The wall correction factor for a spherical ionization chamber used in brachytherapy source calibration

The effect of wall chamber attenuation and scattering is one of the most important corrections that must be determined when the linear interpolation method between two calibration factors of an ionization chamber is used. For spherical ionization chambers the corresponding correction factors A(w) have to be determined by a non-linear trend of the response as a function of the wall thickness. The Monte Carlo and experimental data here reported show that the A(w) factors obtained for an Exradin A4 chamber, used in the brachytherapy source calibration, in terms of reference air kerma rate, are up to 1.2% greater than the values obtained by the linear extrapolation method for the studied beam qualities. Using the Aw factors derived from Monte Carlo calculations, the accuracy of the calibration factor N(K,Ir) for the Exradin A4, obtained by the interpolation between two calibration factors, improves about 0.6%. The discrepancy between the new calculated factor and that obtained using the complete calibration curve of the ion-chamber and the 192Ir spectrum is only 0.1%.     

Determination of the Kwall correction factor for a cylindrical ionization chamber to measure air-kerma in 60Co gamma beams

The factor Kwall to correct for photon attenuation and scatter in the wall of ionization chambers for 60Co air-kerma measurement has been traditionally determined by a procedure based on a linear extrapolation of the chamber current to zero wall thickness. Monte Carlo calculations by Rogers and Bielajew (1990 Phys. Med. Biol. 35 1065-78) provided evidence, mostly for chambers of cylindrical and spherical geometry, of appreciable deviations between the calculated values of Kwall and those obtained by the traditional extrapolation procedure. In the present work an experimental method other than the traditional extrapolation procedure was used to determine the Kwall factor. In this method the dependence of the ionization current in a cylindrical chamber was analysed as a function of an effective wall thickness in place of the physical (radial) wall thickness traditionally considered in this type of measurement. To this end the chamber wall was ideally divided into distinct regions and for each region an effective thickness to which the chamber current correlates was determined. A Monte Carlo calculation of attenuation and scatter effects in the different regions of the chamber wall was also made to compare calculation to measurement results. The Kwall values experimentally determined in this work agree within 0.2% with the Monte Carlo calculation. The agreement between these independent methods and the appreciable deviation (up to about 1%) between the results of both these methods and those obtained by the traditional extrapolation procedure support the conclusion that the two independent methods providing comparable results are correct and the traditional extrapolation procedure is likely to be wrong. The numerical results of the present study refer to a cylindrical cavity chamber like that adopted as the Italian national air-kerma standard at INMRI-ENEA (Italy). The method used in this study applies, however, to any other chamber of the same type.     

Evidence for using Monte Carlo calculated wall attenuation and scatter correction factors for three styles of graphite-walled ion chamber

The basic equation for establishing a 60Co air-kerma standard based on a cavity ionization chamber includes a wall correction term that corrects for the attenuation and scatter of photons in the chamber wall. For over a decade, the validity of the wall correction terms determined by extrapolation methods (K(w)K(cep)) has been strongly challenged by Monte Carlo (MC) calculation methods (K(wall)). Using the linear extrapolation method with experimental data, K(w)K(cep) was determined in this study for three different styles of primary-standard-grade graphite ionization chamber: cylindrical, spherical and plane-parallel. For measurements taken with the same 60Co source, the air-kerma rates for these three chambers, determined using extrapolated K(w)K(cep) values, differed by up to 2%. The MC code 'EGSnrc' was used to calculate the values of K(wall) for these three chambers. Use of the calculated K(wall) values gave air-kerma rates that agreed within 0.3%. The accuracy of this code was affirmed by its reliability in modelling the complex structure of the response curve obtained by rotation of the non-rotationally symmetric plane-parallel chamber. These results demonstrate that the linear extrapolation technique leads to errors in the determination of air-kerma.     

