EBT剂量胶片测量电子线百分深度剂量的应用研究

目的 研究EBT剂量胶片在临床电子线百分深度剂量(PDD)中的测量方法.方法 采用14.7 cm×5.1 cm的矩形射野,在同一张EBT胶片上进行5阶梯度的剂量刻度.应用上述刻度方法,针对4、6、8、10、12和15 MeV电子线,在小水箱中采用竖直和倾斜5°两种方式测量PDD,并与半导体探头的三维水箱扫描结果以及平行板电离室在小水箱中测量结果进行比较和分析°结果当剂量胶片上端与水面平齐时,EBT测量的PDD曲线与两种探头测量的结果具有较好一致性,并且倾斜和竖直测量两种方式无明显差异.当剂量胶片上端伸出水面时,在竖自测量方式下剂量建成区内测量结果明显低于其他测量结果,而倾斜测量方式下则无明显影响.结论 新的剂量刻度方式快捷可靠,可显著减少剂量胶片用量.在测量电子线PDD时建议将胶片倾斜一定角度进行,以便减小胶片上端与水面不平齐所引起的测量误差.     

EBT剂量胶片测量电子线百分深度剂量的应用研究

目的 研究EBT剂量胶片在临床电子线百分深度剂量(PDD)中的测量方法.方法 采用14.7 cm×5.1 cm的矩形射野,在同一张EBT胶片上进行5阶梯度的剂量刻度.应用上述刻度方法,针对4、6、8、10、12和15 MeV电子线,在小水箱中采用竖直和倾斜5°两种方式测量PDD,并与半导体探头的三维水箱扫描结果以及平行板电离室在小水箱中测量结果进行比较和分析°结果当剂量胶片上端与水面平齐时,EBT测量的PDD曲线与两种探头测量的结果具有较好一致性,并且倾斜和竖直测量两种方式无明显差异.当剂量胶片上端伸出水面时,在竖自测量方式下剂量建成区内测量结果明显低于其他测量结果,而倾斜测量方式下则无明显影响.结论 新的剂量刻度方式快捷可靠,可显著减少剂量胶片用量.在测量电子线PDD时建议将胶片倾斜一定角度进行,以便减小胶片上端与水面不平齐所引起的测量误差.     

EBT剂量胶片测量电子线百分深度剂量的应用研究

目的 研究EBT剂量胶片在临床电子线百分深度剂量(PDD)中的测量方法.方法 采用14.7 cm×5.1 cm的矩形射野,在同一张EBT胶片上进行5阶梯度的剂量刻度.应用上述刻度方法,针对4、6、8、10、12和15 MeV电子线,在小水箱中采用竖直和倾斜5°两种方式测量PDD,并与半导体探头的三维水箱扫描结果以及平行板电离室在小水箱中测量结果进行比较和分析°结果当剂量胶片上端与水面平齐时,EBT测量的PDD曲线与两种探头测量的结果具有较好一致性,并且倾斜和竖直测量两种方式无明显差异.当剂量胶片上端伸出水面时,在竖自测量方式下剂量建成区内测量结果明显低于其他测量结果,而倾斜测量方式下则无明显影响.结论 新的剂量刻度方式快捷可靠,可显著减少剂量胶片用量.在测量电子线PDD时建议将胶片倾斜一定角度进行,以便减小胶片上端与水面不平齐所引起的测量误差.     

基于水吸收剂量校准因子的高能光子束和电子束吸收剂量测定指南北大核心CSCD

医用电子直线加速器的吸收剂量校准是放射治疗质量控制最重要的内容之一,特别是当前普遍开展的精准放疗,对吸收剂量测定的精度提出了更高要求。基于水吸收剂量校准因子的吸收剂量测定规程,相对基于空气比释动能/照射量校准因子的吸收剂量测定规程,具有吸收剂量测定不确定度更小、无需量的转换计算、物理概念更简单、计算公式更简化等优势。本指南参考国内外相关标准,对医用直线加速器高能射束基于水吸收剂量校准因子的吸收剂量测定方法及相关要求作出了规定,为国内医疗机构基于水吸收剂量校准因子测定外照射高能光子束和高能电子束的吸收剂量提供指导,为精确放疗的广泛开展提供支持。     

The use of high density metal foils to increase surface dose in low-energy clinical electron beams.

