SSRMP Recommendations No 9: Reference dosimetry in low and medium energy x-ray beams.

The SSRMP recommendations on reference dosimetry in kilovolt beams as used in radiation therapy were revised to establish current practice in Switzerland. The recommendations specify the dosimetry formalism, reference class dosimeter systems and conditions used for the calibration of low and medium energy x-ray beams. Practical guidance is provided on the determination of the beam quality specifier and all corrections required for converting instrument readings to absorbed dose to water. Guidance is also provided on the determination of relative dose under non-reference conditions and on the cross calibration of instruments. The effect of lack of electron equilibrium and influence of contaminant electrons when using thin window plane parallel chambers at x-ray tube potentials higher than 50kV is elaborated in an appendix. In Switzerland the calibration of the reference system used for dosimetry is regulated by law. METAS and IRA are the authorities providing this calibration service to the radiotherapy departments. The last appendix of these recommendations summarise this calibration chain.

Design and validation of a dosimetric comparison scheme tailored for ultra-high dose-rate electron beams to support multicenter FLASH preclinical studies.

BACKGROUND AND PURPOSE: We describe a multicenter cross validation of ultra-high dose rate (UHDR) (>= 40 Gy/s) irradiation in order to bring a dosimetric consensus in absorbed dose to water. UHDR refers to dose rates over 100-1000 times those of conventional clinical beams. UHDR irradiations have been a topic of intense investigation as they have been reported to induce the FLASH effect in which normal tissues exhibit reduced toxicity relative to conventional dose rates. The need to establish optimal beam parameters capable of achieving the in vivo FLASH effect has become paramount. It is therefore necessary to validate and replicate dosimetry across multiple sites conducting UHDR studies with distinct beam configurations and experimental set-ups. MATERIALS AND METHODS: Using a custom cuboid phantom with a cylindrical cavity (5 mm diameter by 10.4 mm length) designed to contain three type of dosimeters (thermoluminescent dosimeters (TLDs), alanine pellets, and Gafchromic films), irradiations were conducted at expected doses of 7.5 to 16 Gy delivered at UHDR or conventional dose rates using various electron beams at the Radiation Oncology Departments of the CHUV in Lausanne, Switzerland and Stanford University, CA. RESULTS: Data obtained between replicate experiments for all dosimeters were in excellent agreement (±3%). In general, films and TLDs were in closer agreement with each other, while alanine provided the closest match between the expected and measured dose, with certain caveats related to absolute reference dose. CONCLUSION: In conclusion, successful cross-validation of different electron beams operating under different energies and configurations lays the foundation for establishing dosimetric consensus for UHDR irradiation studies, and, if widely implemented, decrease uncertainty between different sites investigating the mechanistic basis of the FLASH effect.

Determination of the gamma and X-ray emission intensities of erbium-169.

The gamma and X-ray emission intensities of 169Er were determined using radionuclidically pure 169Er. The activity of the 169Er source was standardized by the triple-to-double-coincidence ratio technique. Three independent measurements were performed to measure the emission intensities using calibrated high-purity germanium spectrometers. The efficiencies were computed with the Monte Carlo method and validated using several experimental measurements. Final results present a large uncertainty reduction compared to previous evaluations. The emission intensities per decay of 169Er are reported as 1.401(40).10-5 for the 109.8 keV line and 1.513(19).10-6 for the 118.2 keV line. The values obtained for the X-ray lines show large discrepancies with the reference values.

Activity standardisation of 223Ra.

We report here on the primary activity standardisation of a223Ra dichloride solution in equilibrium with its decay daughters. Both the triple-to-double-coincidence-ratio (TDCR) method with an in-house TDCR detector and the CIEMAT-NIST efficiency tracing (CNET) technique with a commercial counter were used. The liquid scintillation efficiencies for both methods are about 6 while the activities they predict with about 0.4% relative standard uncertainty agree within 0.15%. For backup, the solution was also standardised with 4πγ NaI(Tl) integral counting with a well-type NaI(Tl) detector, and efficiencies computed by Monte Carlo simulations using the GEANT code. This simple technique, unused previously for this nuclide, yielded an activity concentration compatible with, but 1% lower than, the one determined by liquid scintillation counting.

Determination of the gamma and X-ray emission intensities of terbium-161.

In this study, the gamma and X-ray emission intensities of 161Tb were determined using a high-purity germanium spectrometer. The samples used were previously standardised by coincidence counting and Triple to Double Coincidence Ratio (TDCR) methods. A total of 28 gamma-rays and 4 X-rays were measured and compared with previous measurements performed more than 30 years ago. Most of the lines are in agreement, while large discrepancies are observed for 5 lines. The uncertainties have been dramatically decreased with respect to previous measurements giving a better knowledge of the 161 Tb day.

A portable precision ionization chamber: The transfer ionization reference chamber.

