Dosimetry of clinical neutron and proton beams: an overview of recommendations

Neutron therapy beams are obtained by accelerating protons or deuterons on Beryllium. These neutron therapy beams present comparable dosimetric characteristics as those for photon beams obtained with linear accelerators; for instance, the penetration of a p(65)+Be neutron beam is comparable with the penetration of an 8 MV photon beam. In order to be competitive with conventional photon beam therapy, the dosimetric characteristics of the neutron beam should therefore not deviate too much from the photon beam characteristics. This paper presents a brief summary of the neutron beams used in radiotherapy. The dosimetry of the clinical neutron beams is described. Finally, recent and future developments in the field of physics for neutron therapy is mentioned. In the last two decades, a considerable number of centres have established radiotherapy treatment facilities using proton beams with energies between 50 and 250 MeV. Clinical applications require a relatively uniform dose to be delivered to the volume to be treated, and for this purpose the proton beam has to be spread out, both laterally and in depth. The technique is called 'beam modulation' and creates a region of high dose uniformity referred to as the 'spread-out Bragg peak'. Meanwhile, reference dosimetry in these beams had to catch up with photon and electron beams for which a much longer tradition of dosimetry exists. Proton beam dosimetry can be performed using different types of dosemeters, such as calorimeters, Faraday cups, track detectors and ionisation chambers. National standard dosimetry laboratories will, however, not provide a standard for the dosimetry of proton beams. To achieve uniformity on an international level, the use of an ionisation chamber should be considered. This paper reviews and summarises the basic principles and recommendations for the absorbed dose determination in a proton beam, utilising ionisation chambers calibrated in terms of absorbed dose to water. These recommendations are based on the recent IAEA TRS398 Code of Practice: 'Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water'.     

Response of silicon diode dosemeters to scattered radiation from megavoltage photon beams

Dose response effects of diodes due to the high atomic number of silicon relative to water are investigated. While quality chances in the primary component of a megavoltage beam with depth are minimal. Compton scattered photons are shown to have a substantial effect on the quality leading to their enhanced absorption in silicon via the photoelectric effect. Monte Carlo methods were used to study and model this phenomenon. Measurements of dose rate, depth and field size dependence are examined for commercially available diode detectors and ionisation chambers.     

Determination of depth-dose curves in beta dosimetry

In beta dosimetry, the absorbed dose rate changes rapidly with the depth in a given medium. Its knowledge is essential for the full characterisation of the beta reference fields and the evaluation of the response of beta detectors. This work presents a general formalism for the precise determination of beta depth-dose curves by means of ionisation chamber measurements. An extrapolation chamber is not required. The formalism is appropriate for the determination of the full range depth-dose curve of up to 10 mm depth and more, when all electrons are stopped. Particular care was taken for the determination of the correction factors for the ISO 6980 reference fields, which are the most common beta reference fields. The formalism is proved experimentally: The depth-dose curves of all beta sources available at the Physikalisch-Technische Bundesanstalt (PTB) were determined and compared with the curves published in ISO 6980, yielding an excellent agreement. The presented formalism reflects the state-of-the-art of depth-dose measurements at the PTB.     

Stability of A-150 plastic ionisation chamber response over a approximately 30-y period

At the Northern Illinois University Institute for Neutron Therapy at Fermilab, the clinical tissue-equivalent ionisation chamber response is measured every treatment day using a cesium source that was configured to match readings obtained at the National Bureau of Standards. Daily measurements are performed in air using the air-to-tissue dose conversion factors given in AAPM Report #7. The measured exposure calibration factors have been tabulated and graphed as a function of time from 1978 to present. For A-150 plastic ionisation chambers, these factors exhibit a sinusoidal variation with a period of approximately 1 y and amplitude of +/- 1%. This variation, attributable to the hygroscopic nature of A-150 plastic, is correlated with the relative humidity of the facility, and is greater than the humidity corrections for gas described in the literature. The data suggest that chamber calibration should be performed at least weekly to accommodate these variations.     

