Characterization and real-time optical measurements of the ionizing radiation dose response for a new radiochromic medium

A new radiochromic film, GafChromic EBT, was investigated for use in a real-time radiation dosimetry system. It was found to be approximately eight times more sensitive to ionizing radiation dose, exhibited less postexposure development and achieved stable readout faster than one of its predecessors, GafChromic MD-55. A clear distinction in change in optical density between exposure and postexposure was observed, but the measurements obtained during exposure were not linear with time or dose. This could not be explained by a shift in wavelength of maximum change in absorbance, as it was stable at approximately 636 nm during the entire exposure range (up to 9.52 Gy). Increasing the spectral window of interest over which calculations were performed did little to correct the nonlinearity. The radiochromic film exhibited small dose rate dependence in real-time measurements, with an increase in standard deviation of change in optical density measurements from 0.9% to 1.8% over a sixfold variation in dose rate. Overall, GafChromic EBT has increased sensitivity and decreased postexposure darkening, and this bodes well for its potential role as a radiation dosimeter, including real-time applications.     

Low dose fraction behavior of high sensitivity radiochromic film

A high sensitivity (HS) model of radiochromic film is receiving increasing use. The film's linear sensitometric response in the range of 0.5-40 Gy would make this film an ideal candidate for complex dosimetry applications that require tissue equivalence. This study investigates the potential use for clinical dosimetry of typical radiotherapy fractions at relatively low doses (0.5-5 Gy). The experiment involved exposing 25 pre-exposed pieces of HS film to five equal fractions of doses from 0.5 to 5 Gy 24 hours apart. The cumulative dose for each film was carefully monitored and optical density measurements were used as the sole determination of film response to dose. The average behavior of the various fractionation schemes was roughly consistent with previous observations of the MD-55 radiochromic film with about twice the overall sensitivity as expected. However, at low doses and low dose increments, unexpected variations beyond a well-documented low dose nonlinearity were observed. These unexpected variations may indicate complex polymer kinetics at low doses. This type of film would require extra care beyond that described in TG-55 for accurate use at low doses or low dose fraction schemes.     

Energy and integrated dose dependence of MOSFET dosimeter sensitivity for irradiation energies between 30 kV and 60Co

Since metal-oxide-semiconductor field effect transistors (MOSFETs) medical applications in radiotherapy and radiology are gaining popularity, evaluating them under radiation of different energies is of major interest. This study aims at a characterization of MOSFET sensitivity with regard to total integrated dose. Sensitivity is expressed by the water calibration factor (CFw) and allows the user to associate the voltage difference reading displayed by the device to a dose value in water at the MOSFET location. The CFw of seven p-type dual-bias MOSFETs were measured for several accumulated doses. The radiation sources used were a 60Co unit ((E)gamma: 1.25 MeV), an 192Ir high dose rate unit ((E)gamma: 380 keV), and an orthovoltage unit providing two x-ray energy spectra for tube voltages of 30 kV((E)gamma:14.8 KeV) and 150 kV((E)gamma:70.1 keV). The CFw value diminishes with increasing threshold voltage, especially for low-energy radiation. It was stable for 60Co irradiations, while it decreased 6%, 5%, and 15% for beam energies of 192Ir, 150 kV, and 30 kV, respectively. The decrease rate is higher for the first half of the device lifetime. This behavior is explained by an alteration of the effective electric field applied to the MOSFET during irradiation, caused by the accumulation of holes at the Si-SiO2 interface. It is strongly dependent on the nature of the radiation, and particularly affects low x-ray energies. A frequent calibration of the device for this radiation type is essential in order to achieve adequate measurement accuracy, especially in low-energy applications, such as superficial therapy, brachytherapy, and diagnostic and interventional radiology.     

Energy dependence (75 kVp to 18 MV) of radiochromic films assessed using a real-time optical dosimeter

The response of radiochromic film, GafChromic EBT, was investigated for dependence on x-ray beam energy using a previously reported real-time optical readout approach. X-ray beams of energy from 75 kVp to 18 MV were employed. The dose-induced change in optical density for the EBT film was compared to values obtained for GafChromic HS and MD-55 films, exposed under the same conditions. All responses were normalized to that obtained for 60Co irradiation. While change in optical density for 1 Gy of applied dose as measured with HS and MD-55 films decreased by approximately 40% at low energies, the mean change in optical density of EBT film remained within 3% of that in the 60Co beam over the entire energy range.     

