Monte Carlo simulations of dose near a nonradioactive gold seed

The relative doses and hot/cold spot positions around a non-radioactive gold seed, irradiated by a 6 or 18 MV photon beam in water, were calculated using Monte Carlo simulation. Phase space files of 6 and 18 MV photon beams with a field size of 1 x 1 cm2 were generated by a Varian 21 EX linear accelerator using the EGSnrc and BEAMnrc code. The seed (1.2 x 1.2 x 3.2 mm3) was positioned at the isocenter in a water phantom (20 x 20 x 20 cm2) with source-to-axis distance = 100 cm. For the single beam geometry, the relative doses (normalized to the dose at 5 mm distance above the isocenter) at the upstream seed surface were calculated to be 1.64 and 1.56 for the 6 and 18 MV beams respectively when the central beam axis (CAX) is parallel to the width of the seed. These doses were slightly higher than those (1.58 and 1.52 for 6 and 18 MV beams respectively) calculated when the CAX is perpendicular to the width of the seed. Compared to the relative dose profiles with the same beam geometry without the seed in the water phantom, the presence of the seed affects the dose distribution at about 3 mm distance beyond both the upstream and downstream seed surface. For a pair of opposing beams with equal and unequal beam weight, the hot and cold spots of both opposing beams were mixed. For a 360 degree photon arc around the longitudinal axis of the seed, the relative dose profile along the width of the seed was similar to that of the opposing beam pair, except the former geometry has a larger dose gradient near the seed surface. In this study, selected results from our simulation were compared to previous measurements using film dosimetry.     

Photonuclear dose calculations for high-energy photon beams from Siemens and Varian linacs

The dose from photon-induced nuclear particles (neutrons, protons, and alpha particles) generated by high-energy photon beams from medical linacs is investigated. Monte Carlo calculations using the MCNPX code are performed for three different photon beams from two different machines: Siemens 18 MV, Varian 15 MV, and Varian 18 MV. The linac head components are simulated in detail. The dose distributions from photons, neutrons, protons, and alpha particles are calculated in a tissue-equivalent phantom. Neutrons are generated in both the linac head and the phantom. This study includes (a) field size effects, (b) off-axis dose profiles, (c) neutron contribution from the linac head, (d) dose contribution from capture gamma rays, (e) phantom heterogeneity effects, and (f) effects of primary electron energy shift. Results are presented in terms of absolute dose distributions and also in terms of DER (dose equivalent ratio). The DER is the maximum dose from the particle (neutron, proton, or alpha) divided by the maximum photon dose, multiplied by the particle quality factor and the modulation scaling factor. The total DER including neutrons, protons, and alphas is about 0.66 cSv/Gy for the Siemens 18 MV beam (10 cm x 10 cm). The neutron DER decreases with decreasing field size while the proton (or alpha) DER does not vary significantly except for the 1 cm x 1 cm field. Both Varian beams (15 and 18 MV) produce more neutrons, protons, and alphas particles than the Siemens 18 MV beam. This is mainly due to their higher primary electron energies: 15 and 18.3 MeV, respectively, vs 14 MeV for the Siemens 18 MV beam. For all beams, neutrons contribute more than 75% of the total DER, except for the 1 cm x 1 cm field (approximately 50%). The total DER is 1.52 and 2.86 cSv/Gy for the 15 and 18 MV Varian beams (10 cm x 10 cm), respectively. Media with relatively high-Z elements like bone may increase the dose from heavy charged particles by a factor 4. The total DER is sensitive to primary electron energy shift. A Siemens 18 MV beam with 15 MeV (instead of 14 MeV) primary electrons would increase by 40% the neutron DER and by 210% the proton + alpha DER. Comparisons with measurements (neutron yields from different materials and neutron dose equivalent) are also presented. Using the NCRP risk assessment method, we found that the dose equivalent from leakage neutrons (at 50-cm off-axis distance) represent 1.1, 1.1, and 2.0% likelihood of fatal secondary cancer for a 70 Gy treatment delivered by the Siemens 18 MV, Varian 15 MV, and Varian 18 MV beams, respectively.     

