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Development and clinical evaluation of an ionization chamber array with 3.5 mm pixel pitch for quality assurance in advanced radiotherapy techniques

Purpose: To characterize a new air vented ionization chamber technology, suitable to build detector arrays with small pixel pitch and independence of sensitivity on dose per pulse. Methods: The prototype under test is a linear array of air vented ionization chambers, consisting of 80 pixels with 3.5 mm pixel pitch distance and a sensitive volume of about 4 mm{sup 3}. The detector has been characterized with {sup 60}Co radiation and MV x rays from different linear accelerators (with flattened and unflattened beam qualities). Sensitivity dependence on dose per pulse has been evaluated under MV x rays by changing both the source to detector distance and the beam quality. Bias voltage has been varied in order to evaluate the charge collection efficiency in the most critical conditions. Relative dose profiles have been measured for both flattened and unflattened distributions with different field sizes. The reference detectors were a commercial array of ionization chambers and an amorphous silicon flat panel in direct conversion configuration. Profiles of dose distribution have been measured also with intensity modulated radiation therapy (IMRT), stereotactic radiosurgery (SRS), and volumetric modulated arc therapy (VMAT) patient plans. Comparison has been done with a commercial diode array and with Gafchromic EBT3 films. Results: Repeatability and stability under continuous gamma irradiation are within 0.3%, in spite of low active volume and sensitivity (∼200 pC/Gy). Deviation from linearity is in the range [0.3%, −0.9%] for a dose of at least 20 cGy, while a worsening of linearity is observed below 10 cGy. Charge collection efficiency with 2.67 mGy/pulse is higher than 99%, leading to a ±0.9% sensitivity change in the range 0.09–2.67 mGy/pulse (covering all flattened and unflattened beam qualities). Tissue to phantom ratios show an agreement within 0.6% with the reference detector up to 34 cm depth. For field sizes in the range 2 × 2 to 15 × 15 cm{sup 2}, the output factors are in agreement with a thimble chamber within 2%, while with 25 × 25 cm{sup 2} field size, an underestimation of 4.0% was found. Agreement of field and penumbra width measurements with the flat panel is of the order of 1 mm down to 1 × 1 cm{sup 2} field size. Flatness and symmetry values measured with the 1D array and the reference detectors are comparable, and differences are always smaller than 1%. Angular dependence of the detector, when compared to measurements taken with a cylindrical chamber in the same phantom, is as large as 16%. This includes inhomogeneity and asymmetry of the design, which during plan verification are accounted for by the treatment planning system (TPS). The detector is capable to reproduce the dose distributions of IMRT and VMAT plans with a maximum deviation from TPS of 3.0% in the target region. In the case of VMAT and SRS plans, an average (maximum) deviation of the order of 1% (4%) from films has been measured. Conclusions: The investigated technology appears to be useful both for Linac QA and patient plan verification, especially in treatments with steep dose gradients and nonuniform dose rates such as VMAT and SRS. Major limitations of the present prototype are the linearity at low dose, which can be solved by optimizing the readout electronics, and the underestimation of output factors with large field sizes. The latter problem is presently not completely understood and will require further investigations.

60 APPLIED LIFE SCIENCES↗

Comparative study of ionization chamber detectors vis-a-vis a CCD detector for dispersive XAS measurement in transmission geometry

We have designed and fabricated parallel plate ionization chamber detectors and voltage vs. current characteristics (V-I curve) of the detectors were recorded with synchrotron radiation to qualify for use in X-ray Absorption Spectroscopy (XAS) measurements. After qualifying the ionization chambers, the detectors were used in the dispersive EXAFS beamline (BL-08) at INDUS-2 SRS in Turbo-XAS geometry. Using the same setup and under the same setting, XAS spectra were also recorded with a CCD detector and the observation on relative performance of the ionization chamber vis-a-vis the CCD detector is presented in this paper.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Theoretical study of energy deposition in ionization chambers for tritium measurements