Dose and energy dependence of response of Gafchromic XR-QA film for kilovoltage x-ray beams

There is a growing interest in Gafchromic films for patient dosimetry in radiotherapy and in radiology. A new model (XR-QA) with high sensitivity to low dose was tested in this study. The response of the film to different x-ray beam energies (range 28-145 kVp with various filtrations, dose range 0-100 mGy) and to visible light was investigated, together with the after exposure darkening properties. Exposed films were digitized with a commercially available, optical flatbed scanner. A single functional form for dose versus net pixel value variation has been determined for all the obtained calibration curves, with a unique fit parameter different for each of the used x-ray beams. The film response was dependent on beam energy, with higher colour variations for the beams in the range 80-140 kVp. Different sources of uncertainties in dose measurements, governed by the digitalization process, the film response uniformity and the calibration curve fit procedure, have been considered. The overall one-sigma dose measurement uncertainty depended on the beam energy and decreased with increasing absorbed dose. For doses above 10 mGy and beam energies in the range 80-140 kVp the total uncertainty was less than 5%, whereas for the 28 kVp beam the total uncertainty at 10 mGy was about 10%. The post-exposure colour variation was not negligible in the first 24 h after the exposure, with a consequent increase in the calculated dose of about 10%. Results of the analysis of the sensitivity to visible light indicated that a short exposure of this film to ambient and scanner light during the measurements will not have a significant impact on the radiation dosimetry.     

Dose response characteristics of new models of GAFCHROMIC films: dependence on densitometer light source and radiation energy

This paper presents a systematic study of the dose response characteristics of two new models and one commonly used model of GAFCHROMIC film: HS, XR-T, and MD55-2, respectively. We irradiated these film models with three different radiation sources: I-125, Ir-192, and 6 MV photon beam (6 MVX). We scanned the films with three different densitometers: a He-Ne laser with a wavelength of 633 nm, a spot densitometer with a wavelength of 671 nm, and a CCD camera densitometer with interchangeable LED boxes with wavelengths of 665 nm (red), 520 nm (green), and 465 nm (blue). We compared the film sensitivities in terms of net optical density (NOD) per unit dose in Gy. The sensitivity of each film model depends on radiation energy and the densitometer light source. Using He-Ne laser based densitometer as a reference standard, we found the sensitivities (NOD/Gy) for the red lights of wavelengths, 671 nm and 665 nm, are higher by factors of about 2.5 and 2, respectively. The sensitivities for green (520 nm) and blue (465 nm) lights are lower than that for He-Ne laser (633 nm) by factors of about 2 and 4, respectively. The energy dependence of the sensitivity varies with the film model, but is similar for all densitometer light sources. Comparing I-125 to Ir-192 and 6MVX, we note that (a) model XR-T is about eight times more sensitive, and (b) models HS and MD55-2 are about 40% less sensitive. Relative to MD55-2, XR-T is 12 times more sensitive for I-125 but comparable for Ir-192 and 6MVX, whereas HS is 2 to 3 times more sensitive in all cases. This set of results can serve as useful information for making decisions in selecting the film model and compatible densitometer to achieve the best accuracy of dosimetry in the appropriate dose range.     

Temperature and hydration effects on absorbance spectra and radiation sensitivity of a radiochromic medium

The effects of temperature on real time changes in optical density (DeltaOD) of GAFCHROMIC EBT film were investigated. The spectral peak of maximum change in absorbance (lambdamax) was shown to downshift linearly when the temperature of the film was increased from 22 to 38 degrees C. The DeltaOD values were also shown to decrease linearly with temperature, and this decrease could not be attributed to the shift in lambdamax. A compensation scheme using lambdamax and a temperature-dependent correction factor was investigated, but provided limited improvement. Part of the reason may be the fluctuations in hydration of the active component, which were found to affect both position of absorbance peaks and the sensitivity of the film. To test the effect of hydration, laminated and unlaminated films were desiccated. This shifted both the major and minor absorbance peaks in the opposite direction to the change observed with temperature. The desiccated film also exhibited reduced sensitivity to ionizing radiation. Rehydration of the desiccated films did not reverse the effects, but rather gave rise to another form of the polymer with absorbance maxima upshifted further 20 nm. Hence, the spectral characteristics and sensitivity of the film can be dependent on its history, potentially complicating both real-time and conventional radiation dosimetry.     