A portable instrument was developed at the Institute of Radiation Physics (IRA) for on-site radionuclides measurements. It will enable the measurement of short-lived radionuclides in nuclear medicine departments or isotope production centres. The system involves an ionization chamber read directly by an electrometer and it was optimized to ensure a good reproducibility through the selection of an appropriate vial, filling volume and source position in the well chamber, as well as monitoring the external background and performing a detailed uncertainty estimation. The calibration factors were determined using solutions whose activity concentration is traceable to the international reference system using the IRA reference chamber. Currently the transfer ionization chamber is calibrated for F-18, C-11, O-15, N-13, I-131 and Tc-99m. The final instrument is able to measure isotope activities with a relative standard uncertainty not larger than 1%.

High dose-per-pulse electron beam dosimetry - A model to correct for the ion recombination in the Advanced Markus ionization chamber.

PURPOSE: The purpose of this work was to establish an empirical model of the ion recombination in the Advanced Markus ionization chamber for measurements in high dose rate/dose-per-pulse electron beams. In addition, we compared the observed ion recombination to calculations using the standard Boag two-voltage-analysis method, the more general theoretical Boag models, and the semiempirical general equation presented by Burns and McEwen. METHODS: Two independent methods were used to investigate the ion recombination: (a) Varying the grid tension of the linear accelerator (linac) gun (controls the linac output) and measuring the relative effect the grid tension has on the chamber response at different source-to-surface distances (SSD). (b) Performing simultaneous dose measurements and comparing the dose-response, in beams with varying dose rate/dose-per-pulse, with the chamber together with dose rate/dose-per-pulse independent Gafchromic™ EBT3 film. Three individual Advanced Markus chambers were used for the measurements with both methods. All measurements were performed in electron beams with varying mean dose rate, dose rate within pulse, and dose-per-pulse (10-2  ≤ mean dose rate ≤ 103 Gy/s, 102  ≤ mean dose rate within pulse ≤ 107  Gy/s, 10-4  ≤ dose-per-pulse ≤ 101  Gy), which was achieved by independently varying the linac gun grid tension, and the SSD. RESULTS: The results demonstrate how the ion collection efficiency of the chamber decreased as the dose-per-pulse increased, and that the ion recombination was dependent on the dose-per-pulse rather than the dose rate, a behavior predicted by Boag theory. The general theoretical Boag models agreed well with the data over the entire investigated dose-per-pulse range, but only for a low polarizing chamber voltage (50 V). However, the two-voltage-analysis method and the Burns & McEwen equation only agreed with the data at low dose-per-pulse values (≤ 10-2 and ≤ 10-1  Gy, respectively). An empirical model of the ion recombination in the chamber was found by fitting a logistic function to the data. CONCLUSIONS: The ion collection efficiency of the Advanced Markus ionization chamber decreases for measurements in electron beams with increasingly higher dose-per-pulse. However, this chamber is still functional for dose measurements in beams with dose-per-pulse values up toward and above 10 Gy, if the ion recombination is taken into account. Our results show that existing models give a less-than-accurate description of the observed ion recombination. This motivates the use of the presented empirical model for measurements with the Advanced Markus chamber in high dose-per-pulse electron beams, as it enables accurate absorbed dose measurements (uncertainty estimation: 2.8-4.0%, k = 1). The model depends on the dose-per-pulse in the beam, and it is also influenced by the polarizing chamber voltage, with increasing ion recombination with a lowering of the voltage.

High dose-per-pulse electron beam dosimetry: Usability and dose-rate independence of EBT3 Gafchromic films.

PURPOSE: The aim of this study was to assess the suitability of Gafchromic EBT3 films for reference dose measurements in the beam of a prototype high dose-per-pulse linear accelerator (linac), capable of delivering electron beams with a mean dose-rate (Dm ) ranging from 0.07 to 3000 Gy/s and a dose-rate in pulse (Dp ) of up to 8 × 106 Gy/s. To do this, we evaluated the overall uncertainties in EBT3 film dosimetry as well as the energy and dose-rate dependence of their response. MATERIAL AND METHODS: Our dosimetric system was composed of EBT3 Gafchromic films in combination with a flatbed scanner and was calibrated against an ionization chamber traceable to primary standard. All sources of uncertainties in EBT3 dosimetry were carefully analyzed using irradiations at a clinical radiotherapy linac. Energy dependence was investigated with the same machine by acquiring and comparing calibration curves for three different beam energies (4, 8 and 12 MeV), for doses between 0.25 and 30 Gy. Dm dependence was studied at the clinical linac by changing the pulse repetition frequency (f) of the beam in order to vary Dm between 0.55 and 4.40 Gy/min, while Dp dependence was probed at the prototype machine for Dp ranging from 7 × 103 to 8 × 106 Gy/s. Dp dependence was first determined by studying the correlation between the dose measured by films and the charge of electrons measured at the exit of the machine by an induction torus. Furthermore, we compared doses from the films to independently calibrated thermo-luminescent dosimeters (TLD) that have been reported as being dose-rate independent up to such high dose-rates. RESULTS: We report that uncertainty below 4% (k = 2) can be achieved in the dose range between 3 and 17 Gy. Results also demonstrated that EBT3 films did not display any detectable energy dependence for electron beam energies between 4 and 12 MeV. No Dm dependence was found either. In addition, we obtained excellent consistency between films and TLDs over the entire Dp range attainable at the prototype linac confirming the absence of any dose-rate dependence within the investigated range (7 × 103 to 8 × 106 Gy/s). This aspect was further corroborated by the linear relationship between the dose-per-pulse (Dp ) measured by films and the charge per pulse (Cp ) measured at the prototype linac exit. CONCLUSION: Our study shows that the use of EBT3 Gafchromic films can be extended to reference dosimetry in pulsed electron beams with a very high dose rate. The measurement results are associated with an overall uncertainty below 4% (k = 2) and are dose-rate and energy independent.

