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In the last few years there has been an increasing interest in the measurement of the absorbed dose from radionuclides, with special attention devoted to molecular radiotherapy treatments. In particular, the determination of the absorbed dose from beta emitting radionuclides in liquid solution poses a number of issues when dose measurements are performed using thermoluminescent dosimeters (TLD). Finite volume effect, i.e. the exclusion of radioactivity from the volume occupied by the TLD is one of these. Furthermore, TLDs need to be encapsulated into some kind of waterproof envelope that unavoidably contributes to beta particle attenuation during the measurement. The purpose of this study is twofold: I) to measure the absorbed dose to water, D w , using LiF:Mg,Cu,P chips inside a PMMA cylindrical phantom filled with a homogenous 90YCl3 aqueous solution II) to assess the uncertainty budget related to D w measurements. To this purpose, six cylindrical PMMA phantoms were manufactured at ENEA. Each phantom can host a waterproof PMMA stick containing 3 TLD chips encapsulated by a polystyrene envelope. The cylindrical phantoms were manufactured so that the radioactive liquid environment surrounds the whole stick. Finally, D w measurements were compared with Monte Carlo (MC) calculations. The measurement of absorbed dose to water from 90YCl3 radionuclide solution using LiF:Mg,Cu,P TLDs turned out to be a viable technique, provided that all necessary correction factors are applied. Using this method, a relative combined standard uncertainty in the range 3.1–3.7% was obtained on each D w measurement. The major source of uncertainty was shown to be TLDs calibration, with associated uncertainties in the range 0.7–2.2%. Comparison of measured and MC-calculated absorbed dose per emitted beta particle provided good results, with the two quantities being in the ratio 1.08.

Purpose The complexity of the modern Stereotactic Body Radiation Therapy (SBRT) techniques requires comprehensive quality assurance programs, to ensure the right treatment to the patient. Dosimetry of small radiation fields is a challenge especially for radiotherapy centres starting to work on this issue. The matter to be discussed here concerns the need of detailed measurement procedures and cross checks to be paired to the usual recommendations on detectors and correction factors. Materials and Methods The presented work involved 24 Italian radiotheraphy centres, with the specific purpose to minimize systematic errors in output factor measurements over different radiotherapy centres. Using the unshielded silicon diode IBA Razor, reference curves for the relative signal ratio (RSR) as a function of beam size were created for each Linac family. Results With this study we have demonstrated consistency of small field dosimetry on all the centres involved, moreover all radiotherapy centres using Razor are allowed to compare measurements amongst each other and centres with values deviating more than 5% from the reference curve are advised to repeat their measurements. With this procedure, some critical issues were detected from two centres in RSR measurements, that, if implemented into the own treatment planning system, would induce an unwanted overdosage larger than 5%. Conclusions The proposed approach could allow one to envision high-skilled therapy centres providing support to those featuring minor experience and could represent an important strategy for the clinical implementation of emerging technologies at high quality levels. The methodology adopted exploits crowd knowledge methods which could be applied in others areas of radiation dosimetry.

Purpose To calculate by Monte Carlo simulations kQ factors for Farmer-type ionization chambers in megavoltage photon beams using the new key dosimetry data recommended by the International Commission on Radiation Units and Measurements (ICRU) Report 90. Methods Monte Carlo calculations were performed with the EGSnrc code system using both the ICRU 90 and the ICRU 37 data. Farmer-type ionization chambers with graphite and plastic walls and with graphite wall and a plastic waterproofing sleeve were considered (Nuclear Enterprise NE 2571, IBA FC65-G and FC65-P). kQ factors were calculated for photon beams in the range 6–25 MV using phase-space files as input radiation sources. The photon beam qualities in terms of TPR20,10 and %dd(10)x were established by simulating the depth-dose curves in water. Absorbed doses to the air cavity and to water were calculated using the egs_chamber user code with a target statistical uncertainty below 0.1%. Results The update of key dosimetry data according to the ICRU report 90 had an impact of −0.2% in the absorbed dose to water and up to 0.5% in the absorbed dose to the air cavity. Nevertheless, changes partially offset each other when entering in kQ as ratio, and the final impact on the kQ values was below 0.3%. Conclusions The calculated values of kQ tend to be lower than the current values in the IAEA TRS-398 protocol with differences up to about 0.5%. A slightly better agreement (within 0.3%) is observed with the Monte-Carlo calculated values provided by the addendum to the AAPM’s TG-51 protocol.

