Comparison study of MOSFET detectors and diodes for entrance in vivo dosimetry in 18 MV x-ray beams

The feasibility of dual bias dual metal oxide semiconductor field effect transistors (MOSFETs) for entrance in vivo dose measurements in high energy x-rays beams (18 MV) was investigated. A comparison with commercially available diodes for in vivo dosimetry for the same energy range was performed. As MOSFETs are sold without an integrated build-up cap, different caps were tested: 3 cm bolus, 2 cm bolus, 2 cm hemispherical cap of a water equivalent material (Plastic Water) and a metallic hemispherical cap. This metallic build-up cap is the same as the one that is mounted on the in vivo diode used in this study. Intrinsic precision and response linearity with dose were determined for MOSFETs and diodes. They were then calibrated for entrance in vivo dosimetry in an 18 MV x-ray beam. Calibration included determination of the calibration factor in standard reference conditions and of the correction factors (CF) when irradiation conditions differed from those of reference. Correction factors for field size, source surface distance, wedge, and temperature were determined. Sensitivity variation with accumulated dose and the lifetime of both types of detectors were also studied. Finally, the uncertainties of entrance in vivo measurements using MOSFET and diodes were discussed. Intrinsic precision for MOSFETs for the high sensitivity mode was 0.7% (1 s.d.) as compared to the 0.05% (1 s.d.) for the studied diodes. The linearity of the response with dose was excellent (R2 = 1.000) for both in vivo dosimetry systems. The absolute values of the studied correction factors for the MOSFETs when covered by the different build-up caps were of the same order of those determined for the diodes. However, the uncertainties of the correction factors for MOSFETs were significantly higher than for diodes. Although the intrinsic precision and the uncertainty on the CF was higher for MOSFET detectors than for the studied diodes, the total uncertainty in entrance dose determination, once they were calibrated, was of 2.9% (1 s.d.) while for diodes it was 2.0% (1 s.d.). MOSFETs showed no sensitivity variation with accumulated dose or temperature. When used in the high sensitivity mode, after approximately 50 Gy of accumulated dose MOSFETs could no longer be used as radiation dosimeters. In conclusion, MOSFETs can be used for entrance in vivo dosimetry in high energy x-rays beams if covered by an appropriate build-up cap. Metallic build-up caps, such as those used for in vivo diodes, have the advantage of greater patient comfort and less perturbation of the treatment field than the other build-up caps tested, while keeping the correction factors of the same order.     

Validation of Monte Carlo calculated surface doses for megavoltage photon beams

Recent work has shown that there is significant uncertainty in measuring build-up doses in mega-voltage photon beams especially at high energies. In this present investigation we used a phantom-embedded extrapolation chamber (PEEC) made of Solid Water to validate Monte Carlo (MC)-calculated doses in the dose build-up region for 6 and 18 MV x-ray beams. The study showed that the percentage depth ionizations (PDIs) obtained from measurements are higher than the percentage depth doses (PDDs) obtained with Monte Carlo techniques. To validate the MC-calculated PDDs, the design of the PEEC was incorporated into the simulations. While the MC-calculated and measured PDIs in the dose build-up region agree with one another for the 6 MV beam, a non-negligible difference is observed for the 18 MV x-ray beam. A number of experiments and theoretical studies of various possible effects that could be the source of this discrepancy were performed. The contribution of contaminating neutrons and protons to the build-up dose region in the 18 MV x-ray beam is negligible. Moreover, the MC calculations using the XCOM photon cross-section database and the NIST bremsstrahlung differential cross section do not explain the discrepancy between the MC calculations and measurement in the dose build-up region for the 18 MV. A simple incorporation of triplet production events into the MC dose calculation increases the calculated doses in the build-up region but does not fully account for the discrepancy between measurement and calculations for the 18 MV x-ray beam.     

Build-up and surface dose measurements on phantoms using micro-MOSFET in 6 and 10 MV x-ray beams and comparisons with Monte Carlo calculations

