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DOE OSTI2016

SU-F-T-111: Investigation of the Attila Deterministic Solver as a Supplement to Monte Carlo for Calculating Out-Of-Field Radiotherapy Dose

Purpose: To use the Attila deterministic solver as a supplement to Monte Carlo for calculating out-of-field organ dose in support of epidemiological studies looking at the risks of second cancers. Supplemental dosimetry tools are needed to speed up dose calculations for studies involving large-scale patient cohorts. Methods: Attila is a multi-group discrete ordinates code which can solve the 3D photon-electron coupled linear Boltzmann radiation transport equation on a finite-element mesh. Dose is computed by multiplying the calculated particle flux in each mesh element by a medium-specific energy deposition cross-section. The out-of-field dosimetry capability of Attila is investigated by comparing average organ dose to that which is calculated by Monte Carlo simulation. The test scenario consists of a 6 MV external beam treatment of a female patient with a tumor in the left breast. The patient is simulated by a whole-body adult reference female computational phantom. Monte Carlo simulations were performed using MCNP6 and XVMC. Attila can export a tetrahedral mesh for MCNP6, allowing for a direct comparison between the two codes. The Attila and Monte Carlo methods were also compared in terms of calculation speed and complexity of simulation setup. A key perquisite for this work was the modeling of a Varian Clinac 2100 linear accelerator. Results: The solid mesh of the torso part of the adult female phantom for the Attila calculation was prepared using the CAD software SpaceClaim. Preliminary calculations suggest that Attila is a user-friendly software which shows great promise for our intended application. Computational performance is related to the number of tetrahedral elements included in the Attila calculation. Conclusion: Attila is being explored as a supplement to the conventional Monte Carlo radiation transport approach for performing retrospective patient dosimetry. The goal is for the dosimetry to be sufficiently accurate for use in retrospective epidemiological investigations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-AB-BRB-04: Cherenkov Imaging for Radiation Therapy Dose Verification On Patients

Despite widespread IMRT treatments at modern radiation therapy clinics, precise dosimetric commissioning of an IMRT system remains a challenge. In the most recent report from the Radiological Physics Center (RPC), nearly 20% of institutions failed an end-to-end test with an anthropomorphic head and neck phantom, a test that has rather lenient dose difference and distance-to-agreement criteria of 7% and 4 mm. The RPC report provides strong evidence that IMRT implementation is prone to error and that improved quality assurance tools are required. At the heart of radiation therapy dosimetry is the multidimensional dosimeter. However, due to the limited availability of water-equivalent dosimetry materials, research and development in this important field is challenging. In this session, we will review a few dosimeter developments that are either in the laboratory phase or in the pre-commercialization phase. 1) Radiochromic plastic. Novel formulations exhibit light absorbing optical contrast with very little scatter, enabling faster, broad beam optical CT design. 2) Storage phosphor. After irradiation, the dosimetry panels will be read out using a dedicated 2D scanning apparatus in a non-invasive, electro-optic manner and immediately restored for further use. 3) Liquid scintillator. Scintillators convert the energy from x-rays and proton beams into visible light, which can be recorded with a scientific camera (CCD or CMOS) from multiple angles. The 3D shape of the dose distribution can then be reconstructed. 4) Cherenkov emission imaging. Gated intensified imaging allows video-rate passive detection of Cherenkov emission during radiation therapy with the room lights on. Learning Objectives: To understand the physics of a variety of dosimetry techniques based upon optical imaging To investigate the strategies to overcome respective challenges and limitations To explore novel ideas of dosimeter design Supported in part by NIH Grants R01CA148853, R01CA182450, R01CA109558. Brian Pogue is founder and president of the company DoseOptics LLC, dedicated to developing and commercializing the first dedicated Cerenkov imaging camera and system for radiation dose imaging. Work reported in this talk does not involve the use of DoseOptics technology.; H. Li, this work was supported in part by NIH Grant No. R01CA148853; S. Beddar, NIH funding R01-CA182450.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Investigation of the Attila Deterministic Solver for Out-of-Field Organ Dose Calculations for Radiotherapy Patients

