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This addendum to the code of practice for the determination of absorbed dose for x-rays below 300 kV has recently been approved by the IPEM and introduces three main changes: (i) Due to a lack of available data the original code recommended a value of unity for k(ch) in the very-low-energy range (0.035-1.0 mm Al HVL). A single table of k(ch) values, ranging from 1.01 to 1.07, applicable to both designated chamber types is now presented. (ii) For medium-energy x-rays (0.5-4 mm Cu HVL) methods are given to determine the absorbed dose to water either at 2 cm depth or at the surface of a phantom depending on clinical needs. Determination of the dose at the phantom surface is derived from an in-air measurement and by extending the low-energy range up to 4 mm Cu HVL. Relevant backscatter factors and ratios of mass energy absorption coefficients are given in the addendum. (iii) Relative dosimetry: although not normally forming part of a dosimetry code of practice a brief review of the current literature on this topic has been added as an appendix. This encompasses advice on techniques for measuring depth doses, applicator factors for small field sizes, dose fall off with increasing SSD and choice of appropriate phantom materials and ionization chambers.

The absorbed-dose calibration service from NPL is based on a primary-standard calorimeter that measures absorbed dose to graphite. Secondary-standard dosemeters are calibrated in absorbed dose to water in a 60Co gamma-ray beam and in x-ray beams over a range of generating potentials from 4 MV to 19 MV. Two methods were used to convert the calibrations of working-standard ionization chambers from absorbed dose to graphite into absorbed dose to water. One method involved the use of published interaction data for photons and secondary electrons, and required a knowledge of the chamber construction. The second method involved the calculation of the ratio of absorbed dose in graphite and water phantoms irradiated consecutively in the same photon beam using the photon-fluence scaling theorem. The two methods were in agreement to 0.1%.