This work is intended to investigate the application and accuracy of micro-MOSFET for superficial dose measurement under clinically used MV x-ray beams. Dose response of micro-MOSFET in the build-up region and on surface under MV x-ray beams were measured and compared to Monte Carlo calculations. First, percentage-depth-doses were measured with micro-MOSFET under 6 and 10 MV beams of normal incidence onto a flat solid water phantom. Micro-MOSFET data were compared with the measurements from a parallel plate ionization chamber and Monte Carlo dose calculation in the build-up region. Then, percentage-depth-doses were measured for oblique beams at 0 degrees-80 degrees onto the flat solid water phantom with micro-MOSFET placed at depths of 2 cm, 1 cm, and 2 mm below the surface. Measurements were compared to Monte Carlo calculations under these settings. Finally, measurements were performed with micro-MOSFET embedded in the first 1 mm layer of bolus placed on a flat phantom and a curved phantom of semi-cylindrical shape. Results were compared to superficial dose calculated from Monte Carlo for a 2 mm thin layer that extends from the surface to a depth of 2 mm. Results were (1) Comparison of measurements with MC calculation in the build-up region showed that micro-MOSFET has a water-equivalence thickness (WET) of 0.87 mm for 6 MV beam and 0.99 mm for 10 MV beam from the flat side, and a WET of 0.72 mm for 6 MV beam and 0.76 mm for 10 MV beam from the epoxy side. (2) For normal beam incidences, percentage depth dose agree within 3%-5% among micro-MOSFET measurements, parallel-plate ionization chamber measurements, and MC calculations. (3) For oblique incidence on the flat phantom with micro-MOSFET placed at depths of 2 cm, 1 cm, and 2 mm, measurements were consistent with MC calculations within a typical uncertainty of 3%-5%. (4) For oblique incidence on the flat phantom and a curved-surface phantom, measurements with micro-MOSFET placed at 1.0 mm agrees with the MC calculation within 6%, including uncertainties of micro-MOSFET measurements of 2%-3% (1 standard deviation), MOSFET angular dependence of 3.0%-3.5%, and 1%-2% systematical error due to phantom setup geometry asymmetry. Micro-MOSFET can be used for skin dose measurements in 6 and 10 MV beams with an estimated accuracy of +/- 6%.     

Dosimetric properties of radiophotoluminescent glass rod detector in high-energy photon beams from a linear accelerator and cyber-knife

A fully automatic radiophotoluminescent glass rod dosimeter (GRD) system has recently become commercially available. This article discusses the dosimetric properties of the GRD including uniformity and reproducibility of signal, dose linearity, and energy and directional dependence in high-energy photon beams. In addition, energy response is measured in electron beams. The uniformity and reproducibility of the signal from 50 GRDs using a 60Co beam are both +/- 1.1% (one standard deviation). Good dose linearity of the GRD is maintained for doses ranging from 0.5 to 30 Gy, the lower and upper limits of this study, respectively. The GRD response is found to show little energy dependence in photon energies of a 60Co beam, 4 MV (TPR20(10)=0.617) and 10 MV (TPR(20)10=0.744) x-ray beams. However, the GRD responses for 9 MeV (mean energy, Ez = 3.6 MeV) and 16 MeV (Ez = 10.4 MeV) electron beams are 4%-5% lower than that for a 60Co beam in the beam quality dependence. The measured angular dependence of GRD, ranging from 0 degrees (along the long axis of GRD) to 120 degrees is within 1.5% for a 4 MV x-ray beam. As applications, a linear accelerator-based radiosurgery system and Cyber-Knife output factors are measured by a GRD and compared with those from various detectors including a p-type silicon diode detector, a diamond detector, and an ion chamber. It is found that the GRD is a very useful detector for small field dosimetry, in particular, below 10 mm circular fields.     

Benchmarking of Monte Carlo simulation of bremsstrahlung from thick targets at radiotherapy energies

Several Monte Carlo systems were benchmarked against published measurements of bremsstrahlung yield from thick targets for 10-30 MV beams. The quantity measured was photon fluence at 1 m per unit energy per incident electron (spectra), and total photon fluence, integrated over energy, per incident electron (photon yield). Results were reported at 10-30 MV on the beam axis for Al and Pb targets and at 15 MV at angles out to 90 degrees for Be, Al, and Pb targets. Beam energy was revised with improved accuracy of 0.5% using an improved energy calibration of the accelerator. Recently released versions of the Monte Carlo systems EGSNRC, GEANT4, and PENELOPE were benchmarked against the published measurements using the revised beam energies. Monte Carlo simulation was capable of calculation of photon yield in the experimental geometry to 5% out to 30 degrees, 10% at wider angles, and photon spectra to 10% at intermediate photon energies, 15% at lower energies. Accuracy of measured photon yield from 0 to 30 degrees was 5%, 1 s.d., increasing to 7% for the larger angles. EGSNRC and PENELOPE results were within 2 s.d. of the measured photon yield at all beam energies and angles, GEANT4 within 3 s.d. Photon yield at nonzero angles for angles covering conventional field sizes used in radiotherapy (out to 10 degrees), measured with an accuracy of 3%, was calculated within 1 s.d. of measurement for EGSNRC, 2 s.d. for PENELOPE and GEANT4. Calculated spectra closely matched measurement at photon energies over 5 MeV. Photon spectra near 5 MeV were underestimated by as much as 10% by all three codes. The photon spectra below 2-3 MeV for the Be and Al targets and small angles were overestimated by up to 15% when using EGSNRC and PENELOPE, 20% with GEANT4. EGSNRC results with the NIST option for the bremsstrahlung cross section were preferred over the alternative cross section available in EGSNRC and over EGS4. GEANT4 results calculated with the "low energy" physics list were more accurate than those calculated with the "standard" physics list.     