Fluence perturbation in photon beams under nonequilibrium conditions

The perturbation effect in parallel-plate ionization chambers used for buildup measurements has been investigated. The fluence perturbation due to electrons emitted through the side walls are thoroughly investigated by measurements using film and extrapolation chambers and by calculations. The electron fluence varies both with side wall material and chamber geometry. In order to obtain a small perturbation effect, the chamber should have a large guard width compared to the electrode separation and the side walls should have as large an angle as possible with the central axis. The side wall should be of the same material as the rest of the chamber. The perturbation effect is also dependent on the electron contamination of the beam and angular distribution of the electron fluence. It is thus not possible to correct the perturbation effect in one parallel-plate chamber with fixed plate separation with correction factors obtained with extrapolation chambers of other dimensions. In order to make accurate surface dose measurements extrapolation chambers are therefore strongly recommended in favor of fixed parallel-plate chambers.     

Absolute neutron dosimetry: effects of ionization chamber wall thickness

To assess the effect of ionization chamber wall thickness on absolute neutron absorbed dose determinations, measurements were made of the charge collected by an A-150 tissue-equivalent plastic ionization chamber irradiated by a p(66)Be(49) neutron therapy beam as a function of chamber wall thickness both in air and in four different media: tissue-equivalent solution, water, motor oil, and glycerin. Wall thicknesses ranged from 1 to 31 mm, where isolation of the chamber gas volume from protons originating outside the chamber wall was assured. The in-air measurements compare favorably with earlier buildup measurements performed with an A-150 extrapolation chamber in an A-150 phantom. The in-phantom results may be explained if the effect of charged particles reaching the gas volume from the medium and the wall as well as the differences in neutron attenuation by the wall and the medium displaced by the wall are taken into account. The errors in absolute absorbed dose determination caused by ignoring the above processes are assessed.     

An EGSnrc investigation of cavity theory for ion chambers measuring air kerma

The EGSnrc system is used to compare the response of an aluminum-walled thimble chamber to that of a graphite-walled thimble chamber for a 60Co beam. When compared to previous experimental results, the EGSnrc values of the ratios of chamber response differ by as much as 0.7% from the experiment. However, it is shown that this difference can be more than accounted for by switching from using the graphite mean excitation energy of 78 eV used in dosimetry protocols to the value of 86.8 eV suggested by more recent stopping-power experiments. This suggests that the uncertainty analysis of Monte Carlo results must be done more carefully, by taking into account uncertainties in the underlying basic data such as the electron and photon cross sections. In comparison to Spencer-Attix cavity theory for a thick-walled ion chamber, the Monte Carlo calculated values of the chamber response differ from the expected ones by 0.15% and 0.01% for the graphite and aluminum chambers, respectively, which are comparable to previously reported values for the Spencer-Attix correction factors. EGSnrc is also used to investigate the effect on the chamber response of thin dag layers on the inside of the aluminum wall. There is good agreement between the calculated and measured changes in chamber response versus the thickness of the dag. The results are compared to the predictions of the Almond-Svensson extension of cavity theory and show that the theory does not correctly predict the chamber response in the presence of thin dag layers. This finding is in agreement with previously reported experimental results. It is demonstrated that the values of alpha, the fraction of ionizations in the gas arising from electrons generated in the dag layer, used in the theory, are not the source of the disagreement.     

The energy response of a T.P.A. Mk-II ionization chamber using GEANT4 Monte Carlo simulation

The low energy model of the GEANT4 Monte Carlo toolkit was used to simulate the energy response of a T.P.A. Mk-II ionization chamber under a variety of different conditions. The sample position resulting in the maximum response along the axial direction of the chamber was obtained. The parameters of the simulation were chosen to account for the maximum effect of the particle backscattering and the setting of most suitable values for the production thresholds and the energy cuts in the GEANT4 Monte Carlo code. The chamber response for different compositions of detector elements was also studied. The simulated radioactive source was a glass ampoule containing 3.6 ml of the radionuclide in an aqueous solution. The energy response of the chamber at the maximum response was obtained for simulations for (60)Co, (22)Na and (59)Fe nuclides. Verification of the simulated response was obtained using experimental measurements with radioactive sources. The simulated results were in good agreement with the experimentally measured data to within 0.04-2.0%. In the energy range below 200 keV the response curve was complex due to the increase of photoelectric cross sections of the chamber materials. Effects due to backscattering occur at boundaries between chamber elements and also become significant at sites of lead shielding at photon energies above 700 keV. The chamber response for different compositions of detector elements was also studied. The response of the chamber depended highly on the energies of emitting particles, source position and materials used in electrodes and thimble wall.     

