Comparison of detector performance in small 6 MV and 6 MV FFF beams using a Versa HD accelerator

Applicability evaluation of the TRS-483 protocol for the determination of small-field output factors using different multi-leaf collimator and field-shaping types

PURPOSE

To evaluate the applicability of TRS-483 output correction factors (CFs) for small-field output factors (OFs) using different multi-leaf collimators (MLC) and field-shaping types.

METHODS

All measurements were performed on TrueBeam, TrueBeam STx, and Halcyon using 6 MV flattening filter-free energy. Four detectors, including CC01, CC04, microDiamond, and EDGE, were used. Nominal field sizes ranging from 1 × 1 to 4 × 4, and 10 × 10 cm2 were used to measure small-field OFs at source-to-axis distance of 100 cm with a 0° gantry angle in a 3D water phantom. Further, the field-shaping types were defined using jaw collimator or MLC (five different configurations). A field size of 10 × 10 cm2 was used as the reference for calculation of OFs obtained as ratio of detector readings (OFdet). The percentage difference and coefficient of variation of OFdet and OFdet corrected by applying CF were compared for each field size and configuration.

RESULTS

For OFdet corrected by applying CF, the ranges of percentage difference and coefficient of variation in all configurations for ≥ 2 × 2 cm2 fields were reduced from 1.2-2.2 to 0.8-1.3 percentage points (%pt) and from 0.5-1.0 to 0.4-0.7%, respectively. For 1 × 1 cm2 field, the ranges of percentage difference and coefficient of variation were reduced from 3.3-5.7 to 1.2-2.2 %pt and from 2.2-3.7 to 0.8-1.1%, respectively.

CONCLUSIONS

The CFs described in TRS-483 dosimetry protocol have broad applicability in reducing OF variations between detectors under different MLC and field-shaping types.

Evaluation and Comparison of Dosimetric Characteristics of Semiflex®3D and Microdiamond in Relative Dosimetry under 6 and 15 MV Photon Beams in Small Fields

BACKGROUND

In modern radiotherapy techniques, the frequently small and non-uniformed fields can increase treatment efficiency due to their highly conformal dose distribution. Particular features including lack of Lateral Charge Particle Equilibrium (LCPE) lead to detectors with high resolution since any error in obtained dosimetric data could cause patient mistreatments.

OBJECTIVE

This study aims to evaluate and compare two small detectors (Semiflex^®3D and microdiamond) dosimetric characteristics in small field relative dosimetry.

MATERIAL AND METHODS

In this experimental study, the dosimetric properties of Semiflex^®3D and microdiamond were assessed under 6 and 15 MV photon beams. The linearity and stability of the detector's response and dose rate were measured. Square-field sizes ranging from 0.6×0.6 - 5×5 cm² were used for obtaining percentage depth dose curves (PDDs) and in-plane profiles. The angular and temperature dependence of both detectors' responses were also studied.

RESULTS

The detector response shows good stability, no deviation from linearity, and low dose rate dependence (≤1.6%). PDDs and in-plan profiles of both detectors are in good agreement and no significant difference was observed except for the high dose gradient regions (P-value≤0.017). Both detectors demonstrated low angular dependence (<0.3%) with temperature dependence lower than 1% for both detectors.

CONCLUSION

The results indicate both investigated detectors were well performed in small field relative dosimetry and for measuring penumbra, it is better to use microdiamond detector.

Comparison and Validation of Multiple Detectors against Monte Carlo Simulation for the Use of Small-Field Dosimetry

Aim

The aim of this study was to compare the Exradin W2 scintillator, PTW microDiamond, IBA Razor Nano, and IBA Razor chamber detectors for small-field dose measurements and validate the measured data against the EGSnrc user code and observe the variation between daisy-chained and direct measurement methods for the above detectors.

Materials and Methods

The W2 scintillator, microDiamond, Razor Nano, and Razor chamber detectors were used to measure the in-plane and cross-plane profiles and the output factors (OFs) at 10 cm depth, and 90 source-to-surface distance for 6MV X-rays (Elekta Versa HD). The field sizes ranged from 0.5 cm × 0.5 cm to 5 cm × 5 cm. The BEAMnrc/DOSXYZnrc user codes (EGSnrc) were used to simulate the reference profiles. Gamma analysis was performed to compare the measured and simulated dose distributions.