An undeniable paradox in the current practice of radiation oncology is that the therapeutic radiation often used to treat cancer is also a known carcinogen. Indeed, the potential for inducing second cancers in patients receiving radiotherapy has been well established. Retrospective epidemiological studies are an important way to assess the risks of late effects in radiotherapy patients. Such investigations attempt to correlate organ dose with the incidence of secondary cancers in a cohort of patients. Individualized patient dosimetry is a critical component of these studies and is challenging for two reasons. First, medical images describing the patient's anatomy are either non-existent or, if they exist, often only cover a portion of the body. This means that whole body computational human phantoms must be used as a surrogate for the patient's true anatomy in order to perform dose calculations far from the treatment site. Second, the gold standard dosimetry approach calls for the use of Monte Carlo radiation transport simulations which are far too slow for studies involving large-scale patient cohorts. This paper describes a preliminary effort at the National Cancer Institute aimed at addressing these dosimetry challenges. The Attila software (Varian Medical Systems, Palo Alto, CA) is investigated as an alternative to Monte Carlo for performing out-of-field organ dose calculations for radiotherapy patients. Whereas as Monte Carlo uses stochastic methods, Attila can deterministically solve the linear Boltzmann equation throughout the entire solution space. It is hypothesized that dose calculations with Attila will offer comparable accuracy to Monte Carlo, but with significant faster computation times. At least one study has demonstrated this for in-field dose calculations [3]. To our knowledge Attila has not yet been used to perform out-of-field organ dosimetry. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

Seed Placement in Permanent Breast Seed Implant Brachytherapy: Are Concerns Over Accuracy Valid?

Purpose: To evaluate seed placement accuracy in permanent breast seed implant brachytherapy (PBSI), to identify any systematic errors and evaluate their effect on dosimetry. Methods and Materials: Treatment plans and postimplant computed tomography scans for 20 PBSI patients were spatially registered and used to evaluate differences between planned and implanted seed positions, termed seed displacements. For each patient, the mean total and directional seed displacements were determined in both standard room coordinates and in needle coordinates relative to needle insertion angle. Seeds were labeled according to their proximity to the anatomy within the breast, to evaluate the influence of anatomic regions on seed placement. Dosimetry within an evaluative target volume (seroma + 5 mm), skin, breast, and ribs was evaluated to determine the impact of seed placement on the treatment. Results: The overall mean (±SD) difference between implanted and planned positions was 9 ± 5 mm for the aggregate seed population. No significant systematic directional displacements were observed for this whole population. However, for individual patients, systematic displacements were observed, implying that intrapatient offsets occur during the procedure. Mean displacements for seeds in the different anatomic areas were not found to be significantly different from the mean for the entire seed population. However, small directional trends were observed within the anatomy, potentially indicating some bias in the delivery. Despite observed differences between the planned and implanted seed positions, the median (range) V{sub 90} for the 20 patients was 97% (66%-100%), and acceptable dosimetry was achieved for critical structures. Conclusions: No significant trends or systematic errors were observed in the placement of seeds in PBSI, including seeds implanted directly into the seroma. Recorded seed displacements may be related to intrapatient setup adjustments. Despite observed seed displacements, acceptable postimplant dosimetry was achieved.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

