Uncertainty and routine use of Aerial l-alanine – Electron spin resonance dosimetry system

Aerial l-alanine pellet dosimeter is characterized by MiniScope MS300 electron spin resonance spectrometer measurements using Aer'EDE Version 2.0.4. software for dose calculation. The measurement traceability is achieved by Aerial dosimetry laboratory where dosimeters for calibration curve were irradiated by electron beam accelerator. Dose determinations in Aerial are traceable to National Physical Laboratory (NPL). The software used for construction of calibration curve gives also the standard deviation of the residuals of measurements for calibration that is used for dose uncertainty calculation. In aim to determine whether this value can actually be taken as absorbed dose uncertainty during usage of this dosimetry system, alanine dosimeters were irradiated with doses between 5 and 32 kGy by ⁶⁰Co laboratory source for internal calibration. The dose rate at the places for irradiation was (20 ± 0.5) mGy s⁻¹ determined by Fricke dosimeter. Measurement of each irradiated dosimeter was repeated ten times in ten days. The results of measurements were analyzed to identify the sources of uncertainty, as well as their quantification in evaluation of total measurement uncertainty. In addition to statistical effects, the very low dose rate that was used for the irradiation of alanine dosimeters affects the measurements of absorbed dose, particularly for higher absorbed doses where the measured dose can be up to 3% lower than the real.     

Photon dosimetry methods outside the target volume in radiation therapy: Optically stimulated luminescence (OSL), thermoluminescence (TL) and radiophotoluminescence (RPL) dosimetry

Dosimetry methods outside the target volume are still not well established in radiotherapy. Luminescence detectors due to their small dimensions, very good sensitivity, well known dose and energy response are considered as an interesting approach in verification of doses outside the treated region. The physical processes of thermoluminescence (TL), radiophotoluminescence (RPL) and optically stimulated luminescence (OSL) are very similar and can be described in terms of the energy band model of electron-hole production following irradiation.This work is a review of the main dosimetric characteristics of luminescence detectors which were used in experiments performed by EURADOS Working Group 9 for in-phantom measurements of secondary radiation (scattered and leakage photons). TL LiF:Mg,Ti detectors type MTS-7 (IFJ PAN, Poland), types TLD-100 and TLD-700 (Harshaw), OSL Al₂O₃:C detectors type nanoDot™ (Landauer Inc.) and RPL rod glass elements type GD-352M (Asahi Techno Glass Coorporation) are described. The main characteristics are discussed, together with the readout and calibration procedures which lead to a determination of absorbed dose to water.All dosimeter types used show very good uniformity, batch reproducibility and homogeneity. For improved accuracy, individual sensitivity correction factors should be applied for TL and OSL dosimeters while for RPL dosimeters there is no need for individual sensitivity corrections.The dose response of all dosimeters is linear for a wide range of doses.The energy response of GD-352M type dosimeters (with Sn filter) used for out-of-field measurements is flat for medium and low energy X-rays.The energy dependence for TLDs is low across the range of photon energies used and the energy correction was neglected. A significant over response of Al₂O₃:C OSLDs irradiated in kilovoltage photon beams was taken into account. The energy correction factor f_en was calculated by using the 2006 PENELOPE Monte Carlo code.With suitable calibration, all dosimeter types are appropriate for out-of-field dose measurements as well as for the in-phantom measurements of radiotherapy MV X-rays beams.     

Assessment of fast and thermal neutron ambient dose equivalents around the KFUPM neutron source storage area using nuclear track detectors