Monte Carlo modeling of the response of NRC's 90Sr/90Y primary beta standard

The BEAMnrc/EGSnrc Monte Carlo code system is employed to develop a model of the National Research Council of Canada primary standard of absorbed dose to tissue in a beta radiation field, comprising an extrapolation chamber and 90Sr/90Y beta source. We benchmark the model against the measured response of the chamber in terms of absorbed dose to air, for three different experimental setups when irradiated by the 90Sr/90Y source. For the first setup, the chamber cavity depth is fixed at 0.2 cm and the source-to-chamber distance varied between 11 and 60 cm. In the other two cases, the source-to-chamber distance is fixed at 30 cm. In one case the response for different chamber depths is studied, while in the other case the chamber depth is fixed at 0.2 cm as different thicknesses of Mylar are added to the front surface of the extrapolation chamber. The agreement as a function of distance between the calculated and measured responses is within 0.37% for a variation in response of a factor of 29. In the case of dose versus chamber depth, the agreement is within 0.4% for the ISO-recommended nominal depths of 0.025-0.25 cm. Agreement between calculated and measured responses is very good (between 0.02% and 0.2%) for added Mylar foils of thicknesses up to 10.8 mg cm(-2). For larger Mylar thicknesses, deviations of 0.6%-1.2% are observed, which are possibly due to the systematic uncertainties associated with the restricted collisional stopping powers of air or Mylar used in the calculations. We conclude that our simulation model represents the extrapolation chamber and 90Sr/90Y source with adequate accuracy to calculate correction factors for accurate realization of dose rate to tissue at a depth of 7 mg cm(-2) in an ICRU tissue phantom, despite the fact that the uncertainties in the physical characteristics of the source leave some uncertainty in certain calculated quantities.     

Ultrasonic measurement of arterial wall for quantitative diagnosis of atherosclerosis--elasticity imaging of arterial wall and atherosclerotic plaque

To provide useful information for the diagnosis of atherosclerosis in addition to the imaging of morphology using B-mode ultrasonography, we have developed a method, namely, the phased-tracking method, to measure the small change in the thickness of the arterial wall due to the heartbeat. This change in thickness corresponds to strain due to the change in internal pressure, and the elasticity of the arterial wall is obtained by the simultaneous measurement of the change in thickness and pulse pressure. Furthermore, an elasticity image can be classified into tissue components using the reference data obtained by in vitro experiments because the elastic properties are different among the tissue components in the arterial wall. We have measured the elasticity distributions of lipids, blood clots, fibrous tissue, and calcified tissue in vitro. From these results, it was found that arterial tissues can be classified into soft tissues (lipids, blood clots) and hard tissues (fibrous tissue, calcified tissue) on the basis of their elasticity. However, it is difficult to differentiate lipids from blood clots and fibrous tissue from calcified tissue because the elasticity distributions of these components overlap each other. To overcome this problem, we proposed a tissue classification method in which, the elasticity distribution of each small region of interest (not a single pixel) in an elasticity image was used in the classification of lipids, blood clots, fibrous tissue, and calcified tissue, respectively. Tissue classification results obtained by this method showed good agreement with the pathological image of the corresponding section.     

Build-up curves of scanned high energy electron beams from the Sagittaire linear accelerator

A study of the build-up curves using an extrapolation chamber for 7, 10, 13, 16, and 19 MeV electron beams, from a Sagittaire linear accelerator, is presented. The effect of the ionization chamber bias polarity, field size, collimation and surface obliquity on the shape of the relative ionization curve was investigated. No clinically significant change is observed except the displacement of the maximum ionization point was observed for the oblique incidence of the beam.     