Peripheral dose measurements for 6 and 18 MV photon beams on a linear accelerator with multileaf collimator

Peripheral dose (PD) to critical structures outside treatment volume is of clinical importance. The aim of the current study was to estimate PD on a linear accelerator equipped with multileaf collimator (MLC). Dose measurements were carried out using an ionization chamber embedded in a water phantom for 6 and 18 MV photon beams. PD values were acquired for field sizes from 5 x 5 to 20 x 20 cm2 in increments of 5 cm at distances up to 24 cm from the field edge. Dose data were obtained at two collimator orientations where the measurement points are shielded by MLC and jaws. The variation of PD with the source to skin distance (SSD), depth, and lateral displacement of the measurement point was evaluated. To examine the dependence of PD upon the tissue thickness at the entrance point of the beam, scattered dose was measured using thermoluminescent dosemeters placed on three anthropomorphic phantoms simulating 5- and 10-year-old children and an average adult patient. PD from 6 MV photons varied from 0.13% to 6.75% of the central-axis maximum dose depending upon the collimator orientation, extent of irradiated area, and distance from the treatment field. The corresponding dose range from 18 MV x rays was 0.09% to 5.61%. The variation of PD with depth and with lateral displacements up to 80% of the field dimension was very small. The scattered dose from both photon beams increased with the increase of SSD or tissue thickness along beam axis. The presented dosimetric data set allows the estimation of scattered dose outside the primary beam.     

A Monte Carlo comparison of the response of the PTW-diamond and the TL-diamond detectors in megavoltage photon beams

A detailed Monte Carlo study of the PTW-diamond solid state detector response in megavoltage photon beams (60Co gamma rays to 25 MV x rays) has been performed with the EGS4 Monte Carlo Code. The sensitive volume of the diamond detector is a disk of diameter 4.4 mm and thickness 0.40 mm. The phantom material was water and the irradiation depth was usually 3 cm but additional simulations were performed at six other depths for the 10 and 25 MV x rays. Results show that the PTW-diamond detector response per unit of absorbed dose is constant within 1% for photon beam energies ranging from 60Co gamma rays to 25 MV x rays. Accurate depth dose curves for 10 and 25 MV x-ray beams may be measured with the diamond detector since the response per unit of absorbed dose at different depths in a water phantom is also constant to within 1% for depths ranging from 3 to 25 cm and field sizes ranging from 2.5 cm by 2.5 cm to 10 cm by 10 cm. An examination of the difference between the PTW-diamond detector and the wall-less form of the detector (e.g., TLDs) revealed that there is no significant difference in their response in megavoltage photon beams. This implies that the encapsulation of the diamond dosimeter causes less than a 1.3% change in its response for these megavoltage photon beams. Analysis of the total dose deposited in the sensitive volume of the detector shows that the PTW-diamond detector behaves as an intermediate-sized cavity, not a simple Bragg-Gray cavity, since the dose contribution from photon interactions within the cavity (alpha(c)) to the total cavity dose is 8% for 25 MV x rays and increases to 42% for 60Co gamma rays.     

Accurate skin dose measurements using radiochromic film in clinical applications

Megavoltage x-ray beams exhibit the well-known phenomena of dose buildup within the first few millimeters of the incident phantom surface, or the skin. Results of the surface dose measurements, however, depend vastly on the measurement technique employed. Our goal in this study was to determine a correction procedure in order to obtain an accurate skin dose estimate at the clinically relevant depth based on radiochromic film measurements. To illustrate this correction, we have used as a reference point a depth of 70 micron. We used the new GAFCHROMIC dosimetry films (HS, XR-T, and EBT) that have effective points of measurement at depths slightly larger than 70 micron. In addition to films, we also used an Attix parallel-plate chamber and a home-built extrapolation chamber to cover tissue-equivalent depths in the range from 4 micron to 1 mm of water-equivalent depth. Our measurements suggest that within the first millimeter of the skin region, the PDD for a 6 MV photon beam and field size of 10 x 10 cm2 increases from 14% to 43%. For the three GAFCHROMIC dosimetry film models, the 6 MV beam entrance skin dose measurement corrections due to their effective point of measurement are as follows: 15% for the EBT, 15% for the HS, and 16% for the XR-T model GAFCHROMIC films. The correction factors for the exit skin dose due to the build-down region are negligible. There is a small field size dependence for the entrance skin dose correction factor when using the EBT GAFCHROMIC film model. Finally, a procedure that uses EBT model GAFCHROMIC film for an accurate measurement of the skin dose in a parallel-opposed pair 6 MV photon beam arrangement is described.     