Current Status of Radiopharmaceutical Therapy

In radiopharmaceutical therapy (RPT), a radionuclide is systemically or locally delivered with the goal of targeting and delivering radiation to cancer cells while minimizing radiation exposure to untargeted cells. Examples of current RPTs include thyroid ablation with the administration of {sup 131}I, treatment of liver cancer with {sup 90}Y microspheres, the treatment of bony metastases with {sup 223}Ra, and the treatment of neuroendocrine tumors with {sup 177}Lu-DOTATATE. New RPTs are being developed where radionuclides are incorporated into systemic targeted therapies. To assure that RPT is appropriately implemented, advances in targeting need to be matched with advances in quantitative imaging and dosimetry methods. Currently, radiopharmaceutical therapy is administered by intravenous or locoregional injection, and the treatment planning has typically been implemented like chemotherapy, where the activity administered is either fixed or based on a patient’s body weight or body surface area. RPT pharmacokinetics are measurable by quantitative imaging and are known to vary across patients, both in tumors and normal tissues. Therefore, fixed or weight-based activity prescriptions are not currently optimized to deliver a cytotoxic dose to targets while remaining within the tolerance dose of organs at risk. Methods that provide dose estimates to individual patients rather than to reference geometries are needed to assess and adjust the injected RPT dose. Accurate doses to targets and organs at risk will benefit the individual patients and decrease uncertainties in clinical trials. Imaging can be used to measure activity distribution in vivo, and this information can be used to determine patient-specific treatment plans where the dose to the targets and organs at risk can be calculated. The development and adoption of imaging-based dosimetry methods is particularly beneficial in early clinical trials. In this work we discuss dosimetric accuracy needs in modern radiation oncology, uncertainties in the dosimetry in RPT, and best approaches for imaging and dosimetry of internal radionuclide therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-D-16A-07: Photobleaching Predicts Necrosis in Interstitial PDT

Purpose: Dosimetry for PDT has proven to be a challenge thus far, and for prediction of PDT outcome, a singlet oxygen model based on fundamental photophysical parameters has been developed. Previously, the photobleaching effect of photosensitizers was taken into account in the singlet oxygen explicit dosimetry model; here we report of direct measurements of photobleaching in the same model to assess the conditions under which implicit dosimetry using photobleaching can serve as an intermediate surrogate for PDT damage. Methods: Fluorescence spectra were measured interstitially in sensitized mouse tumors prior to after irradiation via a cylindrical diffuser. Photobleaching was determined by the relative decrease in fluorescence amplitude from the initial pre-treatment measurement. Spectra were analyzed by singular value decomposition to determine the photosensitizer concentration. Different photosensitizers were used to see the effect of photobleaching on PDT outcome and the impact of fluence on photobleaching. The drugs used were BPD (at two drug-light intervals), HPPH, and Photofrin. PDT outcome was determined by tumor necrosis radii measured upon sectioning and staining of treated tumors. Results: Post-PDT photosentizer concentrations were compared to initial pre-PDT photosensitizer concentrations, and the decrease was greater with a higher fluence measured during treatment. Furthermore, photobleaching and necrosis radius were found to be positively correlated. The relationship between photobleaching and necrosis radius is sensitizer-dependent, however the differences among sensitizers can be understood in terms of their respective photophysical parameters. Conclusions: Photobleaching is predictive of PDT outcome, but a comprehensive singlet oxygen model, has the potential to further improve the prediction of PDT outcome and the understanding of implicit dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-09: A Monte Carlo Analysis of the Relationship Between Cherenkov Light Emission and Dose for Electrons, Protons, and X-Ray Photons