Absorbed dose measurements of a handheld 50 kVP X-ray source in water with thermoluminescence dosemeters

Absorbed dose rate measurements of a 50 kV(p) handheld X-ray probe source in a water phantom are described. The X-ray generator is capable of currents of up to 40 microA, and is designed for cranial brachytherapy and intraoperative applications with applicators. The measurements were performed in a computer-controlled water phantom in which both the source and the detectors are mounted. Two different LiF thermoluminescence dosemeter (TLD) phosphors were employed for the measurements, MTS-N (LiF:Mg,Ti) and MCP-N (LiF:Mg,Cu,P). Two small ionisation chambers (0.02 and 0.0053 cm(3)) were also employed. The TLDs and chambers were positioned in watertight mounts made of water-equivalent plastic. The chambers were calibrated in terms of air-kerma rate, and conventional protocols were used to convert the measurements to absorbed dose rate. The TLDs were calibrated at National Institute of Standards and Technology (NIST) in terms of absorbed dose rate using a (60)Co teletherapy beam and narrow-spectrum X-ray beams. For the latter, absorbed dose was inferred from air-kerma rate using calculated air-kerma-to-dose conversion factors. The reference points of the various detectors were taken as the center of the TLD volumes and the entrance windows of the ionisation chambers. Measurements were made at distances of 3-45 mm from the detector reference point to the source center. In addition, energy dependence of response measurements of the TLDs used was made using NIST reference narrow spectrum X-ray beams. Measurement results showed reasonable agreement in absorbed dose rate determined from the energy dependence corrected TLD readings and from the ionisation chambers. Volume averaging effects of the TLDs at very close distances to the source were also evident.     

Study of the dosimetric characteristics of cosmic radiation at civil aviation altitudes

The dependence of the doses on solar activity for intermediate levels of the solar modulation parameter has been studied by means of simulations carried out by the Monte Carlo transport code FLUKA. The vertical cut-off rigidities investigated lie between 0.4 and 6.1 GV. The calculated results show that the linear dependence proposed in a previous work, for the effective dose rate as a function of the solar modulation parameter, can be considered as an acceptable approximation. In addition, some dosimetric characteristics of cosmic radiation and some properties of the dosemeters in use for monitoring in the cosmic ray environment have been analysed with a view to simplifying measurements. The depth-dose curves in the ICRU sphere and the response of a tissue-equivalent ionisation chamber have been determined by the FLUKA code for a number of cosmic ray spectra On the basis of the calculated results, it is concluded that a value of the depth. d, which would make the ambient dose equivalent a conservative predictor of the effective dose, cannot be specified for cosmic radiation. However, the operational quantity can be useful in order to verify the predictions of Monte Carlo calculations. It is demonstrated that a crude approximation of the ambient dose equivalent could be obtained by multiplying by 2 the absorbed dose measured by a tissue-equivalent ionisation chamber with wall thickness of 10 mm.     

Preliminary results on a dedicated silicon diode detector for proton dosimetry

The present work reports preliminary measurements on the behaviour of a new p-type stereotactic silicon diode. Hi-pSi, produced by Scanditronix and dedicated to proton dosimetry. Diode response was investigated in low-energy proton beams (26.7 MeV and 12 MeV nominal energy), mainly with attention to stability, linearity, dose rate and energy dependence of the detector response. Three different Hi-pSi diodes of the same type were investigated. The diode response was linear with dose and the standard deviation of repeated readings was less than 2.5%. A marked dependence on dose rate was observed for one of the diodes (a response increase of 47% in the 0.7-11 Gy x min(-1) range). After the dose rate and water to silicon mass collision stopping power ratio correction of the diode response in the depth dose measurements, the difference, at the Bragg peak, with respect to the reference chamber was about 4%, ascribed to poor knowledge of the materials in front of the sensitive volume. The diode response was also nearly independent of linear energy transfer (LET) in the 9.6-21.5 MeV effective energy range.     