A set of five ²⁴¹Am–Be neutron sources are utilized in research and teaching at King Fahd University of Petroleum and Minerals (KFUPM). Three of these sources have an activity of 16 Ci each and the other two are of 5 Ci each. A well-shielded storage area was designed for these sources. The aim of the study is to check the effectiveness of shielding of the KFUPM neutron source storage area. Poly allyl diglycol carbonate (PADC) Nuclear track detectors (NTDs) based fast and thermal neutron area passive dosimeters have been utilized side by side for 33 days to assess accumulated low ambient dose equivalents of fast and thermal neutrons at 30 different locations around the source storage area and adjacent rooms. Fast neutron measurements have been carried out using bare NTDs, which register fast neutrons through recoils of protons, in the detector material. NTDs were mounted with lithium tetra borate (Li₂B₄O₇) converters on their surfaces for thermal neutron detection via and nuclear reactions. The calibration factors of NTD both for fast and thermal neutron area passive dosimeters were determined using thermoluminescent dosimeters (TLD) with and without a polyethylene moderator. The calibration factors for fast and thermal neutron area passive dosimeters were found to be 1.33 proton tracks and 31.5 alpha tracks , respectively. The results show variations of accumulated dose with the locations around the storage area. The fast neutron dose equivalents rates varied from as low as up to whereas those for thermal neutron ranged from as low as up to . The study indicates that the area passive neutron dosimeter was able to detect dose rates as low as 7 and from accumulated dose for thermal and fast neutrons, respectively, which were not possible to detect with the available active neutron dosimeters.     

Out-of-field dose measurements in radiotherapy – An overview of activity of EURADOS Working Group 9: Radiation protection in medicine

This review of dosimetry for second cancer risk estimation introduces work carried out by Working Group 9 (WG9: Radiation Protection Dosimetry in Medicine) of the European Radiation Dosimetry Group (EURADOS). The work concentrates on the measurement of out-of-field doses in water phantoms using a variety of dosimeters to measure photon and neutron doses. These include optically stimulated luminescence (OSL), radiophotoluminescence (RPL) and thermoluminescence (TLD) dosimeters for photon dosimetry (together with ion chambers for reference measurements) and track etch and superheated emulsion detectors for neutron measurements. The motivation of WG 9 was to assess undue, non-target patient doses in radiotherapy and the related risks of second malignancy. Improvements in cancer treatment have increased survival times and thus increased incidence of second cancer may be expected in the future. In addition, increased whole body exposure may result from some developments in radiotherapy. This means that radiotherapy clinics will need to simulate their treatments in order to estimate and minimise doses to healthy tissues and organs. The proposed work is designed to generate a robust dataset of out-of-field dose measurements which can be used for the development and validation of dose algorithms.     

Radiotherapy out-of-field dosimetry: Experimental and computational results for photons in a water tank

The first objective of this work was to check and select a set of four kinds of passive photon, dosimeters (two thermo-luminescence dosimeter (TLD) types, one radiophotoluminescence (RPL) dosimeter and one optically stimulated luminescence (OSL) dosimeter) together with a common measurement protocol. Dosimeters were calibrated in a reference clinical linear acccelerator beam in a water tank at a reference facility at the Laboratoire National Henri Becquerel (CEA LIST/LNE LNHB, Saclay. Radiation qualities of 6, 12 and 20 MV were used with standard calibration conditions described in IAEA TRS 398 and non-standard conditions. Profile and depth dose ion chamber measurements were also made to provide reference values. Measurements were made in a water tank into which pipes could be inserted which held dosimeters in pre-determined and reproducible positions. The water tank was built to enable investigation of doses up to 60 cm from the beam axis. A first set of experiments was carried out with the beam passing through the tank. From this first experiment, penumbra and out-of-field dose profiles including water and collimator scatter and leakage were found over three orders of magnitude. Two further sets of experiments using the same experimental arrangement with the beam outside the tank, to avoid water scatter, were designed to measure collimator scatter and leakage by closing the jaws of the collimator. Depending on the energy, typical leakage and collimator scatter represents 10–40% and 30–50% of the total out-of-field doses respectively. It was concluded that all dosimeters can be used for out-of-field photon dosimetry. All show good uniformity, good reproducibility, and can be used down to low doses expected at distances remote from the subsequent radiotherapy target volume.     