Purpose: A number of recent studies have proposed that light emitted by the Cherenkov effect may be used for a number of radiation therapy dosimetry applications. Here we investigate the fundamental nature and accuracy of the technique for the first time by using a theoretical and Monte Carlo based analysis. Methods: Using the GEANT4 architecture for medically-oriented simulations (GAMOS) and BEAMnrc for phase space file generation, the light yield, material variability, field size and energy dependence, and overall agreement between the Cherenkov light emission and dose deposition for electron, proton, and flattened, unflattened, and parallel opposed x-ray photon beams was explored. Results: Due to the exponential attenuation of x-ray photons, Cherenkov light emission and dose deposition were identical for monoenergetic pencil beams. However, polyenergetic beams exhibited errors with depth due to beam hardening, with the error being inversely related to beam energy. For finite field sizes, the error with depth was inversely proportional to field size, and lateral errors in the umbra were greater for larger field sizes. For opposed beams, the technique was most accurate due to an averaging out of beam hardening in a single beam. The technique was found to be not suitable for measuring electron beams, except for relative dosimetry of a plane at a single depth. Due to a lack of light emission, the technique was found to be unsuitable for proton beams. Conclusions: The results from this exploratory study suggest that optical dosimetry by the Cherenkov effect may be most applicable to near monoenergetic x-ray photon beams (e.g. Co-60), dynamic IMRT and VMAT plans, as well as narrow beams used for SRT and SRS. For electron beams, the technique would be best suited for superficial dosimetry, and for protons the technique is not applicable due to a lack of light emission. NIH R01CA109558 and R21EB017559.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-J-64: Evaluation of a Commercial EPID-Based in Vivo Dosimetric System in the Presence of Lung Tissue Heterogeneity

Purpose: To study the performance of Dosimetry Check (DC), an EPID-based dosimetry software, which allows performing transit dosimetry, in low density medium, by comparing calculations in-phantom, and analysing results for 15 lung patients. Methods: DC software (v.3.8, pencil beam-based algorithm) has been tested, for plans (Eclipse v.10.0 TPS) delivered in two Varian Clinac iX equipped with aS1000 EPIDs.In the CIRS lung phantom, comparisons between DC and Eclipse (Acuros) were performed for several plans: (1) four field box; (2) square field delivered in arc mode; (3) RapidArc lung patient plan medially centred; (4) RapidArc lung patient plan centred in one lung. Reference points analysed: P1 (medial point, plans 1–3) and P2 (located inside one lung, plan 4).For fifteen lung patients treated with RapidArc, the isocentre and 9 additional points inside the PTV as well as the gamma passing rate (3%/3mm) for the PTV and at the main planes were studied. Results: In-phantom:P1: Per-field differences in plan 1: good agreement for AP-PA fields; discrepancy of 7% for the lateral fields. Global differences (plans 1–3): about 4%, showing a compensating effect of the individual differences.P2: Global difference (plan 4): 15 %. This represents the worst case situation as it is a point surrounded by lung tissue, where the DC pencil beam algorithm is expected to give the greater difference against Acuros.Lung patients: Mean point difference inside the PTV:(5.4±4.2) %. Gamma passing rate inside the PTV:(45±12) %. Conclusion: The performance of DC in heterogeneous lung medium was studied with a special phantom and the results for 15 patients were analysed. The found deviations show that even though DC is a highly promising in vivo dosimetry tool, there is a need of incorporating a more accurate algorithm mainly for plans with low density regions involved.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-368: Effect of a Strong Magnetic Field On Select Radiation Dosimeters

Purpose: To determine the effect of a strong magnetic field on TLD-100, OSLD (Al{sub 2}O{sub 2}:C), and PRESAGE dosimetry devices. This study will help to determine which types of dosimeters can be used for quality assurance and in-vivo dosimetry measurements in a magnetic resonance imaginglinear accelerator (MRI-linac) system. Methods: The dosimeters were separated into two categories which were either exposed or not exposed to a strong magnetic field. In each category a set of dosimeters was irradiated with 0, 2, or 6 Gy. To expose the dosimeters to a magnetic field the samples in that category were place in a Bruker small animal magnetic resonance scanner at a field strength slightly greater than 2.5 T for at least 1 hour preirradiation and at least 1 hour post-irradiation. Irradiations were performed with a 6 MV x-ray beam from a Varian TrueBeam linac with 10×10 cm{sup 2} field at a 600 MU/min dose rate. The samples that received no radiation dose were used as control detectors. Results: The readouts of the dosimeters which were not exposed to a strong magnetic field were compared with the measurements of the dosimetry devices which were exposed to a magnetic field. No significant differences (less than 2% difference) in the performance of TLD, OSLD, or PRESAGE dosimeters due to exposure to a strong magnetic field were observed. Conclusion: Exposure to a strong magnetic field before and after irradiation does not appear to change the dosimetric properties of TLD, OSLD, or PRESAGE which indicates that these dosimeters have potential for use in quality assurance and in-vivo dosimetry in a MRI-linac. We plan to further test the effect of magnetic fields on these devices by irradiating them in the presence of a magnetic fields similar to those produced by a MRI-linac system. Elekta-MD Anderson Cancer Center Research Agreement.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-446: Evaluation of the Dosimetric Properties of a Diode Detector to Proton Radiosurgery

