Objective.In this work, we present and evaluate a technique for performing interface measurements of beta particle-emitting radiopharmaceutical therapy agents in solution.Approach.Unlaminated EBT3 film was calibrated for absorbed dose to water using a NIST matched x-ray beam. Custom acrylic source phantoms were constructed and placed above interfaces comprised of bone, lung, and water-equivalent materials. The film was placed perpendicular to these interfaces and measurements for absorbed dose to water using solutions of90Y and177Lu were performed and compared to Monte Carlo absorbed dose to water estimates simulated with EGSnrc. Surface and depth dose profile measurements were also performed.Main results.Surface absorbed dose to water measurements agreed with predicted results within 3.6% for177Lu and 2.2% for90Y. The agreement between predicted and measured absorbed dose to water was better for90Y than177Lu for depth dose and interface profiles. In general, agreement withink= 1 uncertainty bounds was observed for both radionuclides and all interfaces. An exception to this was found for the bone-to-water interface for177Lu due to the increased sensitivity of the measurements to imperfections in the material surfaces.Significance. This work demonstrates the feasibility and limitations of using radiochromic film for performing absorbed dose to water measurements on beta particle-emitting radiopharmaceutical therapy agents across material interfaces.

Objective. This work introduces a novel approach to performing active and passive dosimetry for beta-emitting radionuclides in solution using common dosimeters. The measurements are compared to absorbed dose to water (Dw) estimates from Monte Carlo (MC) simulations. We present a method for obtaining absorbed dose to water, measured with dosimeters, from beta-emitting radiopharmaceutical agents using a custom SPECT/CT compatible phantom for validation of Monte Carlo based absorbed dose to water estimates.Approach. A cylindrical, acrylic SPECT/CT compatible phantom capable of housing an IBA EFD diode, Exradin A20-375 parallel plate ion chamber, unlaminated EBT3 film, and thin TLD100 microcubes was constructed for the purpose of measuring absorbed dose to water from solutions of common beta-emitting radiopharmaceutical therapy agents. The phantom is equipped with removable detector inserts that allow for multiple configurations and is designed to be used for validation of image-based absorbed dose estimates with detector measurements. Two experiments with131I and one experiment with177Lu were conducted over extended measurement intervals with starting activities of approximately 150-350 MBq. Measurement data was compared to Monte Carlo simulations using the egs_chamber user code in EGSnrc 2019.Main results. Agreement withink= 1 uncertainty between measured and MC predictedDwwas observed for all dosimeters, except the A20-375 ion chamber during the second131I experiment. Despite the agreement, the measured values were generally lower than predicted values by 5%-15%. The uncertainties atk = 1 remain large (5%-30% depending on the dosimeter) relative to other forms of radiation therapy.Significance. Despite high uncertainties, the overall agreement between measured and simulated absorbed doses is promising for the use of dosimeter-based RPT measurements in the validation of MC predictedDw.

The radiotherapy is performed with the aim of delivering the optimal dose to the target volume with minimal side effect of surrounding normal tissue. For this purpose, quality assurance is essential to ensure that the target volume is correctly irradiated in the optimal geometrical arrangement, and the absorbed dose evaluation is essential to ensure that the prescribed dose is correctly delivered. The absorbed doses are generally evaluated using a small cavity ionization chamber that utilizes gas ionization. For the evaluation of absorbed dose to water using ionization chambers, the national dose and charge standards, ionization chambers and electrometer calibration systems are required. And it is also required standard dosimetry protocol that recommend conditions such as fields, depths, and optimal ionization chambers for the measurement, as well as reliable physical data. This manuscript reviews the transition of standard dosimetry of absorbed dose to water in external beam radiotherapy, including the background of dose standards, ionization chamber calibration systems, units, and physical constants.

Objective. Despite the number of treatments performed with electronic brachytherapy (eBT) there is no uniform methodology for reference dosimetry for international traceability to primary dosimetry standards in different eBT systems. The objective of this study is to propose a formalism for traceability reference dosimetry in superficial eBT, that is easy to apply in the clinic. This method was investigated for an Elekta Esteya with one applicator.Approach. The calibration x-ray spectrum at the primary standards dosimetry laboratory was matched to the measured eBT photon spectrum. Subsequently, two ionization chambers of different types were calibrated at the primary standard dosimetry laboratory (PSDL) in terms of air kerma against a primary standard. The chambers were used to measure ionization chamber reading ratios in-air at different distances from the applicator. Monte Carlo based air kerma ratios were calculated at different positions from the eBT applicator as well as backscatter factors in water and average mass energy absorption ratios in water and in air. Relative measurements with radiochromic films were performed in a water phantom to determine the ratio of absorbed dose to water,Dw, at the surface toDwat 1 cm depth in water. These were compared with Monte Carlo calculations.Main results. Calculations and measurements were combined to estimate theDwat the surface and at 1 cm depth in water. Ionization chamber agreement of the surface dose was 1.7%, within an uncertainty of 6.8% (k= 2). They agreed with the manufacturer dosimetry within 1.8%, with an uncertainty of 5.0% (k= 2). The feasibility of the formalism and methodology for the Esteya system was demonstrated.Significance. This study proposes a method for harmonization of traceable reference dosimetry for eBT contact treatments which does not involve a detailed simulation of the ionization chamber. The method demonstrated feasibility for one eBT system using one surface applicator. In the future the method could be applied for different eBT systems.

