The use of recombination chambers at radiation therapy facilities

The paper presents an overview of the applications of recombination chambers for dosimetric measurements at radiotherapy facilities. The chambers were used at electron, proton and heavy ion accelerators, in the beam and in the vicinity of the accelerators at very different dose rates. The examples of measurements discussed in the paper include: the determination of the absorbed dose and radiation quality parameters of a 170 MeV proton beam and BNCT (boron neutron capture therapy) beam, neutron dose measurements at a phantom surface outside the beam of a 15 MV electron medical accelerator, determination of ambient dose equivalent, H1 (10) outside the irradiated phantom in the proton therapy treatment room at JINR (Dubna, Russia), and at working places outside the shielding of the heavy ion therapy facility at GSI (Darmstadt, Germany).     

Dosimetry and fast neutron energies characterization of photoneutrons produced in some medical linear accelerators

This work focusses on the estimation of induced photoneutrons energy, fluence, and strength using nuclear track detector (NTD) (CR-39). Photoneutron energy was estimated for three different linear accelerators, LINACs as an example for the commonly used accelerators. For high-energy linear accelerators, neutrons are produced as a consequence of photonuclear reactions in the target nuclei, accelerator head, field-flattening filters and beam collimators, and other irradiated objects. NTD (CR-39) is used to evaluate energy and fluence of the fast neutron. Track length is used to estimate fast photoneutrons energy for linear accelerators (Elekta 10 MV, Elekta 15 MV, and Varian 15 MV). Results show that the estimated neutron energies for the three chosen examples of LINACs reveals neutron energies in the range of 1–2 MeV for 10 and 15 MV X-ray beams. The fluence of neutrons at the isocenter (Φ_total) is found to be (4×10⁶ n cm² Gy^?1) for Elekta machine 10 MV. The neutron source strengths Q are calculated. It was found to be 0.2×10¹² n Gy^?1 X-ray at the isocenter. This work represents simple, low cost, and accurate methods of measuring fast neutrons dose and energies.     

In-phantom neutron dose distribution for bladder cancer cases treated with high-energy photons

This work presents an estimation of the neutron dose distribution for common bladder cancer cases treated with high-energy photons of 15 MV therapy accelerators. Neutron doses were measured in an Alderson phantom, using TLD 700 and 600 thermoluminescence dosimeters, resembling bladder cancer cases treated with high-energy photons from 15 MV LINAC and having a treatment plan using the four-field pelvic box technique. Thermal neutron dose distribution in the target area and the surrounding tissue was estimated. The sensitivity of all detectors for both gamma and neutrons was estimated and used for correction of the TL reading. TLD detectors were irradiated with a Co⁶⁰ gamma standard source and thermal neutrons at the irradiation facility of the National Institute for Standards (NIS). The TL to dose conversion factor was estimated in terms of both Co⁶⁰ neutron equivalent dose and thermal neutron dose. The dose distribution of photo-neutrons throughout each target was estimated and presented in three-dimensional charts and isodose curves. The distribution was found to be non-isotropic through the target. It varied from a minimum of 0.23 mSv/h to a maximum of 2.07 mSv/h at 6 cm off-axis. The mean neutron dose equivalent was found to be 0.63 mSv/h, which agrees with other published literature. The estimated average neutron equivalent to the bladder per administered therapeutic dose was found to be 0.39 mSv Gy^?1, which is also in good agreement with published literature. As a consequence of a complete therapeutic treatment of 50 Gy high-energy photons at 15 MV, the total thermal neutron equivalent dose to the abdomen was found to be about 0.012 Sv.     

