter), and planned doses (0.1, 0.5, 2, and 10 Gy).

RESULTS

In the case of the phantom irradiations, planned and measured doses showed discrepancies smaller than the 5% accuracy of the TPS, except in cases in which the dosimeter was not centered in the irradiation field. The differences were larger for animal irradiations (from -3.3% to 8.8%) because of variations of the beam energy spectrum and the nonequivalence between materials at medium and low energy.

CONCLUSIONS

This study highlighted the complexity to implement one-dimension in vivo dosimetry in orthovoltage millimetric beams. Nevertheless, DosiRat is well adapted to in vivo dosimetry because of its small volume and its direct reading and allowed in vivo control of planned doses for anterior beams down to 5 mm diameter.

[Characterization of Small Volume Plastic Scintillation Detector]

Some radiation detectors are used for quality assurance and measured to radiation dose for high precision external beam radiotherapy. Recently, plastic scintillation detectors for MeV X-ray measurement are commercially released. The purpose of this study was to evaluate the performance of a commercial plastic scintillation detector with respect to the dose linearity, dose rate dependence, and the output coefficient compared the ionization chamber and the semiconductor detector using each different X-ray energy with or without flattening filter. The result that the dose linearity of each detector showed a linear response in any detectors. Dose rate dependence of plastic scintillation detector was increased when setting dose rate was changed, especially setting to low dose rate. The output coefficient of plastic scintillation detector was equivalent as that of the semiconductor detector even in smallest irradiation field. In conclusion, it was suggested that the plastic scintillation detector is a suitable detector in dose verification measurements for high precision external beam radiotherapy, although we must be with care to low dose rate measurements.

Different Dosimeters/Detectors Used in Small-Field Dosimetry: Pros and Cons

With the advent of complex and precise radiation therapy techniques, the use of relatively small fields is needed. Using such field sizes can cause uncertainty in dosimetry; therefore, special attention is required both in dose calculations and measurements. There are several challenges in small-field dosimetry such as the steep gradient of the radiation field, volume averaging effect, lack of charged particle equilibrium, partial occlusion of radiation source, beam alignment, and unable to use a reference dosimeter. Due to these challenges, special dosimeters are needed for small-field dosimetry, and this review article discusses this topic.

Effect of Magnetic Field Strength on Plastic Scintillation Detector Response

Purpose

To characterize the response of plastic scintillation detectors (PSDs) to high-energy photon radiation as a function of magnetic field strength.

Materials and Methods

PSDs were placed inside a plastic phantom held at the center point between 2 magnets and irradiated using a 6-MV photon beam from a linear accelerator. The magnetic field was varied from 0 T to 1.5 T by 0.3-T increments. The light emission and stem-effect-corrected response as a function of magnetic field strength were obtained for both a commercial PSD (Exradin W1, Standard Imaging) and an in-house hyperspectral PSD. Spectral signatures were obtained for the in-house PSD, and light emission from a bare fiber was also measured.

Results

Light emission increased as magnetic field strength increased for all detectors tested. The tested PSDs exhibited an increase in light intensity of 10% to 20%, mostly owing to the increase in Cerenkov light produced within and transmitted along the optical fiber. When corrected for stem effects, the increase in PSD response went down to 2.4% for both detectors. This most likely represents the change in the inherent dose deposition within the phantom.

Conclusion

PSDs with a suitable stem-effect removal approach were less dependent on magnetic field strength and had better water equivalence than did ion chambers tested in previous studies. PSDs therefore show great promise for use in both quality assurance and in-vivo dosimetry applications in a magnetic field environment.

