Electron paramagnetic resonance (EPR) dosimetry using lithium formate in radiotherapy: comparison with thermoluminescence (TL) dosimetry using lithium fluoride rods

Solid-state radiation dosimetry by electron paramagnetic resonance (EPR) spectroscopy and thermoluminescence (TL) was utilized for the determination of absorbed doses in the range of 0.5-2.5 Gy. The dosimeter materials used were lithium formate and lithium fluoride (TLD-100 rods) for EPR dosimetry and TL dosimetry, respectively. 60Co gamma-rays and 4, 6, 10 and 15 MV x-rays were employed. The main objectives were to compare the variation in dosimeter reading of the respective dosimetry systems and to determine the photon energy dependence of the two dosimeter materials. The EPR dosimeter sensitivity was constant over the dose range in question, while the TL sensitivity increased by more than 5% from 0.5 to 2.5 Gy, thus displaying a supralinear dose response. The average relative standard deviation in the dosimeter reading per dose was 3.0% and 1.2% for the EPR and TL procedures, respectively. For EPR dosimeters, the relative standard deviation declined significantly from 4.3% to 1.1% over the dose range in question. The dose-to-water energy response for the megavoltage x-ray beams relative to 60Co gamma-rays was in the range of 0.990-0.979 and 0.984-0.962 for lithium formate and lithium fluoride, respectively. The results show that EPR dosimetry with lithium formate provides dose estimates with a precision comparable to that of TL dosimetry (using lithium fluoride) for doses above 2 Gy, and that lithium formate is slightly less dependent on megavoltage photon beam energy than lithium fluoride.     

An experimental and Monte Carlo investigation of the energy dependence of alanine/EPR dosimetry: I. Clinical x-ray beams

The energy dependence of alanine/EPR dosimetry, in terms of absorbed dose-to-water for clinical 6, 10, 25 MV x-rays and 60Co gamma-rays was investigated by measurements and Monte Carlo (MC) calculations. The dose rates were traceable to the NRC primary standard for absorbed dose, a sealed water calorimetry. The electron paramagnetic resonance (EPR) spectra of irradiated pellets were measured using a Bruker EMX 081 EPR spectrometer. The DOSRZnrc Monte Carlo code of the EGSnrc system was used to simulate the experimental conditions with BEAM code calculated input spectra of x-rays and gamma-rays. Within the experimental uncertainty of 0.5%, the alanine EPR response to absorbed dose-to-water for x-rays was not dependent on beam quality from 6 MV to 25 MV, but on average, it was about 0.6% lower than its response to 60Co gamma-rays. Combining experimental data with Monte Carlo calculations, it is found that the alanine/EPR response per unit absorbed dose-to-alanine is the same for clinical x-rays and 60Co gamma-rays within the uncertainty of 0.6%. Monte Carlo simulations showed that neither the presence of PMMA holder nor varying the dosimeter thickness between 1 mm and 5 mm has significant effect of the energy dependence of alanine/EPR dosimetry within the calculation uncertainty of 0.3%.     

A direct comparison of water calorimetry and Fricke dosimetry

Considerable effort has been devoted to measuring the absorbed dose to water using water calorimetry. Most of these efforts have been hampered by a lack of adequate knowledge of the heat defect of water. We argue that there is now sufficient information to establish with considerable confidence the heat defect of high-purity water containing various dissolved gases. For the present work we used water saturated with a 50/50 mixture of H2 and O2 gases, for which the heat defect is calculated to be -2.1%. As a test of this assignment, we have compared the absorbed dose to water as measured using water calorimetry with that obtained from Fricke dosimetry. The water calorimeter consisted of a small sealed vessel containing 100 ml of stirred water saturated with a 50/50 mixture of H2 and O2 gases. It was irradiated with 20 MV x-rays at a dose rate of about 0.4 Gy s-1. The same vessel was then filled with Fricke dosemeter solution, and irradiated under identical conditions. Our Fricke dosimetry is based on the Svensson and Brahme value of epsilon G (3.515 x 10(-3) 1 cm-1 J-1) and agrees to within 0.2% with the dose to water for 60Co gamma-rays obtained via graphite calorimetry. We find that for 20 MV x-rays, the dose to water determined by water calorimetry is 1.006 +/- 0.004 times the dose determined by Fricke dosimetry. Within 0.6(+/- 0.4)%, this result supports the calculated heat defect of -2.1% for water saturated with a 50/50 mixture of H2 and O2 gases.     