The influence of field size and off-axis distance on photoneutron spectra of the 18 MV Siemens Oncor linear accelerator beam

At present, high energy electron linear accelerators (LINACs) producing photons with energies higher than 10 MeV have a wide use in radiotherapy (RT). However, in these beams fast neutrons could be generated, which results in undesired contamination of the therapeutic beams. These neutrons affect the shielding requirements in RT rooms and also increase the out-of-field radiation dose to patients. The neutron flux becomes even more important when high numbers of monitor units are used, as in the intensity modulated radiotherapy. Herein, to evaluate the exposure of patients and medical personnel, it is important to determine the full radiation field correctly. A model of the dual photon beam medical LINAC, Siemens ONCOR, used at the University Hospital Centre of Osijek was built using the MCNP611 code. We tuned the model according to measured photon percentage depth dose curves and profiles. Only 18 MV photon beams were modeled. The dependence of neutron dose equivalent and energy spectrum on field size and off-axis distance in the patient plane was analyzed. The neutron source strength (Q) defined as a number of neutrons coming from the head of the treatment unit per x-ray dose (Gy) delivered at the isocenter was calculated and found to be 1.12 × 10¹² neutrons per photon Gy at isocenter. The simulation showed that the neutron flux increases with increasing field size but field size has almost no effect on the shape of neutron dose profiles. The calculated neutron dose equivalent of different field sizes was between 1 and 3 mSv per photon Gy at isocenter. The mean energy changed from 0.21 MeV to 0.63 MeV with collimator opening from 0 × 0 cm² to 40 × 40 cm². At the 50 cm off-axis the change was less pronounced. According to the results, it is reasonable to conclude that the neutron dose equivalent to the patient is proportional to the photon beam-on time as suggested before. Since the beam-on time is much higher when advanced radiotherapy techniques are used to fulfill high conformity demands, this makes the neutron flux determination even more important. We also showed that the neutron energy in the patient plane significantly changes with field size. This can introduce significant uncertainty in dosimetry of neutrons due to strong dependence of the neutron detector response on the neutron energy in the interval 0.1–5 MeV.     

Sensitization of the analytical methods for photoneutron calculations to the wall concrete composition in radiation therapy

The effect of wall material on photoneutron production in radiation therapy rooms was studied using Monte Carlo (MC) simulations. An analytical formula was proposed to take into account the concrete composition in photoneutron dose calculations. Using the MCNPX MC code, the 18 MV photon beam of the Varian Clinac 2100 and a typical treatment room with concrete compositions according to report No. 144 of National Council of Radiation Protection (NCRP) were simulated. Number of room produced photoneutrons per Gray of X-ray at the isocenter was determined for different types of concrete and named as “Q_W”. This new factor was inserted in the used formula for photoneutron fluence calculations at the inner entrance of maze. The photoneutron fluence was calculated using new proposed formula at the inner entrance of maze for all studied concretes. The difference between conventional and proposed equations varied from 11% to 46% for studied concretes. It was found that room produced photoneutrons could be significant for high density concretes. Additionally, applying the new proposed formula can consider the effect of wall material composition on the photoneutron production in high energy radiation therapy rooms. Further studies to confirm the accuracy of newly developed method is recommended.     

Calibration of PADC-based neutron area dosemeters in the neutron field produced in the treatment room of a medical LINAC

PADC-based nuclear track detectors have been widely used as convenient ambient dosemeters in many working places. However, due to the large energy dependence of their response in terms of ambient dose equivalent (H¹(10)) and to the diversity of workplace fields in terms of energy distribution, the appropriate calibration of these dosemeters is a delicate task. These are among the reasons why ISO has introduced the 12789 Series of Standards, where the simulated workplace neutron fields are introduced and their use to calibrate neutron dosemeters is recommended. This approach was applied in the present work to the UAB PADC-based nuclear track detectors. As a suitable workplace, the treatment room of a 15 MV Varian CLINAC DHX medical accelerator, located in the Ospedale S. Chiara (Pisa), was chosen. Here the neutron spectra in two points of tests (1.5 m and 2 m from the isocenter) were determined with the INFN-LNF Bonner Sphere Spectrometer equipped with Dysprosium activation foils (Dy-BSS), and the values of H¹(10) were derived on this basis. The PADC dosemeters were exposed in these points. Their workplace specific H*(10) responses were determined and compared with those previously obtained in different simulated workplace or reference (ISO 8529) neutron fields.     

