Two-dimensional solid-state array detectors: A technique for in vivo dose verification in a variable effective area.

PURPOSE: We introduce a technique that employs a 2D detector in transmission mode (TM) to verify dose maps at a depth of dmax in Solid Water. TM measurements, when taken at a different surface-to-detector distance (SDD), allow for the area at dmax (in which the dose map is calculated) to be adjusted. METHODS: We considered the detector prototype "MP512" (an array of 512 diode-sensitive volumes, 2 mm spatial resolution). Measurements in transmission mode were taken at SDDs in the range from 0.3 to 24 cm. Dose mode (DM) measurements were made at dmax in Solid Water. We considered radiation fields in the range from 2 × 2 cm2 to 10 × 10 cm2 , produced by 6 MV flattened photon beams; we derived a relationship between DM and TM measurements as a function of SDD and field size. The relationship was used to calculate, from TM measurements at 4 and 24 cm SDD, dose maps at dmax in fields of 1 × 1 cm2 and 4 × 4 cm2 , and in IMRT fields. Calculations were cross-checked (gamma analysis) with the treatment planning system and with measurements (MP512, films, ionization chamber). RESULTS: In the square fields, calculations agreed with measurements to within ±2.36%. In the IMRT fields, using acceptance criteria of 3%/3 mm, 2%/2 mm, 1%/1 mm, calculations had respective gamma passing rates greater than 96.89%, 90.50%, 62.20% (for a 4 cm SSD); and greater than 97.22%, 93.80%, 59.00% (for a 24 cm SSD). Lower rates (1%/1 mm criterion) can be explained by submillimeter misalignments, dose averaging in calculations, noise artifacts in film dosimetry. CONCLUSIONS: It is possible to perform TM measurements at the SSD which produces the best fit between the area at dmax in which the dose map is calculated and the size of the monitored target.

The relative biological effectiveness for carbon, nitrogen, and oxygen ion beams using passive and scanning techniques evaluated with fully 3D silicon microdosimeters.

BACKGROUND: The aim of this study was to measure the microdosimetric distributions of a carbon pencil beam scanning (PBS) and passive scattering system as well as to evaluate the relative biological effectiveness (RBE) of different ions, namely 12 C, 14 N, and 16 O, using a silicon-on-insulator (SOI) microdosimeter with well-defined 3D-sensitive volumes (SV). Geant4 simulations were performed with the same experimental setup and results were compared to the experimental results for benchmarking. METHOD: Two different silicon microdosimeters with rectangular parallelepiped and cylindrical shaped SVs, both 10 µm in thickness were used in this study. The microdosimeters were connected to low noise electronics which allowed for the detection of lineal energies as low as 0.15 keV/µm in tissue. The silicon microdosimeters provide extremely high spatial resolution and can be used for in-field and out-of-field measurements in both passive scattering and PBS deliveries. The response of the microdosimeters was studied in 290 MeV/u 12 C, 180 MeV/u 14 N, 400 MeV/u 16 O passive ion beams, and 290 MeV/u 12 C scanning carbon therapy beam at heavy ion medical accelerator in Chiba (HIMAC) and Gunma University Heavy Ion Medical Center (GHMC), Japan, respectively. The microdosimeters were placed at various depths in a water phantom along the central axis of the ion beam, and at the distal part of the Spread Out Bragg Peak (SOBP) in 0.5 mm increments. The RBE values of the pristine Bragg peak (BP) and SOBP were derived using the microdosimetric lineal energy spectra and the modified microdosimetric kinetic model (MKM), using MKM input parameters corresponding to human salivary gland (HSG) tumor cells. Geant4 simulations were performed in order to verify the calculated depth-dose distribution from the treatment planning system (TPS) and to compare the simulated dose-mean lineal energy to the experimental results. RESULTS: For a 180 MeV/u 14 N pristine BP, the dose-mean lineal energy yD¯ obtained with two types of silicon microdosimeters started from approximately 29 keV/µm at the entrance to 92 keV/µm at the BP, with a maximum value in the range of 412 to 438 keV/µm at the distal edge. For 400 MeV/u 16 O ions, the dose-mean lineal energy yD¯ started from about 24 keV/µm at the entrance to 106 keV/µm at the BP, with a maximum value of approximately 381 keV/µm at the distal edge. The maximum derived RBE10 values for 14 N and 16 O ions were found to be 3.10 ± 0.47 and 2.93 ± 0.45, respectively. Silicon microdosimetry measurements using pencilbeam scanning 12 C ions were also compared to the passive scattering beam. CONCLUSIONS: These SOI microdosimeters with well-defined three-dimensional (3D) SVs have applicability in characterizing heavy ion radiation fields and measuring lineal energy deposition with sub-millimeter spatial resolution. It has been shown that the dose-mean lineal energy increased significantly at the distal part of the BP and SOBP due to very high LET particles. Good agreement was observed for the experimental and simulation results obtained with silicon microdosimeters in 14 N and 16 O ion beams, confirming the potential application of SOI microdosimeter with 3D SV for quality assurance in charged particle therapy.

