BACKGROUND: Water phantoms are required to perform reference dosimetry and beam quality measurements but there are no published studies about the size requirements for such phantoms.
OBJECTIVE: To investigate, using Monte Carlo techniques, the size requirements for water phantoms used in reference dosimetry and/or to measure the beam quality specifiers % d d ( 10 ) x $\\%dd(10)_{\\sf x}$ and T P R 10 20 $TPR^{20}_{10}$ .
METHODS: The EGSnrc application DOSXYZnrc is used to calculate D ( 10 ) $D(10)$ , the dose per incident fluence at 10 cm depth in a water phantom irradiated by incident 10 × 10 cm 2 $10\\,\\times \\,10 \\, {\\rm {cm}}^{2}$   beams of 60 Co $^{60}{\\rm {Co}}$   or 6 MV photons. The water phantom dimensions are varied from 30 × 30 × 40 cm 3 $30 \\,\\times \\, 30 \\,\\times \\, 40 \\, {\\rm {cm}}^3$ to 15 × 15 × 22 cm 3 $15 \\,\\times \\, 15 \\,\\times \\, 22 \\, {\\rm {cm}}^3$ and occasionally smaller. The % d d ( 10 ) x $\\%dd(10)_{\\sf x}$ and T P R 10 20 $TPR^{20}_{10}$ values are also calculated with care being taken to distinguish T P R 10 20 $TPR^{20}_{10}$ results when using Method A (changing depth of water in phantom) and Method B (moving entire phantom). Typical statistical uncertainties are 0.03%.
RESULTS: Phantom dimensions have only minor effects for phantoms larger than 20 × 20 × 25 cm 3 $20 \\,\\times \\, 20 \\,\\times \\, 25 \\, {\\rm {cm}}^3$ . A table of corrections to the dose at 10 cm depth in 10 × 10 cm 2 $10 \\,\\times \\, 10 \\, {\\rm {cm}}^{2}$   beams of 60 Co $^{60}{\\rm {Co}}$   or 6 MV photons are provided and range from no correction to 0.75% for a 60 Co $^{60}{\\rm {Co}}$  beam incident on a 20 × 20 × 15 cm 3 $20 \\,\\times \\, 20 \\,\\times \\, 15 \\, {\\rm {cm}}^3$ phantom. There can be distinct differences in the T P R 10 20 $TPR^{20}_{10}$ values measured using Method A or Method B, especially for smaller phantoms. It is explicitly demonstrated that, within ± $\\pm$ 0.15%, T P R 10 20 $TPR^{20}_{10}$ values for a 30 × 30 × 30 cm 3 $30 \\,\\times \\, 30 \\,\\times \\, 30 \\, {\\rm {cm}}^3$ phantom measured using Method A or B are independent of source detector distance between 40 and 200 cm.
CONCLUSIONS: The phantom sizes recommended in the TG-51 and IAEA TRS-398 reference dosimetry protocols are adequate for accurate reference dosimetry and in some cases are even conservative. Correction factors are necessary for accurate measurement of the dose at 10 cm depth in smaller phantoms and these factors are provided. Very accurate beam quality specifiers are not required for reference dosimetry itself, but for specifying beam stability and characteristics it is important to specify phantom sizes and also the method used for T P R 10 20 $TPR^{20}_{10}$  measurements.