Purpose: To test the PTW PR60020 proton dosimetry diode in radiation fields relevant to proton radiosurgery applications and evaluate its suitability as a high resolution, real time dosimetry device. Methods: Data was collected using our standard nominal radiosurgery energies of 126 MeV and 155 MeV through a single stage scattering system, corresponding to a range of 9.7 and 15 cm in water respectively. Various beam modulations were tested as part of this study. Depth dose and beam profile measurements were completed with the PTW PR60020 dosimetry diode with comparative measurements using a PTW Markus ionization chamber and EBT2 Gafchromic film. Monte Carlo simulations were also completed for comparison. Results: The single 1 mm{sup 2} by 20 μm thick sensitive volume allowed for high spatial resolution measurements while maintaining sufficient sensitive volume to ensure that measurements could be completed without excessive beam delivery. Depth dose profiles exhibited negligible LET dependence which typically impacts film and other solid state dosimetry devices, while beam ranges measured with the PTW diode were within 1 mm of ion chamber data. In an edge on arrangement beam profiles were also measured within 0.5 mm full-width at half-maximum at various depths as compared to film and simulation data. Conclusion: The PTW PR60020 proved to be a very useful radiation metrology apparatus for proton radiosurgery applications. Its waterproof and rugged construction allowed for easy deployment in phantoms or water tanks that are commonly used in proton radiosurgery QA. Dosimetrically, the diode exhibited negligible LET dependence as a function of depth, while in edge on arrangement to the incident proton beam it facilitated the measurement of beam profiles with a spatial resolution comparable to both Monte Carlo and film measurements. This project was sponsored in part by funding from the Department of Defense (DOD# W81XWH-BAA-10-1)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-T-527: Prior Knowledge Guided TomoTherapy Treatment Planning

Purpose: The quality and efficiency of radiotherapy treatment planning are highly planer dependent. Previously we have developed a statistical model to correlate anatomical features with dosimetry features of head and neck Tomotherapy treatment. The model enables us to predict the best achievable dosimetry for individual patient prior to treatment planning. The purpose of this work is to study if the prediction model can facilitate the treatment planning in both the efficiency and dosimetric quality. Methods: The anatomy-dosimetry correlation model was used to calculate the expected DVH for nine patients formerly treated. In Group A (3 patients), the model prediction agreed with the clinic plan; in Group B (3 patients), the model predicted lower larynx mean dose than the clinic plan; in Group C (3 patients), the model suggested the brainstem could be further spared. Guided by the prior knowledge, we re-planned all 9 cases. The number of interactions during the optimization process and dosimetric endpoints between the original clinical plan and model-guided re-plan were compared. Results: For Group A, the difference of target coverage and organs-at-risk sparing is insignificant (p>0.05) between the replan and the clinical plan. For Group B, the clinical plan larynx median dose is 49.4±4.7 Gy, while the prediction suggesting 40.0±6.2 Gy (p<0.05). The re-plan achieved 41.5±6.6 Gy, with similar dose on other structures as clinical plan. For Group C, the clinical plan brainstem maximum dose is 44.7±5.5 Gy. The model predicted lower value 32.2±3.8 Gy (p<0.05). The re-plans reduced brainstem maximum dose to 31.8±4.1 Gy without affecting the dosimetry of other structures. In the replanning of the 9 cases, the times operator interacted with TPS are reduced on average about 50% compared to the clinical plan. Conclusion: We have demonstrated that the prior expert knowledge embedded model improved the efficiency and quality of Tomotherapy treatment planning.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-553: Characterization of Plastic Scintillator Detectors for Radiation Therapy