Impact of a monolithic silicon detector operating in transmission mode on clinical photon beams.

PURPOSE: To investigate the effect on surface dose, as a function of different field sizes and distances from the solid water phantom to transmission detector (Dsd), of using the monolithic silicon detector MP512T in transmission mode. METHODS: The influence of operating the MP512T in transmission mode on the surface dose of a phantom for SSD 100cm was evaluated by using a Markus IC. The MP512T was fixed to an adjustable stand holder and was positioned at different Dsd, ranging from 0.3 to 24 cm. For each Dsd, measurements were carried out for irradiation field sizes of 5 × 5cm2, 8 × 8 cm2 and 10 × 10 cm2. Measurements were obtained under two different operational setups, (i) with the MP512T face-up and (ii) with the MP512T face-down. In addition, the transmission factors for the MP512T and the printed circuit board were only evaluated using a Farmer IC. RESULTS: For all Dsd and all field sizes, the MP512T led to the surface dose increasing by less than 25% when in the beam. For Dsd >18 cm the surface dose increase is less than 5%, and negligible for field size 5 × 5 cm2. The difference in the surface dose perturbation for the MP512T operating face up or operating face down is negligible (<2%) for all field sizes. The transmission factor of the MP512T ranged from 1.020 to 0.9950 for all measured Dsd and field sizes. CONCLUSION: The study demonstrated that positioning the MP512T in air between the Linac head and the phantom produced negligible perturbation of the surface dose for Dsd >18 cm, and was completely transparent for 6 MV photon beams.

Microdosimetric measurements of a clinical proton beam with micrometer-sized solid-state detector.

PURPOSE: Microdosimetry is a vital tool for assessing the microscopic patterns of energy deposition by radiation, which ultimately govern biological effect. Solid-state, silicon-on-insulator microdosimeters offer an approach for making microdosimetric measurements with high spatial resolution (on the order of tens of micrometers). These high-resolution, solid-state microdosimeters may therefore play a useful role in characterizing proton radiotherapy fields, particularly for making highly resolved measurements within the Bragg peak region. In this work, we obtain microdosimetric measurements with a solid-state microdosimeter (MicroPlus probe) in a clinical, spot-scanning proton beam of small spot size. METHODS: The MicroPlus probe had a 3D single sensitive volume on top of silicon oxide. The sensitive volume had an active cross-sectional area of 250 µm × 10 µm and thickness of 10 µm. The proton facility was a synchrotron-based, spot-scanning system with small spot size (σ ≈ 2 mm). We performed measurements with the clinical beam current (≈1 nA) and had no detected pulse pile-up. Measurements were made in a water-equivalent phantom in water-equivalent depth (WED) increments of 0.25 mm or 1.0 mm along pristine Bragg peaks of energies 71.3 MeV and 159.9 MeV, respectively. For each depth, we measured lineal energy distributions and then calculated the dose-weighted mean lineal energy, y¯D. The measurements were repeated for two field sizes: 4 × 4 cm2 and 20 × 20 cm2 . RESULTS: For both 71.3 MeV and 159.9 MeV and for both field sizes, y¯D increased with depth toward the distal edge of the Bragg peak, a result consistent with Monte Carlo calculations and measurements performed elsewhere. For the 71.3 MeV, 4 × 4 cm2 beam (range at 80% distal falloff, R80  = 3.99 cm), we measured y¯D=1.96±0.08 keV/µm at WED = 2 cm, and y¯D=10.6±0.32 keV/µm at WED = 3.95 cm. For the 71.3 MeV, 20 × 20 cm2 beam, we measured y¯D=2.46±0.12 keV/µm at WED = 2.6 cm, and y¯D=11.0±0.24 keV/µm at WED = 3 cm. For the 159.9 MeV, 4 × 4 cm2 beam (R80  = 17.7 cm), y¯D=2.24±0.15 keV/µm at WED = 5 cm, and y¯D=8.99±0.71 keV/µm at WED = 17.6 cm. For the 159.9 MeV, 20 × 20 cm2 beam, y¯D=2.56±0.10 keV/µm at WED = 5 cm, and y¯D=9.24±0.73 keV/µm at WED = 17.6 cm. CONCLUSIONS: We performed microdosimetric measurements with a novel solid-state, silicon-on-insulator microdosimeter in a clinical spot-scanning proton beam of small spot size and unmodified beam current. For all of the proton field sizes and energies considered, the measurements of y¯D were in agreement with expected trends. Furthermore, we obtained measurements with a spatial resolution of 10 µm in the beam direction. This spatial resolution greatly exceeded that possible with a conventional gaseous tissue-equivalent proportional counter and allowed us to perform a high-resolution investigation within the Bragg peak region. The MicroPlus probe is therefore suitable for applications in proton radiotherapy.