BACKGROUND: In water calorimetry, absolute dose to water is determined by measuring radiation-induced temperature rises. In conventional water calorimeters, temperature detectors are housed in handmade glass vessels that are filled with high-purity water, thus mitigating radiation-induced exo/endothermic chemical reactions of impurities that would otherwise introduce additional heat gain/loss, known as heat defect. Being hand-crafted, these glass vessels may suffer from imperfections, have shape and design constraints, are often backordered, and can be prohibitively expensive.
OBJECTIVE: The purpose of this work is to determine suitability of 3D-printed plastic vessels that are further coated for use in water calorimetry applications, and to study their stability and characterize their associated heat defect correction factor ( k hd ) ${k_{{\\mathrm{hd}}}})$ . This novel vessel production technique would allow for cost-effective rapid construction of vessels that can be produced with high accuracy and designs that are simply not practical with current glass vessel construction techniques. This in turn enables water calorimetry applications in many novel radiation delivery modalities, which may include spherical vessels in GammaKnife ICON water calorimetry as an example.
METHODS: Eight vessels were 3D-printed using Accura ClearVue in an SLA 3D-printer. Two vessels were coated with Parylene C and four were coated with Parylene N. The water calorimetry preparation procedures followed for these vessels was identical to that of our traditional glass-vessels (i.e., same cleaning procedures, same high purity water, and same saturation procedures with high purity hydrogen gas). The performance of each vessel was characterized using our in-house built water calorimeter in an Elekta Versa using both 6 MV flattening filter-free (FFF) and 18 MV beams. The stability of the coating as function of time and accumulated dose was evaluated through repeated measurements. k hd ${k_{{\\mathrm{hd}}}}\\;$ of each vessel was determined through cross-comparisons against an Exradin A1SL ionization chamber with direction calibration link to Canada\'s primary standard laboratory.
RESULTS: k HD ${k_{{\\mathrm{HD}}}}\\;$ of the two uncoated vessels differed by 2.8% under a 6 MV FFF beam. Vessels coated with Parylenes resulted in a stable and reproducible heat defect for both energies. An overall k hd ${k_{{\\mathrm{hd}}}}$ of 1.001 ± 0.010 and 1.005 ± 0.010 were obtained for Parylene N and Parylene C coated vessels respectively. All Parylene coated vessels showed agreement, within the established uncertainties, to the zero-heat defect observed in a hydrogen-saturated glass vessel system. An additional long-term study (17 days) of a Parylene N vessel showed no change in response with accumulated dose and time. Electron microscopy images of a Parylene N coated vessel showed a uniform intact coating after repeated irradiations.
CONCLUSIONS: An uncoated 3D-printed vessel is not viable for water calorimetry because it exhibits an unstable vessel-dependent heat defect. However, applying a Parylene coating stabilizes the heat defect, suggesting that coated 3D-printed vessels may be suitable for use in water calorimetry. This method facilitates the creation of intricate vessel shapes, which can be efficiently manufactured using 3D printing.

Objective. In this experimental work we compared the determination of absorbed dose to water using four ionization chambers (ICs), a PTW-34045 Advanced Markus, a PTW-34001 Roos, an IBA-PPC05 and a PTW-30012 Farmer, irradiated under the same conditions in one continuous- and in two pulsed-scanned proton beams.Approach. The ICs were positioned at 2 cm depth in a water phantom in four square-field single-energy scanned-proton beams with nominal energies between 80 and 220 MeV and in the middle of 10 × 10 × 10 cm3dose cubes centered at 10 cm or 12.5 cm depth in water. The water-equivalent thickness (WET) of the entrance window and the effective point of measurement was considered when positioning the plane parallel (PP) ICs and the cylindrical ICs, respectively. To reduce uncertainties, all ICs were calibrated at the same primary standards laboratory. We used the beam quality (kQ) correction factors for the ICs under investigation from IAEA TRS-398, the newly calculated Monte Carlo (MC) values and the anticipated IAEA TRS-398 updated recommendations.Main results. Dose differences among the four ICs ranged between 1.5% and 3.7% using both the TRS-398 and the newly recommendedkQvalues. The spread among the chambers is reduced with the newlykQvalues. The largest differences were observed between the rest of the ICs and the IBA-PPC05 IC, obtaining lower dose with the IBA-PPC05.Significance. We provide experimental data comparing different types of chambers in different proton beam qualities. The observed dose differences between the ICs appear to be related to inconsistencies in the determination of thekQvalues. For PP ICs, MC studies account for the physical thickness of the entrance window rather than the WET. The additional energy loss that the wall material invokes is not negligible for the IBA-PPC05 and might partially explain the lowkQvalues determined for this IC. To resolve this inconsistency and to benchmark MC values,kQvalues measured using calorimetry are needed.