Peripheral doses in radiotherapy: A comparison between IMRT,VMAT and Tomotherapy

The goal of this intercomparison is to determine the peripheral doses during treatment of prostate and head and neck (H&N) cancers. In the case of prostate cancer, two different treatment techniques are compared: intensity-modulated radiation therapy (IMRT – 10 MV and 18 MV), on a Varian Clinac 2100 C/D and Tomotherapy. VMAT (also on a Varian Clinac 2100 C/D) was compared to Tomotherapy, for H&N cancer. The treatment devices are located at the university hospitals of Leuven and Brussels, respectively. A common treatment protocol was agreed between the two clinical centers and this same protocol was used by each partner. For the higher energy modalities (10 MV and 18 MV) we also assessed the neutron contribution to the total dose, by using bubble detectors. In this way, the performance (in terms of peripheral doses) of the different treatment techniques, when faced with the same dose distribution constraints, was evaluated. The doses were evaluated with an anthropomorphic phantom loaded with TLD detectors. Summarizing our results, we can conclude that low energy radiation techniques, namely VMAT and Tomotherapy, have more interesting performances when compared to IMRT at energies of 10 MV and 18 MV, with respect to peripheral dose. On the one hand the former are associated with lower photon doses and, on the other hand, there is no contribution from neutrons to the total dose.     

Neutron spectrometry and determination of neutron ambient dose equivalents in different LINAC radiotherapy rooms

A project has been set up to study the effect on a radiotherapy patient of the neutrons produced around the LINAC accelerator head by photonuclear reactions induced by photons above ～8 MeV. These neutrons may reach directly the patient, or they may interact with the surrounding materials until they become thermalised, scattering all over the treatment room and affecting the patient as well, contributing to peripheral dose. Spectrometry was performed with a calibrated and validated set of Bonner spheres at a point located at 50 cm from the isocenter, as well as at the place where a digital device for measuring neutrons, based on the upset of SRAM memories induced by thermal neutrons, is located inside the treatment room. Exposures have taken place in six LINAC accelerators with different energies (from 15 to 23 MV) with the aim of relating the spectrometer measurements with the readings of the digital device under various exposure and room geometry conditions. The final purpose of the project is to be able to relate, under any given treatment condition and room geometry, the readings of this digital device to patient neutron effective dose and peripheral dose in organs of interest. This would allow inferring the probability of developing second malignancies as a consequence of the treatment. Results indicate that unit neutron fluence spectra at 50 cm from the isocenter do not depend on accelerator characteristics, while spectra at the place of the digital device are strongly influenced by the treatment room geometry.     

Dosimetric studies of the eye lens using a new dosemeter – Surveys in interventional radiology departments

During interventional radiology (IR) and cardiology (IC) procedures, medical staff can receive high doses to their eye lenses. The Retrospective Evaluation of Lens Injuries and Dose study organized in Argentina in 2010 found incipient opacity in 50% of IC physicians and 41% of IC technicians/nurses. These results, added to the recommendations of the International Commission on Radiological Protection, which lowered their former occupational equivalent dose limit for the lens, led us to assess the eye lens dose, Hp(3), during interventional procedures.To this end, a new dosemeter was designed and calibrated at the National Atomic Energy Commission of Argentina to evaluate Hp(3). Personal dose equivalent (Hp(10)), and Hp(3) were assessed for 3 months in two IC and IR departments. An Alderson phantom was used to simulate monthly exposures of five occupational staff members.Hp(3) and Hp(10) were obtained monthly for 14 occupational staff members exposed to 121 IR and IC procedures. We concluded that the annual effective dose and Hp(3) were lower than 0.3 and 10 mSv, respectively and the average cumulative Hp(3) for working life was lower than 400 and 200 mSv for physicians and technicians/scrub nurse, respectively. An occupational annual dose constraint of 0.3 mSv was calculated.     