A 3D correction method for predicting the readings of a PinPoint chamber on the CyberKnife® M6™ machine

The use of small fields in radiation therapy techniques has increased substantially in particular in stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). However, as field size reduces further still, the response of the detector changes more rapidly with field size, and the effects of measurement uncertainties become increasingly significant due to the lack of lateral charged particle equilibrium, spectral changes as a function of field size, detector choice, and subsequent perturbations of the charged particle fluence. This work presents a novel 3D dose volume-to-point correction method to predict the readings of a 0.015 cc PinPoint chamber (PTW 31014) for both small static-fields and composite-field dosimetry formed by fixed cones on the CyberKnife^® M6^™ machine. A 3D correction matrix is introduced to link the 3D dose distribution to the response of the PinPoint chamber in water. The parameters of the correction matrix are determined by modeling its 3D dose response in circular fields created using the 12 fixed cones (5 mm-60 mm) on a CyberKnife^® M6^™ machine. A penalized least-square optimization problem is defined by fitting the calculated detector reading to the experimental measurement data to generate the optimal correction matrix; the simulated annealing algorithm is used to solve the inverse optimization problem. All the experimental measurements are acquired for every 2 mm chamber shift in the horizontal planes for each field size. The 3D dose distributions for the measurements are calculated using the Monte Carlo calculation with the MultiPlan^® treatment planning system (Accuray Inc., Sunnyvale, CA, USA). The performance evaluation of the 3D conversion matrix is carried out by comparing the predictions of the output factors (OFs), off-axis ratios (OARs) and percentage depth dose (PDD) data to the experimental measurement data. The discrepancy of the measurement and the prediction data for composite fields is also performed for clinical SRS plans. The optimization algorithm used for generating the optimal correction factors is stable, and the resulting correction factors were smooth in the spatial domain. The measurement and prediction of OFs agree closely with percentage differences of less than 1.9% for all the 12 cones. The discrepancies between the prediction and the measurement PDD readings at 50 mm and 80 mm depth are 1.7% and 1.9%, respectively. The percentage differences of OARs between measurement and prediction data are less than 2% in the low dose gradient region, and 2%/1 mm discrepancies are observed within the high dose gradient regions. The differences between the measurement and prediction data for all the CyberKnife based SRS plans are less than 1%. These results demonstrate the existence and efficiency of the novel 3D correction method for small field dosimetry. The 3D correction matrix links the 3D dose distribution and the reading of the PinPoint chamber. The comparison between the predicted reading and the measurement data for static small fields (OFs, OARs and PDDs) yield discrepancies within 2% for low dose gradient regions and 2%/1 mm for high dose gradient regions; the discrepancies between the predicted and the measurement data are less than 1% for all the SRS plans. The 3D correction method provides an access to evaluate the clinical measurement data and can be applied to non-standard composite fields intensity modulated radiation therapy point dose verification.

Technical Note: Evaluation of plastic scintillator detector for small field stereotactic patient-specific quality assurance

PURPOSE

To evaluate the performance of a commercial plastic scintillator detector (PSD) for small-field stereotactic patient-specific quality assurance (QA) measurements using flattening-filter-free beam.

METHODS

A total of 10 spherical targets [volume range: (0.03 cc-2 cc)] were planned with two techniques: (a) dynamic conformal arc (DCA-10 plans) and (b) volumetric modulated arc therapy (VMAT-10 plans). All plans were generated using Varian Eclipse treatment planning system, and AcurosXB v.13 algorithm in 1.0 mm grid size. Additionally, 14 previously treated cranial and spine SRS plans were evaluated [6 DCA, 8 VMAT, volume range: (0.04 cc-119.02 cc)]. Plan modulation was quantified via two metrics: MU per prescription dose (MU/Rx) and Average Leaf Pair Opening (ALPO). QA was performed on the Varian Edge linear accelerator equipped with HDMLC. Three detectors were used: (a) PinPoint ion chamber (PTW; active volume 0.015 cc), (b) Exradin W1 PSD (Standard Imaging; active volume 0.002 cc), and (c) Gafchromic EBT3 film (Ashland). PinPoint chamber and PSD were positioned perpendicular to beam axis in a Lucy phantom (Standard Imaging); films were placed horizontally capturing the coronal plane.