Cavity ionisation theory applied to the design of a maximum permissible fluence instrument.

The maximun permissible fluence is proposed as a practical concept in radiological monitoring of photon fields. It is virtually this concept that is used for monitoring neutron fields. The practicability of designing instruments with a required response function over a large energy range is examined. Cavity isonisation theory is employed to examine the effect of gas filling, wall material, chamber size and wall thickness on response function and the optimum parameters for the design of an ionisation chamber are thus identified. An experimental chamber of parameters close to the optimum has been constructed and its response compared with the response calculated from cavity ionisation theory. It is concluded that it is possible to design an instrument, the energy response of which follows the maximum permissible fluence. The approach and data in this paper will facilitate any necessary design changes which would arise in the event of national regulation being modified.     

Use of a two-dimensional ionization chamber array for proton therapy beam quality assurance

Two-dimensional ion chamber arrays are primarily used for conventional and intensity modulated radiotherapy quality assurance. There is no commercial device of such type available on the market that is offered for proton therapy quality assurance. We have investigated suitability of the MatriXX, a commercial two-dimensional ion chamber array detector for proton therapy QA. This device is designed to be used for photon and electron therapy QA. The device is equipped with 32 x 32 parallel plate ion chambers, each with 4.5 mm diam and 7.62 mm center-to-center separation. A 250 MeV proton beam was used to calibrate the dose measured by this device. The water equivalent thickness of the buildup material was determined to be 3.9 mm using a 160 MeV proton beam. Proton beams of different energies were used to measure the reproducibility of dose output and to evaluate the consistency in the beam flatness and symmetry measured by MatriXX. The output measurement results were compared with the clinical commissioning beam data that were obtained using a 0.6 cc Farmer chamber. The agreement was consistently found to be within 1%. The profiles were compared with film dosimetry and also with ion chamber data in water with an excellent agreement. The device is found to be well suited for quality assurance of proton therapy beams. It provides fast two-dimensional dose distribution information in real time with the accuracy comparable to that of ion chamber measurements and film dosimetry.     

Fraction of ionization from electrons arising in the wall of an ionization chamber

The accuracy of high-energy x-ray dosimetry can be improved by taking account of differences between the compositions of the chamber wall and the buildup cap or dosimetry phantom. The fraction of the ionization due to secondary electrons arising in the chamber wall has been determined as a function of wall thickness for 60Co gamma rays and x rays in the range of 2-25 MV for Farmer-type chambers. Secondary electrons arising in the accelerator head were removed from the x-ray beams by a magnetic field placed just in front of the ionization chamber. For 60Co gamma rays, the fraction increases from 40% to 100% as the wall thickness increases from 0.05 to 0.55 g cm-2. For a 0.05 g cm-2 wall, fraction decreases from 60% to 10% as the x-ray energy is increased from 2 to 25 MV. Limited data obtained with different chambers suggest that the fraction is independent of chamber wall composition when the thickness is expressed in g cm-2.     

The effect of CO2 on ventilation and breath-holding during exercise and while breathing through an added resistance

1. Ventilation was measured while subjects were made to rebreathe from a bag containing CO(2) and O(2) in order to expose them to a steadily rising CO(2) tension (P(CO2)). The object of the experiments was to determine the effect of a variety of stimuli upon the increase in ventilation and fall in breath-holding time which occurs in response to the rising P(CO2).2. Steady-state exercise at 200 kg.m/min resulted in a small fall in the slope of the ventilation-CO(2) response curve (S(V)) and a small, though not statistically significant, fall in the P(CO2) at which ventilation would be zero by extrapolation (B(V)). There was a marked fall in the slope of the breath-holding-CO(2) response curve (S(BH)) and an increase in the P(CO2) at which breath-holding time became zero by extrapolation (B(BH)).3. These results have been interpreted with the aid of a model of the control of breath-holding and it is suggested that there is no change in CO(2) sensitivity on exercise, either during rebreathing or breath-holding.4. An increase in the resistance to breathing caused a marked reduction in S(V) and B(V), but no change in the breath-holding-CO(2) response curve. These findings suggest that the flattening of the ventilation-CO(2) response curve is mechanical in origin and acute airway obstruction produces no change in CO(2) sensitivity.5. On the basis of these results, we suggest that more information about CO(2) sensitivity can be obtained by a combination of ventilation and breath-holding-CO(2) response curves.     