BACKGROUND AND PURPOSE: This paper describes a practical method of elevating the surface dose of clinical electron beams in the energy range 3-12 MeV using thin high density metal foils (tin and lead) as an alternative to tissue equivalent bolus. Because, relative to water, these materials exhibit a high scattering power to stopping power ratio, the desired dose elevation may be achieved with less energy loss than conventional bolus and consequently a gain in therapeutic interval. METHODS: The foil thickness required to raise the surface dose to 90% off peak, for a given electron energy, was calculated using published scattering and stopping power data. An empirical expression is derived to facilitate calculation of foil thickness (tin or lead) to produce a given surface dose. RESULTS AND CONCLUSIONS: Measurements were made to confirm the predictions of the derived expression and were found to be in good agreement.     

The role of biologically effective dose (BED) in clinical oncology

There are many clinical situations in which radiobiological considerations can be usefully applied and all clinicians should be aware of the potential benefits of developing a quantitative radiobiological approach to their practice. The concept of biologically effective dose (BED) in particular is useful for quantifying treatment expectations, but clinical oncologists should recognize that careful interpretation of modelling results is required before clinical decisions can be made and that there is a lack of reliable human parameters for application in some situations. Correct use of the BED concept will, in more complex treatment situations, sometimes involve the use of multiple parameters and BED calculations. Examples include: 1. Where the dose per fraction is being altered and it is possible that normal tissue tolerance may be compromised, calculations should include two or more alpha/beta ratio values, some being less than 3 Gy, in order to estimate the 'worst case scenario'. 2. A single one-point BED calculation will not be representative of the biological effect throughout a large planning target volume where there are significant 'hot spots'. Multiple BED evaluations are then indicated. 3. Where there are combinations of radiotherapy treatments or phases of treatments, these can be quantitatively assessed by the addition of BEDs, although the volume of tissue is not inherently included in the BED calculation and any high-dose region needs to be separately assessed as in point 2. 4. Allowance for tumour clonogen repopulation during therapy is required for some tumour types. 5. Different histological classes of cancers require the use of different alpha/beta ratios. Where there is reasonable doubt regarding this parameter, a suitable range should be used. The principles involved are illustrated by worked examples. Attention to detail and the examination of ranges of possible results should offer a safer guide to alternative dose fractionation schedules, although the ultimate choice will be tempered by clinical circumstances.     

Experimental determination of depth-scaling factors and central axis depth dose for clinical electron beams

Depth-scaling factors rho(eff) for clear polystyrene and polymethylmethacrylate (PMMA) phantoms have been determined experimentally as a function of nominal electron-beam energy in the range 6 to 22 MeV. Values of rho(eff) have been calculated from the ratio rho(eff) = R(wat)(50) / R(med)(50), where R(wat)(50) and R(med)(50) are the measured depths of 50% ionization in electron solid water and plastic (clear polystyrene and PMMA) phantoms, respectively. Measurements were made using an Attix chamber in an electron solid water phantom, a Holt chamber in a clear polystyrene phantom, and a Markus chamber in a PMMA phantom. The average value of measured rho(poly)(eff) was found to be 0.999 +/- 0.009. This is higher than the value of 0.975 recommended by Task Group 25 (TG-25) of the American Association of Physicists in Medicine (AAPM) by 2.5%. Depending on energy, the maximum differences between the AAPM TG-25-recommended and the measured values lie in the range 1% to 3.5%. Similarly, the average value of measured rho(PMMA)(eff) was found to be 1.168 +/- 0.023. This is higher than the AAPM TG-25-recommended value of 1.115, by 5%. Depending on energy, the maximum differences between the AAPM TG-25-recommended and the measured values lie in the range 3% to 8%. Central axis depth dose curves in water were generated for 6, 15, and 20 MeV electron beams from measured depth-ionization data in PMMA and clear polystyrene phantoms following the recommendations of the AAPM TG-25 report and using both TG-25-recommended and experimentally determined values of depth-scaling factors rho(eff). For both phantoms, either the TG-25-recommended value or the experimentally determined values of rho(eff) yielded agreement to within about 2 mm among all depth doses in water at the depths of clinical relevance.     

Concept of depth dose functions for radiotherapy beams: definition and values for different energy beams.

Depth dose functions are defined and based on empirically observed interrelation of percent depth doses for different energy beams. By using this function, if the depth dose for a given source-surface distance (SSD), field size and depth are known for a standard beam energy, the corresponding depth dose for another beam energy can be derived. The results obtained are accurate to within ±1% in a considerable range of SSD, field size and depths used in routine radiotherapy. The formulation can be extended to hold at depths between the surface and depth of maximum but is somewhat less accurate than ±1% for depths up to two times the depth of maximum. This method is of considerable usefulness in computer dosimetry algorithms to save memory space and/or to increase speed by avoiding multiple table look up procedures. It is the particular importance in irregular field dose calculations for high energy beams where specific measured data for separation of primary and scatter components of dose are not available.     

