B Healy

Dose-response stability and integrity of the dose distribution of various polymer gel dosimeters

In this study the stability of different polymer gel dosimeters is investigated. Further to a previous chemical stability study on a (6%T, 50%C) PAG gel, the change in slope and intercept of the linear part of the R2-dose plot is recorded with time for different gel formulations. In addition to this R2-dose-response stability study, the dose edge of a half-blocked field was recorded with time. Three different PAG type polymer gels, a hydroxyethyl acrylate (HEA) gel and two different normoxic polymer gels were investigated. In the PAG type polymer gels, the relative concentration of gelatin and comonomers was varied in order to study the influence of the different components, that constitute the dosimeter, on the stability. It is shown that the R2-dose-response stability is largely determined by the chemical composition of the gel dosimeters. All the PAG gel dosimeters and the normoxic gel dosimeters are found to preserve the integrity of the dose distribution up to 22 days after irradiation. The half-life of the change in dose sensitivity of a MAGIC gel is found to be 18 h compared to 5.7 h for a (6%T, 50%C) PAG gel. A maximum relative decrease in dose sensitivity of 21% was noted for the MAGIC gel compared to an increase of 50% for a (6%T, 50%C) PAG gel. A loss of integrity of the dose distribution was found in the HEA gel.

Experimental determination of the diffusion coefficient in two-dimensions in ferrous sulphate gels using the finite element method

A novel two-dimensional finite element method for modelling the diffusion which occurs in Fricke or ferrous sulphate type radiation dosimetry gels is presented. In most of the previous work, the diffusion coefficient has been estimated using simple one-dimensional models. This work presents a two-dimensional model which enables the diffusion coefficient to be determined in a much wider range of experimental situations. The model includes the provision for the determination of a drift parameter. To demonstrate the technique comparative diffusion measurements between ferrous sulphate radiation dosimetry gels, with and without xylenol orange chelating agent and carbohydrate additives have been undertaken. Diffusion coefficients of 9.7.±4, 13.3±0.6 and 9.5±0.8 10−3cm2h−1 were determined for ferrous sulphate radiation dosimetry gels with and without xylenol orange and with xylenol orange and sucrose additives respectively.

Output factor measurements for a kilovoltage x-ray therapy unit

Output factors at the surface for treatment cones and lead cut-outs have been measured for a Pantak Therapax SXT 150 superficial therapy unit with x-ray beam qualities from 1 to 13 mm Al HVL. A variety of phantom materials and two ionisation chambers were tested for their suitability in output factor and percentage depth dose measurement. Solid water proved a useful water-equivalent phantom material with discrepancies between measurements in water and solid water less than 2.3% for percentage depth dose and less than 0.6% for output factors. Larger measurement discrepancies were found for Plastic Water and Perspex. A PTW Markus chamber was found to compare well with a NE 2532/3 low energy chamber in percentage depth dose measurement, but discrepancies arose between the chambers in output factor measurements, up to 5% for small field sizes. Measurements indicated that the Markus chamber had an energy dependent response in the kilovoltage range, which could account for the discrepancy in output factor measurement.

Investigation and analysis of ferrous sulfate polyvinyl alcohol (PVA) gel dosimeter

Ferrous sulfate (Fe(SO4)2) PVA gels were investigated for a range of absorbed doses up to 20 Gy using both magnetic resonance imaging (MRI) and spectrophotometry to determine R1 and optical density (OD) dose responses and G values. It was found that R1- and OD-dose sensitivities increased with O2 saturation or by the introduction of a freeze-thaw cycle during preparation of the PVA gel. The storage temperature of the Fe(SO4)2 PVA gel at -18 degrees C increased R1-dose sensitivity above that of gels stored at 5 degrees C. The addition of sucrose to the formulation was found to result in the largest increase in both R1- and OD-dose sensitivities. Fe(SO4)2 PVA gel with and without the addition of xylenol orange was demonstrated to have a G value of approximately 20 ions/100 eV and with sucrose approximately 24 ions/100 eV.

Effect of saccharide additives on response of ferrous–agarose–xylenol orange radiotherapy gel dosimeters

Glucose, sucrose, starch, and locust bean gum have been used as additives to the ferrous-agarose-xylenol orange (FAX) gel dosimeter. The saccharide enhanced dosimeters were found to have a higher dose sensitivity over a standard FAX gel as measured by both optical density change and magnetic resonance imaging (MRI). With optical density measurement, OD-dose sensitivity increases were up to 55% for glucose, 122% for sucrose and 43% for starch, while locust bean gum did not give a consistent response. With MRI, R1-dose sensitivity increases were up to 178% with sucrose addition. The FAX gel with sucrose was studied in greatest detail. The OD-dose sensitivity dependence on cooling rate was reduced for the sucrose FAX gel over the standard FAX gel, which has significant implications for uniform dose sensitivity in large gel phantoms. The thermal oxidation rate in the sucrose FAX gel was up to 2.3 times higher than in the standard gel. The OD-dose sensitivity of oxygenated sucrose FAX gels was 4.3 times greater than standard FAX gels, while continued enhancement in OD-dose sensitivity with increased sucrose concentrations beyond 2.0 g/l was found only for the oxygenated sucrose FAX gels. Both the molar absorption coefficient of the ferric ion-xylenol orange complex at 543 nm and gel pH were not affected by the presence of sucrose, with the implication that the higher OD-dose sensitivity of gels with saccharides is due to increased chain reaction production of ferric ions.