Ultra-thin TLDs for skin dose determination in high energy photon beams

Estimation of surface dose is very important for patients undergoing radiation therapy. In this work we investigate the dose at the surface of a water phantom and at a depth of 0.007 cm, the practical reference depth for skin as recommended by ICRP and ICRU, with ultra-thin TLDs and Monte Carlo calculations. The calculations and measurements were carried out for fields ranging from 5 x 5 cm2 to 20 x 20 cm2 for 6 MV, 10 MV and 18 MV photon beams. The variation of the surface dose with angle of incidence and field size was investigated. Also, the exit dose was computed and measured for the same fields and angles of incidence. The dose at the ICRU reference depth was computed. Good agreement (+/-5%) was achieved between measurements and calculations. The surface dose at the entrance increased with the angle of incidence and/or the field size. The exit dose decreased with the angle of incidence but it increased with field size. The dose at the surface of the patient is mostly dependent on the beam energy, modality and beam obliquity rather than the field size and field separation. By correlating TLD measurements with Monte Carlo calculations, we were able to predict the dose at the skin surface with good accuracy. Knowing the dose received at the surface of the patient can lead to prediction of skin reactions helping with the design of new treatment techniques and alternative dose fractionation schemes.     

Diamond detector versus silicon diode and ion chamber in photon beams of different energy and field size

The aim of this work was to test the suitability of a PTW diamond detector for nonreference condition dosimetry in photon beams of different energy (6 and 25 MV) and field size (from 2.6 cm x 2.6 cm to 10 cm x 10 cm). Diamond behavior was compared to that of a Scanditronix p-type silicon diode and a Scanditronix RK ionization chamber. Measurements included output factors (OF). percentage depth doses (PDD) and dose profiles. OFs measured with diamond detector agreed within 1% with those measured with diode and RK chamber. Only at 25 MV, for the smallest field size, RK chamber underestimated OFs due to averaging effects in a pointed shaped beam profile. Agreement was found between PDDs measured with diamond detector and RK chamber for both 6 MV and 25 MV photons and down to 5 cm x 5 cm field size. For the 2.6 cm x 2.6 cm field size, at 25 MV, RK chamber underestimated doses at shallow depth and the difference progressively went to zero in the distal region. PDD curves measured with silicon diode and diamond detector agreed well for the 25 MV beam at all the field sizes. Conversely, the nontissue equivalence of silicon led, for the 6 MV beam, to a slight overestimation of the diode doses in the distal region, at all the field sizes. Penumbra and field width measurements gave values in agreement for all the detectors but with a systematic overestimate by RK measurements. The results obtained confirm that ion chamber is not a suitable detector when high spatial resolution is required. On the other hand, the small differences in the studied parameters, between diamond and silicon systems, do not lead to a significant advantage in the use of diamond detector for routine clinical dosimetry.     

Characteristics of an 18 MV photon beam from a Therac 20 Medical Linear Accelerator

The 18 MV photon beam characteristics of a Therac 20 Medical Linear Accelerator manufactured by Atomic Energy of Canada Ltd, are presented. Tissue phantom ratios (TRP's) and percent depth dose data are given; for a 10 x 10 cm field, the percent depth dose at a depth of 10 cm is 78.5 (SSD 100 cm). The relative dose factors (RDF'S) are given and are analyzed to elucidate the relative contributions from phantom scatter, collimator scatter, and backscatter from the top of the collimators into the monitor chambers. The effect of field size and depth on the penumbra is described. Crossplots of the beam at a depth of 5 cm indicate that the flattening filter could be improved; there are hot spots of 108% near the corners of 40 x 40 fields.     