Energy deposition in ionization chambers has been theoretically studied for tritium measurements in gaseous form. A one-dimension model is introduced to establish the quantitative relationship between energy deposition rate and many factors, including carrier gas, gas pressure, wall material, chamber size, and gas temperature. Energy deposition rate has been calculated at pressure varying from 5 kPa to 500 kPa based on some approximations. It is found that energy deposition rate varies greatly for different parameters, especially at low gas pressure. For the same chamber, energy deposition rate in argon is much higher than in deuterium, as much as 70.7% higher at 5 kPa. Gold plated chamber gives highest energy deposition rate in the calculations while aluminum chamber results in the lowest. As chamber size gets smaller, β ray emitted by tritium will deposit less energy in the sensitive region of the chamber. For chambers flowing through with the same gas, energy deposition rate in a 10 L chamber is 23.9% higher than in a 0.05 L chamber at 5 kPa. Gas temperature also places slight influence on energy deposition rate, and 373 K will lead to 6.7% lower deposition rate than 233 K at 5 kPa. In addition, experiments have been performed to obtain energy deposition rate in a gold plated chamber, which show good accordance with theoretical calculations.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-623: Polarity Effects for Small Volume Ionization Chambers in Cobalt-60 Beams

Purpose: To investigate the polarity effects for small volume ionization chambers in {sup 60}Co gamma-ray beams using the Leksell Gamma Knife Perfexion. Methods: Measurements were made for 7 small volume ionization chambers (a PTW 31016, an Exradin A14, 2 Capintec PR0-5P, and 3 Exradin A16) using a PTW UNIDOSwebline Universal Dosemeter and an ELEKTA solid water phantom with proper inserts. For each ion chamber, the temperature/pressure corrected electric charge readings were obtained for 16 voltage values (±50V, ±100V, ±200V, ±300V, ±400V, ±500V, ±600V, ±700V). For each voltage, a five-minute leakage charge reading and a series of 2-minute readings were continuously taken during irradiation until 5 stable signals (less than 0.05% variation) were obtained. The average of the 5 reading was then used for the calculation of the polarity corrections at the voltage and for generating the saturation curves. Results: The polarity effects are more pronounced at high or low voltages than at the medium voltages for all chambers studied. The voltage dependence of the 3 Exradin A16 chambers is similar in shape. The polarity corrections for the Exradin A16 chambers changes rapidly from about 1 at 500V to about 0.98 at 700V. The polarity corrections for the 7 ion chambers at 300V are in the range from 0.9925 (for the PTW31016) to 1.0035 (for an Exradin A16). Conclusion: The polarity corrections for certain micro-chambers are large even at normal operating voltage.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Monte Carlo study of the depth-dependent fluence perturbation in parallel-plate ionization chambers in electron beams

Purpose: The electron fluence inside a parallel-plate ionization chamber positioned in a water phantom and exposed to a clinical electron beam deviates from the unperturbed fluence in water in absence of the chamber. One reason for the fluence perturbation is the well-known “inscattering effect,” whose physical cause is the lack of electron scattering in the gas-filled cavity. Correction factors determined to correct for this effect have long been recommended. However, more recent Monte Carlo calculations have led to some doubt about the range of validity of these corrections. Therefore, the aim of the present study is to reanalyze the development of the fluence perturbation with depth and to review the function of the guard rings. Methods: Spatially resolved Monte Carlo simulations of the dose profiles within gas-filled cavities with various radii in clinical electron beams have been performed in order to determine the radial variation of the fluence perturbation in a coin-shaped cavity, to study the influences of the radius of the collecting electrode and of the width of the guard ring upon the indicated value of the ionization chamber formed by the cavity, and to investigate the development of the perturbation as a function of the depth in an electron-irradiated phantom. The simulations were performed for a primary electron energy of 6 MeV. Results: The Monte Carlo simulations clearly demonstrated a surprisingly large in- and outward electron transport across the lateral cavity boundary. This results in a strong influence of the depth-dependent development of the electron field in the surrounding medium upon the chamber reading. In the buildup region of the depth-dose curve, the in–out balance of the electron fluence is positive and shows the well-known dose oscillation near the cavity/water boundary. At the depth of the dose maximum the in–out balance is equilibrated, and in the falling part of the depth-dose curve it is negative, as shown here the first time. The influences of both the collecting electrode radius and the width of the guard ring are reflecting the deep radial penetration of the electron transport processes into the gas-filled cavities and the need for appropriate corrections of the chamber reading. New values for these corrections have been established in two forms, one converting the indicated value into the absorbed dose to water in the front plane of the chamber, the other converting it into the absorbed dose to water at the depth of the effective point of measurement of the chamber. In the Appendix, the in–out imbalance of electron transport across the lateral cavity boundary is demonstrated in the approximation of classical small-angle multiple scattering theory. Conclusions: The in–out electron transport imbalance at the lateral boundaries of parallel-plate chambers in electron beams has been studied with Monte Carlo simulation over a range of depth in water, and new correction factors, covering all depths and implementing the effective point of measurement concept, have been developed.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Quality assurance of proton beams using a multilayer ionization chamber system