Investigation of the dose rate dependency of the PAGAT gel dosimeter at low dose rates

Medical physicists need dosimeters such as gel dosimeters capable of determining three-dimensional dose distributions with high spatial resolution. To date, in combination with magnetic resonance imaging (MRI), polyacrylamide gel (PAG) polymers are the most promising gel dosimetry systems. The purpose of this work was to investigate the dose rate dependency of the PAGAT gel dosimeter at low dose rates. The gel dosimeter was used for measurement of the dose distribution around a Cs-137 source from a brachytherapy LDR source to have a range of dose rates from 0.97 Gy h^?1 to 0.06 Gy h^?1. After irradiation of the PAGAT gel, it was observed that the dose measured by gel dosimetry was almost the same at different distances (different dose rates) from the source, although the points nearer the source had been expected to receive greater doses. Therefore, it was suspected that the PAGAT gel is dose rate dependent at low dose rates. To test this further, three other sets of measurements were performed by placing vials containing gel at different distances from a Cs-137 source. In the first two measurements, several plastic vials were exposed to equal doses at different dose rates. An ionization chamber was used to measure the dose rate at each distance. In addition, three TLD chips were simultaneously irradiated in order to verify the dose to each vial. In the third measurement, to test the oxygen diffusion through plastic vials, the experiment was repeated again using plastic vials in a nitrogen box and glass vials. The study indicates that oxygen diffusion through plastic vials for dose rates lower than 2 Gy h^?1 would affect the gel dosimeter response and it is suggested that the plastic vials or (phantoms) in an oxygen free environment or glass vials should be used for the dosimetry of low dose rate sources using PAGAT gel to avoid oxygen diffusion through the vials.     

EPR of gamma irradiated solid sucrose and UV spectra of its solution. An attempt for calibration of solid state/EPR dosimetry

A simple new approach for independent calibration of solid state/EPR (SS/EPR) dosimetry system is reported. It is based on the fact that: (i) gamma-irradiation of solid sucrose (sugar) induces stable EPR detectable free radicals accompanied by UV detectable brown colour stable in the solid state and in solution; (ii) both the EPR intensity of gamma-irradiated solid sucrose and its solution UV absorbance linearly depend on the absorbed dose high energy radiation and may be independently used for dosimetric purpose; (iii) UV spectrometers are calibrated. The correlation between EPR response and absorbed dose radiation of solid sucrose and UV absorption of its solutions is used in the present communication for calibration purpose. The procedure of sucrose extraction from sucrose-paraffin dosimeters is described. The calibration procedure may be applied to any other (alanine, self-calibrated, etc.) SS/EPR dosimeters, simultaneously irradiated with sucrose.     

面向个人剂量计校准的小尺度伽玛参考辐射模拟研究

针对伽玛射线个人剂量计基于标准伽玛参考辐射进行校准时检定效率低、校准工作复杂和需要远程送检的关键技术问题,建构了1 Ci 137Cs放射源小尺度参考辐射场物理模型,采用蒙特卡罗方法,研究了小尺度参考辐射场内的剂量分布、装置结构和待检剂量计变化导致散射射线对剂量场的影响,获得了待检剂量计形状、数量、类型和装置结构产生的散射伽玛射线对小尺度参考辐射量值定度的影响结果。研究结果表明,1 Ci 137Cs可以为小尺度参考辐射辐射场检验点提供1.5 mSv/h的伽玛遂行剂量率,辐照个人剂量计载台直径30 cm束斑上的剂量率相对标准偏差约为0.48%。当载台厚度为20 mm时,散射射线对小尺度参考辐射检验点处剂量率值的影响率为3.27%,高于剂量计尺寸（1.62%）和剂量计数量（0.56%）的影响。     

UV dosimeter based on polyamide woven fabric and nitro blue tetrazolium chloride as an active compound

This paper reports on the preparation and features of a UV light dosimeter composed of nitro blue tetrazolium chloride (NBT) and polyamide woven fabric. This textile dosimeter is based on the conversion reaction of NBT into formazan, which was initially examined in aerated aqueous solutions through steady state UV irradiation. Irradiated solutions change their colour as a consequence of the formation of polydisperse NBT formazan particles. This was analysed in relation to the absorbed dose of UV light through UV–VIS spectrophotometry and dynamic laser light scattering measurements. When NBT substrate molecules are embedded in polyamide textile, UV irradiation leads to similar effects as in solution. However, the tinge intensity changes at much lower absorbed doses. The dependence of the tinge intensity on the absorbed dose was followed by measurements of the remission of light from the NBT-polyamide samples. Consequently, the calibration parameters were calculated such as the dose sensitivity, dose range, and quasi-linear dose range. An improvement of the NBT-polyamide samples by application of a colour levelling agent and improvement of their resistance to humidity is presented. Finally, the samples were used for estimation of absorbed UV energy distribution showing their capability as new dosimeters for in-plane high resolution radiation dose measurements.     