Dosimetry of therapeutic photon beams using an extended dose range film

For intensity modulated radiation therapy (IMRT) dose distribution verification, multidimensional measurements are required to quantify the steep dose-gradient regions. High resolution, two-dimensional dose distributions can be measured using radiographic film. However, the photon energy response of film is known to be a function of depth, field size, and photon beam energy, potentially reducing the accuracy of dose distribution measurements. The dosimetric properties of the recently developed Kodak EDR2 film were investigated and compared to those of Kodak XV film. The dose responses of both film types to 6 MV and 18 MV photon beams were investigated for depths of 5 cm, 10 cm, and 15 cm and field sizes of 4x4 cm2 and 15x15 cm2. This analysis involved the determination of sensitometric curves for XV and EDR2 films, the determination of dose profiles from exposed XV and EDR2 films, and comparison of the film-generated dose profiles to ionization chamber measurements. For the combinations of photon beam energy, depth, and field size investigated here, our results indicate that the sensitometric curves are nearly independent of field size and depth of calibration. For a field size of 4x4 cm2, a single sensitometric curve for either EDR2 and XV film can be used for the determination of relative dose profiles. For the larger field size, the sensitometric curve for EDR2 film is superior to XV film in regions where the dose falls below 20% of the central axis dose, due to the effects that the increased low energy scattered photon contributions have on film response. The limited field size and depth dependence of sensitometric data measured using EDR2 film, along with the inherently wide linear dose-response range of EDR2 film, makes it better suited to the verification of IMRT dose distributions.     

Variation of sensitometric curves of radiographic films in high energy photon beams.

Film dosimetry is an important tool for the verification of irradiation techniques. The shape of the sensitometric curve depends on the type of film as well as on the irradiation and processing conditions. Existing data concerning the influence of irradiation geometry on the sensitometric curve are conflicting. In particular the variation of optical density, OD, with field size and depth in a phantom shows large differences in magnitude between various authors. This variation, as well as the effect of beam energy and film plane orientation on OD, was therefore investigated for two types of film, Kodak X-Omat V and Agfa Structurix D2. Films were positioned in a solid phantom, either perpendicular or (almost) parallel to the beam axis, and irradiated to different dose levels using various photon beams (Co-60, 6 MV, 15 MV, 18 MV, 45 MV). It was found that the sensitometric curves of the Kodak film derived at different depths are almost identical for the four x-ray beams. For the Kodak film the differences in OD with depth are less than 2%, except for the Co-60 beam, where the difference is about 4% at 10 cm depth for a 15 cm x 15 cm field. The slope of the sensitometric curve of the Agfa film is somewhat more dependent on photon beam energy, depth and field size. The sensitometric curves of both types of film are almost independent of the film plane orientation, except for shallow depths. For Co-60 and for the same dose, the Kodak and Agfa films gave at dose maximum an OD lower by 4% and 6%, respectively, for the parallel compared to the perpendicular geometry. Good dosimetric results can be obtained if films from the same batch are irradiated with small to moderate field sizes (up to about 15 cm x 15 cm), at moderate depths (up to about 15 cm), using a single calibration curve, e.g., for a 10 cm x 10 cm field.     

Energy spectra, angular spread, fluence profiles and dose distributions of 6 and 18 MV photon beams: results of monte carlo simulations for a varian 2100EX accelerator