Measurement and analysis of supralinearity in LiF TLD-100 irradiated by 1.5 keV x-rays

Measurements of the response of lithium fluoride TLD-100 to 1.5 keV ultrasoft x-rays, 240 keV x-rays and 137Cs gamma-rays at doses below 70 Gy are presented and the implications for the track interaction model are discussed. This model proposes that thermoluminescence is due to the combination electrons and holes formed along secondary charged particle tracks. As the dose is increased, the average distance between particle tracks is reduced and there is a greater probability of combination between neighbouring tracks; this mechanism is used to explain the supralinear response of lithium fluoride to certain radiations. Measurements using ultrasoft x-rays are interesting in this context because the energy from each photon is deposited in a small volume, therefore the probability of combination between neighbouring events should only be significant at high doses. The results, however, show that lithium fluoride exhibits a significant supralinear response to 1.5 keV x-rays after only a few tens of grays and suggests that the track interaction model alone cannot explain the phenomenon of supralinearity.     

Dosimetry comparison and characterisation of an Al K ultrasoft x-ray beam from an MRC cold-cathode source

Ultrasoft x-rays of 0.3-5 keV have provided a unique tool for the investigation of intracellular mechanisms of radiation action in biological organisms, including mammalian cells. However, their use presents unique practical problems in dosimetry and experimental design. Detailed interpretation of the biological results requires reliable dosimetry and well characterised monoenergetic beams. This paper presents a comparison between two fundamentally different dosimetric techniques, namely the ionisation current in an extrapolation chamber and photon counts in a proportional counter. Agreement within 7% was obtained when these two methods were applied to an Al K x-ray beam (1.5 keV) from an MRC cold-cathode transmission target discharge tube as previously used in many biological experiments. Photographic film was calibrated as a relative dosimetric technique and used for investigation of the intensity uniformity of the radiation field. These techniques provide a comprehensive characterisation of the beam in the position of the biological cells, including photon flux (or absorbed dose rate), spectral purity (showing much less than 1% bremsstrahlung relative to characteristic Al x-rays) and uniformity over the irradiation area (within about 5% for mammalian cell irradiations).     

Addendum to the IPEMB code of practice for the determination of absorbed dose for x-rays below 300 kV generating potential (0.035 mm Al-4 mm Cu HVL)

This addendum to the code of practice for the determination of absorbed dose for x-rays below 300 kV has recently been approved by the IPEM and introduces three main changes: (i) Due to a lack of available data the original code recommended a value of unity for k(ch) in the very-low-energy range (0.035-1.0 mm Al HVL). A single table of k(ch) values, ranging from 1.01 to 1.07, applicable to both designated chamber types is now presented. (ii) For medium-energy x-rays (0.5-4 mm Cu HVL) methods are given to determine the absorbed dose to water either at 2 cm depth or at the surface of a phantom depending on clinical needs. Determination of the dose at the phantom surface is derived from an in-air measurement and by extending the low-energy range up to 4 mm Cu HVL. Relevant backscatter factors and ratios of mass energy absorption coefficients are given in the addendum. (iii) Relative dosimetry: although not normally forming part of a dosimetry code of practice a brief review of the current literature on this topic has been added as an appendix. This encompasses advice on techniques for measuring depth doses, applicator factors for small field sizes, dose fall off with increasing SSD and choice of appropriate phantom materials and ionization chambers.     

The energy dependence of lithium formate EPR dosimeters for clinical electron beams

The objective of this study was to investigate the potential of using polycrystalline lithium formate for EPR (electron paramagnetic resonance) dosimetry of clinical electron beams, with the main focus on the dose-to-water energy response. Lithium formate dosimeters were irradiated using (60)Co gamma-rays and 6-20 MeV electrons in a PMMA phantom to doses in the range of 3-9 Gy. A plane-parallel ion chamber was used for water-based absolute dosimetry. In addition, the electron/photon transport was simulated using the EGSnrc Monte Carlo code. From the EPR measurements, the standard deviation of single dosimeter readings was 1.2%. The experimental energy response (the lithium formate dosimeter reading per absorbed dose to water for electrons relative to that for (60)Co gamma rays) was nearly independent of the electron energy and on average 0.99 +/- 0.03. The Monte Carlo calculated energy response was on average 0.5% higher than the experimental energy response, the difference being not significant. Simulations with water and polystyrene as irradiation media indicated that the energy response of lithium formate dosimeters was nearly independent of the phantom materials. In conclusion, lithium formate EPR dosimetry of clinical electron beams provides precise dose measurements with low dependence on the electron energy.     