In recent years, MR-Linac, a radiotherapy linear accelerator (linac) equipped with magnetic resonance (MR) imaging, has been deployed in clinical facilities across Japan. Because of the magnetic field of MR-Linac, which can affect the dose distributions and dose response of ionization chambers, conventional reference dosimetry for absorbed dose to water using an ionization chamber becomes impractical. Consequently, the magnetic field effect should be considered in the reference dosimetry for MR-Linac. Although numerous studies have delved into this matter and several magnetic field correction methods have been proposed to extend the conventional formalism, a practical protocol for reference dosimetry for MR-Linac remains elusive.The purpose of this review are as follows: (i) to summarize and evaluate literature and existing datasets as well as identify any gaps that highlight areas for the future research on this topic; (ii) to elucidate dosimetric challenges associated with ionization chamber dosimetry in magnetic fields; and (iii) to propose a formalism for reference dosimetry for MR-Linac based on available literature and datasets. This review focuses on studies based on commercially available MR-Linacs and datasets, specifically tailored for reference-class cylindrical ion chambers.

OBJECTIVE: The purpose of this study was to directly calculate [Formula: see text] correction factors for four cylindrical ICs for a 0.35 T MR-linac using the Monte Carlo (MC) method.
METHODS: A previously-validated TOPAS/GEANT4 MC head model of the 0.35 T MR-linac was employed. The MR-compatible Exradin A12, A1SL, A26, and A28 cylindrical ICs were modeled considering the dead volume in the air cavity. The [Formula: see text] correction factor was determined for initial electron energies of 5-7 MeV. The correction factor was calculated for all four angular orientations in the lateral plane. The impact of the 0.35 T magnetic field on the IC response was also investigated.
RESULTS: The maximum beam quality dependence in the [Formula: see text] exhibited by the A12, A1SL, A26, and A28 ICs was 1.10 %, 2.17 %, 0.81 %, and 1.75 %, respectively, considering all angular orientations. The magnetic field dependence was < 1 % and the maximum [Formula: see text] correction was < 2 % when the detector was aligned along the direction of the magnetic field at 0° and 180° angles. The A12 IC over-responded up to 5.40 % for the orthogonal orientation. An asymmetry in the response of up to 8.30 % was noted for the A28 IC aligned at 90° and 270° angles.
CONCLUSIONS: A parallel orientation for the IC, with respect to the magnetic field, is recommended for reference dosimetry in MRgRT. Both over and under-response in the IC signal was noted for the orthogonal orientations, which is highly dependent on the cavity diameter, cavity length, and the dead volume.

Objectives.In an addendum to AAPM TG-51 protocol, McEwenet al, (DOI:10.1118/1.4866223) introduced a new factorPrpto account for the radial dose distribution of the photon beam over the detector volume mainly in flattening filter free (FFF) beams.Prpand its extension to non-FFF beam reference dosimetry is investigated to see its impact in a clinical situation.Approches.ThePrpwas measured using simplified version of Sudhyadhomet al(DOI:10.1118/1.4941691) for Elekta and Varian FFF beams with two commonly used calibration detectors; PTW-30013 and Exradin-A12 ion chambers after acquiring high resolution profiles in detectors cardinal coordinates. For radial dose correction factor, the ion chambers were placed in a small water phantom and the central axis position was set to center of the sensitive volume on the treatment table and was studied by rotating the table by 15-degree interval from -90 to +90 degrees with respect to the initial (zero) position.Main results.The magnitude ofPrpvaries very little with machine, detector and beam energies to a value of 1.003 ± 0.0005 and 1.005 ± 0.0005 for 6FFF and 10FFF, respectively. The radial anisotropy for the Elekta machine with Exradin-A12 and PTW-30013 detector the magnitudes are in the range of (0.9995±0.0011 to 1.0015±0.0010) and (0.9998±0.0007 to 1.0015±0.0010), respectively. Similarly, for the Varian machine with Exradin-A12 and PTW-30013 ion chambers, the magnitudes are in the range of (1.0004±0.0010 to 1.0018±0.0018) and (1.0006±0.0009 to 1.0027±0.0007), respectively.Significance.ThePrpis ≤ 0.3% and 0.5% for 6FFF and 10FFF, respectively. The radial dose correction factor in regular beams also does not impact the dosimetry where the maximum magnitude is ±0.2% which is within experimental uncertainty.