Clinical dosimetry is typically performed using ion chambers calibrated in terms of absorbed dose to water. As primary measurement standards for this quantity for low and medium energy x-rays are available only since a few years, most dosimetry protocols for this photon energy range are still based on air kerma calibration. For that reason, data for beam quality correction factors k Q , Q 0 , necessary for the application of dose to water based protocols, are scarce in literature. Currently the international IAEA TRS-398 Code of Practice is under revision and new k Q , Q 0 factors for a large number of ion chambers will be introduced in the update of this protocol. Several international groups provided the IAEA with experimental and Monte Carlo based data for this revision. Within the European Community the EURAMET 16NRM03 RTNORM project was initiated for that purpose. In the present study, Monte Carlo based results for the beam quality correction factors in medium energy x-ray beams for six ion chambers applying different Monte Carlo codes are presented. Additionally, the perturbation factor p Q , necessary for the calculation of dose to water from an air kerma calibration coefficient, was determined. The beam quality correction factor k Q , Q 0 for the chambers varied in the investigated energy range by about 4%–5%, and for five out of six chambers the data could be fitted by a simple logarithmic function, if the half-value-layer was used as the beam quality specifier. Corresponding data using different Monte Carlo codes for the same ion chamber agreed within 0.5%. For the perturbation factor p Q , the data did not obey a comparable simple relationship with the beam quality specifier. The variation of p Q for all ion chambers was in the range of 3%–4%. Compared to recently published data, our p Q data is around 1% larger, although the same Monte Carlo code has been used. Compared to the latest experimental data, there are even deviations in the range of 2%.

The IAEA is currently coordinating a multi-year project to update the TRS-398 Code of Practice for the dosimetry of external beam radiotherapy based on standards of absorbed dose to water. One major aspect of the project is the determination of new beam quality correction factors, kQ, for megavoltage photon beams consistent with developments in radiotherapy dosimetry and technology since the publication of TRS-398 in 2000. Specifically, all values must be based on, or consistent with, the key data of ICRU Report 90. Data sets obtained from Monte Carlo (MC) calculations by advanced users and measurements at primary standards laboratories have been compiled for 23 cylindrical ionization chamber types, consisting of 725 MC-calculated and 179 experimental data points. These have been used to derive consensus kQ values as a function of the beam quality index TPR20,10 with a combined standard uncertainty of 0.6%. Mean values of MC-derived chamber-specific fch factors for cylindrical and plane-parallel chamber types in 60Co beams have also been obtained with an estimated uncertainty of 0.4%., This is the version of the article before editing, as submitted by an author to Physics in Medicine and Biology. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at https://iopscience.iop.org/article/10.1088/1361-6560/ab807b/pdf

Lithium fluoride crystals were gamma irradiated at three different clinical doses (5, 10 and 20 Gy) with the 60Co reference beam of the Italian National Institute of Ionizing Radiation Metrology. The irradiations created optically-active point defects in the crystal lattice, among which the aggregate F2 and F3+ color centers, whose visible photoluminescence spectra were subsequently measured for increasing power densities of a 445 nm laser excitation in stationary conditions. The careful analysis of the spectra best fits vs. the excitation laser power suggests the presence of an emission band spectrally overlapped with the F3+ one and ascribable to F3 (R2) defects. Finally, a suitable elaboration of the resulting data for the emission band of the F3+ centers allows estimating a parameter of the energy triplet state of these defects, whose value well agrees with the literature.