Absorption spectroscopy of EBT model GAFCHROMIC film

The introduction of radiochromic films has solved some of the problems associated with conventional 2D radiation detectors. Their high spatial resolution, low energy dependence, and near-tissue equivalence make them ideal for measurement of dose distributions in radiation fields with high dose gradients. Precise knowledge of the absorption spectra of these detectors can help to develop more suitable optical densitometers and potentially extend the use of these films to other areas such as the measurement of the radiation beam spectral information. The goal of this study is to present results of absorption spectra measurements for the new GAFCHROMIC film, EBT type, exposed to 6 MV photon beam in the dose range from 0 to 6 Gy. Spectroscopic analysis reveals that in addition to the two main absorption peaks, centered at around 583 and 635 nm, the absorption spectrum in the spectral range from 350 to 800 nm contains six more absorption bands. Comparison of the absorption spectra reveals that previous HD-810, MD-55, as well as HS GAFCHROMIC film models, have nearly the same sensitive layer base material, whereas the new EBT model, GAFCHROMIC film has a different composition of its sensitive layer. We have found that the two most prominent absorption bands in EBT model radiochromic film do not change their central wavelength position with change in a dose deposited to the film samples.     

Use of new radiochromic devices for peripheral dose measurement: potential in-vivo dosimetry application

The authors have studied the feasibility of using three new high-sensitivity radiochromic devices in measuring the doses to peripheral points outside the primary megavoltage photon beams. The three devices were GAFCHROMIC® EBT film, prototype Low Dose (LD) Film, and prototype LD Card. The authors performed point dosimetry using these three devices in water-equivalent solid phantoms at x = 3,5,8,10, and 15 cm from the edge of 6 MV and 15 MV photon beams of 10x10 cm², and at depths of 0, 0.5 cm, and depth of maximum dose. A full sheet of EBT film was exposed with 5000 MU. The prototype LD film pieces were 1.5x2 cm² in size. Some LD films were provided in the form of a card in 1.8x5 cm² holding an active film in 1.8x2 cm². These are referred to as “LD dosimeter cards”. The small LD films and cards were exposed with 500 MU. For each scanned film, a 6 mm circular area centered at the measurement point was sampled and the mean pixel value was obtained. The calibration curves were established from the calibration data for each combination of film/cards and densitometer/scanner. The doses at the peripheral points determined from the films were compared with those obtained using ion chamber at respective locations in a water phantom and general agreements were found. It is feasible to accurately measure peripheral doses of megavoltage photon beams using the new high-sensitivity radiochromic devices. This near real-time and inexpensive method can be applied in a clinical setting for dose measurements to critical organs and sensitive patient implant devices.     

Synchrotron stereotactic radiotherapy: dosimetry by Fricke gel and Monte Carlo simulations

Synchrotron stereotactic radiotherapy (SSR) consists in loading the tumour with a high atomic number element (Z), and exposing it to monochromatic x-rays from a synchrotron source (50-100 keV), in stereotactic conditions. The dose distribution results from both the stereotactic monochromatic x-ray irradiation and the presence of the high Z element. The purpose of this preliminary study was to evaluate the two-dimensional dose distribution resulting solely from the irradiation geometry, using Monte Carlo simulations and a Fricke gel dosimeter. The verification of a Monte Carlo-based dosimetry was first assessed by depth dose measurements in a water tank. We thereafter used a Fricke dosimeter to compare Monte Carlo simulations with dose measurements. The Fricke dosimeter is a solution containing ferrous ions which are oxidized to ferric ions under ionizing radiation, proportionally to the absorbed dose. A cylindrical phantom filled with Fricke gel was irradiated in stereotactic conditions over several slices with a continuous beam (beam section = 0.1 x 1 cm2). The phantom and calibration vessels were then imaged by nuclear magnetic resonance. The measured doses were fairly consistent with those predicted by Monte Carlo simulations. However, the measured maximum absolute dose was 10% underestimated regarding calculation. The loss of information in the higher region of dose is explained by the diffusion of ferric ions. Monte Carlo simulation is the most accurate tool for dosimetry including complex geometries made of heterogeneous materials. Although the technique requires improvements, gel dosimetry remains an essential tool for the experimental verification of dose distribution in SSR with millimetre precision.     