Purpose: To characterize basic performance of plastic scintillator detectors (PSD) designed for dosimetry of radiation therapy. Methods: The Exradin W1 Scintillator is a plastic scintillating fiber-based detector designed for highly accurate measurement of small radiotherapy fields used in patient plan verification and machine commissioning and QA procedures. The Cerenkov emissions were corrected using spectral separation. The optical signal was converted to electronic signal with a photodiode. We measured its dosimetry performance, including percentage depth dose, output factor, dose and dose rate linear response. We compared the dosimetry results with reference ion chamber measurements. Results: The dosimetry results of PSD agree well with reference ion chamber measurements. For percentage depth dose, the differences between PSD and ion chamber results are on average 1.7±1.1% and 0.8±0.8% with a maximum of 3.5% and 2.7% for 6MV and 15MV beams, respectively. For the output factors, PSD measurements are within 2% from ion chamber results. The dose linear response is within 1% when dose is larger than 20 MU for both 6 MV and 15 MV. The dose rate linear response is within 1% for the entire dose rate used (100 MU/min to 600MU/min). Conclusions: The current design of PSD is feasible for the dosimtry measurement in radiation therapy. This combination of PSD and photodiode system could be extended to multichannel array detection of dose distribution. It might as well be used as range verification in proton therapy. The work is partially supported by: DOD (W81XWH-09-2-0174) and American Cancer Society (IRG-78-002-28)

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-E-18A-03: How Accurately Can the Peak Skin Dose in Fluoroscopy Be Determined Using Indirect Dose Metrics?

Purpose: Skin dosimetry is important for fluoroscopically-guided interventions, as peak skin doses (PSD) that Result in skin reactions can be reached during these procedures. The purpose of this study was to assess the accuracy of different indirect dose estimates and to determine if PSD can be calculated within ±50% for embolization procedures. Methods: PSD were measured directly using radiochromic film for 41 consecutive embolization procedures. Indirect dose metrics from procedures were collected, including reference air kerma (RAK). Four different estimates of PSD were calculated and compared along with RAK to the measured PSD. The indirect estimates included a standard method, use of detailed information from the RDSR, and two simplified calculation methods. Indirect dosimetry was compared with direct measurements, including an analysis of uncertainty associated with film dosimetry. Factors affecting the accuracy of the indirect estimates were examined. Results: PSD calculated with the standard calculation method were within ±50% for all 41 procedures. This was also true for a simplified method using a single source-to-patient distance (SPD) for all calculations. RAK was within ±50% for all but one procedure. Cases for which RAK or calculated PSD exhibited large differences from the measured PSD were analyzed, and two causative factors were identified: ‘extreme’ SPD and large contributions to RAK from rotational angiography or runs acquired at large gantry angles. When calculated uncertainty limits [−12.8%, 10%] were applied to directly measured PSD, most indirect PSD estimates remained within ±50% of the measured PSD. Conclusions: Using indirect dose metrics, PSD can be determined within ±50% for embolization procedures, and usually to within ±35%. RAK can be used without modification to set notification limits and substantial radiation dose levels. These results can be extended to similar procedures, including vascular and interventional oncology. Film dosimetry is likely an unnecessary effort for these types of procedures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-C-19A-05: Evaluation of a New Reusable 3D Dosimeter