Results

The OFs measured with the W2 scintillator, microDiamond, Razor Nano chamber, Razor chamber, and the calculated Monte Carlo (MC) showed agreement to within 1% for the 3 cm × 3 cm field size. The uncertainty in the MC simulation was observed to be 0.4%. The percent difference in OFs measured using daisy-chained and direct measurement methods was within 0.15%, 0.4%, 1.4%, and 2.4% for microDiamond, W2 scintillator, Nano, and Razor chamber detectors, respectively.

Conclusion

The lateral beam profiles and OFs of W2 scintillator, microDiamond, Razor Nano, and Razor chambers exhibit good agreement with the MC simulation within the nominal field sizes. Our results demonstrate that we can achieve considerable time-saving by directly measuring small-field OFs without daisy-chained methods using microDiamond and W2 scintillator. In terms of ease of use, sensitivity, reproducibility, and from a practical standpoint, we recommend microDiamond for small-field dosimetry.

Effect of inaccurate small field output factors on brain SRS plans

External beam radiotherapy often includes the use of field sizes 3 × 3 cm²or less, which can be defined as small fields. Dosimetry is a difficult, yet important part of the radiotherapy process. The dosimetry of small fields has additional challenges, which can lead to treatment inconsistencies if not done properly. Most important is the use of an appropriate detector, as well as the application of the necessary corrections. The International Atomic Energy Agency and the American Association of Physicists in Medicine provide the International Code of Practice (CoP) TRS-483 for the dosimetry of small static fields used in external MV photon beams. It gives guidelines on how to apply small-field correction factors for small field dosimetry. The purpose of this study was to evaluate the impact of inaccurate small-field output factors on clinical brain stereotactic radiosurgery plans with and without applying the small-field correction factors as suggested in the CoP. Small-field correction factors for a Varian TrueBeam linear accelerator were applied to uncorrected relative dose factors. Uncorrected and corrected clinical plans were created with two different beam configurations, 6 MV with a flattening filter (6 WFF) and 6 MV without a flattening filter (6 FFF). For the corrected plans, the planning target volume mean dose was 1.6 ± 0.9% lower with p < 0.001 for 6 WFF and 1.8 ± 1.5% lower with p < 0.001 for 6 FFF. For brainstem, a major organ at risk, the corrected plans had a dose that was 1.6 ± 0.9% lower with p = 0.03 for 6 WFF and 1.8 ± 1.5% lower with p = 0.10 for 6 FFF. This represents a systematic error that should and can be corrected.

Dosimetry of a 6 MV flattening filter-free small photon beam using various detectors

The present study aimed to dosimetrically evaluate the small-fields of a 6 MV flattening filter-free (FFF) photon beam using different detectors.The 6 MV FFF photon beam was used for measurement of output factor, depth dose, and beam profile of small-fields of sizes 0.6 cm × 0.6 cm to 6.0 cm × 6.0 cm. The five detectors used were SNC125c, PinPoint, EDGE, EBT3, and TLD-100. All measurements were performed as per the International Atomic Energy Agency TRS 483 protocol. Output factors measured using different detectors as direct reading ratios showed significant variation for the smallest fields, whereas after correcting them according to TRS 483, all sets of output factors were nearly compatible with each other when measurement uncertainty was also considered. The beam profile measured using SNC125c showed the largest penumbra for all field sizes, whereas the smallest was recorded with EDGE. Compared with that of EBT3, the surface dose was found to be much higher for all the other detectors. PinPoint, EBT3, TLD-100, and EDGE were found to be the detector of choice for small-field output factor measurements; however, PinPoint needs special attention when used for the smallest field size (0.6 cm × 0.6 cm). EDGE and EBT3 are optimal for measuring beam profiles. EBT3, PinPoint, and EDGE can be selected for depth dose measurements, and EBT3 is suitable for surface dose estimation.

Small-field output ratio determination using 6 mol% Ge-doped silica fibre dosimeters

This work investigates the suitability of locally fabricated 6 mol% Ge-doped optical fibres as dosimeters for small-field output ratio measurements. Two fabrications of fibre, cylindrical (CF) and flat (FF) fibres, were used to measure doses in small photon fields, from 4 to 15 mm. The findings were compared to those of commercial Ge-doped fibre (COMM), EBT3 film and an IBA CC01 ionization chamber. Irradiations were carried out using a 6 MV SRS photon beam operating at a dose rate of 1000 cGy min^-1, delivering a dose of 16 Gy. To minimise the possibility of the fibres failing to be exposed to the intended dose in small fields, the fibres were accommodated in a custom-made Perspex phantom. For the 4 mm cone the CF and FF measured output ratios were found to be smaller than obtained with EBT3 film by 32% and 13% respectively. Conversely, while for the 6 to 15 mm cone fields the FF output ratios were consistently greater than those obtained using EBT3 film, the CF output ratios differed from those of EBT3 film by at most 3.2%, at 6 mm, otherwise essentially agreeing with EBT3 values at the other field sizes. For the 4 to 7.5 mm cones, all output ratios obtained from Ge-doped optical fibre measurements were greater than those of IBA CC01 ionization chamber. The measured FF and CF output ratios for the 7.5 to 15 mm cones agreed with published MC estimates to within 15% and 13%, respectively. Down to 6 mm cone field, present measurements point to the potential of CF as a small-field dosimeter, its use recommended to be complemented by the use of EBT3 film for small-field dosimetry.