RESULTS

PSD, film, and PinPoint chamber measured average differences of 1.00 ± 1.54%, 1.30 ± 1.69%, and -0.66 ± 2.36%, respectively, compared to AcurosXB dose calculation. As the target volume decreased, PinPoint chamber measured lower doses (maximum -5.07% at 0.07 cc target), while PSD and film measured higher doses (2.87% and 2.54% at 0.03 cc target) than AcurosXB. Film agreed with the benchmark detector PSD by an average difference of 0.31 ± 1.20%, but suffered from larger uncertainty; PinPoint chamber underestimated dose by more than 4% for targets smaller than 0.2 cc. Taking PSD as the measurement standard, DCA plans achieved good QA results across all volumes studied, with an average of -0.07 ± 0.89%; for VMAT plans, PSD measured consistently higher dose (1.95 ± 1.36%) than AcurosXB. Correlation study revealed that plan modulation quantified by both MU/Rx and ALPO correlated significantly with QA results.

CONCLUSION

Among all three detectors, PSD demonstrated superior performances in plans with small fields and heavy modulation. High consistency and low uncertainty made PSD a suitable detector for clinical routine SRS QA. PinPoint chamber should be avoided for targets smaller than 0.2 cc; film dosimetry can be utilized with careful evaluation of its uncertainty bracket. Compared to PSD measurements, AcurosXB calculation demonstrated high accuracy for nonmodulated small fields. The positive correlation between plan modulation and QA discrepancy calls for our attention for clinical SRS plans with high modulation.

Investigating the Electronic Portal Imaging Device for Small Radiation Field Measurements

Purpose:

With the advent of state-of-the-art treatment technologies, the use of small fields has increased, and dosimetry in small fields is highly challenging. In this study, the potential use of Varian electronic portal imaging device (EPID) for small field measurements was explored for 6 and 15 MV photon beams.

Materials and Methods:

The output factors and profiles were measured for a range of jaw-collimated square field sizes starting from 0.8 cm × 0.8 cm to 10 cm × 10 cm using EPID. For evaluation purpose, reference data were acquired using Exradin A16 microionization chamber (0.007 cc) for output factors and stereotactic field diode for profile measurements in a radiation field analyzer.

Results:

The output factors of EPID were in agreement with the reference data for field sizes down to 2 cm × 2 cm and for 2 cm × 2 cm; the difference in output factors was +2.06% for 6 MV and +1.56% for 15 MV. For the lowest field size studied (0.8 cm × 0.8 cm), the differences were maximum; +16% for 6 MV and +23% for 15 MV photon beam. EPID profiles of both energies were closely matching with reference profiles for field sizes down to 2 cm × 2 cm; however, penumbra and measured field size of EPID profiles were slightly lower compared to its counterpart.

Conclusions:

EPID is a viable option for profile and output factor measurements for field sizes down to 2 cm × 2 cm in the absence of appropriate small field dosimeters.

Stereotactic radiosurgery alone for multiple brain metastases? A review of clinical and technical issues

Over the past three decades several randomized trials have enabled evidence-based practice for patients presenting with limited brain metastases. These trials have focused on the role of surgery or stereotactic radiosurgery (SRS) with or without whole brain radiation therapy (WBRT). As a result, it is clear that local control should be optimized with surgery or SRS in patients with optimal prognostic factors presenting with up to 4 brain metastases. The routine use of adjuvant WBRT remains debatable, as although greater distant brain control rates are observed, there is no impact on survival, and modern outcomes suggest adverse effects from WBRT on patient cognition and quality of life. With dramatic technologic advances in radiation oncology facilitating the adoption of SRS into mainstream practice, the optimal management of patients with multiple brain metastases is now being put forward. Practice is evolving to SRS alone in these patients despite a lack of level 1 evidence to support a clinical departure from WBRT. The purpose of this review is to summarize the current state of the evidence for patients presenting with limited and multiple metastases, and to present an in-depth analysis of the technology and dosimetric issues specific to the treatment of multiple metastases.