Characterization of proton pencil beam scanning and passive beam using a high spatial resolution solid-state microdosimeter.

PURPOSE: This work aims to characterize a proton pencil beam scanning (PBS) and passive double scattering (DS) systems as well as to measure parameters relevant to the relative biological effectiveness (RBE) of the beam using a silicon on insulator (SOI) microdosimeter with well-defined 3D sensitive volumes (SV). The dose equivalent downstream and laterally outside of a clinical PBS treatment field was assessed and compared to that of a DS beam. METHODS: A novel silicon microdosimeter with well-defined 3D SVs was used in this study. It was connected to low noise electronics, allowing for detection of lineal energies as low as 0.15 keV/µm. The microdosimeter was placed at various depths in a water phantom along the central axis of the proton beam, and at the distal part of the spread-out Bragg peak (SOBP) in 0.5 mm increments. The RBE values of the pristine Bragg peak (BP) and SOBP were derived using the measured microdosimetric lineal energy spectra as inputs to the modified microdosimetric kinetic model (MKM). Geant4 simulations were performed in order to verify the calculated depth-dose distribution from the treatment planning system (TPS) and to compare the simulated dose-mean lineal energy to the experimental results. RESULTS: For a 131 MeV PBS spot (124.6 mm R90 range in water), the measured dose-mean lineal energy yD¯ increased from 2 keV/µm at the entrance to 8 keV/µm in the BP, with a maximum value of 10 keV/µm at the distal edge. The derived RBE distribution for the PBS beam slowly increased from 0.97 ± 0.14 at the entrance to 1.04 ± 0.09 proximal to the BP, then to 1.1 ± 0.08 in the BP, and steeply rose to 1.57 ± 0.19 at the distal part of the BP. The RBE distribution for the DS SOBP beam was approximately 0.96 ± 0.16 to 1.01 ± 0.16 at shallow depths, and 1.01 ± 0.16 to 1.28 ± 0.17 within the SOBP. The RBE significantly increased from 1.29 ± 0.17 to 1.43 ± 0.18 at the distal edge of the SOBP. CONCLUSIONS: The SOI microdosimeter with its well-defined 3D SV has applicability in characterizing proton radiation fields and can measure relevant physical parameters to model the RBE with submillimeter spatial resolution. It has been shown that for a physical dose of 1.82 Gy at the BP, the derived RBE based on the MKM model increased from 1.14 to 1.6 in the BP and its distal part. Good agreement was observed between the experimental and simulation results, confirming the potential application of SOI microdosimeter with 3D SV for quality assurance in proton therapy.

Development of a silicon diode detector for skin dosimetry in radiotherapy.