Objective.This project aims to provide a novel method for performing dosimetry measurements on TRT radionuclides using a custom-made SPECT/CT compatible phantom, common active and passive detectors, and Monte Carlo simulations. In this work we present a feasibility study using99mTc for a novel approach to obtaining reproducible measurements of absorbed-dose-to-water from radionuclide solutions using active and passive detectors in a custom phantom for the purpose of benchmarking Monte Carlo-based absorbed-dose-to-water estimates.Approach. A cylindrical, acrylic SPECT/CT compatible phantom capable of housing an IBA EFD diode, SNC600c Farmer type ion chamber, and TLD-100 microcubes was designed and built for the purpose of assessing internal absorbed-dose-to-water at various points within a solution of99mTc. The phantom is equipped with removable inserts that allow for numerous detector configurations and is designed to be used for verification of SPECT/CT-based absorbed-dose estimates with traceable detector measurements at multiple locations. Three experiments were conducted with exposure times ranging from 11 to 21 h with starting activities of approximately 10-16 GBq. Measurement data was compared to Monte Carlo simulations using the egs_chamber user code in EGSnrc 2019.Main results. In general, the ionization chamber measurements agreed with the Monte Carlo simulations withink= 1 uncertainty values (±4% and ±7%, respectively). Measurements from the TLDs yielded results withink= 1 agreement of the MC prediction (±6% and ±5%, respectively). Agreement withink= 1 uncertainty (±6% and ±7%, respectively) was obtained for the diode for one of three conducted experiments.Significance. While relatively large uncertainties remain, the agreement between measured and simulated absorbed-doses provides proof of principal that dosimetry of radionuclide solutions with active detectors may be performed using this type of phantom with potential modifications for beta-emitting radionuclides to be introduced in future work.

OBJECTIVE: The recently worldwide standard measurement of electron beam reference dosimetry include the International Atomic Energy Agency (IAEA) Technical Report Series (TRS)-398 and Association of Physicists in Medicine (AAPM) Task Group (TG)-51 protocols. Muir et al. have modified calibration methods for electron beam calibration based on AAPM TG-51. They found that the use of cylindrical chambers at low energy gave acceptable results. In this study, we propose and report a modified calibration for electron beam based on IAEA TRS-398, the standard reference dosimetry protocol worldwide.
METHODS: This work was carried out with energies of 6, 8, 10, 12, and 15 MeV. The electron beam is generated from Elektra Synergy Platform and Versa HD linear accelerator. The charge readings were measured with PTW 30013, IBA CC13, Exradin A1Sl, and Exradin A11 chambers connected to the electrometer. The dose calculation uses an equation of modified calibration for electron beam using the updated k Q ${k_Q}$ factor in previous work. The absorbed dose to water for electron beam is expressed in dose per monitor unit (cGy/MU). Thus, we compared dose per monitor unit (D/MU) calculation using a modified calibration to TRS-398.
RESULTS: In this work, we have succeeded in implementing the modified calibration of electron beam based on TRS-398 by applying a cylindrical chamber in all energy beams and using the updated k Q ${k_Q}$ factor. The ratio of the absorbed dose to water between original and modified calibration protocols of TRS-398 (Dw ) for the cylindrical chamber was 1.002 on the Elekta Synergy Platform and 1.000 on the Versa HD while for the parallel-plate chamber it was 1.013 on the Elekta Synergy Platform and 1.014 on the Versa HD. Based on these results, both the cylindrical and parallel-plate chambers are still within the tolerance limit allowed by the TRS-398 protocol, which is ±2%. Therefore, modified calibration based on TRS-398 gives acceptable results and is simpler to use clinically.