Small field size dose-profile measurements using gel dosimeters,gafchromic films and micro-thermoluminescent dosimeters

The introduction of mini-multi-leaf collimators (MMLC) into radiotherapy has seen the use of smaller field sizes become increasingly important. Small field sizes that tightly conform to precise target regions are sought in radiotherapy to deliver doses with a high therapeutic ratio. MMLCs have made it possible to shrink field sizes in radiotherapy to below half a centimetre. The dosimetry of such fields with conventional dosimeters such as gas-ionisation chambers is not feasible due to limitations caused by the chambers relatively large size compared to the size of the collimated beam. In this work, the dose distribution of radiotherapy beams collimated to such small sizes were examined using polyacrylamide gels dosimeters, Gafchromic films and micro-thermoluminescence dosimeters (micro-TLDs). Dose penumbra widths obtained with gel dosimeters, Gafchormic film and micro-TLDs were generally in agreement with each other, although a wider FWHM of the field was measured with gel in comparison to film. An asymmetric dose distribution between the two axis profiles of a 3 × 3 mm collimated field was observed and can be attributed to an inherent asymmetry of the MMLC.     

Electron paramagnetic resonance radiation dosimetry in fingernails

There is now an increased need for accident dosimetry due to the increased risk of significant exposure to ionizing radiation from terrorism or accidents. In such scenarios, dose measurements should be made in individuals rapidly and with sufficient accuracy to enable effective triage. Electron paramagnetic resonance (EPR) is a physical method of high potential for meeting this need, providing direct measurements of the radiation-induced radicals, which are unambiguous signatures of exposure to ionizing radiation. For individual retrospective dosimetry, EPR in tooth enamel is a proven and effective technique when isolated teeth can be obtained. There are some promising developments that may make these measurements feasible without the need to remove the teeth, but their field applicability remains to be demonstrated. However, currently it is difficult under emergency conditions to obtain tooth enamel in sufficient amounts for accurate dose measurements. Since fingernails are much easier to sample, they can be used in potentially exposed populations to determine if they were exposed to life-threatening radiation doses. Unfortunately, only a few studies have been carried out on EPR radiation-induced signals in fingernails, and, while there are some promising aspects, the reported results were generally inconclusive. In this present paper, we report the results of a systematic investigation of the potential use of fingernails as retrospective radiation dosimeters.     

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.     

The role of TL dosimetry in estimating patient doses

A system of determining entrance surface doses (ESDs) from diagnostic X-ray examination is described. It is shown that the radiation yield calibrations of X-ray units (μGym²mAs⁻¹) can be based on very simple measurements with TL dosimeters. Comparisons of determined ESDs with the guidelines of international organizations are carried out with the aim of demonstrating the idea of how these values can be utilized in limiting patient doses.     

Introduction to dosimetry and risk estimation of second cancer induction following radiotherapy

This brief review of dosimetry in second cancer dosimetry introduces work carried out by Working Group 9 (Radiation Protection Dosimetry in Medicine) of the European Radiation Dosimetry Group (EURADOS). The work described in the following papers in this edition was presented at a Workshop on Dosimetry for Second Cancer Risk Estimation given at the EURADOS Annual meeting in Vienna on February 8th 2012. The work concentrates on the measurement of out-of-field doses in water tanks and BOMAB-like phantoms using a variety of dosimeters to measure photon and neutron doses. These include optically stimulated luminescence (OSL), radiophotoluminescence (RPL) and thermoluminescence (TLD) dosimeters for photon dosimetry (together with ion chambers for reference measurements traceable to primary standards) and track etch and bubble detectors for neutron measurements. A discussion of the various phantoms available for these measurements is presented together with a brief introduction to a model for the relationship between organ doses and the risk of induction of second cancers. The estimation of second cancer risks is not trivial and involves processes which are currently incompletely understood. However, progress in this field requires a robust foundation and methodology for the measurement or calculation of organ doses following radiotherapy, so that risks can be placed in perspective, algorithms for out-of-field doses can be compared with measured data, and future epidemiological studies may have a reliable foundation of organ dosimetry for retrospective dosimetry studies.     