Measurement of energy dependence for XRCT radiochromic film

Gafchromic XRCT, radiochromic film is assessed over a broad energy range, from kilovoltage to megavoltage x rays for variations in reflected optical density to dose response. A large energy dependence was found with reflected optical density output for the same delivered dose varying from 7.8 +/- 0.35 at 25.5 keV (50 kVp) peaking at 12.1 +/- 0.5 at 54 keV (125 kVp) to 0.975 +/- 0.03 at 2300 keV (10 MV) when normalized to 1 at 1400 keV (6 MV) energy. The response is constant (within 3%) in the 36-69 keV equivalent photon energy range, which corresponds to x-ray tube generating potentials of approximately 100-150 kVp. This matches well with beam qualities for diagnostic computed topography applications.     

Bone and mucosal dosimetry in skin radiation therapy: a Monte Carlo study using kilovoltage photon and megavoltage electron beams

This study examines variations of bone and mucosal doses with variable soft tissue and bone thicknesses, mimicking the oral or nasal cavity in skin radiation therapy. Monte Carlo simulations (EGSnrc-based codes) using the clinical kilovoltage (kVp) photon and megavoltage (MeV) electron beams, and the pencil-beam algorithm (Pinnacle(3)?treatment planning system) using the MeV electron beams were performed in dose calculations. Phase-space files for the 105 and 220 kVp beams (Gulmay D3225 x-ray machine), and the 4 and 6?MeV electron beams (Varian 21 EX linear accelerator) with a field size of 5?cm diameter were generated using the BEAMnrc code, and verified using measurements. Inhomogeneous phantoms containing uniform water, bone and air layers were irradiated by the kVp photon and MeV electron beams. Relative depth, bone and mucosal doses were calculated for the uniform water and bone layers which were varied in thickness in the ranges of 0.5-2?cm and 0.2-1?cm. A uniform water layer of bolus with thickness equal to the depth of maximum dose (d(max)) of the electron beams (0.7?cm for 4 MeV and 1.5?cm for 6 MeV) was added on top of the phantom to ensure that the maximum dose was at the phantom surface. From our Monte Carlo results, the 4 and 6 MeV electron beams were found to produce insignificant bone and mucosal dose (<1%), when the uniform water layer at the phantom surface was thicker than 1.5?cm. When considering the 0.5?cm thin uniform water and bone layers, the 4 MeV electron beam deposited less bone and mucosal dose than the 6 MeV beam. Moreover, it was found that the 105 kVp beam produced more than twice the dose to bone than the 220 kVp beam when the uniform water thickness at the phantom surface was small (0.5?cm). However, the difference in bone dose enhancement between the 105 and 220 kVp beams became smaller when the thicknesses of the uniform water and bone layers in the phantom increased. Dose in the second bone layer interfacing with air was found to be higher for the 220 kVp beam than that of the 105 kVp beam, when the bone thickness was 1?cm. In this study, dose deviations of bone and mucosal layers of 18% and 17% were found between our results from Monte Carlo simulation and the pencil-beam algorithm, which overestimated the doses. Relative depth, bone and mucosal doses were studied by varying the beam nature, beam energy and thicknesses of the bone and uniform water using an inhomogeneous phantom to model the oral or nasal cavity. While the dose distribution in the pharynx region is unavailable due to the lack of a commercial treatment planning system commissioned for kVp beam planning in skin radiation therapy, our study provided an essential insight into the radiation staff to justify and estimate bone and mucosal dose.     