Purpose The increasing interest in SBRT treatments encourages the use of flattening filter free (FFF) beams. Aim of this work was to evaluate the performance of the PTW60019 microDiamond detector under 6 MV and 10MVFFF beams delivered with the EDGE accelerator (Varian Medical System, Palo Alto, USA). A flattened 6 MV beam was also considered for comparison. Methods Short term stability, dose linearity and dose rate dependence were evaluated. Dose per pulse dependence was investigated in the range 0.2–2.2 mGy/pulse. MicroDiamond profiles and output factors (OFs) were compared to those obtained with other detectors for field sizes ranging from 40 × 40 cm2 to 0.6 × 0.6 cm2. In small fields, volume averaging effects were evaluated and the relevant correction factors were applied for each detector. Results MicroDiamond short term stability, dose linearity and dependence on monitor unit rate were less than 0.8% for all energies. Response variations with dose per pulse were found within 1.8%. MicroDiamond output factors (OF) values differed from those measured with the reference ion-chamber for less than 1% up to 40 × 40 cm2 fields where silicon diodes overestimate the dose of ≈3%. For small fields (

In the last few years there has been an increasing interest in the measurement of the absorbed dose from radionuclides, with special attention devoted to molecular radiotherapy treatments. In particular, the determination of the absorbed dose from beta emitting radionuclides in liquid solution poses a number of issues when dose measurements are performed using thermoluminescent dosimeters (TLD). Finite volume effect, i.e. the exclusion of radioactivity from the volume occupied by the TLD is one of these. Furthermore, TLDs need to be encapsulated into some kind of waterproof envelope that unavoidably contributes to beta particle attenuation during the measurement. The purpose of this study is twofold: I) to measure the absorbed dose to water, D

Plant cultivation on spacecraft or planetary outposts is a promising and actual perspective both for food and bioactive molecules production. To this aim, plant response to ionizing radiations, as an important component of space radiation, must be assessed through on-ground experiments due to the potentially fatal effects on living systems. Hereby, we investigated the effects of X-rays and γ-rays exposure on tomato “hairy root” cultures (HRCs), which represent a solid platform for the production of pharmaceutically relevant molecules, including metabolites and recombinant proteins. In a space application perspective, we used an HRC system previously fortified through the accumulation of anthocyanins, which are known for their anti-oxidant properties. Roots were independently exposed to different photon radiations, namely X-rays (250 kV) and γ-rays (Co60, 1.25 MeV), both at the absorbed dose levels of 0.5, 5, and 10 Gy. Molecular changes induced in the proteome of HRCs were investigated by a comparative approach based on two-dimensional difference in-gel electrophoresis (2D-DIGE) technology, which allowed to highlight dynamic processes activated by these environmental stresses. Results revealed a comparable response to both photon treatments. In particular, the presence of differentially represented proteins were observed only when roots were exposed to 5 or 10 Gy of X-rays or γ-rays, while no variations were appreciated at 0.5 Gy of both radiations, when compared with unexposed control. Differentially represented proteins were identified by mass spectrometry procedures and their functional interactions were analyzed, revealing variations in the activation of stress response integrated mechanisms as well as in carbon/energy and protein metabolism. Specific results from above-mentioned procedures were validated by immunoblotting. Finally, a morphometric analysis verified the absence of significant alterations in the development of HRCs, allowing to ascribe the observed variations of protein expression to processes of acclimation to ionizing radiations. Overall results contribute to a meaningful risk evaluation for biological systems exposed to extra-terrestrial environments, in the perspective of manned interplanetary missions planned for the near future.

Purpose To assess the capability of different types of detectors to measure relative output factors (OF) at high dose per pulse by comparison with alanine dosimeters, which are independent of dose rate. Methods Measurements were made in 9 MeV and 7 MeV electron beams produced by a Novac7 accelerator for intraoperative radiotherapy. Applicators with diameter of 10-7-6-5 and 4 cm were used. The dose per pulse varied from about 30 mGy, for the 10 cm reference applicator, to about 70 mGy, for the 4 cm applicator. Five types of plane-parallel ionization chambers (PTW Advanced Markus, Markus and Roos, IBA PPC40 and PPC05), two types of silicon diodes (PTW 60017 and IBA EFD3G) and a PTW 60019 microDiamond were considered. For the ionization chambers, correction factors for ion recombination effects were determined for each applicator using a modified two-voltage-analysis method that includes the free-electron component. Results Reference OF values were determined by alanine dosimeters with a standard combined uncertainty of 0.8%. Deviations from the reference OFs were generally within 1.5% for all the detectors, hence within the 95% confidence interval of alanine measurements. Larger deviations of up to about 2% obtained in a few cases are consistent with a 0.7% long-term reproducibility of OF measurements. Conclusions Comparison with alanine measurements demonstrated that all the detectors considered in this work can be used to measure OFs in high dose-per-pulse electron beams with an accuracy better than 2%, provided that appropriate corrections for ion recombination effects are applied when using ionization chambers.