Electron backscatter corrections for parallel-plate chambers

The wall of an ionization chamber is commonly assumed to have a negligible effect on chamber response in electron beams. For cylindrical chambers with thin walls this assumption is valid. However, parallel-plate chambers commonly possess large mechanical supports which may affect chamber response in a manner not accounted for in current dosimetry protocols. This is due to changes with energy in the relative backscattered electron fluence between chamber support and phantom materials. To investigate this effect, electron backscatter from low atomic number materials has been measured with electrons from 6 to 20 MeV. The effect of the diameter and thickness of the backscattering material has also been studied. Based on these data, Lucite and polystyrene chambers in water phantoms are expected to underrespond by 1% and 2% at 6 MeV. The expected underresponse decreases to 0.8% and 0.4% for polystyrene and Lucite at 12 MeV and is insignificant above 16 MeV. Two commercially available parallel-plate chambers were compared with a cylindrical chamber in electron beams from 6 to 20 MeV. Using the 20-MeV intercomparison, the expected chamber responses at the lower energies were calculated and compared with measurements. Both parallel-plate chambers underresponded by approximately 1% at 6 MeV and 0.5% at 9 MeV which is qualitatively consistent with the electron backscatter data. Recommendations for minimizing electron backscatter effects through chamber design are discussed.     

Non-linear analysis of the arterial pulsatile flow: assessment of a model allowing a non-invasive ultrasonic functional exploration.

Ultrasonic measurements and modelling of blood flow in large vessels allows non-invasive evaluation of clinically interesting hemodynamic variables. To this aim, a non-linear mathematical model for the pulsatile arterial flow is proposed using the approximation of "local flow" theory. The model requires only measurements of instantaneous radius and centre-line blood velocity, and the knowledge of the tube distensibility to calculate blood velocity profiles, pressure gradient and wall shear stress. Evaluation of the proposed model using experimental data obtained from the literature proved that it can provide reliable results. In addition, as shown by assessing significance of various non-linear terms, results did not significantly change when a linear pressure-radius relationship was used instead of a non-linear relationship. Also, the model was found to be moderately sensitive to arterial tapering. Thus, the proposed model is suitable for a non-invasive clinical arterial exploration since it only requires three measurements which can be easily and precisely obtained in vivo using ultrasonic methods: the instantaneous radius, the centre-line velocity and the mean pulse wave velocity, this last variable characterizing the tube distensibility when assuming a linear pressure-radius relationship.     

A large-area ionization chamber for portal image calibration

Methods of removing the effects of linear accelerator (linac) output fluctuation from electronic portal images are described and compared. The output of the linac is measured using a specially constructed large-area ionization chamber during imaging and recorded with the image. The use of a dose-rate signal directly from the linac monitor chamber is discussed. Various versions of a quadratic thickness calibration scheme are tested, incorporating linac output data measured by the ionization chamber. Experimental results are presented showing that the incorporation of data from the ionization chamber gives improved absolute calibration accuracy and flatness. Immediately after calibration, the mean systematic thickness error in calibration of a uniform 136.8 mm water-equivalent slab was shown to be no more than 0.6 mm with a thickness variation within each image also of no more than +/-0.8 mm. This was true even when imaging with an unstable linac beam giving mean thickness errors between images of 8.8 mm and variations within each image of +/-4.9 mm without the ionization chamber correction. Up to one month after calibration, use of the ionization chamber to remove short-term linac fluctuations is shown to still keep mean thickness errors to less than 1.6 mm with variations within each image of no more than +/-1.4 mm.     