A water calorimeter for neutron dosimetry

A water calorimeter has been used for the direct measurement of absorbed dose to water in a d(15) + Be neutron beam. The absorbed dose measured with the calorimeter was compared with that measured with an Exradin ionisation chamber, constructed of A-150 plastic. The doses measured by the ionisation chamber were calculated according to the European (ECNEU) protocol. Absorbed dose to tissue measured with the calorimeter was 4.3% lower than that measured with the ionisation chamber. Relative to ionisation chamber dosimetry, dose measurements with the calorimeter in the neutron beam were 9% lower than similar measurements in 4 and 9 MV photon beams. The significance of the results is discussed in terms of the heat defect in water.     

Visible absorption properties of radiation exposed XR type-T radiochromic film

The visible absorption spectra of Gafchromic XR type-T radiochromic film have been investigated to analyse the dosimetry characteristics of the film with visible light densitometers. Common densitometers can use photospectrometry, fluorescent light (broad-band visible), helium neon (632 nm), light emitting diode (LED) or other specific bandwidth spectra. The visible absorption spectra of this film when exposed to photon radiation show peaks at 676 nm and 618 nm at 2 Gy absorbed doses which shift to slightly lower wavelengths (662 nm and 612 nm at 8 Gy absorbed dose) at higher doses. This is similar to previous models of Gafchromic film such as MD-55-2 and HS but XR type-T also includes a large absorption at lower visible wavelengths due to 'yellow' dyes placed within the film to aid with visible recognition of the film exposure level. The yellow dye band pass is produced at approximately 520 nm to 550 nm and absorbs wavelengths lower than this value within the visible spectrum. This accounts for the colour change from yellow to brown through the added absorption in the red wavelengths with radiation exposure. The film produces a relatively high dose sensitivity with up to 0.25 OD units per Gy change at 672 nm at 100 kVp x-ray energy. Variations in dose sensitivity can be achieved by varying wavelength analysis.     

Bragg-Gray theory and ion chamber dosimetry for photon beams

The validity of the Bragg-Gray cavity theory in photon radiation dosimetry for photon energies from 10 keV to 10 MeV has been investigated quantitatively in this paper. A crucial assumption for Bragg-Gray cavity theory to be valid is that the dose from photon interactions in the detector material is negligible. The ratio, Fair, of the absorbed dose resulting from photon interactions in an air cavity, DPA(air), to that in air under the condition of charged-particle equilibrium, DCPE(air), has been used as a parameter to determine if the air cavity can be classified as a Bragg-Gray cavity. Monte Carlo calculated results show that, for monoenergetic photon beams of energies above about 220 keV, the dose ratio, Fair, is smaller than 0.05 for an air cavity of 6 mm thickness and 6 mm diameter in vacuum. Furthermore, it is shown that the Burlin general cavity theory seriously overestimates the departure from Bragg-Gray behaviour. For clinical photon beams the dose ratio, Fair, is 0.29 for a 150 kVp beam and 0.27 for a 240 kVp beam compared to 0.006 for a 60 Co beam if the cavity is placed at a depth of 5 cm in water. This study confirms that typical air-filled ionization chambers cannot be considered to be Bragg-Gray cavities for low- and medium-energy photon radiation.     