Small field dose measurements using plastic scintillation detector in heterogeneous media

PURPOSE

The purpose of this study was to evaluate a plastic scintillation detector for the measurement of small field dosimetry and to verify the accuracy of measured dose in comparison with Monte Carlo calculation in a heterogeneous medium.

METHODS

The study is performed with CyberKnife planning and delivery system. The setup consists of a custom made solid lung phantom with the insert of an Exradin W1 scintillation detector or an Exradin A16 ion chamber. The measurement was done for a series of cone sizes from 5 mm to 60 mm, and the dose was calculated by Monte Carlo algorithm in MultiPlan workstation. The difference between measurement and calculation was reported.

RESULTS

Our preliminary results demonstrated the applicability of plastic scintillation detectors in the measurement of small field dosimetry in a heterogeneous medium. The difference between the calculated and measured output factors was less than 3% for all cone sizes from 60 mm down to 5 mm. Without any corrections, the measured dose from the scintillation detector calibrated to the ion chamber reading was also within 3% of the Monte Carlo calculation in the lung phantom for cone sizes 20 mm or larger.

CONCLUSIONS

Small field dosimetry is particularly relevant to stereotactic radiation treatment. The accuracy of dose calculation for small static beams is critical to dose planning so would potentially affect the treatment outcomes in a heterogeneous medium. Our results have shown good agreement with plastic scintillation detector in both homogeneous and heterogeneous medium.

Measurement of Total Scatter Factor for Stereotactic Cones with Plastic Scintillation Detector

Advanced radiotherapy modalities such as stereotactic radiosurgery (SRS) and image-guided radiotherapy may employ very small beam apertures for accurate localized high dose to target. Accurate measurement of small radiation fields is a well-known challenge for many dosimeters. The purpose of this study was to measure total scatter factors for stereotactic cones with plastic scintillation detector and its comparison against diode detector and theoretical estimates. Measurements were performed on Novalis Tx^™ linear accelerator for 6MV SRS beam with stereotactic cones of diameter 6 mm, 7.5 mm, 10 mm, 12.5 mm, and 15 mm. The advantage of plastic scintillator detector is in its energy dependence. The total scatter factor was measured in water at the depth of dose maximum. Total scatter factor with plastic scintillation detector was determined by normalizing the readings to field size of 10 cm × 10 cm. To overcome energy dependence of diode detector for the determination of scatter factor with diode detector, daisy chaining method was used. The plastic scintillator detector was calibrated against the ionization chamber, and the reproducibility in the measured doses was found to be within ± 1%. Total scatter factor measured with plastic scintillation detector was 0.728 ± 0.3, 0.783 ± 0.05, 0.866 ± 0.55, 0.885 ± 0.5, and 0.910 ± 0.06 for cone sizes of 6 mm, 7.5 mm, 10 mm, 12.5 mm, and 15 mm, respectively. Total scatter factor measured with diode detector was 0.733 ± 0.03, 0.782 ± 0.02, 0.834 ± 0.07, 0.854 ± 0.02, and 0.872 ± 0.02 for cone sizes of 6 mm, 7.5 mm, 10 mm, 12.5 mm, and 15 mm, respectively. The variation in the measurement of total scatter factor with published Monte Carlo data was found to be −1.3%, 1.9%, −0.4%, and 0.4% for cone sizes of 7.5 mm, 10 mm, 12.5 mm, and 15 mm, respectively. We conclude that total scatter factor measurements for stereotactic cones can be adequately carried out with a plastic scintillation detector. Our results show a high level of consistency within our data and compared well with published data.