The automatic computation of pressure-derived maximal shortening velocity (Vmax) of the unloaded contractile element in the intact canine heart left ventricle

Estimation of the maximum velocity (Vmax) of the contractile element of the intact left ventricular wall muscle demands extrapolation of the force-velocity curve to zero load. The present paper describes our on-line computation system for measuring and analysing pressure derived Vmax using both linear (Vmax-lin) and exponential (Vmax-exp) extrapolation methods. The developed pressure during isovolumetric phase of systole was used as an equivalent of the force. Testing on anaesthetized artificially ventilated dogs showed the exponential function to fit pressure-velocity data better than the straight line did. The Vmax-exp attained 15-35% greater values than Vmax-lin, but both responded almost equally when considered on the basis of linear regression analysis (r = 0.991, n = 725). Changes of contractility caused by i.v. infusion of isoproterenol, calcium chloride or propranolol were practically similar when assessed by either method of Vmax computation, or by dP/dtmax. Volume loading by dextran infusion increased not only dP/dtmax, by 33 +/- 13%, but also Vmax, up to 24 +/-. When arterial pressure was raised by phenylephrine infusion, or heart rate by atrial pacing, dP/dtmax increased significantly while Vmax remained unaltered. Hence, the linear and exponential dP/dtmax increased significantly while Vmax remained unaltered. Hence, the linear and exponential extrapolation procedures provided comparable values for Vmax, but the linear one due to its simplicity is more suited for on-line computation. The Vmax thus obtained is, however, not independent of the changes in preload.     

Using Monte Carlo simulations to commission photon beam output factors--a feasibility study

This study investigates the feasibility of using Monte Carlo methods to assist the commissioning of photon beam output factors from a medical accelerator. The Monte Carlo code, BEAMnrc, was used to model 6 MV and 18 MV photon beams from a Varian linear accelerator. When excellent agreements were obtained between the Monte Carlo simulated and measured dose distributions in a water phantom, the entire geometry including the accelerator head and the water phantom was simulated to calculate the relative output factors. Simulated output factors were compared with measured data, which consist of a typical commission dataset for the output factors. The measurements were done using an ionization chamber in a water phantom at a depth of 10 cm with a source-detector distance of 100 cm. Square fields and rectangular fields with widths and lengths ranging from 4 cm to 40 cm were studied. The result shows a very good agreement (< 1.5%) between the Monte Carlo calculated and the measured relative output factors for a typical commissioning dataset. The Monte Carlo calculated backscatter factors to the beam monitor chamber agree well with measured data in the literature. Monte Carlo simulations have also been shown to be able to accurately predict the collimator exchange effect and its component for rectangular fields. The information obtained is also useful to develop an algorithm for accurate beam modelling. This investigation indicates that Monte Carlo methods can be used to assist commissioning of output factors for photon beams.     

Influence of detector size in photon beam profile measurements

Correction is necessary to account for the detector size in clinical dosimetry of photon and electron beams. This correction is due to the absorbed dose gradient present in a finite-size detector. Further corrections are necessary when the detector and phantom materials are not the same. These corrections are due to the perturbation in the charged-particle fluence. Generally these corrections are applied to measurements along the central axis of the beam. Cross beam profile measurements, however, are not usually corrected for detector size. The ionization profile is also usually assumed to be equivalent to the absorbed dose profile. We have corrected the ionization chamber size effect by two approaches: extrapolation of measurements to zero detector size and deconvolution of measurements using a simple model for the detector response function. We have measured absorbed dose profiles to water using a small water-equivalent plastic scintillation detector. Film profile measurements were also studied. The ionization profile corrected for detector size and absorbed dose profile were not equal, probably due to loss of charged-particle equilibrium in the beam edges. For ionization chamber measurements, knowledge of the charged-particle spectrum is needed to convert ionization to absorbed dose to water. This is not necessary for relative absorbed dose measurements under charged-particle equilibrium. Film has been shown to be a straightforward and reliable method for cross beam profile measurements.