Optically stimulated luminescence (OSL) of carbon-doped aluminum oxide (Al2O3:C) for film dosimetry in radiotherapy

INTRODUCTION AND PURPOSE: Conventional x-ray films and radiochromic films have inherent challenges for high precision radiotherapy dosimetry. Here we have investigated basic characteristics of optically stimulated luminescence (OSL) of irradiated films containing carbon-doped aluminum oxide (Al2O3:C) for dosimetry in therapeutic photon and electron beams. MATERIALS AND METHODS: The OSL films consist of a polystyrene sheet, with a top layer of a mixture of single crystals of Al2O3:C, ground into a powder, and a polyester base. The total thickness of the films is 0.3 mm. Measurements have been performed in a water equivalent phantom, using 4, 6, 10, and 18 MV photon beams, and 6-22 MeV electron beams. The studies include assessment of the film response (acquired OSL signal/delivered dose) on delivered dose (linearity), dose rate (1-6 Gy/min), beam quality, field size and depth (6 MV, ranges 4 x 4-30 x 30 cm2, dmax-35 cm). Doses have been derived from ionization chamber measurements. OSL films have also been compared with conventional x-ray and GafChromic films for dosimetry outside the high dose area, with a high proportion of low dose scattered photons. In total, 787 OSL films have been irradiated. RESULTS: Overall, the OSL response for electron beams was 3.6% lower than for photon beams. Differences between the various electron beam energies were not significant. The 6 and 18 MV photon beams differed in response by 4%. No response dependencies on dose rate were observed. For the 6 MV beam, the field size and depth dependencies of the OSL response were within +/-2.5%. The observed inter-film response variation for films irradiated with the same dose varied from 1% to 3.2% (1 SD), depending on the measurement day. At a depth of 20 cm, 5 cm outside the 20 x 20 cm2 6 and 18 MV beams, an over response of 17% was observed. In contrast to GafChromic and conventional x-ray films, the response of the Al2O3:C films is linear in the clinically relevant dose range 0-200 cGy. CONCLUSIONS: Measurement of the OSL signal of irradiated films containing Al2O3:C is a promising technique for film dosimetry in radiotherapy with no or small response variations with dose rate, beam quality, field size and depth, and a linear response from 0 to 200 cGy.     

A comparison of the AAPM "Protocol for the determination of absorbed dose from high-energy photon and electron beams" with currently used protocols

A comparison of the AAPM "Protocol for the determination of absorbed dose from high-energy photon and electron beams" (TG21) with currently used protocols for electron and photon dosimetry is presented. These protocols are the International Commission on Radiation Units and Measurements Report 21, "Radiation Dosimetry: Electrons with Initial Energies Between 1 and 50 MeV" (ICRU21), and the AAPM "Protocol for the Dosimetry of X- and Gamma Ray Beams with Maximum Energies Between 0.6 and 50 MeV" (SCRAD). Assuming a given radiation exposure and chamber parameters, doses to water at dmax for electron beams and at 5 g/cm2 for photon beams are calculated using the three protocols and then compared. The doses for photon beams calculated using the TG21 and SCRAD protocols are found to differ by 3% or less at energies below 10 MeV. The largest differences occur in photon doses at high energies where the dose calculated with the TG21 protocol is as much as 5.5% greater than that calculated with the SCRAD protocol for a typical thimble ionization chamber. For low electron beam energies, the doses calculated with the ICRU21 protocol are as much as 5% less than TG21 doses when using thimble chambers constructed of tissue-equivalent materials in a water phantom. If dosimetry measurements are performed in polystyrene, the dose calculated using TG21 may be greater than the ICRU21 dose, depending on chamber size and composition. An explanation for some of the differences between the protocols is presented emphasizing the dependence on chamber geometry, chamber composition, and phantom composition.     

Characterizing a pulse-resolved dosimetry system for complex radiotherapy beams using organic scintillators

A fast-readout dosimetry system based on fibre-coupled organic scintillators has been developed for the purpose of conducting point measurements of absorbed dose in radiotherapy beams involving high spatial and temporal dose gradients. The system measures the dose for each linac radiation pulse with millimetre spatial resolution. To demonstrate the applicability of the system in complex radiotherapy fields, output factors and per cent depth dose measurements were performed in solid water for a 6 MV photon beam and compared with Monte Carlo simulated doses for square fields down to 0.6 cm × 0.6 cm size. No significant differences between measurements and simulations were observed. The temporal resolution of the system was demonstrated by measuring dose per pulse, beam start-up transients and the quality factor for 6 MV. The precision of dose per pulse measurements was within 2.7% (1 SD) for a 10 cm × 10 cm field at 10 cm depth. The dose per pulse behaviour compared well with linac target current measurements and accumulated dose measurements, and the system was able to resolve transient dose delivery differences between two Varian linac builds. The system therefore shows promise for reference dosimetry and quality assurance of complex radiotherapy treatments.     