An investigation of dose changes for therapeutic kilovoltage x-ray beams with underlying lead shielding

Kilovoltage x-ray beams are used to treat cancer on or close to the skin surface. Many clinical cases use high atomic number materials as shielding to reduce dose to underlying healthy tissues. In this work, we have investigated the effect on both the surface dose and depth doses in a water phantom with lead shielding at depth in the phantom. The EGSnrc Monte Carlo code was used to simulate the water phantom and to calculate the surface doses and depth doses using primary x-ray beam spectra derived from an analytical model. The x-ray beams were in the energy range of 75-135 kVp with field sizes of 2, 5 and 8 cm diameter. The lead sheet was located beneath the water surface at depths ranging from 0.5-7.5 cm. The surface dose decreased as the lead was positioned closer to the water surface and as the field size was increased. The variation in surface dose as a function of x-ray beam energy was only small but the maximum reduction occurred for the 100 kVp x-ray beam. For the 8 cm diameter field with the lead at 1 cm depth and using the 100 kVp x-ray beam, the surface dose was reduced to 0.898 of the surface dose in the water phantom only. Measured surface dose changes, using a Farmer-type ionization chamber, agreed with the Monte Carlo calculated doses. Calculated depth doses in water with a lead sheet positioned below the surface showed that the dose fall-off increased as the lead was positioned closer to the water surface as compared to the depth dose in the water phantom only. Monte Carlo calculations of the total x-ray beam spectrum at the water surface showed that the total fluence decreased due to a reduction in backscatter from within the water and very little backscatter from the lead. The mean energy of the x-ray spectrum varied less than 1 keV, with the lead at 1 cm beneath the water phantom surface. As the Monte Carlo calculations showed good agreement with the measured results, this method can be used to verify surface dose changes in clinical situations where measurements are difficult. The clinical impact of the use of lead must be considered in the dose prescription for patients being treated with kilovoltage x-ray beams.

Dose Reduction from Loss of Backscatter in Superficial X-ray Radiation Therapy with the Pantak SXT 150 Unit

Loss of backscatter has been measured for a Pantak Therapax SXT 150 superficial x-ray therapy unit. Ionisation chamber measurements at the surface were performed in solid water with and without underlying lead to confirm the applicability of previous published measurements. Measurements of loss of backscatter with and without lead allowed the effect of underlying lead to be separated from the effect of loss of backscatter. It was found that the difference between the effect of lead and that of air on surface dose is minimal for solid water phantom thickness exceeding 3 cm. Differences up to 3% in dose reduction at the surface were found between this work and previous published results with different x-ray units.

Characterisation of the ferrous-xylenol orange-gelatin (FXG) gel dosimeter

Recent studies have used the ferrous-xylenol orange-gelatin (FXG) gel dosimeter for 3D radiation field mapping using the optical computed tomography technique. However the characterisation of the dosimetry performance of the FXG gel has not been detailed, such as the variation in dose-response of the FXG gel with changes in preparation techniques, constituent concentrations, pre-irradiation storage time, and concentrations of additives such as oxygen and saccharides. In this paper these issues are addressed with the aim of developing a standard FXG gel for future use in radiation dosimetry applications.

Tin foil as bolus material for therapeutic electron beams from the Varian Clinac 2100C/D.

Tin foils of sub-millimetre thickness have been investigated as bolus material for therapeutic electron beams from the Varian Clinac 2100C/D linear accelerator. Measurements with ionisation chamber and radiographic film in Plastic Water or water were performed under tin foil bolus to determine surface dose, therapeutic ranges, output factor correction, penumbra and dose outside the field edge. Appropriate thicknesses of tin foil for 90% dose at the surface were found to be approximately 0.3 mm for 6 MeV, and 0.4 mm for 9 MeV and 12 MeV. Enhanced therapeutic interval with tin foil bolus over water-equivalent bolus has previously been reported, but was found not to be evident for 12 MeV and for a small (4 × 4 cm2) 9 MeV field. The penumbra width of fields with tin foil and water-equivalent bolus were found to be within 2 mm, while the doses at 1 cm outside the field edge were within 1.5% of peak dose. Output factor corrections for fields with tin foil were measured as within 2% of unity. Air gaps between the tin foil and phantom surface up to 5 mm were observed to have minimal effect on output correction factor, relative surface dose, and therapeutic range.

Australasian recommendations for quality assurance in kilovoltage radiation therapy from the Kilovoltage Dosimetry Working Group of the Australasian College of Physical Scientists and Engineers in Medicine

The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups to develop recommendations for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations provide a standard for safe work practices and quality control. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards and should be read in conjunction with relevant national, state or territory legislation which take precedence over the ACPSEM publication Radiation Oncology Reform Implementation Committee (RORIC) Quality Working Group, RANZCR, 2011a; Kron et al. Clin Oncol 27(6):325–329, 2015; Radiation Oncology Reform Implementation Committee (RORIC) Quality Working Group, RANZCR, 2018a, b).