The purpose of this study is to provide detailed characteristics of incident photon beams for different field sizes and beam energies. This information is critical to the future development of accurate treatment planning systems. It also enhances our knowledge of radiotherapy photon beams. The EGS4 Monte Carlo code, BEAM, has been used to simulate 6 and 18 MV photon beams from a Varian Clinac-2100EX accelerator. A simulated realistic beam is stored in a phase space data file, which contains details of each particle's complete history including where it has been and where it has interacted. The phase space files are analysed to obtain energy spectra, angular distribution, fluence profile and mean energy profiles at the phantom surface for particles separated according to their charge and history. The accuracy of a simulated beam is validated by the excellent agreement between the Monte Carlo calculated and measured dose distributions. Measured depth-dose curves are obtained from depth-ionization curves by accounting for newly introduced chamber fluence corrections and the stopping-power ratios for realistic beams. The study presents calculated depth-dose components from different particles as well as calculated surface dose and contribution from different particles to surface dose across the field. It is shown that the increase of surface dose with the increase of the field size is mainly due to the increase of incident contaminant charged particles. At 6 MV, the incident charged particles contribute 7% to 21% of maximum dose at the surface when the field size increases from 10 x 10 to 40 x 40 cm2. At 18 MV, their contributions are up to 11% and 29% of maximum dose at the surface for 10 x 10 cm2 and 40 x 40 cm2 fields respectively. However, the fluence of these incident charged particles is less than 1% of incident photon fluence in all cases.     

Monte Carlo calculations of scatter to primary ratios for normalisation of primary and scatter dose

The separation of total absorbed dose into primary and scatter components is a commonly used technique in photon dose calculations. The primary dose component can be characterised by a measured narrow beam attenuation coefficient and a single normalisation value which establishes the relative proportion of the primary to the total dose at some reference depth and field size. The determination of this normalisation value from measured data requires an extrapolation of measured values for finite field sizes to obtain a zero field size value. We have used Monte Carlo simulations to score primary and scatter dose for photon beams of 4, 6, 10, 15 and 24 MV and report values of the scatter to primary ratio at the depth of dose maximum for the circular equivalent of a 10 cm x 10 cm field. These values have an uncertainty of less than 1% and can be used in lieu of extrapolation of measured data to establish the relative magnitude of the primary dose for a wide range of photon beam energies.     

Commissioning of a medical accelerator photon beam Monte Carlo simulation using wide-field profiles

A method for commissioning an EGSnrc Monte Carlo simulation of medical linac photon beams through wide-field lateral profiles at moderate depth in a water phantom is presented. Although depth-dose profiles are commonly used for nominal energy determination, our study shows that they are quite insensitive to energy changes below 0.3 MeV (0.6 MeV) for a 6 MV (15 MV) photon beam. Also, the depth-dose profile dependence on beam radius adds an additional uncertainty in their use for tuning nominal energy. Simulated 40 cm x 40 cm lateral profiles at 5 cm depth in a water phantom show greater sensitivity to both nominal energy and radius. Beam parameters could be determined by comparing only these curves with measured data.     

AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams.

A protocol is prescribed for clinical reference dosimetry of external beam radiation therapy using photon beams with nominal energies between 60Co and 50 MV and electron beams with nominal energies between 4 and 50 MeV. The protocol was written by Task Group 51 (TG-51) of the Radiation Therapy Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol uses ion chambers with absorbed-dose-to-water calibration factors, N(60Co)D,w which are traceable to national primary standards, and the equation D(Q)w = MkQN(60Co)D,w where Q is the beam quality of the clinical beam, D(Q)w is the absorbed dose to water at the point of measurement of the ion chamber placed under reference conditions, M is the fully corrected ion chamber reading, and kQ is the quality conversion factor which converts the calibration factor for a 60Co beam to that for a beam of quality Q. Values of kQ are presented as a function of Q for many ion chambers. The value of M is given by M = PionP(TP)PelecPpolMraw, where Mraw is the raw, uncorrected ion chamber reading and Pion corrects for ion recombination, P(TP) for temperature and pressure variations, Pelec for inaccuracy of the electrometer if calibrated separately, and Ppol for chamber polarity effects. Beam quality, Q, is specified (i) for photon beams, by %dd(10)x, the photon component of the percentage depth dose at 10 cm depth for a field size of 10x10 cm2 on the surface of a phantom at an SSD of 100 cm and (ii) for electron beams, by R50, the depth at which the absorbed-dose falls to 50% of the maximum dose in a beam with field size > or =10x10 cm2 on the surface of the phantom (> or =20x20 cm2 for R50>8.5 cm) at an SSD of 100 cm. R50 is determined directly from the measured value of I50, the depth at which the ionization falls to 50% of its maximum value. All clinical reference dosimetry is performed in a water phantom. The reference depth for calibration purposes is 10 cm for photon beams and 0.6R50-0.1 cm for electron beams. For photon beams clinical reference dosimetry is performed in either an SSD or SAD setup with a 10x10 cm2 field size defined on the phantom surface for an SSD setup or at the depth of the detector for an SAD setup. For electron beams clinical reference dosimetry is performed with a field size of > or =10x10 cm2 (> or =20x20 cm2 for R50>8.5 cm) at an SSD between 90 and 110 cm. This protocol represents a major simplification compared to the AAPM's TG-21 protocol in the sense that large tables of stopping-power ratios and mass-energy absorption coefficients are not needed and the user does not need to calculate any theoretical dosimetry factors. Worksheets for various situations are presented along with a list of equipment required.     