Purpose: The measurement of percentage depth-dose (PDD) distributions for the quality assurance of clinical proton beams is most commonly performed with a computerized water tank dosimetry system with ionization chamber, commonly referred to as water tank. Although the accuracy and reproducibility of this method is well established, it can be time-consuming if a large number of measurements are required. In this work the authors evaluate the linearity, reproducibility, sensitivity to field size, accuracy, and time-savings of another system: the Zebra, a multilayer ionization chamber system.Methods: The Zebra, consisting of 180 parallel-plate ionization chambers with 2 mm resolution, was used to measure depth-dose distributions. The measurements were performed for scattered and scanned proton pencil beams of multiple energies delivered by the Hitachi PROBEAT synchrotron-based delivery system. For scattered beams, the Zebra-measured depth-dose distributions were compared with those measured with the water tank. The principal descriptors extracted for comparisons were: range, the depth of the distal 90% dose; spread-out Bragg peak (SOBP) length, the region between the proximal 95% and distal 90% dose; and distal-dose fall off (DDF), the region between the distal 80% and 20% dose. For scanned beams, the Zebra-measured ranges were compared with those acquired using a Bragg peak chamber during commissioning.Results: The Zebra demonstrated better than 1% reproducibility and monitor unit linearity. The response of the Zebra was found to be sensitive to radiation field sizes greater than 12.5 × 12.5 cm; hence, the measurements used to determine accuracy were performed using a field size of 10 × 10 cm. For the scattered proton beams, PDD distributions showed 1.5% agreement within the SOBP, and 3.8% outside. Range values agreed within −0.1 ± 0.4 mm, with a maximum deviation of 1.2 mm. SOBP length values agreed within 0 ± 2 mm, with a maximum deviation of 6 mm. DDF values agreed within 0.3 ± 0.1 mm, with a maximum deviation of 0.6 mm. For the scanned proton pencil beams, Zebra and Bragg peak chamber range values demonstrated agreement of 0.0 ± 0.3 mm with a maximum deviation of 1.3 mm. The setup and measurement time for all Zebra measurements was 3 and 20 times less, respectively, compared to the water tank measurements.Conclusions: Our investigation shows that the Zebra can be useful not only for fast but also for accurate measurements of the depth-dose distributions of both scattered and scanned proton beams. The analysis of a large set of measurements shows that the commonly assessed beam quality parameters obtained with the Zebra are within the acceptable variations specified by the manufacturer for our delivery system.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-552: Monte Carlo Calculation of Correction Factors for a Free-Air Ionization Chamber in Support of a National Air-Kerma Standard for Electronic Brachytherapy

Purpose: To use Monte Carlo radiation transport methods to calculate correction factors for a free-air ionization chamber in support of a national air-kerma standard for low-energy, miniature x-ray sources used for electronic brachytherapy (eBx). Methods: The NIST is establishing a calibration service for well-type ionization chambers used to characterize the strength of eBx sources prior to clinical use. The calibration approach involves establishing the well-chamber’s response to an eBx source whose air-kerma rate at a 50 cm distance is determined through a primary measurement performed using the Lamperti free-air ionization chamber. However, the free-air chamber measurements of charge or current can only be related to the reference air-kerma standard after applying several corrections, some of which are best determined via Monte Carlo simulation. To this end, a detailed geometric model of the Lamperti chamber was developed in the EGSnrc code based on the engineering drawings of the instrument. The egs-fac user code in EGSnrc was then used to calculate energy-dependent correction factors which account for missing or undesired ionization arising from effects such as: (1) attenuation and scatter of the x-rays in air; (2) primary electrons escaping the charge collection region; (3) lack of charged particle equilibrium; (4) atomic fluorescence and bremsstrahlung radiation. Results: Energy-dependent correction factors were calculated assuming a monoenergetic point source with the photon energy ranging from 2 keV to 60 keV in 2 keV increments. Sufficient photon histories were simulated so that the Monte Carlo statistical uncertainty of the correction factors was less than 0.01%. The correction factors for a specific eBx source will be determined by integrating these tabulated results over its measured x-ray spectrum. Conclusion: The correction factors calculated in this work are important for establishing a national standard for eBx which will help ensure that dose is accurately and consistently delivered to patients.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy

Purpose: To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. Methods: The authors distinguish between a calibration procedure and an additional correction: 1—the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2—the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical model tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. Results: IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm{sup 2} were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight differences in the shallow region, but 94.5% of the points satisfied the 1%/1 mm criterion. The 90% ranges, defined at the 90% dose position in distal fall off, were in good agreement with those in the water phantom, and the range differences from the water phantom were less than ±0.3 mm. The PDDs measured with the DRMLIC were also consistent with those that of the water phantom; 97% of the points passed the 1%/1 mm criterion. Conclusions: It was demonstrated that the new correction technique suppresses the difference between the depth dose profiles obtained with the MLIC and those obtained from a water phantom, and a DRMLIC enabling fast measurements of both IDD and PDD was developed. The IDDs and PDDs measured with the DRMLIC and using the correction technique were in good agreement with those that of the water phantom, and it was concluded that the correction technique and DRMLIC are useful for depth dose profile measurements in pencil beam scanning proton therapy.

60 APPLIED LIFE SCIENCES↗

SU-E-T-460: Impact of the LINAC Repetition Rate On a High-Resolution Liquid Ionization Chamber Array for Patient-Specific QA

Purpose: The purpose of this study is to investigate the LINAC repetition-rate (dose-rate) dependence of OCTAVIUS 1000SRS liquid ionization chamber (LIC) array for patient specific QA of SRT plans delivered with flattening-filter-free (FFF) beams. Methods: 1) The repetition-rate dependence of 1000SRS was measured in a phantom constructed with 5-cm solid water above and below the array for build-up and backscatter. A 0.3cc calibrated ion chamber was also placed along the central axis 2.3cm below the center chamber of the array for normalizing LINAC output fluctuation. The signals from the center chamber of the array under different repetition rates in the range of 400–2400 MU/min for 6xFFF and 10xFFF beams on a Varian TrueBeamSTx LINAC, normalized by the independent chamber readings, were analyzed for the array response dependence on repetition rates. 2) Twelve Step-and-shoot IMRS QA plans (6xFFF and 10xFFF) were delivered to the array under different repetition rates for analysis and comparison. 3) The absolute doses measured by the center chamber were compared to measurements using an independent ionization chamber with the identical setup, taken as the gold standard. 4) The correction factors based on the actual delivery repetition rate were applied to the measurements, and the results were compared again to the gold standard. Results: 1) The 1000SRS array exhibited repetition-rate dependence for FFF beams, up to 5% for 6xFFF and 10% for 10xFFF; 2) The array showed clinically-acceptable repetition-rate dependence for regular flattened beams; 3) This repetition-rate dependence significantly affected the measurement accuracy, thereby affecting IMRS QA results; 4) By applying an empirical repetition-rate correction, the corrected measurements agreed better with the gold standard ion chamber measurements. Conclusion: OCTAVIUS 1000SRS LIC array exhibited considerable repetition-rate dependence for FFF beams, which will affect the accuracy of the absolute QA measurements, especially for IMRS plans with the step-and-shoot technique.