Purpose: PRESAGE is a radiochromic plastic which has demonstrated strong potential for high resolution single-use 3D dosimetry. This study evaluates a new PRESAGE formulation (Presage-RU) in which the radiochromic response is reversible (the dosimeter optically clears after irradiation), enabling the potential for reusability. Methods: Presage-RU dose response and optical-clearing rates were evaluated in both small volume dosimeters (1×1×4.5cm) and a larger cylindrical dosimeter (8cm diameter, 4.5cm length). All dosimeters were allowed to fully optically clear in dark, room temperature conditions between irradiations. Dose response was determined by irradiating small volume samples from 0–8.0Gy and measuring change in optical density. The cylindrical dosimeter was irradiated with a simple 4-field box plan (parallel opposed pairs of 4cm×4cm AP-PA beams and 2cm×4cm lateral beams) to 20Gy. High resolution 3D dosimetry was achieved utilizing optical-CT readout. Readings were tracked up to 14 days to characterize optical clearing. Results: Initial irradiation yielded a response of 0.0119△OD/(Gy*cm) while two subsequent reirradiations yielded a lower but consistent response of 0.0087△OD/(Gy*cm). Strong linearity of dose response was observed for all irradiations. In the large cylindrical dosimeter, the integral dose within the high dose region exhibited an exponential decay in signal over time (halflife= 23.9 hours), with the dosimeter effectively cleared (0.04% of the initial signal) after 10 days. Subsequent irradiation resulted in 19.5% lower initial signal but demonstrated that the exponential clearing rate remained consistent. Results of additional subsequent irradiations will also be presented. Conclusion: This work introduces a new re-usable radiochromic dosimeter (Presage-RU) compatible with high resolution (sub-millimeter) 3D dosimetry. Sensitivity of the initial radiation was observed to be slightly higher than subsequent irradiations, but the clearing time remained constant, indicating the dosimeter can be re-used after 10 days. Presage-RU has potential to dramatically improve cost-effectiveness and thereby lower the barrier for implementing comprehensive, high resolution 3D dosimetry. John Adamovics is the president of Heuris Inc., which commercializes PRESAGE.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

A study of the short- to long-phantom dose ratios for CT scanning without table translation

Purpose: For CT scanning in the stationary-table modes, AAPM Task Group 111 proposed to measure the midpoint dose on the central and peripheral axes of sufficiently long phantoms. Currently, a long cylindrical phantom is usually not available in many clinical facilities. The use of a long phantom is also challenging because of the heavy weight. In order to shed light on assessing the midpoint dose in CT scanning without table movement, the authors present a study of the short- to long-phantom dose ratios, and perform a cross-comparison of CT dose ratios on different scanner models. Methods: The authors performed Geant4-based Monte Carlo simulations with a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare), and modeled dosimetry measurements using a 0.6 cm{sup 3} Farmer type chamber and a 10-cm long pencil ion chamber. The short (15 cm) to long (90 cm) phantom dose ratios were computed for two PMMA diameters (16 and 32 cm), two phantom axes (the center and the periphery), and a range of beam apertures (3–25 cm). The results were compared with the published data of previous studies with other multiple detector CT (MDCT) scanners and cone beam CT (CBCT) scanners. Results: The short- to long-phantom dose ratios changed with beam apertures but were insensitive to beam qualities (80–140 kV, the head and body bowtie filters) and MDCT and CBCT scanner models. Conclusions: The short- to long-phantom dose ratios enable medical physicists to make dosimetry measurements using the standard CT dosimetry phantoms and a Farmer chamber or a 10 cm long pencil chamber, and to assess the midpoint dose in long phantoms. This method provides an effective approach for the dosimetry of CBCT scanning in the stationary-table modes, and is useful for perfusion and interventional CT.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Technical Note: Influence of the phantom material on the absorbed-dose energy dependence of the EBT3 radiochromic film for photons in the energy range 3 keV–18 MeV