PURPOSE: The aim of in vivo skin dosimetry was to measure the absorbed dose to the skin during radiotherapy, when treatment planning calculations cannot be relied on. It is of particularly importance in hypo-fractionated stereotactic modalities, where excessive dose can lead to severe skin toxicity. Currently, commercial diodes for such applications are with water equivalent depths ranging from 0.5 to 0.8 mm. In this study, we investigate a new detector for skin dosimetry based on a silicon epitaxial diode, referred to as the skin diode. METHOD: The skin diode is manufactured on a thin epitaxial layer and packaged using the "drop-in" technology. It was characterized in terms of percentage depth dose, dose linearity, and dose rate dependence, and benchmarked against the Attix ionization chamber. The response of the skin diode in the build-up region of the percentage depth dose (PDD) curve of a 6 MV clinical photon beam was investigated. Geant4 radiation transport simulations were used to model the PDD in order to estimate the water equivalent measurement depth (WED) of the skin diode. Measured output factors using the skin diode were compared with the MOSkin detector and EBT3 film at 10 cm depth and at surface at isocenter of a water equivalent phantom. The intrinsic angular response of the skin diode was also quantified in charge particle equilibrium conditions (CPE) and at the surface of a solid water phantom. Finally, the radiation hardness of the skin diode up to an accumulated dose of 80 kGy using photons from a Co-60 gamma source was evaluated. RESULTS: The PDD curve measured with the skin diode was within 0.5% agreement of the equivalent Geant4 simulated curve. When placed at the phantom surface, the WED of the skin diode was estimated to be 0.075 ± 0.005 mm from Geant4 simulations and was confirmed using the response of a corrected Attix ionization chamber placed at water equivalent depth of 0.075 mm, with the measurement agreement to within 0.3%. The output factor measurements at 10 cm depth were within 2% of those measured with film and the MOSkin detector down to a field size of 2 × 2 cm2 . The dose-response for all detector samples was linear and with a repeatability within 0.2%. The skin diode intrinsic angular response showed a maximum deviation of 8% at 90 degrees and from 0 to 60 degree is less than 5%. The radiation sensitivity reduced by 25% after an accumulated dose of 20 kGy but after was found to stabilize. At 60 kGy total accumulated dose the response was within 2% of that measured at 20 kGy total accumulated dose. CONCLUSIONS: This work characterizes an innovative detector for in vivo and real-time skin dose measurements that is based on an epitaxial silicon diode combined with the Centre for Medical Radiation Physics (CMRP) "drop-in" packaging technology. The skin diode proved to have a water equivalent depth of measurement of 0.075 ± 0.005 mm and the ability to measure doses accurately relative to reference detectors.

Technical Note: Angular dependence of a 2D monolithic silicon diode array for small field dosimetry.

PURPOSE: This study aims to investigate the 2D monolithic silicon diode array size of 52 × 52 mm2 (MP512) angular response. An angular correction method has been developed that improves the accuracy of dose measurement in a small field. METHODS: The MP512 was placed at the center of a cylindrical phantom, irradiated using 6 MV and 10 MV photons and incrementing the incidence of the beam angle in 15° steps from 0° to 180°, and then in 1° steps between 85° and 95°. The MP512 response was characterized for square field sizes varying between 1 × 1 cm2 and 10 × 10 cm2 . The angular correction factor was obtained as the ratio of MP512 response to EBT3 film measured doses as a function of the incidence angle (Ɵ) and was normalized at 0° incidence angle. Beam profiles of the corrected MP512 responses were compared with the EBT3 responses to verify the effectiveness of the method adopted. RESULTS: The intrinsic angular dependence of the MP512 shows maximum relative deviation from the response normalized to 0° of 18.5 ± 0.5% and 15.5 ± 0.5% for 6 MV and 10 MV, respectively, demonstrating that the angular response is sensitive to the energy. In contrast, the variation of angular response is less affected by field size. Comparison of cross-plane profiles measured by the corrected MP512 and EBT3 shows an agreement within ±2% for all field sizes when the beams irradiated the array at 0°, 45°, 135°, and 180° angles of incidence from the normal to the detector plane. At 90° incidence, corresponding to a depth dose measurement, up to a 6% discrepancy was observed for a 1 × 1 cm2 field of 6 MV. CONCLUSION: An angular correction factor can be adopted for small field sizes. Measurements discrepancies could be encountered when irradiating with very small fields parallel to the detector plane. Using this approach, the MP512 is shown to be a suitable detector for 2D dose mapping of small field size photon beams.

A 2D silicon detector array for quality assurance in small field dosimetry: DUO.