60 APPLIED LIFE SCIENCES↗

High-rate axial-field ionization chamber for particle identification of radioactive beams

The design, construction and performance characteristics of a simple axial-field ionization chamber suitable for identifying ions in a radioactive beam are presented. Optimized for use with low-energy radioactive beams ( < 5 MeV / A ) the detector presents only three 0.5 µm/cm 2 foils to the beam in addition to the detector gas. A fast charge sensitive amplifier (CSA) integrated into the detector design is also described. Coupling this fast CSA to the axial field ionization chamber produces an output pulse with a risetime of 60–70 ns and a fall time of 100 ns, making the detector capable of sustaining a relatively high rate and providing a time resolution of 6–8 ns. Tests with an α source establish the detector energy resolution as ~ 8 % for an energy deposit of ~3.5 MeV. The energy resolution with beams of 2.5 and 4.0 MeV/A 39 K ions and the dependence of the energy resolution on beam intensity is measured. At an instantaneous rate of 3×10 5 ions/s the energy resolution has degraded to 14% with a pileup of 12%. The good energy resolution of this detector at rates up to 3×10 5 ions/s makes it an effective tool in the characterization of low-energy radioactive beams.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry

Purpose: A surface electronic brachytherapy (EBT) device is in fact an x-ray source collimated with specific applicators. Low-energy (<100 kVp) x-ray beam dosimetry faces several challenges that need to be addressed. A number of calibration protocols have been published for x-ray beam dosimetry. The media in which measurements are performed are the fundamental difference between them. The aim of this study was to evaluate the surface dose rate of a low-energy x-ray source with small field applicators using different calibration standards and different small-volume ionization chambers, comparing the values and uncertainties of each methodology. Methods: The surface dose rate of the EBT unit Esteya (Elekta Brachytherapy, The Netherlands), a 69.5 kVp x-ray source with applicators of 10, 15, 20, 25, and 30 mm diameter, was evaluated using the AAPM TG-61 (based on air kerma) and International Atomic Energy Agency (IAEA) TRS-398 (based on absorbed dose to water) dosimetry protocols for low-energy photon beams. A plane parallel T34013 ionization chamber (PTW Freiburg, Germany) calibrated in terms of both absorbed dose to water and air kerma was used to compare the two dosimetry protocols. Another PTW chamber of the same model was used to evaluate the reproducibility between these chambers. Measurements were also performed with two different Exradin A20 (Standard Imaging, Inc., Middleton, WI) chambers calibrated in terms of air kerma. Results: Differences between surface dose rates measured in air and in water using the T34013 chamber range from 1.6% to 3.3%. No field size dependence has been observed. Differences are below 3.7% when measurements with the A20 and the T34013 chambers calibrated in air are compared. Estimated uncertainty (with coverage factor k = 1) for the T34013 chamber calibrated in water is 2.2%–2.4%, whereas it increases to 2.5% and 2.7% for the A20 and T34013 chambers calibrated in air, respectively. The output factors, measured with the PTW chambers, differ by less than 1.1% for any applicator size when compared to the output factors that were measured with the A20 chamber. Conclusions: Measurements using both dosimetric protocols are consistent, once the overall uncertainties are considered. There is also consistency between measurements performed with both chambers calibrated in air. Both the T34013 and A20 chambers have negligible stem effect. Any x-ray surface brachytherapy system, including Esteya, can be characterized using either one of these calibration protocols and ionization chambers. Having less correction factors, lower uncertainty, and based on measurements, performed in closer to clinical conditions, the TRS-398 protocol seems to be the preferred option.

60 APPLIED LIFE SCIENCES↗

Characterization of the ionization chamber for the SPIDER detector

We request 3 days of ATLAS beams for testing the ionization chamber component of the SPIDER detector, a spectrometer for mea suring the mass yields of neutron-induced fission fragments. The ion ization chamber will be a stand alone detector to be coupled to the end of the beam pipe at zero degrees. These tests are a mass and energy specific characterization of the ionization chamber operating conditions specific to SPIDER, including entrance window material options. Once tested, the results will be applied to the energy cal ibration process of SPIDER, a crucial step to achieving high mass resolution.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Conception and realization of a parallel-plate free-air ionization chamber for the absolute dosimetry of an ultrasoft X-ray beam

We report the design of a millimeter-sized parallel plate free-air ionization chamber (IC) aimed at determining the absolute air kerma rate of an ultra-soft X-ray beam (E = 1.5 keV). The size of the IC was determined so that the measurement volume satisfies the condition of charged-particle equilibrium. The correction factors necessary to properly measure the absolute kerma using the IC have been established. Particular attention was given to the determination of the effective mean energy for the 1.5 keV photons using the PENELOPE code. Other correction factors were determined by means of computer simulation (COMSOL™and FLUKA). Measurements of air kerma rates under specific operating parameters of the lab-bench X-ray source have been performed at various distances from that source and compared to Monte Carlo calculations. We show that the developed ionization chamber makes it possible to determine accurate photon fluence rates in routine work and will constitute substantial time-savings for future radiobiological experiments based on the use of ultra-soft X-rays.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-D-213-04: Accounting for Volume Averaging and Material Composition Effects in An Ionization Chamber Array for Patient Specific QA