Multichannel dosemeter and Al2O3:C optically stimulated luminescence fibre sensors for use in radiation therapy: evaluation with electron beams

This article proposes an innovative multichannel optically stimulated luminescence (OSL) dosemeter for on-line in vivo dose verification in radiation therapy. OSL fibre sensors incorporating small Al(2)O(3):C fibre crystals (TLD(500)) have been tested with an X-ray generator. A reproducible readout procedure should reduce the fading-induced uncertainty ( approximately - 1% per decade). OSL readouts are temperature-dependent [ approximately 0.3% K(-1) when OSL stimulation is performed at the same temperature as irradiation; approximately 0.16% K(-1) after thermalisation (20 degrees C)]. Sensor calibration and depth-dose measurements with electron beams have been performed with a Saturne 43 linear accelerator in reference conditions at CEA-LNHB (ionising radiation reference laboratory in France). Predosed OSL sensors show a good repeatability in multichannel operation and independence versus electron energy in the range (9, 18 MeV). The difference between absorbed doses measured by OSL and an ionisation chamber were within +/-0.9% (for a dose of about 1 Gy) despite a sublinear calibration curve.     

High-energy neutron depth-dose distribution experiment

A unique set of high-energy neutron depth-dose benchmark experiments were performed at the Los Alamos Neutron Science Center/Weapons Neutron Research (LANSCE/WNR) complex. The experiments consisted of filtered neutron beams with energies up to 800 MeV impinging on a 30 x 30 x 30 cm3 liquid, tissue-equivalent phantom. The absorbed dose was measured in the phantom at various depths with tissue-equivalent ion chambers. This experiment is intended to serve as a benchmark experiment for the testing of high-energy radiation transport codes for the international radiation protection community.     

The influence of the type of filling gas on the response of ionisation chambers to a mixed high-energy radiation field

Radiation protection dosimetry in radiation fields behind the shielding of high-energy accelerators such as CERN is a challenging task and the quantitative understanding of the detector response used for dosimetry is essential. Measurements with ionisation chambers are a standard method to determine absorbed dose (in the detector material). For applications in mixed radiation fields, ionisation chambers are often also calibrated in terms of ambient dose equivalent at conventional reference radiation fields. The response of a given ionisation chamber to the various particle types of a complex high-energy radiation field in terms of ambient dose equivalent depends of course on the materials used for the construction and the chamber gas used. This paper will present results of computational studies simulating the exposure of high-pressure ionisation chambers filled with different types of gases to the radiation field at CERN's CERN-EU high-energy reference field facility. At this facility complex high-energy radiation fields, similar to those produced by cosmic rays at flight altitudes, are produced. The particle fluence and spectra calculated with FLUKA Monte Carlo simulations have been benchmarked in several measurements. The results can be used to optimise the response of ionisation chambers for the measurement of ambient dose equivalent in high-energy mixed radiation fields.     

A simple method for the evaluation of microwave mixer diodes

A simple method is described for the evaluation of the various microwave mixer diodes which can be used in 9-GHz electron paramagnetic resonance (EPR) spectrometers using magnetic field modulation below 1 kHz. The advantage of this method over other methods is that it is optimized for EPR applications and determines the optimum operating conditions for each microwave diode. This method utilizes a microwave bridge with a reference arm with an attenuator to control the microwave bias power level, and a signal arm where the signal is attenuated, phase shifted, and modulated at the typical magnetic field modulation frequencies. The microwave power from the two arms is recombined and demodulated by the microwave diode. The output of the microwave diode is then recorded with various video loads, microwave bias power, and modulation frequencies. Measurements are performed to determine the effect of the preamplifier that followed the microwave diode on the signal-to-noise ratio (SNR). The recorded spectra are used to determine the SNR, the noise floor, and the 1/f corner frequency. Comparison of these factors for the different types of microwave diodes shows that some Schottky-barrier diodes have noise figures at 1 kHz that are as low as those for tunnel diodes     

Subnanosecond electron beams formed in a gas-filled diode at high pressures

Subnanosecond electron beams can be formed in gas-filled diodes at high pressures (up to 6 and 4 bar in helium and nitrogen, respectively). In a diode filled with air at atmospheric pressure, a beam current amplitude above 240 A was obtained at a pulse duration (FWHM) of ～0.2 s and a beam current density of ～40 A/cm².     