New shielding materials for clinical electron beams

Since lead has recently been recognized as a source of environmental pollution, we have investigated new electron shielding materials that do not contain lead. We compared the shielding thicknesses of a hard plate and a sheet composed of the new materials with that of lead for electron beams. The shielding thickness was evaluated as the thickness required for shielding primary electrons. The comparison revealed the shielding ability of the hard plate and sheet is approximately equivalent to 1.0 and 0.9 times that of lead, respectively. The thickness (in millimeters) required for shielding by the hard-plate, as well as the thickness of lead, is related to approximately half of the electron-beam energy (in MeV). The shielding ability of the sheet is also equivalent to that of Lipowitz alloy. Moreover these materials are environmentally friendly, and can be easily customized into arbitrary shapes. Therefore they can be used as lead substitutes for shielding against electron beams.     

Monitor tables for electron beams in radiotherapy

The application of electron beams in radiotherapy is still based on tables of monitor units, although 3-D treatment planning systems for electron beams are available. This have several reasons: The need for 3-D treatment planning is not recognized; there is no confidence in the calculation algorithm; Monte-Carlo algorithms are too time-consuming; and the effort necessary to measure basic beam data for 3-D planning is considered disproportionate. However, the increasing clinical need for higher dosimetric precision and for more conformal electron beams leads to the requirement for more sophisticated tables of monitor units. The present paper summarizes and discusses the main aspects concerning the preparation of tables of monitor units for electron beams. The measurement equipment and procedures for measuring basic beam data needed for tables of monitor units for electron beams are described for a standard radiation therapy linac. The design of tables of monitor units for standard electron applicators is presented; this design can be extended for individual electron inserts, to variable applicator surface distances, to oblique beam incidence, and the use of bolus material. Typical data of an Elekta linac are presented in various tables.     

Benchmark measurements for lung dose corrections for X-ray beams

A well defined set of clinically relevant reference measurements for photon dose calculations in the presence of the lung have been provided. These benchmark data were mainly obtained in low-density (rho = 0.31 gcm-3) lunglike material as well as in waterlike plastic for 4 and 15 MV X-ray beams. Some additional measurements were performed with materials having a density of 0.015 gcm-3 and 0.18 gcm-3. Phantom geometries included simple layered geometries, finite lung cross section geometries, simulated mediastinum geometries, and simulated tumor in lung geometries. The data are reported as central axis depth doses. A number of parameters were varied, including the field size, the lung geometry, and the distance in and behind the lung.     

Proton beams to replace photon beams in radical dose treatments

With proton beam radiation therapy a smaller volume of normal tissues is irradiated at high dose levels for most anatomic sites than is feasible with any photon technique. This is due to the Laws of Physics, which determine the absorption of energy from photons and protons. In other words, the dose from a photon beam decreases exponentially with depth in the irradiated material. In contrast, protons have a finite range and that range is energy dependent. Accordingly, by appropriate distribution of proton energies, the dose can be uniform across the target and essentially zero deep to the target and the atomic composition of the irradiated material. The dose proximal to the target is lower compared with that in photon techniques, for all except superficial targets. This resultant closer approximation of the planning treatment volume (PTV) to the CTV/GTV (grossly evident tumor volume/subclinical tumor extensions) constitutes a clinical gain by definition; i.e. a smaller treatment volume that covers the target three dimensionally for the entirety of each treatment session provides a clinical advantage. Several illustrative clinical dose distributions are presented and the clinical outcome results are reviewed briefly. An important technical advance will be the use of intensity modulated proton radiation therapy, which achieves contouring of the proximal edge of the SOBP (spread out bragg peak) as well as the distal edge. This technique uses pencil beam scanning. To permit further progressive reductions of the PTV, 4-D treatment planning and delivery is required. The fourth dimension is time, as the position and contours of the tumor and the adjacent critical normal tissues are not constant. A potentially valuable new method for assessing the clinical merits of each of a large number of treatment plans is the evaluation of multidimensional plots of the complication probabilities for each of 'n' critical normal tissues/structures for a specified tumor control probability. The cost of proton therapy compared with that of very high technology photon therapy is estimated and evaluated. The differential is estimated to be ≈1.5 provided there were to be no charge for the original facility and that there were sufficient patients for operating on an extended schedule (6-7 days of 14-16 h) with ≥ two gantries and one fixed horizontal beam.     