Slit design for efficient and accurate MTF measurement at megavoltage x-ray energies

Empirical determination of the modulation transfer function (MTF) for analog and digital mega-voltage x-ray imagers is a challenging task. The most common method used to determine MTF at megavoltage x-ray energies employs a long, narrow slit formed by two parallel, metal blocks in order to form a "slit beam." In this work, a detailed overview of some of the important considerations of slit design is presented. Based on these considerations, a novel, compact slit, using 19 cm thick tungsten blocks, was designed. The prototype slit was configured to attach to the accessory slot of the gantry of a linear accelerator, which greatly simplified the measurement process. Measurements were performed to determine the presampling MTF at 6 MV for an indirect detection active matrix flat panel imager prototype previously developed for megavoltage imaging applications. In addition, the effects of two important slit design parameters, material type and thickness, on the accuracy of MTF determination were investigated via a Monte Carlo-based theoretical study. Empirically determined MTFs obtained from the prototype slit closely match those from an earlier, less compact slit design based on 40 cm thick steel blocks. The results of the Monte Carlo-based theoretical studies indicate that the prototype slit achieves close-to-ideal performance in terms of accurately determining the MTF by virtue of practically 100% beam attenuation in regions other than the slit gap. Furthermore, the theoretical results suggest that it may be possible to achieve even further reductions in slit thickness without compromising measurement accuracy.     

A technique for on-board CT reconstruction using both kilovoltage and megavoltage beam projections for 3D treatment verification

The technologies with kilovoltage (kV) and megavoltage (MV) imaging in the treatment room are now available for image-guided radiation therapy to improve patient setup and target localization accuracy. However, development of strategies to efficiently and effectively implement these technologies for patient treatment remains challenging. This study proposed an aggregated technique for on-board CT reconstruction using combination of kV and MV beam projections to improve the data acquisition efficiency and image quality. These projections were acquired in the treatment room at the patient treatment position with a new kV imaging device installed on the accelerator gantry, orthogonal to the existing MV portal imaging device. The projection images for a head phantom and a contrast phantom were acquired using both the On-Board Imager kV imaging device and the MV portal imager mounted orthogonally on the gantry of a Varian Clinac 21EX linear accelerator. MV projections were converted into kV information prior to the aggregated CT reconstruction. The multilevel scheme algebraic-reconstruction technique was used to reconstruct CT images involving either full, truncated, or a combination of both full and truncated projections. An adaptive reconstruction method was also applied, based on the limited numbers of kV projections and truncated MV projections, to enhance the anatomical information around the treatment volume and to minimize the radiation dose. The effects of the total number of projections, the combination of kV and MV projections, and the beam truncation of MV projections on the details of reconstructed kV/MV CT images were also investigated.     

Photon energy dependence of the sensitivity of radiochromic film and comparison with silver halide film and LiF TLDs used for brachytherapy dosimetry

There is a new radiochromic film, a highly uniform, thin (100-microns) detector whose sensitive layer (6 microns thick) changes from colorless to blue by dye polymerization without processing, upon exposure to ionizing radiation. Because the dose gradients around brachytherapy sources are steep, the high spatial resolution offered by film dosimetry is an advantage over other detectors such as thermoluminescent dosimeters (TLDs). This compares the photon energy dependence of the sensitivities of GafChromic film, silver halide verification film (Kodak X-Omat V Film), and lithium fluoride TLDs (Harshaw), over the photon energy range 28 keV to 1.7 MeV, which is of interest in brachytherapy. Sensitivity of the radiochromic film is observed to decrease by about 30% as effective photon energy decreases from 1710 keV (4-MV x rays) to 28 keV (60-kV x rays, 2-mm A1 filter). In contrast, the sensitivity of verification film increases by 980% and that of LiF TLDs increases by 41%. The variation of the sensitivity of radiochromic film with photon energy is considerably less than that for silver halide film and similar to that for LiF TLDs, but in the opposite direction. Radiochromic film, like LIF TLDs, does not exhibit the drastic sensitivity changes below 127 keV that silver halide film exhibits. Dose distribution in the immediate vicinity of a high activity (370 GBq) brachytherapy 192Ir source has been mapped using radiochromic film and is presented to illustrate the applicability of this new technology to brachytherapy dosimetry.     