Development of a Small-Sized, Flexible, and Insertable Fiber-Optic Radiation Sensor for Gamma-Ray Spectroscopy

We fabricated a small-sized, flexible, and insertable fiber-optic radiation sensor (FORS) that is composed of a sensing probe, a plastic optical fiber (POF), a photomultiplier tube (PMT)-amplifier system, and a multichannel analyzer (MCA) to obtain the energy spectra of radioactive isotopes. As an inorganic scintillator for gamma-ray spectroscopy, a cerium-doped lutetium yttrium orthosilicate (LYSO:Ce) crystal was used and two solid-disc type radioactive isotopes with the same dimensions, cesium-137 (Cs-137) and cobalt-60 (Co-60), were used as gamma-ray emitters. We first determined the length of the LYSO:Ce crystal considering the absorption of charged particle energy and measured the gamma-ray energy spectra using the FORS. The experimental results demonstrated that the proposed FORS can be used to discriminate species of radioactive isotopes by measuring their inherent energy spectra, even when gamma-ray emitters are mixed. The relationship between the measured photon counts of the FORS and the radioactivity of Cs-137 was subsequently obtained. The amount of scintillating light generated from the FORS increased by increasing the radioactivity of Cs-137. Finally, the performance of the fabricated FORS according to the length and diameter of the POF was also evaluated. Based on the results of this study, it is anticipated that a novel FORS can be developed to accurately measure the gamma-ray energy spectrum in inaccessible locations such as narrow areas and holes.

Variation of kQclin,Qmsr (fclin,fmsr) for the small-field dosimetric parameters percentage depth dose, tissue-maximum ratio, and off-axis ratio

PURPOSE

Evaluate the ability of different dosimeters to correctly measure the dosimetric parameters percentage depth dose (PDD), tissue-maximum ratio (TMR), and off-axis ratio (OAR) in water for small fields.

METHODS

Monte Carlo (MC) simulations were used to estimate the variation of kQclin,Qmsr (fclin,fmsr) for several types of microdetectors as a function of depth and distance from the central axis for PDD, TMR, and OAR measurements. The variation of kQclin,Qmsr (fclin,fmsr) enables one to evaluate the ability of a detector to reproduce the PDD, TMR, and OAR in water and consequently determine whether it is necessary to apply correction factors. The correctness of the simulations was verified by assessing the ratios between the PDDs and OARs of 5- and 25-mm circular collimators used with a linear accelerator measured with two different types of dosimeters (the PTW 60012 diode and PTW PinPoint 31014 microchamber) and the PDDs and the OARs measured with the Exradin W1 plastic scintillator detector (PSD) and comparing those ratios with the corresponding ratios predicted by the MC simulations.

RESULTS

MC simulations reproduced results with acceptable accuracy compared to the experimental results; therefore, MC simulations can be used to successfully predict the behavior of different dosimeters in small fields. The Exradin W1 PSD was the only dosimeter that reproduced the PDDs, TMRs, and OARs in water with high accuracy. With the exception of the EDGE diode, the stereotactic diodes reproduced the PDDs and the TMRs in water with a systematic error of less than 2% at depths of up to 25 cm; however, they produced OAR values that were significantly different from those in water, especially in the tail region (lower than 20% in some cases). The microchambers could be used for PDD measurements for fields greater than those produced using a 10-mm collimator. However, with the detector stem parallel to the beam axis, the microchambers could be used for TMR measurements for all field sizes. The microchambers could not be used for OAR measurements for small fields.

CONCLUSIONS

Compared with MC simulation, the Exradin W1 PSD can reproduce the PDDs, TMRs, and OARs in water with a high degree of accuracy; thus, the correction used for converting dose is very close to unity. The stereotactic diode is a viable alternative because it shows an acceptable systematic error in the measurement of PDDs and TMRs and a significant underestimation in only the tail region of the OAR measurements, where the dose is low and differences in dose may not be therapeutically meaningful.

Temperature dependence of BCF plastic scintillation detectors

We examined temperature dependence in plastic scintillation detectors (PSDs) made of BCF-60 or BCF-12 scintillating fiber coupled to optical fiber with cyanoacrylate. PSDs were subjected to a range of temperatures using a temperature-controlled water bath and irradiated at each temperature while either the dose was measured using a CCD camera or the spectral output was measured using a spectrometer. The spectrometer was used to examine the intensity and spectral distribution of scintillation light emitted by the PSDs, Cerenkov light generated within the PSD, and light transmitted through an isolated optical coupling. BCF-60 PSDs exhibited a 0.50% decrease and BCF-12 PSDs a 0.09% decrease in measured dose per °C increase, relative to dose measured at 22 °C. Spectrometry revealed that the total intensity of the light generated by BCF-60 and BCF-12 PSDs decreased by 0.32% and 0.13%, respectively, per °C increase. The spectral distribution of the light changed slightly with temperature for both PSDs, accounting for the disparity between the change in measured dose and total light output. The generation of Cerenkov light was temperature independent. However, light transmitted through optical coupling between the scintillator and the optical fiber also exhibited temperature dependence.