PURPOSE: Nowadays, there are many different applications that use small fields in radiotherapy treatments. The dosimetry of small radiation fields is not trivial due to the problems associated with lateral disequilibrium and source occlusion and requires reliable quality assurance (QA). Ideally such a QA tool should provide high spatial resolution, minimal beam perturbation and real time fast measurements. Many different types of silicon diode arrays are used for QA in radiotherapy; however, their application in small filed dosimetry is limited, in part, due to a lack of spatial resolution. The Center of Medical Radiation Physics (CMRP) has developed a new generation of a monolithic silicon diode array detector that will be useful for small field dosimetry in SRS/SRT. The objective of this study is to characterize a monolithic silicon diode array designed for dosimetry QA in SRS/SRT named DUO that is arranged as two orthogonal 1D arrays with 0.2 mm pitch. METHODS: DUO is two orthogonal 1D silicon detector arrays in a monolithic crystal. Each orthogonal array contains 253 small pixels with size 0.04 × 0.8 mm2 and three central pixels are with a size of 0.18 × 0.18 mm2 each. The detector pitch is 0.2 mm and total active area is 52 × 52 mm2 . The response of the DUO silicon detector was characterized in terms of dose per pulse, percentage depth dose, and spatial resolution in a radiation field incorporating high gradients. Beam profile of small fields and output factors measured on a Varian 2100EX LINAC in a 6 MV radiation fields of square dimensions and sized from 0.5 × 0.5 cm2 to 5 × 5 cm2 . The DUO response was compared under the same conditions with EBT3 films and an ionization chamber. RESULTS: The DUO detector shows a dose per pulse dependence of 5% for a range of dose rates from 2.7 × 10-4 to 1.2 × 10-4 Gy/pulse and 23% when the rate is further reduced to 2.8 × 10-5 Gy/pulse. The percentage depth dose measured to 25 cm depth in solid water phantom beyond the surface and for a field size of 10 × 10 cm2 agrees with that measured using a Markus IC within 1.5%. The beam profiles in both X and Y orthogonal directions showed a good match with EBT3 film, where the FWHM agreed within 1% and penumbra widths within 0.5 mm. The effect of an air gap above the DUO detector has also been studied. The output factor for field sizes ranging from 0.5 × 0.5 cm2 to 5 × 5 cm2 measured by the DUO detector with a 0.5 mm air gap above silicon surface agrees with EBT3 film and MOSkin detectors within 1.8%. CONCLUSIONS: The CMRP's monolithic silicon detector array, DUO, is suitable for SRS/SRT dosimetry and QA because of its very high spatial resolution (0.2 mm) and real time operation.

In vivo real-time rectal wall dosimetry for prostate radiotherapy.

Rectal balloons are used in external beam prostate radiotherapy to provide reproducible anatomy and rectal dose reductions. This is an investigation into the combination of a MOSFET radiation detector with a rectal balloon for realtime in vivo rectal wall dosimetry. The MOSFET used in the study is a radiation detector that provides a water equivalent depth of measurement of 70 microm. Two MOSFETs were combined in a face-to-face orientation. The reproducibility, sensitivity and angular dependence were measured for the dual MOSFET in a 6 MV photon beam. The dual MOSFET was combined with a rectal balloon and irradiated with hypothetical prostate treatments in a phantom. The anterior rectal wall dose was measured in real time and compared with the planning system calculated dose. The dual MOSFET showed angular dependence within +/-2.5% in the azimuth and +2.5%/-4% in the polar axes. When compared with an ion chamber measurement in a phantom, the dual MOSFET agreed within 2.5% for a range of radiation path lengths and incident angles. The dual MOSFET had reproducible sensitivity for fraction sizes of 2-10 Gy. For the hypothetical prostate treatments the measured anterior rectal wall dose was 2.6 and 3.2% lower than the calculated dose for 3DCRT and IMRT plans. This was expected due to limitations of the dose calculation method used at the balloon cavity interface. A dual MOSFET combined with a commercial rectal balloon was shown to provide reproducible measurements of the anterior rectal wall dose in real time. The measured anterior rectal wall dose agreed with the expected dose from the treatment plan for 3DCRT and IMRT plans. The dual MOSFET could be read out in real time during the irradiation, providing the capability for real-time dose monitoring of the rectal wall dose during treatment.