Determination of 137Cs half-life with an ionization chamber.

The half-life of 137Cs was measured with an ionization chamber by following the decay of 5 sources over a 30 years period between 1983 and 2013. The ratio between the ionization chamber current for the cesium sources and 226Ra source was used for the half-life calculation. The value found for the 137Cs half-life is 10,955.2±10.7 days, where the uncertainty evaluation combines type A and B for one standard deviation.

Development, design and validation of solid reference samples.

We developed a method of sample preparation using epoxy compound, which was validated in two steps. First, we studied the homogeneity within samples by scanning tubes filled with radioactive epoxy. We found within-sample homogeneity better than 2%. Then, we studied the homogeneity between samples during a 4.5 h dispensing time. The homogeneity between samples was found to be better than 2%. This study demonstrates that we have a validated method, which assures the traceability of epoxy samples.

Seven years of gamma-ray spectrometry interlaboratory comparisons in Switzerland.

Since the 1990s, regular comparisons of gamma-ray spectrometry in Switzerland were organized to improve laboratory abilities to measure the radioactivity in the environment and food stuffs at typical routine levels. The activity concentration of the test samples and the evaluation of the associated uncertainties remained each year the main required test result. Over the years, the comparisons used certified reference solutions as well as environmental samples. The aim of this study is to research the effect of the comparisons on measurement quality. An analysis of the seven last interlaboratory comparisons revealed that the Swiss measurement capability is up to date. In addition, the results showed that the participants now have an improved evaluation of the uncertainties associated with their measurement.

An absolute dose determination of helical tomotherapy accelerator, TomoTherapy High-Art II.

PURPOSE: A helical tomotherapy accelerator presents a dosimetric challenge because, to this day, there is no internationally accepted protocol for the determination of the absolute dose. Because of this reality, we investigated the different alternatives for characterizing and measuring the absolute dose of such an accelerator. We tested several dosimetric techniques with various metrological traceabilities as well as using a number of phantoms in static and helical modes. METHODS: Firstly, the relationship between the reading of ionization chambers and the absorbed dose is dependent on the beam quality value of the photon beam. For high energy photons, the beam quality is specified by the tissue phantom ratio (TPR20,10) and it is therefore necessary to know the TPR20,10 to calculate the dose delivered by a given accelerator. This parameter is obtained through the ratio of the absorbed dose at 20 and 10 cm depths in water and was measured in the particular conditions of the tomotherapy accelerator. Afterward, measurements were performed using the ionization chamber (model A1SL) delivered as a reference instrument by the vendor. This chamber is traceable in absorbed dose to water in a Co-60 beam to a water calorimeter of the American metrology institute (NIST). Similarly, in Switzerland, each radiotherapy department is directly traceable to the Swiss metrology institute (METAS) in absorbed dose to water based on a water calorimeter. For our research, this traceability was obtained by using an ionization chamber traceable to METAS (model NE 2611A), which is the secondary standard of our institute. Furthermore, in order to have another fully independent measurement method, we determined the dose using alanine dosimeters provided by and traceable to the British metrology institute (NPL); they are calibrated in absorbed dose to water using a graphite calorimeter. And finally, we wanted to take into account the type of chamber routinely used in clinical practice and therefore measured the dose using a Farmer-type instrument (model NE 2571) as well. RESULTS: We found the tomotherapy TPR20,10 value to be around 0.629, which is close to a 4 MV conventional linear accelerator value. During static irradiation, the secondary standard and the alanine dosimeters were compatible within 0.5%. The A1SL relative deviation to the secondary standard was 1.2% and the NE2571 relative deviation to the secondary standard was -1.7%. The measurement in dynamic helical mode found the different dosimeters compatible within 1.4% and the alanine dosimeters and the secondary standard were even found under 0.2%. CONCLUSIONS: We found that the different methods are all within uncertainties as well as globally coherent, and the specific limitations of the various dosimeters are discussed in order to help the medical physicist design an independent reference system. We demonstrated that, taking into account the particular reference conditions, one can use an ionization chamber calibrated for conventional linear accelerators to assert the absolute dose delivered by a tomotherapy accelerator.