Radiation dose measurements for staff members involved in holmium-166 preclinical trial

AimNeutron-activated holmium-166 (¹⁶⁶Ho) is an excellent radionuclide for internal radiation therapy (Eβmax = 1.84 MeV) with an appropriate half-life (26.8 h), which emits photons (81 keV, 6.2%) suitable to be detected by gamma cameras. Preparing and injecting radiopharmaceuticals containing beta/gamma emitting holmium-166 implies a risk of exceeding the upper limit for skin and hand radiation equivalent doses (500 mSv/an). This study was aimed to estimate the whole body and finger exposure for staff responsible for dose preparation, dose dispensing, and dose injection of holmium-166 therapy.MethodsTo measure the finger dose from external exposure, all staff members wore TLD dosimeters. Personal dose equivalents Hp(10) were measured using electronic personal dosimeters (EPD MK2, Thermo Fischer Scientific) placed on the left side of the chest. During our study, staff members administered more than 40 ¹⁶⁶Ho-based therapies for preclinical trial. Appropriate radiation safety procedures and shielding were applied at each stage.ResultsIn this study, the whole body doses were 2.80 ± 1.56 nSv MBq⁻¹ for one ¹⁶⁶Ho-therapy preparation/formulation, and 2.68 ± 1.70 nSv MBq⁻¹ for one intravenous injection. Maximum finger doses were 2.9 ± 0.2 μSv MBq⁻¹ and 2.5 ± 0.3 μSv MBq⁻¹ for preparation and injection, respectively (activities injected: 72 ± 3 MBq).ConclusionExtrapolated annual doses from 300 ¹⁶⁶Ho radionuclide therapies were lower than the annual limit doses for skin and the whole body, 500 mSv and 20 mSv, respectively, reported in the European Directive EURATOM 96/29 when applying appropriate radiation protection standards. However, these doses have to be added to other diagnostic or therapeutic protocols, performed in preclinical facilities.     

Efficiency of ionizers in removing airborne particles in indoor environments

Air ionizers are increasingly being used to clean indoor environments of particle pollution. We tested the efficiency of a small negative ion generator (Aironic AH-202) in removing ultrafine particles from indoor environments. A high-flow air filter fitted with a HEPA filter was used to compare the removal efficiencies. We estimated the percentage of particles removed when the ionizer was operated within a closed chamber of volume 1 m³, in a closed unventilated room of volume 20 m³ and in three force-ventilated rooms of volume 32, 45 and 132 m³. The closed chamber studies were conducted with ambient particles and with smoke at particle number concentrations of 5 × 10³ and 7 × 10⁴ cm⁻³, respectively. In both cases, 70% of the particles were removed by the ionizer in 15 min. In general, the particle removal efficiency of both the ionizer and the air filter decreased as the room size increased. Both devices were also more effective in unventilated rooms than in ventilated rooms. The most important finding in this study was that, while the air filter was more effective than the ionizer in the two small rooms, the ionizer was clearly more effective than the air filter in the three largest rooms. We conclude that air ionizers are more suited than high-flow air filters in removing ultrafine particles from rooms larger than about 25 m³. The investigation also showed that small ions produced by the ionizer, placed in one room, were carried through the air conditioning system into other rooms, effectively removing particles from the air in these rooms in the process.     

A study of the dose distribution in the region of the eye lens and extremities for staff working in interventional cardiology

