Feasibility of portal dosimetry for flattening filter-free radiotherapy.

The feasibility of using portal dosimetry (PD) to verify 6 MV flattening filter-free (FFF) IMRT treatments was investigated. An Elekta Synergy linear accelerator with an Agility collimator capable of delivering FFF beams and a standard iViewGT amorphous silicon (aSi) EPID panel (RID 1640 AL5P) at a fixed SSD of 160 cm were used. Dose rates for FFF beams are up to four times higher than for conventional flattened beams, meaning images taken at maximum FFF dose rate can saturate the EPID. A dose rate of 800 MU/min was found not to saturate the EPID for open fields. This dose rate was subsequently used to characterize the EPID for FFF portal dosimetry. A range of open and phantom fields were measured with both an ion chamber and the EPID, to allow comparison between the two. The measured data were then used to create a model within The Nederlands Kanker Instituut's (NKI's) portal dosimetry software. The model was verified using simple square fields with a range of field sizes and phantom thicknesses. These were compared to calculations performed with the Monaco treatment planning system (TPS) and isocentric ion chamber measurements. It was found that the results for the FFF verification were similar to those for flattened beams with testing on square fields, indicating a difference in dose between the TPS and portal dosimetry of approximately 1%. Two FFF IMRT plans (prostate and lung SABR) were delivered to a homogeneous phantom and showed an overall dose difference at isocenter of ~0.5% and good agreement between the TPS and PD dose distributions. The feasibility of using the NKI software without any modifications for high-dose-rate FFF beams and using a standard EPID detector has been investigated and some initial limitations highlighted.

Quality assurance of electron and photon beam energy using the BQ-CHECK phantom.

The BQ-CHECK phantom (PTW Freiburg, Germany) has been designed to be used with a 2D ion chamber array to facilitate the quality assurance (QA) of electron and photon beam qualities (BQ). The BQ-CHECK phantom has three wedges covering the diagonal axes of the beam: two opposed aluminum wedges used to measure electron energy and a single copper wedge used to measure photon energy. The purpose of this work was to assess the suitability of the BQ-CHECK phantom for use in a routine QA program. A range of percentage depth dose (PDD) curves for two photon beams and four electron beams were measured using a MP3 plotting tank (PTW Freiburg). These beams were used to irradiate a STARCHECK array (PTW Freiburg) with and without the BQ-CHECK phantom on top of the array. For photons, the ratio of the signals from two chambers underneath the copper wedge was used as an effective TPR measurement (TPR(eff)) and, for electrons, the full width at half maximum of the profile (E(FWHM)) underneath the aluminum wedges was used as an electron energy constancy measurement. PDD measurements were compared with TPR(eff) and E(FWHM) to assess the sensitivity of the BQ-CHECK phantom. The clinical tolerances of TPReff were determined for 6 MV (0.634-0.649), and 10MV (0.683-0.692). For electrons, the clinical tolerances of EFWHM were determined for 6 MeV (94.8-103.4 mm), 8 MeV (105.5-114.0 mm), 10 MeV (125.4-133.9 mm) and 12 MeV (138.8-147.3 mm).Electron and photon energy metrics are presented which demonstrate that the BQ-CHECK phantom could be used to form part of an efficient routine monthly QA program. Acceptable beam quality limits for various nominal beam energies were established and at these limits, modified profiles were acquired using the STARCHECK array. From the modified profiles, E(FWHM) and TPR(eff) were determined for the electron and photon beams, respectively. It was demonstrated that both E(FWHM) and the TPR(eff) have a linear relationship with conventional beam quality metrics.