Absorption spectra variations of EBT radiochromic film from radiation exposure

Gafchromic EBT radiochromic film is one of the newest radiation-induced auto-developing x-ray analysis films available for therapeutic radiation dosimetry in radiotherapy applications. The spectral absorption properties in the visible wavelengths have been investigated and results show two main peaks in absorption located at 636 nm and 585 nm. These absorption peaks are different to many other radiochromic film products such as Gafchromic MD-55 and HS film where two peaks were located at 676 nm and 617 nm respectively. The general shape of the absorption spectra is similar to older designs. A much higher sensitivity is found at high-energy x-rays with an average 0.6 OD per Gy variation in OD seen within the first Gy measured at 636 nm using 6 MV x-rays. This is compared to approximately 0.09 OD units for the first Gy at the 676 nm absorption peak for HS film at 6 MV x-ray energy. The film's blue colour is visually different from older varieties of Gafchromic film with a higher intensity of mid-range blue within the film. The film provides adequate relative absorbed dose measurement for clinical radiotherapy x-ray assessment in the 1-2 Gy dose range which with further investigation may be useful for fractionated radiotherapy dose assessment.     

Energy dependence of response of new high sensitivity radiochromic films for megavoltage and kilovoltage radiation energies

The purpose of this paper is to evaluate the energy dependence of the response of two new high sensitivity models of radiochromic films EBT and XR-QA. We determined the dose response curves of these films for four different radiation sources, namely, 6 MV photon beams (6 MVX), Ir-192, I-125, and Pd-103. The first type (EBT) is designed for intensity modulated radiation therapy (IMRT) dosimetry, and the second type (XR-QA) is designed for kilovoltage dosimetry. All films were scanned using red (665 nm) and green (520 nm) light sources in a charge-coupled device-based densitometer. The dose response curves [net optical density (NOD) versus dose] were plotted and compared for different radiation energies and light sources. Contrary to the early GAFCHROMIC film types (such as models XR, HS, MD55-2, and HD810), the net optical densities of both EBT and XR-QA were higher with a green (520 nm) than those with a red (665 nm) light source due to the different absorption spectrum of the new radiochromic emulsion. Both film types yield measurable optical densities for doses below 2 Gy. EBT film response is nearly independent of radiation energy, within the uncertainty of measurement. The NOD values of EBT film at 1 and 2 Gy are 0.13 and 0.25 for green, and 0.1 and 0.17 for red, respectively. In contrast, the XR-QA film sensitivity varies with radiation energy. The doses required to produce NOD of 0.5 are 6.9, 5.4, 0.7, and 0.9 Gy with green light and 19, 13, 1.7, and 1.5 Gy with red light, for 6 MVX, Ir-192, I -125, and Pd-103, respectively. EBT film was found to have minimal photon energy dependence of response for the energies tested and is suitable for dosimetry of radiation with a wide energy spectrum, including primary and scattered radiation. XR-QA film is promising for kilovoltage sources with a narrow energy spectra. The new high sensitivity radiochromic films are promising tools in radiation dosimetry.     

A wide dynamic range, high-spatial-resolution scanning system for radiochromic dye films

This paper describes the evaluation of an inexpensive, commercially available 35 mm transparency slide scanner as a potential alternative scanning device for GafChromic HD-810 radiochromic dye film. Besides its low cost, the principal advantages of this type of scanner are high spatial resolution and high speed (a typical scan taking less than 1 min). With broad-band illumination the useful dose range using grey-scale imaging of GafChromic HD-810 is limited to about 50-800 Gy. By using the colour-scale imaging capability of the scanner we have been able to achieve a significant extension covering a similar range (15-2000 Gy) to that attainable using monochromatic illumination. The short-term reproducibility of the system is good, with a coefficient of variation of doses estimated from repeat scanning of uniformly exposed calibration films of less than 2%. Long-term stability is ensured by the scanning of a manufacturer-supplied test slide. The slide scanner system has been used in the determination of depth dose distributions from a model 'hot particle' source containing 106Ru/Rh. GafChromic dye film stacks irradiated by the source were read out on both the slide scanner and a conventional Joyce Loebl MDM6 scanning stage microdensitometer. The overall agreement between the dose estimates provided by the two systems was within 10%.