A method to remove residual signals in fibre optic luminescence dosimeters

Whenever a fibre optic is used to convey a light signal through a radiation field, it is likely that an unwanted background signal will arise from Cerenkov or fluorescent light which will contaminate the signal. In luminescence dosimetry of high energy beams, when a fibre optic is used to convey the signal from the radiation field to the detector, Cerenkov light is the dominant contributor to the background signal and must be corrected for. In this work, a novel method is demonstrated to separate the signal from the unwanted background. A remotely operated shutter is used to block the signal, allowing the residual background in the fibre optic to be quantified. This background is subtracted from the total measurement acquired in a subsequent irradiation, enabling the luminescence signal to be extracted. Two types of shutter mechanism are considered: an electro-mechanical device to intercept the light path and an LCD device to block the light by cross-polarization. Both shutters were characterized and incorporated into a fibre optic dosimetry system used to measure the radiation dose produced by external beam radiation linear accelerators. The dosimeter using each of the shutters in turn was exposed to a 6 MV photon beam to determine their performance, including the measurement of field size dependent output factors. The mechanical shutter determined the output factors to within 0.29% of those measured with an ionization chamber, whereas the LCD shutter gave results that deviated by up to 2.4%. The switching precision of both shutters was good with standard deviations of less than 0.25% and both were able to completely block the light signal when closed. The use of shutters could therefore be applied to any fibre optic based system to quantify and remove a reproducible background arising from any source including ambient, fluorescent and Cerenkov light.

Determination of the quenching correction factors for plastic scintillation detectors in therapeutic high-energy proton beams

Plastic scintillation detectors (PSDs) have many advantages over other detectors in small field dosimetry due to their high spatial resolution, excellent water equivalence and instantaneous readout. However, in proton beams, the PSDs undergo a quenching effect which makes the signal level reduced significantly when the detector is close to the Bragg peak where the linear energy transfer (LET) for protons is very high. This study measures the quenching correction factor (QCF) for a PSD in clinical passive-scattering proton beams and investigates the feasibility of using PSDs in depth-dose measurements in proton beams. A polystyrene-based PSD (BCF-12, ϕ0.5 mm × 4 mm) was used to measure the depth-dose curves in a water phantom for monoenergetic unmodulated proton beams of nominal energies 100, 180 and 250 MeV. A Markus plane-parallel ion chamber was also used to get the dose distributions for the same proton beams. From these results, the QCF as a function of depth was derived for these proton beams. Next, the LET depth distributions for these proton beams were calculated by using the MCNPX Monte Carlo code, based on the experimentally validated nozzle models for these passive-scattering proton beams. Then the relationship between the QCF and the proton LET could be derived as an empirical formula. Finally, the obtained empirical formula was applied to the PSD measurements to get the corrected depth-dose curves and they were compared to the ion chamber measurements. A linear relationship between the QCF and LET, i.e. Birks' formula, was obtained for the proton beams studied. The result is in agreement with the literature. The PSD measurements after the quenching corrections agree with ion chamber measurements within 5%. PSDs are good dosimeters for proton beam measurement if the quenching effect is corrected appropriately.