Angle dependence of signal currents from cylindrical ionisation chambers

A signal current from a cylindrical ionisation chamber with an ionisation volume of 62.7 cm3, 40 mm in diameter and 50 mm long, peaked when the chamber was lixed at 0 degrees and at 90 degrees in 137Cs and 60Co gamma ray fields for source-chamber distances of 1 m and 2 m. A smaller ionisation chamber showed a small peak at 0 degrees in both fields but not at 90 degrees. However, calculations indicated that the signal current from the smaller chamber would also show a peak at 90 degrees in a 137Cs point-source gamma ray field. Peaks occur because gamma rays attenuate along the cylindrical side wall or along the end walls when a chamber is tilted slightly from 0 degrees or 90 degrees and the direction of the gamma ray beam agrees with the plane of one of these walls. These facts suggest the need for care in the common practice of measuring and calculating responses for cylindrical ionisation chambers fixed perpendicular to gamma ray beams.     

Evaluation of the EDR-2 film for relative dosimetry of high-energy photon and electron beams

A sensitometric study of Kodak XV and EDR-2 radiographic films (Eastman Kodak Company, Rochester, NY) was performed using photons ranging from 75 kV to 18 MV and electrons ranging from 6 to 20 MeV. To investigate the applicability of the EDR-2 film for clinical radiation dosimetry, percentage depth-doses, profiles and distributions in open and dynamically wedged fields were measured using film and compared with data from a linear diode. Moreover, conventional quality assurance dose parameters were measured, including open-field dose profiles to determine flatness and symmetry of photon and electron beams. Finally, film was employed to validate dose distributions produced by complex computerised treatment planning techniques. Our conclusion is that the EDR-2 film is an effective tool for relative dosimetry of photon and electron beams.     

In vivo dosimetry with diodes in a radiotherapy department in Pakistan

The International Commission of Radiological Units (ICRU) sets a tolerance of ±5 % on dose delivery, with more recent data limiting the overall tolerances to ±3 %. One of the best methods for accurate dose delivery and quality check is in vivo dosimetry, while radiotherapy is performed. The present study was carried out to test the applicability of diodes for performing in vivo entrance dose measurements in external photon beam radiotherapy for pelvic tumours and its implementation as quality assurance tool in radiotherapy. During November 2007 to December 2009, in 300 patients who received pelvic radiotherapy on a multileaf-collimator-assisted linear accelerator, the central axis dose was measured by in vivo dosimetry by p-Si diodes. Entrance dose measurements were taken by diodes and were compared with the prescribed dose. Totally 1000 calculations were performed. The mean and standard deviation between measured and prescribed dose was 1.26 ± 2.8 %. In 938 measurements (93.8 %), the deviation was <5 % (1.36 ± 2.9%); in 62 measurements (6.2 %) the mean deviation was >5 % (5.51 ± 2.3 %). Larger variations were seen in lateral and oblique fields more than anteroposterior fields. For larger deviations, patients and diode positional errors were found to be the common factors alone or in combination with other factors. After additional corrections, repeated measurements were achieved within tolerance levels. This study showed that diode-detector-based in vivo dosimetry was simple, cost-effective, provides quick results and can serve as a useful quality assurance tool in radiotherapy. The data acquired in the present study can be used for evaluating output calibration of therapy machine, precision of calculations, effectiveness of treatment plan and patient setup.     