Developing a single-aliquot protocol for measuring equivalent dose in biogenic carbonates

Exploiting biogenic carbonates as thermoluminescence dosimeters requires an understanding of trap kinetics and an appropriate sequence with which to measure equivalent dose. The trap kinetics of two high temperature peaks (peaks II and III) from calcitic snail opercula have been investigated resulting in the calculation of lifetimes of 7.4 × 10⁷ and 1.4 × 10¹¹ years for the two peaks respectively. Two measurement sequences, based upon changes in the application and measurement of a test dose, have been applied to peaks II and III, and though both methods were equally successful in dose recovery and production of a dose response curve some differences were observed. Primarily, the use of method 1 lead to dose dependant sensitivity change implying competition effects occurring during irradiation; method 2 did not experience this phenomenon. As a consequence method 2 was chosen as the most appropriate protocol for single-aliquot dating of this material.When assessing the TL behaviour of the two peaks, peak II performed poorly in dose recovery experiments recovering a dose 60–100% larger than that applied. Disproportionate growth of peak II in response to a beta dose applied prior to measurement, compared to growth following regeneration doses indicated that peak II was not suitable for use in single-aliquot protocols. However, dose recovery results for peak III were all within errors of unity of the given dose, and peak III was therefore chosen as the most appropriate peak for TL dosimetry in these single-aliquot procedures. The lifetime of charge in peak III is sufficient to date over many millions of years, and furthermore using the chosen method 2 the dose response curve has a D₀ of 3,250 ± 163 Gy allowing dating to over 3 million years.     

Angular Gamma Dose Rate Distribution at the Surface of Injected Ducted Concrete Shield

The shielding problems that arise due to the irregular penetrations such as neutral beam injection ducts should be treated carefully to aid in the shield design. The present work was undertaken to describe the effects arising due to radiation streaming through the neutral beam injector ducts (NBID) on the angular distribution of the total gamma ray doses at the outer surface of illmenite concrete shield (? = 4.6g/cm³). The shield is pierced with NBID of different diameters and lengths. The measurements were performed using a collimated beam of both gamma rays and neutrons emitted from one of the horizontal channels of the ET-RR-1 reactor. The measurements were carried out using ⁷LiF teflon thermoliminescent dosimeters. Generally the obtained data reveal that the presence of the total dose increase at the centerline of NBID and which in turn tends to decrease with the increase of scattered angle. An empirical formula describing the differential dose rate ratio is predicted. The experimental data obtained reveal good agreement with the calculated ones.     

Radioluminescence (RL) behaviour of Al2O3:C-potential for dosimetric applications

The radioluminescence (RL) of carbon doped aluminium oxide (Al₂O₃:C) TL dosimeter material (TLD-500) was investigated using a ¹³⁷Cs conversion electron source (which also emits β and γ) for simultaneous irradiation and luminescence excitation. Furthermore, RL dosimetry characteristics of this material were studied. The main RL emission occurs at 420 nm. That matches the known main TL and OSL emissions for this material as well as an emission that was investigated in earlier RL studies, excited at higher energies (4 MeV electrons) and very high pulse delivered doses (≈800 kGy·s⁻¹). Furthermore, the saturation dose for the main peak is reached at the dose level of ≈80 Gy as known from TL and earlier RL investigations. Other peaks at 700 and 790 nm and broad emission bands at photon energies higher than 3.00 eV and others between 2.00 and 2.50 eV were observed. The 700 nm emission shows growth also at higher dose levels, and saturates at an estimated dose of ≈800 Gy. The 790 nm emission reaches its maximum intensity at ≈10 Gy absorbed dose. The reported results give an outlook to the usability and the potential of Al₂O₃:C combined with RL measurements for radiation dosimetry as well as for beta source calibration, using radioluminescence.     