Advanced kernel methods vs. Monte Carlo-based dose calculation for high energy photon beams

Purpose

The aim of this study was to compare the dose calculation accuracy of advanced kernel-based methods and Monte Carlo algorithms in commercially available treatment planning systems.

Materials and methods

Following dose calculation algorithms and treatment planning (TPS) systems were compared: the collapsed cone (CC) convolution algorithm available in Oncentra Masterplan, the XVMC Monte Carlo algorithm implemented in iPlan and Monaco, and the analytical anisotropic algorithm (AAA) implemented in Eclipse. Measurements were performed with a calibrated ionization chamber and radiochromic EBT type films in a homogenous polystyrene phantom and in heterogeneous lung phantoms. Single beam tests, conformal treatment plans and IMRT plans were validated. Dosimetric evaluations included absolute dose measurements, 1D γ-evaluation of depth-dose curves and profiles using 2 mm and 2% dose difference criteria for single beam tests, and γ-evaluation of axial planes for composite treatment plans applying 3 mm and 3% dose difference criteria.

Results

Absolute dosimetry revealed no large differences between MC and advanced kernel dose calculations. 1D γ-evaluation showed significant discrepancies between depth-dose curves in different phantom geometries. For the CC algorithm γ_mean values were 0.90 ± 0.74 vs. 0.43 ± 0.41 in heterogeneous vs. homogeneous conditions and for the AAA γ_mean values were 1.13 ± 0.91 vs. 0.41 ± 0.28, respectively. In general, 1D γ results obtained with both MC TPS were similar in both phantoms and on average equal to 0.5 both for profiles and depth-dose curves. The results obtained with the CC algorithm in heterogeneous phantoms were slightly better in comparison to the AAA algorithm. The 2D γ-evaluation results of IMRT plans and four-field plans showed smaller mean γ-values for MC dose calculations compared to the advanced kernel algorithms (γ_mean for four-field plan and IMRT obtained with Monaco MC were 0.28 and 0.5, respectively, vs. 0.40 and 0.54 for the AAA).

Conclusion

All TPS investigated in this study demonstrated accurate dose calculation in homogenous and heterogeneous phantoms. Commercially available TPS with Monte Carlo option performed best in heterogeneous phantoms. However, the difference between the CC and the MC algorithms was found to be small.     

Mailable TLD system for photon and electron therapy beams

The mailable TLD system developed by the Radiological Physics Center for monitoring calibration of photon beam energies from cobalt 60 to 25 MV and electron beam energies from 6 to 20 MeV has been in use since 1977 for photons and since 1982 for electron beams. Design considerations, proper use of the system and calibration techniques are detailed. The accuracy of the system is comparable to that of ion chamber measurements made in a water phantom, although it shows less precision.     

Film dosimetry of clinical electron beams

Film dosimetry is used widely to obtain relative dose distributions of clinical electron beams in phantoms. Nevertheless, measurement results obtained with film dosimetry may lack precision and reliability. In this paper well defined and reproducible methods in film dosimetry are discussed. By application of these methods, film dosimetry appears to be adequate in measuring relative dose distributions of clinically applied electron beams, with an accuracy of 1% to 2% of the dose maximum, in water and plastics as well as in heterogeneously composed material.     

Skin dose from radiotherapy X-ray beams: The influence of energy

Skin-sparing properties of megavoltage photon beams are compromised by electron contamination. Higher energy beams do not necessarily produce lower surface and basal cell layer doses due to this electron contamination. For a 5 ± 5cm field size the surface doses for 6 MVp and 18MVp X-ray beams are 10% and 7% of their respective maxima. However, at a field size of 40x40cm the percentage surface dose is 42% for both 6 MVp and 18 MVp beams. The introduction of beam modifying devices such as block trays can further reduce the skin-sparing advantages of high energy photon beams. Using a 10mm perspex block tray, the surface doses for 6MVp and 18MVp beams with a 5x5cm field size are 10% and 8%, respectively. At 40x40cm, surface doses are 61 % and 63% for 6MVp and 18MVp beams, respectively. This trend is followed at the basal cell layer depth. At a depth of 1 mm, 18 MVp beam doses are always at least 5% smaller than 6 MVp doses for the same depth at all field sizes when normalized to their respective Dmax values. Results have shown that higher energy photon beams produce a negligible reduction of the delivered dose to the basal cell layer (0.1 mm). Only a small increase in skin sparing is seen at the dermal layer (1 mm), which can be negated by the increased exit dose from an opposing field.