The dose distributions at the region of eye lens and extremities of staff working in interventional cardiology were analyzed. The doses to physicians and nurses from three hospitals in Poland were measured with TL dosimeters (MCP-N) located on various places near eyebrows, on both fingers, wrists, knees and on the ankle. The procedures under investigation were coronary angiography (CA) and percutaneous coronary intervention (PCI), peacemaker and defibrillator implantations (PM/ICDs), cardiac resynchronization therapy with or without defibrillator implantations (CRT-D or CRT) and radiofrequency ablations (RFA). The study aimed at analyzing the distribution of radiation in selected anatomic regions, determining the typical locations of highest doses and estimating the dose ranges for selected types of procedures.The maximum registered doses per procedure to eye lens and ankle were 1.21 mSv and 1.46 mSv for CA PCI procedures, 0.02 mSv and 0.05 mSv for RFA and 0.13 mSv and 0.51 mSv for PM/ICDs, respectively. The maximum doses to fingers, wrists and knees were, accordingly, 2.11 mSv, 1.07 mSv and 0.77 mSv for CA PCI procedures, 0.38 mSv, 0.20 mSv and 0.04 mSv for RFA ones, 0.50 mSv, 0.25 mSv and 0.01 mSv for PM/ICDs procedures and 2.25 mSv, 1.12 mSv and 0.58 mSv for CRT and CRT-D ones. The factors which might influence the dose like utilized radiation, availability of additional protective equipment and position of the staff with respect to X-ray source were also analyzed.The annual doses for eye lens and extremities were estimated on the basis of individual annual workloads of the physicians participating in the study. The highest annual doses were revealed for physicians performing CA PCI procedures. Annual eye lens doses range up to 247 mSv indicating that the occupational limit for eye lens 150 mSv has been surpassed. In case of extremities the maximal estimated annual doses were 355 mSv, 136 mSv, 55 mSv and 328 mSv, for fingers, wrists, knees and for ankle, respectively. Moreover, in the light of ICRP new Statement on Tissue Reactions raising the possibility of lowering the annual limit for the lens of the eye the annual doses estimated in our paper indicate that for some procedures the monitoring of eye lens doses should be considered. On the other hand, it is important to note that most of high occupational doses can be easily avoided if radiation protection tools are used and, moreover, used properly.The present survey is a part of ORAMED project concerning the determination of doses to extremities (fingers, wrists and knees) and eye lens during interventional procedures and includes the detailed analyses of results of Polish partner. They are, however, presented in wider context. The study is additionally extended by the investigation of the dose distribution at the eyebrows and ankle level.     

Radiological impacts of natural radioactivity from phosphogypsum piles in Huelva (Spain)

The activity concentrations of ²²⁶Ra, ²³²Th and ⁴⁰K have been measured by gamma spectroscopy in samples of soil collected from the different zones of around Huelva (Spain). The average activity concentrations of ²²⁶Ra (Bq kg^?1) in the active phosphogypsum (PG) stacks, unrestored and restored zones were 647, 573 and 83 respectively. The corresponding values for ²³²Th and ⁴⁰K (Bq kg^?1) were 8, 10 and 25 and 33, 47 and 225 respectively. As a measure of radiation hazard to the occupational workers and public, the Ra equivalent activities, representative level index and dose rates due to natural radionuclides at 1 m above the ground surface were estimated. The average of absorbed dose rates due to ²²⁶Ra, ²³²Th and ⁴⁰K (nGy/h) from active PG stacks, unrestored and restored zones are 284, 255 and 55.The calculated external γ-radiation average dose (mSv/y) received by the workers of the phosphogypsum piles are estimated to be 0.293, 0.262 and 0.057 which is far below the international agreed dose limit of 20 mSv/y (ICRP-60, 1990) for workers. Also, the radiation dose to a member of the public resulting from the use of PG is negligible compared to the average annual effective dose from natural sources (2.4 mSv/y).     

Measurements of neutron radiation and induced radioactivity for the new medical linear accelerator,the Varian TrueBeam