The dosimetry of carbon-ion beams based on calibrated ionization chambers (ICs) still shows a significantly higher uncertainty compared to high-energy photon beams, a fact influenced mainly by the uncertainty of the correction factor for the beam qualitykQ. Due to a lack of experimental data,kQfactors in carbon-ion beams used today are based on theoretical calculations whose standard uncertainty is three times higher than that of photon beams. To reduce their uncertainty, in this work,kQfactors for two ICs were determined experimentally by means of water calorimetry for the spread-out Bragg peak of a carbon-ion beam, these factors are presented here for the first time. To this end, the absorbed dose to water in the12C-SOBP is measured using the water calorimeter developed at Physikalisch-Technische Bundesanstalt, allowing a direct calibration of the ICs used (PTW 30013 and IBA FC65G) and thereby an experimental determination of the chamber-specifickQfactors. Based on a detailed characterization of the irradiation field, correction factors for several effects that influence calorimetric and ionometric measurements were determined. Their contribution to an overall uncertainty budget of the finalkQfactors was determined, leading to a standard uncertainty forkQof 0.69%, which means a reduction by a factor of three compared to the theoretically calculated values. The experimentally determined values were expressed in accordance with TRS-398 and DIN 6801-1 and compared to the values given there. A maximum deviation of 2.3% was found between the experiment and the literature.

UNASSIGNED: External dosimetry audits are powerful quality assurance instruments for radiotherapy. The aim of this study was to implement an electron dosimetry audit based on a contemporary code of practice within the requirements for calibration laboratories performing proficiency tests. This involved the determination of suitable acceptance criteria based on thorough uncertainty analyses.
UNASSIGNED: Subject of the audit was the determination of absorbed dose to water, D w, and the beam quality specifier, R 50,dos. Fifteen electron beams were measured in four institutes according to the Belgian-Dutch code of practice for high-energy electron beams. The expanded uncertainty (k = 2) for the D w values was 3.6% for a Roos chamber calibrated in 60Co and 3.2% for a Roos chamber cross-calibrated against a Farmer chamber. The expanded uncertainty for the beam quality specifier, R 50,dos, was 0.14 cm. The audit acceptance levels were based on the expanded uncertainties for the comparison results and estimated to be 2.4%.
UNASSIGNED: The audit was implemented and validated successfully. All D w audit results were satisfactory with differences in D w values mostly smaller than 0.5% and always smaller than 1%. Except for one, differences in R 50,dos were smaller than 0.2 cm and always smaller than 0.3 cm.
UNASSIGNED: An electron dosimetry audit based on absorbed dose to water and present-day requirements for calibration laboratories performing proficiency tests was successfully implemented. It proved international traceability of the participants value with an uncertainty better than 3.6% (k = 2).

OBJECTIVE: For x-ray beams in the low and medium energy range, reference dosimetry is established in terms of air kerma. Fricke dosimetry has shown great potential in the absolute measurements of the absorbed dose to water for high-energy ranges. Therefore, the main purpose of this work was to compare the absorbed dose to water for medium-energy x-ray beams obtained through Fricke dosimetry with that obtained from the air kerma rate.
METHODS: To determine the absorbed dose to water using Fricke dosimetry, the polyethylene bags methodology was chosen. Fricke solution was irradiated at four different beam qualities. The absorbed dose to water values obtained using Fricke dosimetry were compared to those obtained using the standard protocol, using the Z-score.
RESULTS: Values of the Z-score were <2 for all measurements of absorbed dose to water, which means that the values obtained using Fricke dosimetry are equivalent to those obtained using the reference protocol. The combined standard uncertainty for the absorbed dose to water obtained by Fricke dosimetry was lower than that obtained with the ionization chamber.
CONCLUSIONS: Chemical dosimetry using a standard FeSO4 solution has been demonstrated to be a potential option as a standard for the quantity absorbed dose to water for medium kV x-ray qualities.

BACKGROUND: To evaluate the difference of absorbed doses calculated to medium and to water by a Monte Carlo (MC) algorithm based treatment planning system (TPS), and to assess the potential clinical impact to dose prescription.
METHODS: Thirty patients, 10 nasopharyngeal cancer (NPC), 10 lung cancer and 10 bone metastases cases, were selected for this study. For each case, the treatment plan was generated using a commercial MC based TPS and dose was calculated to medium (Dm). The plan was recalculated for dose to water (Dw) using the same Monitor Units (MU) and control points. The differences between Dm and Dw were qualitatively evaluated by dose-volume parameters and by the plan subtraction method. All plans were measured using the MapCheck2, and gamma passing rates were calculated.
RESULTS: For NPC and Lung cases, the mean differences between Dw and Dm for the targets were less than 2% and the maximum difference was 3.9%. The maximum difference of D2% for the organs at risk (OARs) was 6.7%. The maximum differences between Dw and Dm were as high as 10% in certain high density regions. For bone metastases cases, the mean differences between Dw and Dm for the targets were more than 2.2% and the maximum difference was 7.1%. The differences between Dw and Dm for the OARs were basically negligible. At 3%&3 mm criterion, the gamma passing rate of Dw plan and Dm plan were close (> 94%).
CONCLUSIONS: The differences between Dw and Dm has little clinical impact for most clinical cases. In bony structures the differences may become clinically significant if the target/OAR is receiving doses close to its tolerance limit which can potentially influence the selection or rejection of a particular plan.