Effects of plastic protective caps on the calibration of therapy beams in water

Plastic 60Co buildup caps have been widely used to protect ionization chambers when calibrating high-energy x-ray and electron beams in water, and have been used consistently by the Radiological Physics Center. Recent calibration protocols base their calculations on a theory that assumes that no protective cap is used during calibration in phantom. The change in ionization within the chamber due to the presence of a protective cap has been investigated for acrylic and polystyrene caps of various wall thicknesses, using 60Co and x-ray beams from 6-25 MV and electron beams from 7-18 MeV. The change has been shown to be small, no more than 0.5% for x rays and 0.7% for electrons using acrylic 60Co caps. The change for polystyrene is seen to be as much as twice that for acrylic. Empirical correction factors to compensate for this effect have been determined. A basis in theory for photons is suggested by an extension of the theory in recent protocols. The effect for electrons is explained only qualitatively.     

Backscatter towards the monitor ion chamber in high-energy photon and electron beams: charge integration versus Monte Carlo simulation

In some linear accelerators, the charge collected by the monitor ion chamber is partly caused by backscattered particles from accelerator components downstream from the chamber. This influences the output of the accelerator and also has to be taken into account when output factors are derived from Monte Carlo simulations. In this work, the contribution of backscattered particles to the monitor ion chamber response of a Varian 2100C linac was determined for photon beams (6, 10 MV) and for electron beams (6, 12, 20 MeV). The experimental procedure consisted of charge integration from the target in a photon beam or from the monitor ion chamber in electron beams. The Monte Carlo code EGS4/BEAM was used to study the contribution of backscattered particles to the dose deposited in the monitor ion chamber. Both measurements and simulations showed a linear increase in backscatter fraction with decreasing field size for photon and electron beams. For 6 MV and 10 MV photon beams, a 2-3% increase in backscatter was obtained for a 0.5 x 0.5 cm2 field compared to a 40 x 40 cm2 field. The results for the 6 MV beam were slightly higher than for the 10 MV beam. For electron beams (6, 12, 20 MeV), an increase of similar magnitude was obtained from measurements and simulations for 6 MeV electrons. For higher energy electron beams a smaller increase in backscatter fraction was found. The problem is of less importance for electron beams since large variations of field size for a single electron energy usually do not occur.     

Evaluation of Al2O3:C optically stimulated luminescence (OSL) dosimeters for passive dosimetry of high-energy photon and electron beams in radiotherapy

This article investigates the performance of Al2O3: C optically stimulated luminescence dosimeters (OSLDs) for application in radiotherapy. Central-axis depth dose curves and optically stimulated luminescence (OSL) responses were obtained in a water phantom for 6 and 18 MV photons, and for 6, 9, 12, 16, and 20 MeV electron beams from a Varian 21EX linear accelerator. Single OSL measurements could be repeated with a precision of 0.7% (one standard deviation) and the differences between absorbed doses measured with OSLDs and an ionization chamber were within +/- 1% for photon beams. Similar results were obtained for electron beams in the low-gradient region after correction for a 1.9% photon-to-electron bias. The distance-to-agreement values were of the order of 0.5-1.0 mm for electrons in high dose gradient regions. Additional investigations also demonstrated that the OSL response dependence on dose rate, field size, and irradiation temperature is less than 1% in the conditions of the present study. Regarding the beam energy/quality dependence, the relative response of the OSLD for 18 MV was (0.51 +/- 0.48)% of the response for the 6 MV photon beam. The OSLD response for the electron beams relative to the 6 MV photon beam. The OSLD response for the electron beams relative to the 6 MV photon beam was in average 1.9% higher, but this result requires further confirmation. The relative response did not seem to vary with electron energy at dmax within the experimental uncertainties (0.5% in average) and, therefore, a fixed correction factor of 1.9% eliminated the energy dependence in our experimental conditions.     