Contemporary linear accelerators applied in radiotherapy generate X-ray and electron beams with energies up to 20 MeV. Such high-energy therapeutic beams induce undesirable photonuclear (γ,n) and electronuclear (e,e'n) reactions in which neutrons and radioisotopes are produced. The originated neutron can also induce reactions such as simple capture, (n,γ), reactions that produce radioisotopes. In this work measurements of the non-therapeutic neutrons and the induced gamma radiation were carried out in the vicinity of a new medical accelerator, namely the Varian TrueBeam. The TrueBeam is a new generation Varian medical linac making it possible to generate the X-ray beams with a dose rate higher than in the case of the previous models by Varian. This work was performed for the X-ray beams with nominal potentials of 10 MV (flattening filter free), 15 MV and 20 MV, and for a 22 MeV electron beam. The neutron measurements were performed by means of a helium chamber and the induced activity method. The identification of radioisotopes produced during emission of the therapeutic beams was based on measurements of the energy spectra of gammas emitted in decays of the produced nuclei. The gamma energy spectra were measured with the use of the high-purity germanium detector. The correlation between the neutron field and the mode and nominal potential was observed. The strongest neutron fluence of 3.1 × 10⁶ cm⁻² Gy⁻¹ and 2.0 × 10⁶ cm⁻² Gy⁻¹ for the thermal and resonance energies, respectively, was measured during emission of the 20 MV X-ray beam. The thermal and resonance neutron fluence measured for the 15 MV X-rays was somewhat less, at 1.1 × 10⁶ cm⁻² Gy⁻¹ for thermal neutrons and 6.7 × 10⁵ cm⁻² Gy⁻¹ for resonance neutrons. The thermal and resonance neutron fluences were smallest for the 10 MV FFF beam and the 22 MeV electron beam and were around two orders of magnitude smaller than those of the 20 MV X-ray beam. This work has shown that the neutron reactions are dominant because of relatively high cross sections for many elements used in the accelerator construction. The detailed analysis of the measured spectra made it possible to identify 11 radioisotopes induced during TrueBeam delivery. In this work the following radioisotopes were identified: ⁵⁶Mn, ¹²²Sb, ¹²⁴Sb, ¹³¹Ba, ⁸²Br, ⁵⁷Ni, ⁵⁷Co, ⁵¹Cr, ¹⁸⁷W, ²⁴Na and ³⁸Cl.     

Evaluation of TL response and intrinsic efficiency of TL dosimeters irradiated using different phantoms in clinical electron beam dosimetry

The TL response of LiF:Mg,Ti microdosimeters and CaSO₄:Dy dosimeters were studied for 12 MeV electron beams using PMMA, liquid water and solid water (SW) phantoms. The different phantom materials affect the electron spectrum incident on the detector and it can alter the response of dosimeters to different radiation types, so this fact should be considered in clinical dosimetry. The dosimeters were irradiated with doses ranging from 0.1 up to 5 Gy using a Varian Clinac 2100C linear accelerator of Hospital Israelita Albert Einstein – HIAE using a 10 × 10 cm² field size and 100 cm source-phantom surface distance, with the dosimeters positioned at the depth of maximum dose. The TL readings were carried out 24 h after irradiation using a Harshaw 3500 TL reader. This paper aims to compare the TL response relative to ⁶⁰Co of the dosimeters for different phantoms used in radiotherapy dosimetry. CaSO₄:Dy dosimeters presented higher TL sensitivity relative to ⁶⁰Co and intrinsic efficiency than microLiF:Mg,Ti dosimeters for all phantoms.     

Measurement-based Monte Carlo simulation of high definition dose evaluation for nasopharyngeal cancer patients treated by using intensity modulated radiation therapy