The Italian National Institute of Ionizing Radiation Metrology (ENEA-INMRI) has designed and built a graphite calorimeter that, in a water phantom, has allowed the determination of the absorbed dose to water in medium-energy x-rays with generating voltages from 180 to 250 kV. The new standard is a miniaturized three-bodies calorimeter, with a disc-shaped core of 21 mm diameter and 2 mm thickness weighing 1.134 g, sealed in a PMMA waterproof envelope with air-evacuated gaps. The measured absorbed dose to graphite is converted into absorbed dose to water by means of an energy-dependent conversion factor obtained from Monte Carlo simulations. Heat-transfer correction factors were determined by FEM calculations. At a source-to-detector distance of 100 cm, a depth in water of 2 g cm-2, and at a dose rate of about 0.15 Gy min-1, results of calorimetric measurements of absorbed dose to water, D w, were compared to experimental determinations, D wK, obtained via an ionization chamber calibrated in terms of air kerma, according to established dosimetry protocols. The combined standard uncertainty of D w and D wK were estimated as 1.9% and 1.7%, respectively. The two absorbed dose to water determinations were in agreement within 1%, well below the stated measurement uncertainties. Advancements are in progress to extend the measurement capability of the new in-water-phantom graphite calorimeter to other filtered medium-energy x-ray qualities and to reduce the D w uncertainty to around 1%. The new calorimeter represents the first implementation of in-water-phantom graphite calorimetry in the kilovoltage range and, allowing independent determinations of D w, it will contribute to establish a robust system of absorbed dose to water primary standards for medium-energy x-ray beams. © 2016 Institute of Physics and Engineering in Medicine.

The high dose and dose-per-pulse rates (up to 130 mGy/pulse) produced by some intraoperative radiation therapy (IORT) accelerators pose specific dosimetric problems due to the high density of electric charge per pulse produced in the ionization chamber cavity. In particular, the correction factor for ion recombination, ks , calculated with the traditional two-voltage method is significantly overestimated and three alternative models have been proposed in the literature allowing for the presence of a free-electron component. However, at present there is no general consensus on the best model to assess the ion recombination correction and controversy remains on the uncertainty associated with k s . In the present work we adopted a Monte Carlo (MC) approach to assess the uncertainty associated with the ion recombination correction in plane-parallel chambers used in high dose-per-pulse electron beam dosimetry. The uncertainty associated with k s was calculated for the following plane-parallel ionization chambers: Scanditronix/Wellhofer Parallel Plate Chamber PPC05 and PPC40, PTW Advanced Markus Model 34 045 and PTW Roos Model 34 001. Input variables for MC calculations were derived from experimental data at 28 and 73 mGy/pulse. Taken together, the results of this study indicate that ks values calculated according to the three ion recombination models do not overlap within their standard uncertainties, suggesting that an additional type-B uncertainty component would be necessary to take into account possible differences between the models. Our results indicate that the combined relative standard uncertainty in k s should be calculated as the sum in quadrature of a (type-A) MC-based uncertainty component and a (type-B) uncertainty contribution evaluated assuming a uniform distribution between k s values obtained from the two extreme models.

The beam quality correction factor, , which corrects for the difference in the ionization chamber response between the reference and clinical beam quality, is an integral part of radiation therapy dosimetry. The uncertainty of is one of the most significant sources of uncertainty in the dose determination. To improve the accuracy of available data, four partners calculated factors for 10 ionization chamber models in linear accelerator beams with accelerator voltages ranging from 6 MV to 25 MV, including flattening-filter-free (FFF) beams. The software used in the calculations were EGSnrc and PENELOPE, and the ICRU report 90 cross section data for water and graphite were included in the simulations. Volume averaging correction factors were calculated to correct for the dose averaging in the chamber cavities. A comparison calculation between partners showed a good agreement, as did comparison with literature. The values from TRS-398 were higher than our values for each chamber where data was available. The values for the FFF beams did not follow the same , relation as beams with flattening filter (values for 10 MV FFF beams were below fits made to other data on average by 0.3%), although our FFF sources were only for Varian linacs.