Integral T-shaped phantom-dosimeter system to measure transverse and longitudinal dose distributions simultaneously for stereotactic radiosurgery dosimetry

A T-shaped fiber-optic phantom-dosimeter system was developed using square scintillating optical fibers, a lens system, and a CMOS image camera. Images of scintillating light were used to simultaneously measure the transverse and longitudinal distributions of absorbed dose of a 6 MV photon beam with field sizes of 1 × 1 and 3 × 3 cm². Each optical fiber has a very small sensitive volume and the sensitive material is water equivalent. This allows the measurements of cross-beam profile as well as the percentage depth dose of small field sizes. In the case of transverse dose distribution, the measured beam profiles were gradually become uneven and the beam edge had a gentle slope with increasing depth of the PMMA phantom. In addition, the maximum dose values of longitudinal dose distribution for 6 MV photon beam with field sizes of 1 × 1 and 3 × 3 cm² were found to be at a depth of approximately 15 mm and the percentage depth dose of both field sizes were nearly in agreement at the skin dose level. Based on the results of this study, it is anticipated that an all-in-one phantom-dosimeter can be developed to accurately measure beam profiles and dose distribution in a small irradiation fields prior to carrying out stereotactic radiosurgery.

Technical note: removing the stem effect when performing Ir-192 HDR brachytherapy in vivo dosimetry using plastic scintillation detectors: a relevant and necessary step

PURPOSE

The purpose of this study was to investigate whether or not a stem effect removal technique is necessary when performing Ir-192 HDR brachytherapy in vivo dosimetry using a scintillation detector.

METHODS

A red-green-blue photodiode connected to a multichannel electrometer was used to detect the light emitted from a plastic scintillation detector (PSD) during irradiation with an Ir-192 HDR brachytherapy source. Accuracy in dose measurement was compared with and without the use of stem effect removal techniques. Monochromatic and polychromatic filtration techniques were studied. An in-house template was built for accurate positioning of catheters in which the source and the PSD were inserted. Dose distribution was measured up to 5 cm from source to detector in the radial and longitudinal directions.

RESULTS

The authors found the stem effect to be particularly important when the source was close to the optical fiber guide and far from the scintillation component of the detector. It can account for up to (72 +/- 3)% of the signal under clinically relevant conditions. The polychromatic filtration outperformed the monochromatic filtration as well as the absence of filtration in regard to dose measurement accuracy.

CONCLUSIONS

It is necessary to implement a stem effect removal technique when building a PSD for in vivo dosimetry during Ir-192 HDR brachytherapy. The PSD that the authors have developed for this study would be suitable for such an application.

Study of the response of plastic scintillation detectors in small-field 6 MV photon beams by Monte Carlo simulations

PURPOSE

To investigate the response of plastic scintillation detectors (PSDs) in a 6 MV photon beam of various field sizes using Monte Carlo simulations.

METHODS

Three PSDs were simulated: A BC-400 and a BCF-12, each attached to a plastic-core optical fiber, and a BC-400 attached to an air-core optical fiber. PSD response was calculated as the detector dose per unit water dose for field sizes ranging from 10 x 10 down to 0.5 x 0.5 cm2 for both perpendicular and parallel orientations of the detectors to an incident beam. Similar calculations were performed for a CC01 compact chamber. The off-axis dose profiles were calculated in the 0.5 x 0.5 cm2 photon beam and were compared to the dose profile calculated for the CC01 chamber and that calculated in water without any detector. The angular dependence of the PSDs' responses in a small photon beam was studied.

RESULTS

In the perpendicular orientation, the response of the BCF-12 PSD varied by only 0.5% as the field size decreased from 10 x 10 to 0.5 x 0.5 cm2, while the response of BC-400 PSD attached to a plastic-core fiber varied by more than 3% at the smallest field size because of its longer sensitive region. In the parallel orientation, the response of both PSDs attached to a plastic-core fiber varied by less than 0.4% for the same range of field sizes. For the PSD attached to an air-core fiber, the response varied, at most, by 2% for both orientations.

CONCLUSIONS

The responses of all the PSDs investigated in this work can have a variation of only 1%-2% irrespective of field size and orientation of the detector if the length of the sensitive region is not more than 2 mm long and the optical fiber stems are prevented from pointing directly to the incident source.