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.     

Analysis of various beamlet sizes for IMRT with 6 MV photons

Application of intensity modulated radiation therapy (IMRT) using multileaf collimation often requires the use of small beamlets to optimize the delivered radiation distribution. Small-beam dose distribution measurements were compared to dose distributions calculated using a commercial treatment planning system that models its data acquired using measurements from relatively large fields. We wanted to evaluate only the penumbra, percent depth-dose (PDD) and output model, so we avoided dose distribution features caused by rounded leaf ends and interleaf leakage by making measurements using the secondary collimators. We used a validated radiochromic film dosimetry system to measure high-resolution dose distributions of 6 MV photon beams. A commercial treatment planning system using the finite size pencil beam (FSPB) dose calculation algorithm was commissioned using measured central axis outputs from 4.0x4.0 to 40.0x40.0 cm2 beams and radiographic-film profile measurements of a 4.0x4.0 cm2 beam at twice the depth of maximum dose (dmax). Calculated dose distributions for square fields of 0.5x0.5 cm2, and 1.0x1.0 cm2, to 6.0x6.0 cm2, in 1.0x1.0 cm2, increments were compared against radiochromic film measurements taken with the film oriented parallel to the beam central axis in a water equivalent phantom. The PDD of the smaller field sizes exhibited behavior typical of small fields, namely a decrease in dmax with decreasing field size. The FSPB accurately modeled the depth-dose and central axis output for depths deeper than the nominal dmax of 1.5 cm plus 0.5 cm. The dose distribution in the build-up and penumbra regions was not accurately modeled for depths less than 2 cm, especially for the fields of 2.0x2.0 cm2 and smaller. Using the gamma function with 2 mm and 2% criteria, the dose model was shown to accurately predict the penumbra. While for single small beams the compared dose distributions passed the gamma function criteria, the clinical appropriateness of these criteria is not clear for a composite IMRT plan. Further investigation of the cumulative impact of the observed dose discrepancies is warranted. We speculate that the observed differences in the penumbra regions arise from some energy dependent artifact in the radiographic-film profiles used for commissioning. In the future, radiochromic film based commissioning might provide a more accurate data set for dose modeling.     

Influence of phantom material and phantom size on radiographic film response in therapy photon beams