To calculate by Monte Carlo simulations kMonte Carlo calculations were performed with the EGSnrc code system using both the ICRU 90 and the ICRU 37 data. Farmer-type ionization chambers with graphite and plastic walls and with graphite wall and a plastic waterproofing sleeve were considered (Nuclear Enterprise NE 2571, IBA FC65-G and FC65-P). kThe update of key dosimetry data according to the ICRU report 90 had an impact of -0.2% in the absorbed dose to water and up to 0.5% in the absorbed dose to the air cavity. Nevertheless, changes partially offset each other when entering in kThe calculated values of k

Measurements of neutron streaming through penetrations in biological shields are being carried out at JET fusion device by means of thermoluminescence (TL) detectors with the objective to validate the neutronics codes and nuclear data widely applied in ITER nuclear analyses in a real fusion environment. TLDs response due to the neutron component of the radiation field is related to the neutron fluence in a well-defined neutron energy spectrum. Therefore, a TLDs calibration in real fusion radiation fields is necessary to allow neutron fluence from TL measurements at JET to be more precisely calculated. Hence, a MCP-N and MCP-7 TLDs produced at the IFJ PAN in Kraków were calibrated at the ENEA facilities of Frascati and Casaccia laboratories. The obtained results have been analysed and new calibration factors are proposed. The detection system based on TLDs developed and calibrated for JET experiments can then be generally applied not only to fusion neutron fields, but also to ITER to monitor the neutron fluence outside the biological shield. © 2018

Purpose: To investigate the feasibility of using the ratio of dose-area product at 20 cm and 10 cm water depths (DAPR20,10) as a beam quality specifier for radiotherapy photon beams with field diameter below 2 cm. Methods: Dose-area product was determined as the integral of absorbed dose to water (Dw) over a surface larger than the beam size. 6 MV and 10 MV photon beams with field diameters from 0.75 cm to 2 cm were considered. Monte Carlo (MC) simulations were performed to calculate energy-dependent dosimetric parameters and to study the DAPR20,10 properties. Aspects relevant to DAPR20,10 measurement were explored using large-area plane-parallel ionization chambers with different diameters. Results: DAPR20,10 was nearly independent of field size in line with the small differences among the corresponding mean beam energies. Both MC and experimental results showed a dependence of DAPR20,10 on the measurement setup and the surface over which Dw is integrated. For a given setup, DAPR20,10 values obtained using ionization chambers with different air-cavity diameters agreed with one another within 0.4%, after the application of MC correction factors accounting for effects due to the chamber size. DAPR20,10 differences among the small field sizes were within 1% and sensitivity to the beam energy resulted similar to that of established beam quality specifiers based on the point measurement of Dw. Conclusions: For a specific measurement setup and integration area, DAPR20,10 proved suitable to specify the beam quality of small photon beams for the selection of energy-dependent dosimetric parameters. © 2017 Associazione Italiana di Fisica Medica

Purpose: To study EBT3 GafChromic film in low-energy protons, and for comparison purposes, in a reference 60Co beam in order to use it as a calibrated dosimetry system in the proton irradiation facility under construction within the framework of the Oncological Therapy with Protons (TOP)-Intensity Modulated Proton Linear Accelerator for RadioTherapy (IMPLART) Project at ENEA-Frascati, Italy. Methods: EBT3 film samples were irradiated at the Istituto Nazionale di Fisica Nucleare—Laboratori Nazionali di Legnaro, Italy, with a 5 MeV proton beam generated by a 7 MV Van de Graaff CN accelerator. The nominal dose rates used were 2.1 Gy/min and 40 Gy/min. The delivered dose was determined by measuring the particle fluence and the energy spectrum in air with silicon surface barrier detector monitors. A preliminary study of the EBT3 film beam quality dependence in low-energy protons was conducted by passively degrading the beam energy. EBT3 films were also irradiated at ENEA-National Institute of Ionizing Radiation Metrology with gamma radiation produced by a 60Co source characterized by an absorbed dose to water rate of 0.26 Gy/min as measured by a calibrated Farmer type ionization chamber. EBT3 film calibration curves were determined by means of a set of 40 film pieces irradiated to various doses ranging from 0.5 Gy to 30 Gy absorbed dose to water. An EPSON Expression 11000XL color scanner in transmission mode was used for film analysis. Scanner response stability, intrafilm uniformity, and interfilm reproducibility were verified. Optical absorption spectra measurements were performed on unirradiated and irradiated EBT3 films to choose the most sensitive color channel to the dose range used. Results: EBT3 GafChromic films show an under response up to about 33% for low-energy protons with respect to 60Co gamma radiation, which is consistent with the linear energy transfer dependence already observed with higher energy protons, and a negligible dose-rate dependence in the 2–40 Gy/min range. Short- and long-term scanner stabilities were 0.5% and 1.5%, respectively; film uniformity and reproducibility were better than 0.5%. Conclusions: The main purpose of this study was to implement EBT3 dosimetry in the proton low-energy radiobiology line of the TOP-IMPLART accelerator, having a maximum energy of 7 MeV. Low-energy proton and 60Co calibrated sources were used to investigate the behavior of film response vs to be written in italicum dose. The calibration in 5 MeV protons is currently used for dose assessment in the radiobiological experiments at the TOP-IMPLART accelerator carried out at that energy value.