Purpose: This study explores novel methods to address two significant challenges affecting measurement of patient-specific quality assurance (QA) with IBA’s Matrixx Evolution™ ionization chamber array. First, dose calculation algorithms often struggle to accurately determine dose to the chamber array due to CT artifact and algorithm limitations. Second, finite chamber size and volume averaging effects cause additional deviation from the calculated dose. Methods: QA measurements were taken with the Matrixx positioned on the treatment table in a solid-water Multi-Cube™ phantom. To reduce the effect of CT artifact, the Matrixx CT image set was masked with appropriate materials and densities. Individual ionization chambers were masked as air, while the high-z electronic backplane and remaining solid-water material were masked as aluminum and water, respectively. Dose calculation was done using Varian’s Acuros XB™ (V11) algorithm, which is capable of predicting dose more accurately in non-biologic materials due to its consideration of each material’s atomic properties. Finally, the exported TPS dose was processed using an in-house algorithm (MATLAB) to assign the volume averaged TPS dose to each element of a corresponding 2-D matrix. This matrix was used for comparison with the measured dose. Square fields at regularly-spaced gantry angles, as well as selected patient plans were analyzed. Results: Analyzed plans showed improved agreement, with the average gamma passing rate increasing from 94 to 98%. Correction factors necessary for chamber angular dependence were reduced by 67% compared to factors measured previously, indicating that previously measured factors corrected for dose calculation errors in addition to true chamber angular dependence. Conclusion: By comparing volume averaged dose, calculated with a capable dose engine, on a phantom masked with correct materials and densities, QA results obtained with the Matrixx Evolution™ can be significantly improved. In addition, necessary correction factors are reduced, allowing for more reliable and meaningful patient-specific QA measurements.

60 APPLIED LIFE SCIENCES↗

SU-G-TeP2-13: Patient-Specific Reduction of Range Uncertainties in Proton Therapy by Proton Radiography with a Multi-Layer Ionization Chamber

Purpose: The conversion from Hounsfield units (HU) to stopping powers is a major source of range uncertainty in proton therapy (PT). Our contribution shows how proton radiographs (PR) acquired with a multi-layer ionization chamber in a PT center can be used for accurate patient positioning and subsequently for patient-specific optimization of the conversion from HU to stopping powers. Methods: A multi-layer ionization chamber was used to measure the integral depth-dose (IDD) of 220 MeV pencil beam spots passing through several anthropomorphic phantoms. The whole area of interest was imaged by repositioning the couch and by acquiring a 45×45 mm{sup 2} frame for each position. A rigid registration algorithm was implemented to correct the positioning error between the proton radiographs and the planning CT. After registration, the stopping power map obtained from the planning CT with the calibration curve of the treatment planning system was used together with the water equivalent thickness gained from two proton radiographs to generate a phantom-specific stopping power map. Results: Our results show that it is possible to make a registration with submillimeter accuracy from proton radiography obtained by sending beamlets separated by more than 1 mm. This was made possible by the complex shape of the IDD due to the presence of lateral heterogeneities along the path of the beam. Submillimeter positioning was still possible with a 5 mm spot spacing. Phantom specific stopping power maps obtained by minimizing the range error were cross-verified by the acquisition of an additional proton radiography where the phantom was positioned in a random but known manner. Conclusion: Our results indicate that a CT-PR registration algorithm together with range-error based optimization can be used to produce a patient-specific stopping power map. Sylvain Deffet reports financial funding of its PhD thesis by Ion Beam Applications (IBA) during the confines of the study and outside the submitted work. Francois Vander Stappen reports being employed by Ion Beam Applications (IBA) during the confines of the study and outside the submitted work.

60 APPLIED LIFE SCIENCES↗

Consequences of air around an ionization chamber: Are existing solid phantoms suitable for reference dosimetry on an MR-linac?