Performance characteristics of a microMOSFET as an in vivo dosimeter in radiation therapy

The commercially available microMOSFET dosimeter was characterized for its dosimetric properties in radiotherapy treatments. The MOSFET exhibited excellent correlation with the dose and was linear in the range of 5-500 cGy. No measurable effect in response was observed in the temperature range of 20-40 degrees C. No significant change in response was observed by changing the dose rate between 100 and 600 monitor units (MU) min(-1) or change in the dose per pulse. A 3% post-irradiation fading was observed within the first 5 h of exposure and thereafter it remained stable up to 60 h. A uniform energy response was observed in the therapy range between 4 MV and 18 MV. However, below 0.6 MeV (Cs-132), the MOSFET response increased with the decrease in energy. The MOSFET also had a uniform dose response in 6-20 MeV electron beams. The directional dependence of MOSFET was within +/-2% for all the energies studied. The inherent build-up of the MOSFET was evaluated dosimetrically and found to have varying water equivalent thickness, depending on the energy and the side of the beam entry. At depth, a single calibration factor obtained by averaging the MOSFET response over different field sizes, energies, orientation and depths reproduced the ion chamber measured dose to within 5%. The stereotactic and the penumbral measurements demonstrated that the MOSFET could be used in a high gradient field such as IMRT. The study showed that the microMOSFET dosimeter could be used as an in vivo dosimeter to verify the dose delivery to the patient to within +/-5%.     

Comparison of PENELOPE Monte Carlo dose calculations with Fricke dosimeter and ionization chamber measurements in heterogeneous phantoms (18 MeV electron and 12 MV photon beams)

Different measurements of depth-dose curves and dose profiles were performed in heterogeneous phantoms and compared to dose distributions calculated by a Monte Carlo code. These heterogeneous phantoms consisted of lung and/or bone heterogeneities. Irradiations and simulations were carried out for an 18 MeV electron beam and a 12 MV photon beam. Depth-dose curves were measured with Fricke dosimeters and with plane and cylindrical ionization chambers. Dose profiles were measured with a small cylindrical ionization chamber at different depths. The LINAC was modelled using the PENELOPE code and phase space files were used as input data for the calculations of the dose distributions in every simulation. The detectors (Fricke dosimeters and ionization chambers) were not modelled in the geometry. There is generally a good agreement between the measurements and PENELOPE. Some discrepancies exist, near interfaces, between the ionization chamber and PENELOPE due to the attenuation of the lower energy electrons by the wall of the ionization chamber.     

Experimental evaluation of a MOSFET dosimeter for proton dose measurements

The metal oxide semiconductor field-effect transistor (MOSFET) dosimeter has been widely studied for use as a dosimeter for patient dose verification. The major advantage of this detector is its size, which acts as a point dosimeter, and also its ease of use. The commercially available TN502RD MOSFET dosimeter manufactured by Thomson and Nielsen has never been used for proton dosimetry. Therefore we used the MOSFET dosimeter for the first time in proton dose measurements. In this study, the MOSFET dosimeter was irradiated with 190 MeV therapeutic proton beams. We experimentally evaluated dose reproducibility, linearity, fading effect, beam intensity dependence and angular dependence for the proton beam. Furthermore, the Bragg curve and spread-out Bragg peak were also measured and the linear-energy transfer (LET) dependence of the MOSFET response was investigated. Many characteristics of the MOSFET response for proton beams were the same as those for photon beams reported in previous papers. However, the angular MOSFET responses at 45, 90, 135, 225, 270 and 315 degrees for proton beams were over-responses of about 15%, and moreover the MOSFET response depended strongly on the LET of the proton beam. This study showed that the angular dependence and LET dependence of the MOSFET response must be considered very carefully for quantitative proton dose evaluations.     

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.     