Measurement-based Monte Carlo (MBMC) simulation using a high definition (HD) phantom was used to evaluate the dose distribution in nasopharyngeal cancer (NPC) patients treated with intensity modulated radiation therapy (IMRT). Around nasopharyngeal cavity, there exists many small volume organs-at-risk (OARs) such as the optic nerves, auditory nerves, cochlea, and semicircular canal which necessitate the use of a high definition phantom for accurate and correct dose evaluation. The aim of this research was to study the advantages of using an HD phantom for MBMC simulation in NPC patients treated with IMRT. The MBMC simulation in this study was based on the IMRT treatment plan of three NPC patients generated by the anisotropic analytical algorithm (AAA) of the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA, USA) using a calculation grid of 2 mm². The NPC tumor was treated to a cumulative dose of 7000 cGy in 35 fractions using the shrinking-field sequential IMRT (SIMRT) method. The BEAMnrc MC Code was used to simulate a Varian EX21 linear accelerator treatment head. The HD phantom contained 0.5 × 0.5 × 1 mm³ voxels for the nasopharyngeal area and 0.5 × 0.5 × 3 mm³ for the rest of the head area. An efficiency map was obtained for the amorphous silicon aS1000 electronic portal imaging device (EPID) to adjust the weighting of each particle in the phase-space file for each IMRT beam. Our analysis revealed that small volume organs such as the eighth cranial nerve, semicircular canal, cochlea and external auditory canal showed an absolute dose difference of ≥200 cGy, while the dose difference for larger organs such as the parotid glands and tumor was negligible for the MBMC simulation using the HD phantom. The HD phantom was found to be suitable for Monte Carlo dose volume analysis of small volume organs.     

Clinical simulations of prostate radiotherapy using BOMAB-like phantoms: Results for neutrons

This paper presents in-phantom photoneutron equivalent doses induced by external radiotherapy, these are necessary to assess organ-averaged equivalent doses to derive the risk of secondary cancer development, associated with non-target organ exposures. The measurements were performed by Working Group 9 “Radiation Protection Dosimetry in Medicine” of the European Radiation Dosimetry Group (EURADOS) for simulations of clinical radiotherapy treatments of prostate cancer. The photoneutron dose measurements were carried out in a BOMAB-like water-filled phantom, by means of superheated emulsions (superheated drop detectors SDD and bubble damage BTI^® detectors) and Poly-Allyl-Diglicol-Carbonate (PADC) solid state nuclear track detectors. Dose data were acquired in a three-dimensional matrix of reproducible measurement points, which are spaced according to detectors size. Four clinical protocols for the treatment of the prostate tumor were considered and compared, by measuring the doses delivered to the planning target volume (PTV) and to peripheral radiosensitive regions (i.e. colon-rectum and bladder). The clinical irradiations were performed in two clinical radiotherapy facilities based on Varian Clinac 2300 CD accelerator: Santa Chiara University Hospital (Pisa, Italy) and Centre of Oncology M. Skłodowska-Curie Memorial Institute (Krakow, Poland). An additional tomotherapy prostate cancer treatment was also simulated in Campo di Marte Hospital (Lucca, Italy). Radiation qualities of 6, 12, 15, 18 and 20 MV were used; all of these are capable of producing photoneutrons. Data from this work span most of the X-ray beam energies and prostate treatment modalities used in the current clinical practice. These data permit the assessment of doses absorbed by a radiotherapy patient either at the treatment volume or at out-of-field organs. Comparison of different dosimeters, under the same irradiation conditions, showed that dosimeters generally agreed within their 20% 1 SD uncertainty. Comparison of different treatment modalities in the two contributing clinical centers (Pisa and Krakow) were also possible, as well as a comparison of dose profiles resulting from the different treatment techniques, delivered at the same primary photon energy. It was in particular found that photon acceleration energies as low as 6 MV are able to produce a non-negligible photoneutron component, which causes an undue dose to the patient of the order of tens microsievert per unit photon dose delivered at the target volume.     

Skin dose assessment in unmodulated and intensity-modulated radiation fields with film dosimetry

Superficial dose from 6- and 18-MV photon beams has been studied by measuring surface dose and shallow build-up dose using radiographic film EDR2, radiochromic film EBT2 and plane-parallel chamber. Measurements have been made for intensity- and non-intensity-modulated beams.The results show that the surface dose was found to be 19.8% and 10% of maximum dose in unmodulated fields for 6 and 18 MV photon beams, respectively. The study further showed that intensity modulation decreased surface dose by 1.1% and 0.7% for the same field size at 6 and 18 MV, respectively, and surface dose was dropped by magnetically sweeping contaminating electrons. EDR2 and EBT2 films show in good agreement in shallow build-up region.This study demonstrated the capability of EDR2 film, in addition to radiochromic film, to measure surface and build-up dose in case of treatment planning system uncertainties with regard to skin toxicity or shallow target coverage.     