The energy dependence of radiographic film can introduce dosimetric errors when evaluating photon beams. The variation of the film response, which is attributed to the changing photon spectrum with depth and field size, has been the subject of numerous publications in recent years. However, these data show large unexplained differences in the magnitude of this variation among independent studies. To try to resolve this inconsistency, this study assesses the dependence of radiographic film response on phantom material and phantom size using film measurements and Monte Carlo calculations. The relative dose measured with film exposed to 6 MV x rays in various phantoms (polystyrene, acrylic, Solid Water, and water; the lateral phantom dimensions vary from 25 to 50 cm square; backscatter thickness varies from 10 to 30 cm) is compared with ion chamber measurements in water. Ranges of field size (5 x 5 to 40 x 40 cm2) and depth (dmax to 20 cm) are studied. For similar phantom and beam configurations, Monte Carlo techniques generate photon fluence spectra from which the relative film response is known from an earlier study. Results from film response measurements agree with those derived from Monte Carlo calculations within 3%. For small fields (< or = 10 x 10 cm2) and shallow depths (< or = 10 cm) the film response variation is small, less than 4%, for all phantoms. However, for larger field sizes and depths, the phantom material and phantom size have a greater influence on the magnitude of the film response. The variation of film response, over the ranges of field sizes and depths studied, is 50% in polystyrene compared with 30% in water. Film responses in Solid Water and water phantoms are similar; acrylic is between water and polystyrene. In polystyrene the variation of film response for a 50 cm square phantom is nearly twice that observed in a 25 cm square phantom. This study shows that differences in the configuration of the phantoms used for film dosimetry can explain much of the inconsistency for film response reported in the literature.     

Suppression of dark current radiation in step-and-shoot intensity modulated radiation therapy by the initial pulse-forming network

The effect of the initial pulse forming network (IPFN) on the suppression of dark current is investigated for a Siemens Primus accelerator. The dark current produces a spurious radiation, which is referred to as dark current radiation (DCR) in this study. In the step-and-shoot delivery of an intensity modulated radiation therapy (IMRT), the DCR could be of some concern for whole body dose along with leakage radiation through collimator jaws or multileaf collimator. By adjusting the IPFN-to-PFN ratio to >0.8, the DCR can be measured with an ion chamber during the "PAUSE" state of the accelerator in the IMRT mode. For 15 MV x rays, the magnitude of the DCR is approximately equal to 0.7% of the dose at dmax for a 10 x 10 cm2 field. The DCR has a similar central axis depth dose as a 15 MV beam as determined from a water phantom scan. When the IPFN-to-PFN ratio is lowered to <0.8, no DCR is detected. For low energy x rays (6 MV), no DCR is detected regardless of the IPFN-to-PFN ratio. Although the DCR is studied only for the Siemens Primus model accelerator, the same precaution applies to other models of modern accelerators from other vendors. Due to the large number of field segments used in a step-and-shoot IMRT, it is imperative therefore, that dark current evaluation be part of machine commissioning and annual calibration for high-energy photon beams. Should DCR be detected, the medical physicist should work with a service engineer to rectify the problem. In view of DCR and whole body dose, low-energy photon beams are advisable for IMRT.     

Investigation of Kodak extended dose range (EDR) film for megavoltage photon beam dosimetry

We have investigated the dependence of the measured optical density on the incident beam energy, field size and depth for a new type of film, Kodak extended dose range (Kodak EDR). Film measurements have been conducted over a range of field sizes (3 x 3 cm2 to 25 x 25 cm2) and depths (d(max) to 15 cm), for 6 MV and 15 MV photons within a solid water phantom, and the variation in sensitometric response (net optical density versus dose) has been reported. Kodak EDR film is found to have a linear response with dose, from 0 to 350 cGy, which is much higher than that typically seen for Kodak XV film (0-50 cGy). The variation in sensitometric response for Kodak EDR film as a function of field size and depth is observed to be similar to that of Kodak XV film; the optical density varied in the order of 2-3% for field sizes of 3 x 3 cm2 and 10 x 10 cm2 at depths of d(max), 5 cm and 15 cm in the phantom. Measurements for a 25 x 25 cm2 field size showed consistently higher optical densities at depths of d(max), 5 cm and 15 cm, relative to a 10 x 10 cm2 field size at 5 cm depth, with 4-5% differences noted at a depth of 15 cm. Fractional depth dose and profiles conducted with Kodak EDR film showed good agreement (2%/2 mm) with ion chamber measurements for all field sizes except for the 25 x 25 cm2 at depths greater than 15 cm, where differences in the order of 3-5% were observed. In addition, Kodak EDR film measurements were found to be consistent with those of Kodak XV film for all fractional depth doses and profiles. The results of this study indicate that Kodak EDR film may be a useful tool for relative dosimetry at higher dose ranges.