Purpose: Water is the reference medium for radiation therapy dosimetry, but for film dosimetry it is more practical to use a solid phantom. As the composition of solid phantoms differs from that of water, the energy dependence of film exposed within solid phantoms may also differ. The energy dependence of a radiochromic film for a given beam quality Q (energy for monoenergetic beams) has two components: the intrinsic energy dependence and the absorbed-dose energy dependence f(Q), the latter of which can be calculated through a Monte Carlo simulation of radiation transport. The authors used Monte Carlo simulations to study the influence of the phantom material on the f(Q) of the EBT3 radiochromic film (Ashland Specialty Ingredients, Wayne, NJ) for photon beams with energies between 3 keV and 18 MeV. Methods: All simulations were carried out with the general-purpose Monte Carlo code PENELOPE 2011. The geometrical model consisted of a cylindrical phantom, with the film positioned at different depths depending on the initial photon energy. The authors simulated monoenergetic parallel photon beams and x-ray beams from a superficial therapy system. To validate their choice of simulation parameters, they also calculated f(Q) for older film models, EBT and EBT2, comparing with published results. In addition to water, they calculated f(Q) of the EBT3 film for solid phantom materials commonly used for film dosimetry: RW1 and RW3 (PTW-Freiburg, Freiburg, Germany), Solid Water (Gammex-RMI, Madison, WI), and PMMA. Finally, they combined their calculated f(Q) with published overall energy response data to obtain the intrinsic energy dependence of the EBT3 film in water. Results: The calculated f(Q) for EBT and EBT2 films was statistically compatible with previously published data. Between 10 keV and 18 MeV, the variation found in f(Q) of the EBT3 film for water was within 2.3%, with a standard statistical uncertainty less than 1%. If the quantity dose-to-water in the phantom is considered, which is the common practice in radiation dosimetry, the maximum difference of energy dependence for the solid phantoms with respect to water is about 6%, at an energy of 50 keV. Conclusions: The EBT3 film shows a reasonably constant absorbed-dose energy dependence when irradiated in water. If the dose-to-water in the phantom is considered, the maximum difference of EBT3 film energy dependence with the solid phantoms studied with respect to water is about 6% (at an energy of 50 keV). The reported overall energy dependence of the EBT3 film in water at energies below 100 keV is mainly due to the intrinsic energy dependence.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

Ion chamber absorbed dose calibration coefficients, N{sub D,w}, measured at ADCLs: Distribution analysis and stability

Purpose: To analyze absorbed dose calibration coefficients, N{sub D,w}, measured at accredited dosimetry calibration laboratories (ADCLs) for client ionization chambers to study (i) variability among N{sub D,w} coefficients for chambers of the same type calibrated at each ADCL to investigate ion chamber volume fluctuations and chamber manufacturing tolerances; (ii) equivalency of ion chamber calibration coefficients measured at different ADCLs by intercomparing N{sub D,w} coefficients for chambers of the same type; and (iii) the long-term stability of N{sub D,w} coefficients for different chamber types by investigating repeated chamber calibrations. Methods: Large samples of N{sub D,w} coefficients for several chamber types measured over the time period between 1998 and 2014 were obtained from the three ADCLs operating in the United States. These are analyzed using various graphical and numerical statistical tests for the four chamber types with the largest samples of calibration coefficients to investigate (i) and (ii) above. Ratios of calibration coefficients for the same chamber, typically obtained two years apart, are calculated to investigate (iii) above and chambers with standard deviations of old/new ratios less than 0.3% meet stability requirements for accurate reference dosimetry recommended in dosimetry protocols. Results: It is found that N{sub D,w} coefficients for a given chamber type compared among different ADCLs may arise from differing probability distributions potentially due to slight differences in calibration procedures and/or the transfer of the primary standard. However, average N{sub D,w} coefficients from different ADCLs for given chamber types are very close with percent differences generally less than 0.2% for Farmer-type chambers and are well within reported uncertainties. Conclusions: The close agreement among calibrations performed at different ADCLs reaffirms the Calibration Laboratory Accreditation Subcommittee process of ensuring ADCL conformance with National Institute of Standards and Technology standards. This study shows that N{sub D,w} coefficients measured at different ADCLs are statistically equivalent, especially considering reasonable uncertainties. This analysis of N{sub D,w} coefficients also allows identification of chamber types that can be considered stable enough for accurate reference dosimetry.

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