A new irradiated quartz for beta source calibration

For luminescence dating to be an accurate absolute dating technique it is very important that we are able to deliver absolutely known radiation doses in the laboratory. This is normally done using a radiation source (alpha, beta, X-ray) calibrated against an absolutely known reference source. Many laboratories have used the various different batches of Risø calibration quartz for the calibration of beta and X-ray sources, but these have been largely undescribed. Here we describe in detail the preparation and luminescence characteristics of a new quartz standard, based on a North Sea beach sand collected from south-western Denmark (Rømø). Two grain sizes (4–11 μm and 180–250 μm) have been examined in detail. These were pre-treated (annealed, dosed and annealed again) to sensitise and stabilise the luminescence signals before being given an absolutely known gamma dose from a point ¹³⁷Cs source in scatter-free geometry. The luminescence characteristics are described; the very intense blue-light stimulated signal is dominated by the fast OSL component and the IR-stimulated signal is negligible. The material is shown to be suitable for measurement using SAR, and the dose recovery ratio is indistinguishable from unity with a standard deviation of <2% for multi-grain aliquots. The material is also shown to be suitable for single-grain calibration, with >80% of the grains giving a useful signal. Although there is an unexplained dispersion in our calibration data of ∼3% (which we cannot attribute to instrument variability), we nevertheless conclude that this material is very suitable for transferring absolute known doses from a standardised gamma source to in-built irradiation sources.     

Optimisation of an EPR dosimetry system for robust and high precision dosimetry

Clinical applications of electron paramagnetic resonance (EPR) dosimetry systems demand high accuracy causing time consuming analysis. The need for high spatial resolution dose measurements in regions with steep dose gradients demands small sized dosimeters. An optimization of the analysis was therefore needed to limit the time consumption. The aim of this work was to introduce a new smaller lithium formate dosimeter model (diameter reduced from standard diameter 4.5 mm to 3 mm and height from 4.8 mm to 3 mm). To compensate for reduced homogeneity in a batch of the smaller dosimeters, a method for individual sensitivity correction suitable for EPR dosimetry was tested. Sensitivity and repeatability was also tested for a standard EPR resonator and a super high Q (SHQE) one. The aim was also to optimize the performance of the dosimetry system for better efficiency regarding measurement time and precision. A systematic investigation of the relationship between measurement uncertainty and number of readouts per dosimeter was performed. The conclusions drawn from this work were that it is possible to decrease the dosimeter size with maintained measurement precision by using the SHQE resonator and introducing individual calibration factors for dosimeter batches. It was also shown that it is possible reduce the number of readouts per dosimeter without significantly decreasing the accuracy in measurements.     

A self consistent normalized calibration protocol for three dimensional magnetic resonance gel dosimetry

In a clinical setting, mixed and inconsistent results have been reported using Magnetic Resonance Relaxation imaging of irradiated aqueous polymeric gels as a three-dimensional dosimeter, for dose verification of conformal radiation therapy. The problems are attributed to the difficulty of identifying an accurate dose calibration protocol for each delivered gel at the radiation site in a clinical setting. While careful calibration is done at the gel manufacturing site in a controlled laboratory setting, there is no guarantee that the dose sensitivity of the gels remains invariant upon delivery, irradiation, magnetic resonance imaging and storage at the clinical site. In this study, we have compared three different dose calibration protocols on aqueous polymeric gels for a variety of irradiation scenarios done in a clinical setting. After acquiring the three-dimensional proton relaxation maps of the irradiated gels, the dose distributions were generated using the off-site manufacturer provided calibration curve (Cal-1), the on-site external tube gel calibration (Cal-2) and the new on-site internal normalized gel calibration (Cal-3) protocols. These experimental dose distributions were compared with the theoretical dose distributions generated by treatment-planning systems. We observed that the experimental dose distributions generated from the Cal-1 and Cal-2 protocols were off by 10% to 40% and up to 200% above the predicted maximum dose, respectively. On the other hand, the experimental dose distributions generated from the Cal-3 protocol matched reasonably well with the theoretical dose distributions to within 10% difference. Our result suggests that an independent on-site normalized internal calibration must be performed for each batch of gel dosimeters at the time of MR relaxation imaging in order to account for the variations in dose sensitivity caused by various uncontrollable conditions in a clinical setting such as oxygen contamination, temperature changes and shelf life of the delivered gel between manufacturing and MR acquisitions.