A comparison of protocols for external beam radiotherapy beam calibrations

A number of codes of practice (CoP) for electron and photon radiotherapy beam dosimetry are currently in use. Comparison is made of the more widely used of these, specifically those of the International Atomic Energy Agency (IAEA TRS-398), the American Association of Physicists in Medicine (AAPM TG-51) and the Institute of Physics and Engineering in Medicine (IPEM 2003). All are based on calibration of ionization chambers in terms of absorbed dose to water, each seeking to reduce uncertainty in delivered dose, providing an even stronger system of primary standards than previous air-kerma based approaches. They also provide a firm, traceable and straight-forward formalism (Radiology, 1996). Included in making dose assessments for the three CoP are calibration coefficients for a range of beam quality indices. Measurements have been performed using clinical photon and electron beams, the absorbed dose to water being obtained following the recommendations given by each code. Electron beam comparisons have been carried out using measurements for electron beams of nominal energies 6, 9, 12, 16 and 20 MeV. Comparisons were also carried out for photon beams of nominal energies 6 and 18 MV. For photon beams use was made of NE2571 cylindrical graphite walled ionization chambers, cross-calibrated against an NE2611 Secondary Standard; for electron beams, PTW Markus and NACP-02 plane-parallel chambers were used. Irradiations were made using Varian 600C/2100C linacs, supported by water tanks and Virtual Water? phantoms. The absorbed doses for photon and electron beams obtained following these CoP are all in good agreement, with deviations of less than 2%. A number of studies have been carried out by different groups in different countries to examine the consistency of dosimetry codes of practice or protocols. The aim of these studies is to confirm that the goal of those codes is met, namely uniformity in establishment of dosimetry of all radiation beam types used in cancer therapy in the world, and this is one of the studies.     

Dynamic beam shaping

Computer control of independent collimator jaw positions and dose is combined with multiple-field summation techniques to design optimized radiation field profiles. Clinically relevant examples are shown for dynamic wedges and compensated mantle fields. Calculation, measurement, and verification techniques are discussed.     

External beam planning module of Eclipse for external beam radiation therapy

Eclipse is a 3-dimensional (3D) treatment planning system for radiation therapy offered by Varian Medical Systems, Inc. The system has the network connectivity for the electronic transfer of image datasets and digital data communication among different equipment. The scope of this project for this special issue of Medical Dosimetry on 3D treatment planning systems is the assessment of planning tools in the external beam planning module of Eclipse to generate optimized treatment plans for patients undergoing external beam radiation therapy. This treatment planning system is relatively mature to be able to generate (1) simple treatment plans, (2) conformal radiation therapy plans, (3) static intensity-modulated radiation therapy (IMRT) plans, (4) volumetric-modulated arc therapy (VMAT) plans, and (5) treatment plans for electron beam therapy. The treatment planning tools are relatively plentiful to assist in the radiation therapy treatment planning. Some new features have been incorporated in the latest version and are helpful for making high-quality treatment plans. However, the location of the tools is not intuitive, and hence, familiarity with the user interface is essential to the efficient use of the treatment planning system. In addition, there are a number of dose algorithms available for the computation of dose distributions. The understanding of each dose computation algorithm is essential for the optimal use of this treatment planning system.     

Electron beam calibration constants

Electron treatment beam calibration constants are tabulated in a convenient form for mean incident electron energies, Eo, of 6 to 21 MeV; and practical reanges, Rp, of 2.75 to 10.53 cm of water. Values of mean electron energy at depth Ed, chamber radius correction factors (Kp), and CE factors may be readily obtained from this chart.     

Evaluation of beam modeling for small fields using a flattening filter-free beam

The characteristics of a flattening filter-free (FFF) beam are different from those of a beam with a flattening filter. For small-field dosimetry, the beam data needed by the radiation treatment planning system (RTPS) includes the percent depth dose (PDD), off-center ratio (OCR), and output factor (OPF) for field sizes down to 3 × 3 cm² to calculate the beam model. The purpose of this study was to evaluate the accuracy of calculations for the FFF beam by the Eclipse^? treatment planning system for field sizes smaller than 3 × 3 cm² (2 × 2 and 1 × 1 cm²). We used 6X and 10X FFF beams by the Varian TrueBeam^? to produce. The AAA and AXB algorithms of the Eclipse were used to compare the Monte Carlo (MC) calculation and the measurements from three dosimeters, a diode detector, a PinPoint dosimeter, and EBT3 film. The PDD curves and the penumbra width in the OCR calculated by the Eclipse, measured data, and those from the MC calculations were in good agreement to within ±2.8 % and ±0.6 mm, respectively. However, the difference in the OPF values between AAA and AXB for a field size of 1 × 1 cm² was 5.3 % for the 6X FFF beam and 7.6 % for the 10X FFF beam. Therefore, we have to confirm the small field data that is included for the RTPS commission procedures.     

Electron beam port films

Portal localization films are taken in order to assure the accurate placement of the treatment field relative to the patient anatomy. This is routinely done for photon fields and maybe for electron fields. This paper describes a technique which uses the bremsstrahlung component of an electron beam of energy 10 MeV and greater to expose a film to image a treatment port. These films provide verification of the placement of the electron field and document the treatment of a specific area.     

Characterization of ultra high energy neutron beam generated by 500 MeV proton beam

An ultra high energy neutron facility was constructed at PARMS, University of Tsukuba, to produce a neutron beam superior to an X-ray beam generated by a modern linac in terms of dose distribution. This has been achieved using the reaction on a thick uranium target struck by 500 MeV proton beam from the booster-synchrotron of High Energy Physics Laboratory. The percentage depth dose of this neutron beam is nearly equivalent to that of X-rays at around 20 MV and the dose rate of 15 cGy per minute. Relative biological effectiveness of this neutron beam has been estimated on the cell killing effect by the use of HMV-I cell line. Resultant survival curve of cells after the neutron irradiation shows the shoulder with n and Dq of 8 and 2.3 Gy, respectively. RBE value at 10(-2) survival level for the present neutron, compared with 137Cs gamma-rays is 1.24. The result suggests that the biological effects of high energy neutrons are not practically large enough whenever the depth dose distribution of neutrons becomes superior to high energy linac X-rays.     

A therapy beam training aid

Beams of X-rays and electrons used in external beam radiotherapy are characterized by differences in penetration, build-up, divergence, scatter etc. This short communication describes a very simple phosphor-loaded box that can be used to demonstrate directly to students the different properties of beams and the effect of field modifiers such as wedge filters, lead shields etc.