Objective. Ionization chambers, mostly used for beam calibration and for reference dosimetry, can show high recombination effects in pulsed high dose rate proton beams. The aims of this paper are: first, to characterize the linearity response of newly designed asymmetrical beam monitor chambers (ABMC) in a 100-226 MeV pulsed high dose rate per pulse scanned proton beam; and secondly, to calibrate the ABMC with a PPC05 (IBA Dosimetry) plane parallel ionization chamber and compare to calibration with a home-made Faraday cup (FC).Approach. The ABMC response linearity was evaluated with both the FC and a PTW 60019 microDiamond detector. Regarding ionometry-based ABMC calibration, recombination factors were evaluated theoretically, then numerically, and finally experimentally measured in water for a plane parallel ionization chamber PPC05 (IBA Dosimetry) throughkssaturation curves. Finally, ABMC calibration was also achieved with FC and compared to the ionometry method for 7 energies.Main results. Linearity measurements showed that recombination losses in the new ABMC design were well taken into account for the whole range of the machine dose rates. The two-voltage-method was not suitable for recombination correction, but Jaffé\'s plots analysis was needed, emphasizing the current IAEA TRS-398 reference protocol limitations. Concerning ABMC calibration, FC based absorbed dose estimation and PPC05-based absorbed dose estimation differ by less than 6.3% for the investigated energies.Significance.So far, no update on reference dosimetry protocols is available to estimate the absorbed dose in ionization chambers for clinical high dose rate per pulse pulsed scanned proton beams. This work proposes a validation of the new ABMC design, a method to take into account the recombination effect for ionometry-based ABMC calibration and a comparison with FC dose estimation in this type of proton beams.

BACKGROUND: The static magnetic field present in magnetic resonance (MR)-guided radiotherapy systems can influence dose deposition and charged particle collection in air-filled ionization chambers. Thus, accurately quantifying the effect of the magnetic field on ionization chamber response is critical for output calibration. Formalisms for reference dosimetry in a magnetic field have been proposed, whereby a magnetic field quality conversion factor kB,Q is defined to account for the combined effects of the magnetic field on the radiation detector. Determination of kB,Q in the literature has focused on Monte Carlo simulation studies, with experimental validation limited to only a few ionization chamber models.
OBJECTIVE: The purpose of this study is to experimentally measure kB,Q for 11 ionization chamber models in two commercially available MR-guided radiotherapy systems: Elekta Unity and ViewRay MRIdian.
METHODS: Eleven ionization chamber models were characterized in this study: Exradin A12, A12S, A28, and A26, PTW T31010, T31021, and T31022, and IBA FC23-C, CC25, CC13, and CC08. The experimental method to measure kB,Q utilized cross-calibration against a reference Exradin A1SL chamber. Absorbed dose to water was measured for the reference A1SL chamber positioned parallel to the magnetic field with its centroid placed at the machine isocenter at a depth of 10 cm in water for a 10 × 10 cm2 field size at that depth. Output was subsequently measured with the test chamber at the same point of measurement. kB,Q for the test chamber was computed as the ratio of reference dose to test chamber output, with this procedure repeated for each chamber in each MR-guided radiotherapy system. For the high-field 1.5 T Elekta Unity system, the dependence of kB,Q on the chamber orientation relative to the magnetic field was quantified by rotating the chamber about the machine isocenter.
RESULTS: Measured kB,Q values for our test dataset of ionization chamber models ranged from 0.991 to 1.002, and 0.995 to 1.004 for the Elekta Unity and ViewRay MRIdian, respectively, with kB,Q tending to increase as the chamber sensitive volume increased. Measured kB,Q values largely agreed within uncertainty to published Monte Carlo simulation data and available experimental data. kB,Q deviation from unity was minimized for ionization chamber orientation parallel or antiparallel to the magnetic field, with increased deviations observed at perpendicular orientations. Overall (k = 1) uncertainty in the experimental determination of the magnetic field quality conversion factor, kB,Q was 0.71% and 0.72% for the Elekta Unity and ViewRay MRIdian systems, respectively.
CONCLUSIONS: For a high-field MR-linac, the characterization of ionization chamber performance as angular orientation varied relative to the magnetic field confirmed that the ideal orientation for output calibration is parallel. For most of these chamber models, this study represents the first experimental characterization of chamber performance in clinical MR-linac beams. This is a critical step toward accurate output calibration for MR-guided radiotherapy systems and the measured kB,Q values will be an important reference data source for forthcoming MR-linac reference dosimetry protocols.