Dose build-up behind air cavities for Co-60, 4, 6 and 8 MV. Measurements and Monte Carlo simulations

It has been shown in several studies that the build-up in photon beams behind air cavities (such as in the head and neck) increases with energy. In this study this effect is investigated over a broad range of energies that have been used for treating head and neck tumours. The study addresses the question of whether an energy lower than 6 MV is desirable and is based on measurements and Monte Carlo (MC) simulations. In a PMMA phantom containing an air cavity (3 x 16 x 3 cm3 at 3 cm depth) an ionization chamber (Capintec PS-033) was used to measure the dose build-up behind the cavity for 4, 6 and 8 MV beam qualities for different field sizes (from 3 x 6 cm2 to 8 x 8 cm2). MC simulations were made using the EGSnrc code for the same geometry and energies as well as for Co-60. Measurements and MC simulations agree well when the fixed-separation plane-parallel chamber measurements have been corrected for the expected over-response in the build-up region. This work demonstrates that the build-up effect of 6 MV is 'closer' to the build-up effect of 8 MV than to that of 4 MV. This suggests that if the build-up effect is of concern when the target volume is in the vicinity of air cavities, 4 MV should be preferred over both 6 MV and 8 MV. This work also shows that the build-up effect for Co-60 is significantly smaller than that of 4 MV. Moreover, the build-up effect increases as the field size decreases. With the increasing use of IMRT (and radiosurgery), small fields are used more frequently making these issues even more relevant. This should be taken into consideration when choosing the accelerator energies for a radiotherapy department.     

Effect of transverse magnetic fields on dose distribution and RBE of photon beams: comparing PENELOPE and EGS4 Monte Carlo codes

The application of a strong transverse magnetic field to a volume undergoing irradiation by a photon beam can produce localized regions of dose enhancement and dose reduction. This study uses the PENELOPE Monte Carlo code to investigate the effect of a slice of uniform transverse magnetic field on a photon beam using different magnetic field strengths and photon beam energies. The maximum and minimum dose yields obtained in the regions of dose enhancement and dose reduction are compared to those obtained with the EGS4 Monte Carlo code in a study by Li et al (2001), who investigated the effect of a slice of uniform transverse magnetic field (1 to 20 Tesla) applied to high-energy photon beams. PENELOPE simulations yielded maximum dose enhancements and dose reductions as much as 111% and 77%, respectively, where most results were within 6% of the EGS4 result. Further PENELOPE simulations were performed with the Sheikh-Bagheri and Rogers (2002) input spectra for 6, 10 and 15 MV photon beams, yielding results within 4% of those obtained with the Mohan et al (1985) spectra. Small discrepancies between a few of the EGS4 and PENELOPE results prompted an investigation into the influence of the PENELOPE elastic scattering parameters C(1) and C(2) and low-energy electron and photon transport cut-offs. Repeating the simulations with smaller scoring bins improved the resolution of the regions of dose enhancement and dose reduction, especially near the magnetic field boundaries where the dose deposition can abruptly increase or decrease. This study also investigates the effect of a magnetic field on the low-energy electron spectrum that may correspond to a change in the radiobiological effectiveness (RBE). Simulations show that the increase in dose is achieved predominantly through the lower energy electron population.     

Single-use MOSFET radiation dosimeters for the quality assurance of megavoltage photon beams

We investigated the applicability of single-use MOSFET detectors as quality-assurance devices. Using ten accelerators available at our institution, we performed output measurements in both water and solid phantoms under photon irradiation. The MOSFET detectors performed well within the manufacturer's specifications, with average deviations of 2.1% and 0.7% for the 6 and 18 MV beams, respectively. The strength of the detector's design, including its wireless set-up, factory calibration and direct read-out, makes the system an acceptable independent quality-assurance device for use in verifying machine output within an accuracy of +/-5%. The MOSFET detectors provide a quick check of machine output, which can be efficacious in detecting gross errors in machine calibrations.     

Response corrections for solid-state detectors in megavoltage photon dosimetry

Solid-state detectors offer high sensitivity, stability and resolution and are frequently the dosimeter of choice for on-line dosimetry and small field therapies such as stereotactic radiosurgery. The departure from tissue equivalence of many solid-state devices, including diodes and MOSFETs, has to be carefully considered at lower energies and for Compton scattered radiation where the strongly Z-dependent photoelectric effect is significant. A modification of Burlin cavity theory is proposed that treats primary and scatter photon spectra separately and this has been applied to determine the correction factors for diode detector measurements of 6 and 15 MV linear accelerator beams. Uncorrected, an unshielded diode overestimates the dose at depth by as much as 15% for the 6 MV beam. The model predicts the effect to within 1% for both energies offering a basis for the correction of diodes for use in routine dosimetry.     