Feasibility study of using Stereotactic Field Diode for field output factors measurement and evaluating three new detectors for small field relative dosimetry of 6 and 10 MV photon beams

This study assesses the feasibility of using stereotactic field diode (SFD) as an alternate to gaf chromic films for field output factor (FF) measurement and further evaluating three new detectors for small field dosimetry. Varian 21EX linear accelerator was used to generate 6 and 10 MV beams of nominal square fields ranging from 0.5 × 0.5 cm² to 10 × 10 cm². One passive (EBT3 films) and five active detectors including IBA RAZOR diode(RD), SFD, RAZOR nanochamber (RNC), pinpoint chamber (PTW31023), and semiflex chamber (PTW31010) were employed. FFs were measured using films and SFD while beam profiles and percentage depth dose (PDD) distribution were acquired with active detectors. Polarity (k_pol) and recombination (k_s) effects of ion chambers were determined and corrected for output ratio measurement. Correction factors (CF) of RD, RNC, and PTW31023 in axial and radial orientation were also measured. Stereotactic field diode measured FFs have shown good agreement with films (with difference of <1%). RD and RNC measured beam profiles were within 3% deviation from the SFD values. Variation in k_pol with field size for RNC and PTW31023 was up to 4% and 0.4% (for fields ≥ 1 × 1 cm²), respectively, while variation in k_s of PTW31023 was <0.2 %. The maximum values of CF have been calculated to be 5.2%, 2.0%, 13.6%, and 25.5% for RD, RNC, PTW31023‐axial, and PTW31023‐radial respectively. This study concludes that SFD with appropriate CFs as given in TRS 483 may be used for measuring FFs as an alternate to EBT3 films. Whereas RD and RNC may be used for beam profile and PDD measurement in small fields. Considering the limit of usability of 2%, RNC may be used without CF for FF measurement in the smallfields investigated in this study.

Evaluation of dosimetric parameters of small fields of 6 MV flattening filter free photon beam measured using various detectors against Monte Carlo simulation

Purpose:

This study aims to evaluate dosimetric parameters like percentage depth dose, dosimetric field size, depth of maximum dose surface dose, penumbra and output factors measured using IBA CC01 pinpoint chamber, IBA stereotactic field diode (SFD), PTW microDiamond against Monte Carlo (MC) simulation for 6 MV flattening filter-free small fields.

Materials and Methods:

The linear accelerator used in the study was a Varian TrueBeam® STx. All field sizes were defined by jaws. The required shift to effective point of measurement was given for CC01, SFD and microdiamond for depth dose measurements. The output factor of a given field size was taken as the ratio of meter readings normalised to 10 × 10 cm2 reference field size without applying any correction to account for changes in detector response. MC simulation was performed using PRIMO (PENELOPE-based program). The phase space files for MC simulation were adopted from the MyVarian Website.

Results and Discussion:

Variations were seen between the detectors and MC, especially for fields smaller than 2 × 2 cm2 where the lateral charge particle equilibrium was not satisfied. Diamond detector was seen as most suitable for all measurements above 1 × 1 cm2. SFD was seen very close to MC results except for under-response in output factor measurements. CC01 was observed to be suitable for field sizes above 2 × 2 cm2. Volume averaging effect for penumbra measurements in CC01 was observed. No detector was found suitable for surface dose measurement as surface ionisation was different from surface dose due to the effect of perturbation of fluence. Some discrepancies in measurements and MC values were observed which may suggest effects of source occlusion, shift in focal point or mismatch between real accelerator geometry and simulation geometry.

Conclusion:

For output factor measurement, TRS483 suggested correction factor needs to be applied to account for the difference in detector response. CC01 can be used for field sizes above 2 × 2 cm2 and microdiamond detector is suitable for above 1 × 1 cm2. Below these field sizes, perturbation corrections and volume averaging corrections need to be applied.