Dosimetric comparison of water phantoms,ion chambers,and data acquisition modes for LINAC characterization

PurposeIn this study a dosimetric comparison utilizing continuous data acquisition and discrete data acquisition is examined using IBA Blue Phantom (IBA Dosimetry, Schwarzenbruck, Germany) and PTW (PTW, Freiberg, Germany) MP3-M water tanks. The tanks were compared according to several factors including set up time, ease of use, and data acquisition times. A tertiary objective is to study the response of several ionization chambers in the two tanks examined.MethodsMeasurements made using a Varian 23EX LINAC (Varian Medical Systems, Palo Alto, CA) include PDDs and beam profiles for various field sizes with IBA CC13, PTW Semiflex 31010, PTW Pinpoint N31016, and PTW 31013 ion chambers for photons (6, 18 MV) and electrons (6, 9, 12, 15, and 18 MeV). Radial and transverse profile scans were done at depths of maximum dose, 5 cm, 10 cm, and 20 cm using the same set of tanks and detectors for the photon beams. Radial and transverse profile scans were done at depth of maximum dose for the electron beams on the same tanks and chambers. Data processing and analysis was performed using PTW's MEPHYSTO Navigator software and IBA's OmniPro Accept version 6.6 for the respective water tank systems.ResultsPDD values agree to within 1% and dmax to within 1 mm for the PTW MP3-M tank using PTW 31010 and Blue Phantom using IBA CC13 chamber, respectively and larger discrepancy with the PTW PinPoint N31016 chamber at 6 MV. With respect to setup time the PTW MP3-M and IBA Blue phantom tank took about 20 and 40 min, respectively. Scan times were longer by 5–15 min per field size in the PTW MP3-M tank for the square field sizes from 1 cm to 40 cm as compared to the IBA Blue phantom. However, data processing times were higher by 7 min per field size with the IBA system.ConclusionsTank measurements showed little deviation with the higher energy photons as compared to the lower energy photons with regards to the PDD measurements. Chamber construction as well as tank set up may be causing the slight deviation in data. It is important to identify the exact source of the potential errors to ensure that proper tank usage is performed when making such measurements to ensure that patient safety is in compliance. Beam profiles done with different chambers and tanks showed little to no deviation from one to another. With regards to continuous versus discrete data measurements the main difference was in the data processing technique used. Discrete data obtained required less data processing as compared to the continuous data acquired.     

Analysis of radiation dose variations measured by passive dosimeters onboard the International Space Station during the solar quiet period (2007–2008)

The average absorbed dose and dose equivalent rates from space radiation were observed using passive dosimeters with same material and configuration at the same location onboard the International Space Station (ISS) over four different occasions (I–IV) between 2007 and 2008. The passive dosimeters consisted of a combination of thermoluminescent detectors (TLDs) and plastic nuclear track detectors (PNTDs). Total average absorbed dose rate increased by 68 ± 9% over two years. The observed increase was due to the incremental increase in the altitude of the ISS over the course of the experiment and the corresponding increase in trapped proton flux encountered during passage of the ISS through the SAA (South Atlantic Anomaly), which was confirmed with the results monitored by DB-8 active dosimeter on the ISS. The PNTD data showed that the average absorbed dose and dose equivalent rates from particles of LET_∞H₂O ≥ 100 keV/μm were 28 ± 2% and 51 ± 3% of ≥10 keV/μm during Periods I–III, while the dose contributions of particles ≥100 keV/μm during Period IV were 36 ± 5% and 59 ± 10%, respectively. The integral dose equivalent distribution during Period IV shows significant enhancement from particles ≥100 keV/μm. These facts suggest that a significant fraction of the high LET component is due to short-range recoil nuclei produced in target fragmentation reactions between primary protons and the nuclei of the passive dosimeters and surrounding materials.