Dual-energy CT-based material extraction for tissue segmentation in Monte Carlo dose calculations

Monte Carlo (MC) dose calculations are performed on patient geometries derived from computed tomography (CT) images. For most available MC codes, the Hounsfield units (HU) in each voxel of a CT image have to be converted into mass density (rho) and material type. This is typically done with a (HU; rho) calibration curve which may lead to mis-assignment of media. In this work, an improved material segmentation using dual-energy CT-based material extraction is presented. For this purpose, the differences in extracted effective atomic numbers Z and the relative electron densities rho(e) of each voxel are used. Dual-energy CT material extraction based on parametrization of the linear attenuation coefficient for 17 tissue-equivalent inserts inside a solid water phantom was done. Scans of the phantom were acquired at 100 kVp and 140 kVp from which Z and rho(e) values of each insert were derived. The mean errors on Z and rho(e) extraction were 2.8% and 1.8%, respectively. Phantom dose calculations were performed for 250 kVp and 18 MV photon beams and an 18 MeV electron beam in the EGSnrc/DOSXYZnrc code. Two material assignments were used: the conventional (HU; rho) and the novel (HU; rho, Z) dual-energy CT tissue segmentation. The dose calculation errors using the conventional tissue segmentation were as high as 17% in a mis-assigned soft bone tissue-equivalent material for the 250 kVp photon beam. Similarly, the errors for the 18 MeV electron beam and the 18 MV photon beam were up to 6% and 3% in some mis-assigned media. The assignment of all tissue-equivalent inserts was accurate using the novel dual-energy CT material assignment. As a result, the dose calculation errors were below 1% in all beam arrangements. Comparable improvement in dose calculation accuracy is expected for human tissues. The dual-energy tissue segmentation offers a significantly higher accuracy compared to the conventional single-energy segmentation.     

Monte Carlo-based treatment planning for a spoiler system with experimental validation using plane-parallel ionization chambers

A beam spoiler is often used to increase the build-up dose near the surface for treatment of superficial treatment areas. Photon-beam spoilers produce a large amount of contaminant electrons, conditions for which standard, commercial treatment-planning system dose-calculation algorithms are inadequate for producing accurate dose calculations. In this study, we implemented a Monte Carlo (MC) dose-calculation algorithm for this spoiler system. With and without a spoiler of 1 cm Lucite, depth doses and transverse profiles in the build-up region were measured for field sizes of 5 x 5 cm2 and 10 x 10 cm2 at the spoiler-to-surface distances (STSDs) of 6, 10 and 15 cm. An Attix chamber and a Markus chamber were used for depth doses, whereas a diode detector was used for transverse profiles. An MC simulation using BEAM/DOSXYZ was used to compare the calculated and the measured data. The MC calculations agreed with the Attix chamber measurements within 2% for all STSDs and field sizes, whereas the Markus data--even with corrections made-showed a discrepancy of about 3.5% with a maximum difference of 7.3% for a field size of 10 x 10 cm2 at an STSD of 6 cm. The MC treatment-planning system was successfully applied to a head-and-neck case using 6 MV photon beams with a beam spoiler.     

Electron beam treatment verification using measured and Monte Carlo predicted portal images

Electron beam treatments may benefit from techniques to verify patient positioning and dose delivery. This is particularly so for complex techniques such as mixed photon and electron beam radiotherapy and electron beam modulated therapy. This study demonstrates that it is possible to use the bremsstrahlung photons in an electron beam from a dual scattering foil linear accelerator to obtain portal images of electron beam treatments. The possibility of using Monte Carlo (MC) simulations to predict the electron beam treatment portal images was explored. The MC code EGSnrc was used to model a Varian CL21EX linear accelerator (linac) and to characterize the bremsstrahlung photon production in the linac head. It was found that the main sources of photons in the electron beam are the scattering foils, the applicator and the beam-shaping cut-out. Images were acquired using the Varian CL21EX linac and the Varian aS500 electronic portal imager (EPI); four electron energies (6, 9, 12, 16 MeV), and different applicator and cut-out sizes were used. It was possible to acquire images with as little as 10.7 MU per image. The contrast, the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), the resolution and an estimate of the modulated transfer function (MTF) of the electron beam portal images were computed using a quality assurance (QA) phantom and were found to be comparable to those of a 6 MV photon beam. Images were also acquired using a Rando anthropomorphic phantom. MC simulations were used to model the aS500 EPID and to obtain predicted portal images of the QA and Rando phantom. The contrast in simulated and measured portal images agrees within +/-5% for both the QA and the Rando phantom. The measured and simulated images allow for a verification of the phantom positioning by making sure that the structure edges are well aligned. This study suggests that the Varian aS500 portal imager can be used to obtain patient portal images of electron beams in the scattering foil linacs.