BACKGROUND: A Faraday cup (FC) facilitates a quite clean measurement of the proton fluence emerging from clinical spot-scanning nozzles with narrow pencil-beams. The utilization of FCs appears to be an attractive option for high dose rate delivery modes and the source models of Monte-Carlo (MC) dose engines. However, previous studies revealed discrepancies of 3%-6% between reference dosimetry with ionization chambers (ICs) and FC-based dosimetry. This has prevented the widespread use of FCs for dosimetry in proton therapy.
OBJECTIVE: The current study aims at bridging the gap between FC dosimetry and IC dosimetry of proton fields delivered with spot-scanning treatment heads. Particularly, a novel method to evaluate FC measurements is introduced.
METHODS: A consistency check is formulated, which makes use of the energy balance and the reciprocity theorem. The measurement data comprise central-axis depth distributions of the absorbed dose of quasi-monochromatic fields with a width of about 28.5 cm and FC measurements of the reciprocal fields with a single spot. These data are complemented by a look-up of energy-range tables, the average Q-value of transmutations, and the escape energy carried away by neutrons and photons. The latter data are computed by MC simulations, which in turn are validated with measurements of the distal dose tail and neutron out-of-field doses. For comparison, the conventional approach of FC evaluation is performed, which computes absorbed dose from the product of fluence and stopping power. The results from the FC measurements are compared with the standard dosimetry protocols and improved reference dosimetry methods.
RESULTS: The deviation between the conventional FC-based dosimetry and the IC-based one according to standard dosimetry protocols was -4.7 ( ± $\\pm$ 3.3)% for a 100 MeV field and -3.6 ( ± $\\pm$ 3.5)% for 200 MeV, thereby agreeing within the reported uncertainties. The deviations could be reduced to -4.0 ( ± $\\pm$ 2.9)% and -3.0 ( ± $\\pm$ 3.1)% by adopting state-of-the-art reference dosimetry methods. The alternative approach using the energy balance gave deviations of only -1.9% (100 MeV) and -2.6% (200 MeV) using state-of-the-art dosimetry. The standard uncertainty of this novel approach was estimated to be about 2%.
CONCLUSIONS: An alternative concept has been established to determine the absorbed dose of monoenergetic proton fields with an FC. It eliminates the strong dependence of the conventional FC-based approach on the MC simulation of the stopping-power and of the secondary ions, which according to the study at hand is the major contributor to the underestimation of the absorbed dose. Some contributions to the uncertainty of the novel approach could potentially be reduced in future studies. This would allow for accurate consistency tests of conventional dosimetry procedures.

Radiotherapy is part of the treatment of over 50% of cancer patients. Its efficacy is limited by the radiotoxicity to the healthy tissue. FLASH-RT is based on the biological effect that ultra-high dose rates (UHDR) and very short treatment times strongly reduce normal tissue toxicity, while preserving the anti-tumoral effect. Despite many positive preclinical results, the translation of FLASH-RT to the clinic is hampered by the lack of accurate dosimetry for UHDR beams. To date radiochromic film is commonly used for dose assessment but has the drawback of lengthy and cumbersome read out procedures. In this work, we investigate the equivalence of a 2D OSL system to radiochromic film dosimetry in terms of dose rate independency. The comparison of both systems was done using the ElectronFlash linac. We investigated the dose rate dependence by variation of the (1) modality, (2) pulse repetition frequency, (3) pulse length and (4) source to surface distance. Additionally, we compared the 2D characteristics by field size measurements. The OSL calibration showed transferable between conventional and UHDR modality. Both systems are equally independent of average dose rate, pulse length and instantaneous dose rate. The OSL system showed equivalent in field size determination within 3 sigma. We show the promising nature of the 2D OSL system to serve as alternative for radiochromic film in UHDR electron beams. However, more in depth characterization is needed to assess its full potential.