Validation of a radiotherapy treatment planning system using an anthropomorphic phantom and MTS-N thermoluminescent detectors

A treatment planning system (TPS) was validated in conditions of simulated radiotherapy (RT) of an anthropomorphic tissue-equivalent phantom. Individually calibrated solid MTS-N (LiF:Mg,Ti) detectors were placed within the treatment volume in this phantom which was then repeatedly irradiated by external 60Co or 6 MV X ray beams. On the basis of TLD-measured depth-dose curves for the two beams, the relative accuracy of determining dose (of the order of 1 Gy) at live depths in a water phantom is about 0.4-0.6%. In the volume of interest representing the target volume, the relative standard difference between the calculated and measured dose values ranged between 1.3% and 2.2% for the 60Co and 6 MV X ray beams, respectively. The TPS-calculated uniformity of irradiation of that volume is within 1%. While fraction-to-fraction repeatability was within 1-2%, systematic underexposure around the reference point, by 2-3%, was found in two consecutive exposures by sets of both beams.     

A method for measuring tissue-equivalent dose using a pin diode and activation foil in epithermal neutron beams with EN < 100 keV

Silicon (Si) pin diodes can be used for neutron dosimetry by observing the change in forward bias voltage caused by neutron induced displacement damage in the diode junction. Pin diode energy response depends on Si displacement damage KERMA (K(Si)). It is hypothesised that tissue-equivalent (TE) neutron dose could be expressed as a linear combination of K(Si) and foil activation terms. Monte Carlo simulations (MCNP) of parallel monoenergetic neutron beams incident on a cylindrical TE phantom were used to calculate TE dose, K(Si) and Au, Cu and Mn foil activations along the central axis of the phantom. For spectra with neutron energies <100 keV, it is possible to estimate the TE kerma based on silicon damage kerma and Cu or Mn foil measurements. More accurate estimates are possible for spectra where the maximum neutron energy does not exceed 30 keV.     

Monte Carlo simulation of a medical linear accelerator for radiotherapy use

A Monte Carlo code MCNPX (Monte Carlo N-particle) was used to model a 25 MV photon beam from a PRIMUS (KD2-Siemens) medical linear electron accelerator at the Centre Antoine Lacassagne in Nice. The entire geometry including the accelerator head and the water phantom was simulated to calculate the dose profile and the relative depth-dose distribution. The measurements were done using an ionisation chamber in water for different square field ranges. The first results show that the mean electron beam energy is not 19 MeV as mentioned by Siemens. The adjustment between the Monte Carlo calculated and measured data is obtained when the mean electron beam energy is approximately 15 MeV. These encouraging results will permit to check calculation data given by the treatment planning system, especially for small fields in high gradient heterogeneous zones, typical for intensity modulated radiation therapy technique.     

Potential clinical utility of a fibre optic-coupled dosemeter for dose measurements in diagnostic radiology

Many types of dosemeters have been investigated for absorbed dose measurements in diagnostic radiology, including ionisation chambers, metal-oxide semiconductor field-effect transistor dosemeters, thermoluminescent dosemeters, optically stimulated luminescence detectors, film and diodes. Each of the aforementioned dosemeters suffers from a critical limitation, either the need to interrogate, or read, the dosemeter to retrieve dose information or large size to achieve adequate sensitivity. This work presents an evaluation of a fibre optic-coupled dosemeter (FOCD) for use in diagnostic radiology dose measurement. This dosemeter is small, tissue-equivalent and capable of providing true real-time dose information. The FOCD has been evaluated for dose linearity, angular dependence, sensitivity and energy dependence at energies, beam qualities and beam quantities relevant to diagnostic radiology. The FOCD displayed excellent dose linearity and high sensitivity, while exhibiting minimal angular dependence of response. However, the dosemeter does exhibit positive energy dependence, and is subject to attenuation of response when bent.     

On the Matching and Tuning of a Helical Resonator: Mechanical and Electrical Solutions in X Band

The use of varactor diodes to match and tune an X-band helical resonator is compared to mechanical tuning. It is shown that only small corrections can be achieved with electrical solutions because of the V-1/2 variations of the junction capacity of the low-loss GaAs diode. For the time being, only mechanical devices allow large corrections for the matching and tuning of a helical resonator.