Purpose: A protocol for reference dosimetry for the MR-linac is under development. The 1.5 T magnetic field changes the mean path length of electrons in an air-filled ionization chamber but has little effect on the electron trajectories in a surrounding phantom. It is therefore necessary to correct the response of an ionization chamber for the influence of the magnetic field. Solid phantoms are used for dosimetry measurements on the MR-linac, but air is present between the chamber wall and phantom insert. This study aimed to determine if this air influences the ion chamber measurements on the MR-linac. The absolute response of the chamber and reproducibility of dosimetry measurements were assessed on an MR-linac in solid and water phantoms. The sensitivity of the chamber response to the distribution of air around the chamber was also investigated. Methods: Measurements were performed on an MR-linac and replicated on a conventional linac for five chambers. The response of three waterproof chambers was measured with air and with water between the chamber and the insert to measure the influence of the air volume on absolute chamber response. The distribution of air around the chamber was varied indirectly by rotating each chamber about the longitudinal chamber axis in a solid phantom and a water phantom (waterproof chambers only) and measuring the angular dependence of the chamber response, and varied directly by displacing the chamber in the phantom insert using a paper shim positioned at different orientations between the chamber casing and the insert. Results: The responses of the three waterproof chambers measured on the MR-linac were 0.7%–1.2% higher with water than air in the chamber insert. The responses of the chambers on the conventional linac changed by less than 0.3% when air in the insert was replaced with water. The angular dependence of the chambers ranged from 0.6% to 1.9% in the solid phantom on the MR-linac but was less than 0.5% in water on the MR-linac and less than 0.3% in the solid phantom on the conventional linac. Inserting a shim around the chamber induced changes of the chamber response in a magnetic field of up to 2.2%, but the change in chamber response on the conventional linac was less than 0.3%. Conclusions: The interaction between the magnetic field and secondary electrons in the air around the chamber reduces the charge collected from 0.7% to 1.2%. The large angular dependence of ion chambers measured in the plastic phantom in a magnetic field appears to arise from a change of air distribution as the chamber is moved within the insert, rather than an intrinsic isotropy of the chamber sensitivity to radiation. It is recommended that reference dosimetry measurements on the MR-linac can be performed only in water, rather than in existing plastic phantoms.

60 APPLIED LIFE SCIENCES↗

Time-resolved dosimetry using a pinpoint ionization chamber as quality assurance for IMRT and VMAT

Purpose: To develop a method to verify the dose delivery in relation to the individual control points of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) using an ionization chamber. In addition to more effective problem solving during patient-specific quality assurance (QA), the aim is to eventually map out the limitations in the treatment chain and enable a targeted improvement of the treatment technique in an efficient way. Methods: Pretreatment verification was carried out for 255 treatment plans that included a broad range of treatment indications in two departments using the equipment of different vendors. In-house developed software was used to enable calculation of the dose delivery for the individual beamlets in the treatment planning system (TPS), for data acquisition, and for analysis of the data. The observed deviations were related to various delivery and measurement parameters such as gantry angle, field size, and the position of the detector with respect to the field edge to distinguish between error sources. Results: The average deviation of the integral fraction dose during pretreatment verification of the planning target volume dose was −2.1% ± 2.2% (1 SD), −1.7% ± 1.7% (1 SD), and 0.0% ± 1.3% (1 SD) for IMRT at the Radboud University Medical Center (RUMC), VMAT (RUMC), and VMAT at the Wellington Blood and Cancer Centre, respectively. Verification of the dose to organs at risk gave very similar results but was generally subject to a larger measurement uncertainty due to the position of the detector at a high dose gradient. The observed deviations could be related to limitations of the TPS beam models, attenuation of the treatment couch, as well as measurement errors. The apparent systematic error of about −2% in the average deviation of the integral fraction dose in the RUMC results could be explained by the limitations of the TPS beam model in the calculation of the beam penumbra. Conclusions: This study showed that time-resolved dosimetry using an ionization chamber is feasible and can be largely automated which limits the required additional time compared to integrated dose measurements. It provides a unique QA method which enables identification and quantification of the contribution of various error sources during IMRT and VMAT delivery.

60 APPLIED LIFE SCIENCES↗