Use of routine quality assurance procedures to detect the loss of a linear accelerator primary scattering foil.

The effects of the mechanical loss of a stainless steel primary scattering foil on a 12-MeV electron beam from a dedicated intraoperative electron accelerator are discussed. Routine quality assurance tests, including dose output constancy, energy constancy, and beam uniformity (flatness and symmetry), were used to determine the nature of the malfunction when it occurred. It is concluded that these quality assurance checks, if done with the frequencies recommended by the AAPM Task Group 40 Report [Med. Phys. 21, 581-619 (1994)] and repeated at the time of occurrence, are sufficient to detect loss of an electron scattering foil.

Comprehensive analysis of electron beam central axis dose for a radiotherapy linear accelerator.

This work evaluates the application of AAPM task group 25 (TG25) methodology for determination of central axis depth dose for a radiotherapy linear accelerator, whose dual scattering foil system and applicators were recently modified. The percent depth dose (%DD) and the dose output factor have been measured for square and rectangular fields at 100- and 110-cm source-to-surface distance (SSDs). At 100-cm SSD, results showed that %DD for a specific energy and field size can vary with applicator, the largest variation being for the 20-MeV, 10 x 10-cm field where a spread of +/- 2.5% or +/- 3 mm about the mean %DD is observed. The square-root method determines rectangular field %DD within 1%. Output factors for rectangular fields are calculated from square field values more accurately using a square-root method than the equivalent-square method recommended by TG25. At 110-cm SSD, the %DD calculated from that at 100-cm SSD using an inverse square factor does not agree with measured values for all fields. The maximum difference observed for the 20-MeV, 6 x 6-cm field was 5.5% or 10 mm. Output data at the 110-cm SSD show that the square-root method is suitable for determination of the air-gap correction factors of rectangular fields. In summary, the recommendations of TG25 work reasonably well for central axis electron beam dosimetry for this version of a radiotherapy linear accelerator, except in limited cases where applicator-scattered electrons apparently cause minor but clinically significant discrepancies.

Clinical dosimetry for implementation of a multileaf collimator.

In order to initiate the use of a multileaf collimator (MLC) in the clinic, a set of technical procedures needs to be available sufficient to create MLC leaf settings and to deliver an accurate dose of radiation through the MLC-shaped field. Dosimetry data for clinical use of the MLC were measured. Dosimetric characteristics included central axis percent depth dose, output factors, and penumbra. In this paper, it has been concluded that a dose control monitor unit calculation procedure that has been applied to the use of conventional secondary field-shaping blocks can be applied to the multileaf collimator dosimetry. The multileaf collimator penumbra (20% to 80%) is only slightly wider (1-3 mm) than the penumbra of the conventional collimator jaws. Beam's-eye-view comparisons made between the isodose curves in fields shaped by conventional Cerrobend blocks and isodose curves in fields shaped by the multileaf collimator demonstrated that the 50% isodose line at 10-cm depth exhibited the discrete steps of the multileaf collimator leaves, but that the 90% and 10% isodose curves of the multileaf were close to those shaped by Cerrobend blocks.

Dosimetric characteristics of wedges mounted beyond the blocking tray.

In a beam accessory configuration for a linear accelerator using a prototype multileaf collimator, newly designed wedges were mounted beyond the blocking tray. The isodose curves, depth of maximum dose, surface dose, and wedge transmission factors were measured for the wedges designed for this unique configuration. The same set of wedges was used for both 6- and 18-MV x rays. The shape of the wedged isodose curves was essentially unchanged from those produced by the conventional wedges located above the blocking tray. The isodose curves exhibited the desired wedge angles over the range of field sizes from 5 x 5 to 15 x 40 cm. In the 10 x 10-cm field, the average difference between the observed wedge angle and the desired wedge angle was 3.8 degrees. The surface doses ranged from 18% to 35% for the wedged 10 x 10-cm fields as compared with about 15% for the same open field. Dosimetrically the wedges were acceptable for clinical use.

Dose-response characteristics of a ferrous-sulphate-doped gelatin system for determining radiation absorbed dose distributions by magnetic resonance imaging (Fe MRI).

The nuclear magnetic resonance (NMR) longitudinal relaxation rate R1 dose-response characteristics of a ferrous-sulphate-doped chemical dosimeter system (Fe MRI) immobilized in a gelatin matrix were explored. Samples containing various concentrations of the FeSO4 dosimeter were irradiated to absorbed doses of 0-150 Gy. R1 relaxation rates were determined by imaging the samples at a field strength of 1.5T(1H Lamor frequency of 63.8 MHz). The response of the system was found to be approximately linear up to doses of 50 Gy for all FeSO4 concentrations studied (0.1-2.0 mM). Changing concentrations in the range of 0.1-0.5 mM affected both the slope and intercept of the dose-response curve. For concentrations of 0.5-2.0 mM, the slope of the dose-response curves remained constant at approximately 0.0423 s-1 Gy-1 in the dose range of 0-50 Gy. However, the intercept of the curve continued to increase in that region, as expected, because of the additional paramagnetic ions. The reproducibility of the absorbed dose estimates for measurements made over a 22 cm field of view was found to be 5% in the range of 20-50 Gy (an uncertainty of 0.81 Gy on average), decreasing to approximately 10% in the dose range of 5-10 Gy.

Dosimetry characteristics of metallic cones for intraoperative radiotherapy.

Dosimetry data were obtained on the first dedicated linear accelerator of its type designed for electron intraoperative radiotherapy (IORT) within an operating room. The linear accelerator uses a high dose rate, 9 Gy.min-1, to reduce the treatment time. Its chrome-plated brass treatment cones, designed with straight ends and 22.5 degrees beveled ends, are not mechanically attached to the collimator head, but are aligned using a laser projection system. Dosimetry measurements were made for each combination of energy (6, 9, 12, 15, and 16 MeV), cone size (diameters range from 5 to 12 cm), and cone type (22.5 degrees beveled or straight). From these data, depth-dose curves, cone output, and air-gap correction factors were generated that allow the calculation of the monitor setting for delivering a prescribed dose at any depth for any irradiation condition (energy, cone, air gap). Isodose data were measured for every cone using film in a solid water phantom. Scatter off the inside wall of the cone resulted in peripheral dose horns near the surface that were energy and cone dependent, being as large as 120%.