Generation and modelling of megavoltage photon beams for contrast-enhanced radiation therapy

Contrast-enhanced radiation therapy (CERT) is a treatment approach involving the irradiation of tumours containing high atomic number (Z) contrast media, using low-quality x-ray beams. This work describes the experimental generation of x-ray beams using a linear accelerator with low-Z target materials (beryllium and aluminium), in order to produce photon energy spectra appropriate for CERT. Measurements were made to compare the experimental beams to conventional linear accelerator photon beams in terms of per cent depth dose. Monte Carlo simulation was used to model the generation of each beam, and models were validated against experimental measurement. Validated models were used to demonstrate changes in photon spectra as well as to quantify the variation of tumour dose enhancement with iodinated contrast medium concentration in a simulated tumour volume. Finally, the ratio of the linear attenuation coefficient for iodinated contrast medium relative to water was determined experimentally as a function of iodine concentration. Beams created with low-Z targets show significant changes in energy spectra compared to conventional beams. For the 4 MeV/Be beam, for example, 33% of photons have energies below 60 keV. Measurements and calculation show that both the linear attenuation coefficient ratio and dose enhancement factor (DEF) increase most rapidly at concentrations below 46 mg I ml(-1). There is a significant dependence of DEF on electron energy and a lesser dependence on target material. The 4 MeV/Be beam is the most promising in terms of magnitude of DEF - for example, DEF values of 1.16 and 1.29 are obtained for concentrations of 20 mg I ml(-1) and 50 mg I ml(-1), respectively. DEF will increase or decrease, respectively, for shallower or deeper tumours at a rate of approximately 1.1% cm(-1). In summary, we show that significant dose enhancement is possible by altering the linear accelerator target and filtration, but the magnitude is highly dependent on contrast medium concentration.     

Development and initial evaluation of a spectral microdensitometer for analysing radiochromic films

Radiation dose deposited on a radiochromic film is considered as a dose image. A precise image extraction system with commensurate capabilities is required to measure the transmittance of the image and translate it to radiation dose. This paper describes the development of a spectral microdensitometer which has been designed to achieve this goal under the conditions of (a) the linearity and sensitivity of the dose response curve of the radiochromic film being highly dependent on the wavelength of the analysing light, and (b) the inherent high spatial resolution of the film. The microdensitometer consists of a monochromator which provides an analysing light of variable wavelength, a film tray on a high-precision scanning stage, a transmission microscope coupled to a thermoelectrically cooled CCD camera, a microcomputer and corresponding interfaces. The measurement of the transmittance of the radiochromic film is made at the two absorption peaks with maximum sensitivities. The high spatial resolution of the instrument, of the order of micrometres, is achieved through the use of the microscope combined with a measure-and-step technique to cover the whole film. The performance of the instrument in regard to the positional accuracy, system reproducibility and dual-peak film calibration was evaluated. The results show that the instrument fulfils the design objective of providing a precise image extraction system for radiochromic films with micrometre spatial resolution and sensitive dose response.     

Suitability of radiochromic medium for real-time optical measurements of ionizing radiation dose

A system, consisting of a novel optical fiber-based readout configuration and model-based method, has been developed to test suitability of a certain radiochromic medium for real-time measurements of ionizing radiation dose. Using this system with the radiochromic film allowed dose measurements to be performed during, and immediately after, exposure. The rates of change in OD before, during, and after exposure differ, and the change in OD during exposure was found to be proportional to applied dose in the tested range of 0-4 Gy. Estimating applied dose within an average error of less than 5% did not require a waiting time of 24-48 h as generally recommended with this radiochromic film. The errors can be further reduced by performing a calibration for each individual dosimeter setup instead of relying on batch calibration. Measurements of change in OD were found to be independent of dose-rate in the 95-570 cGy/min range for applied dose of 1 Gy or less. Some error was introduced due to dose-rate variation for doses of 2 Gy and above. The major limiting factor in utilizing this radiation sensitive medium for real-time in vivo dosimetry is the strong dependence on temperature in the clinically relevant range of 20-38 degrees C.     

Energy dependence of the response of lithium fluoride TLD rods in high energy electron fields.

The energy dependence of lithium fluoride dosemeters is a complicated function of energy as well as of cavity size. In the application of TLD to charged particle dosimetry, a cavity perturbation effect may exist even though the ratios of the mass stopping powers are constant over the energies encountered. This effect was investigated for lithium fluoride rods in electron fields ranging in energy from 2-5 to 20 MeV. A 13% change of TL response per unit of absorbed dose was measured over that energy range. A semi-empirical theory was developed to account for the cavity effect, using Burlin cavity theory as a starting point. The agreement between theory and measurement is satisfactory.