Purpose: Aim of the present work is to evaluate the synthetic single crystal diamond Schottky photodiode developed at the laboratories of “Tor Vergata” University in Rome in a new dosimeter configuration specifically designed for offline wireless in vivo dosimetry (IVD) applications. Methods: The new diamond based dosimeter, single crystal diamond detector (SCDD-iv), consists of a small unwired detector and a small external reading unit that can be connected to commercial electrometers for getting the detector readout after irradiation. Two nominally identical SCDD-iv dosimeter prototypes were fabricated and tested. A basic dosimetric characterization of detector performances relevant for IVD application was performed under irradiation with 60Co and 6 MV photon beams. Preirradiation procedure, response stability, short and long term reproducibility, leakage charge, fading effect, linearity with dose, dose rate dependence, temperature dependence, and angular response were investigated. Results: The SCDD-iv is simple, with no cables linked to the patient and the readout is immediate. The range of response with dose has been tested from 1 up to 12 Gy; the reading is independent of the accumulated dose and dose rate independent in the range between about 0.5 and 5 Gy/min; its temperature dependence is within 0.5% between 25 and 38 °C, and its directional dependence is within 2% from 0° to 90°. The combined relative standard uncertainty of absorbed dose to water measurements is estimated lower than the tolerance and action level of 5%. Conclusions: The reported results indicate the proposed novel offline dosimeter based on a synthetic single crystal diamond Schottky photodiode as a promising candidate for in vivo dosimetry applications with photon beams.

Background: PET/CT has recently been shown to be a viable alternative to traditional post-infusion imaging methods providing good quality images of 90Y-laden microspheres after selective internal radiation therapy (SIRT). In the present paper, first we assessed the quantitative accuracy of 90Y-PET using an anthropomorphic phantom provided with lungs, liver, spine, and a cylindrical homemade lesion located into the hepatic compartment. Then, we explored the accuracy of different computational approaches on dose calculation, including (I) direct Monte Carlo radiation transport using Raydose, (II) Kernel convolution using Philips Stratos, (III) local deposition algorithm, (IV) Monte Carlo technique (MCNP) considering a uniform activity distribution, and (V) MIRD (Medical Internal Radiation Dose) analytical approach. Finally, calculated absorbed doses were compared with those obtained performing measurements with LiF:Mg,Cu,P TLD chips in a liquid environment. Results: Our results indicate that despite 90Y-PET being likely to provide high-resolution images, the 90Y low branch ratio, along with other image-degrading factors, may produce non-uniform activity maps, even in the presence of uniform activity. A systematic underestimation of the recovered activity, both for the tumor insert and for the liver background, was found. This is particularly true if no partial volume correction is applied through recovery coefficients. All dose algorithms performed well, the worst case scenario providing an agreement between absorbed dose evaluations within 20%. Average absorbed doses determined with the local deposition method are in excellent agreement with those obtained using the MIRD and the kernel-convolution dose calculation approach. Finally, absorbed dose assessed with MC codes are in good agreement with those obtained using TLD in liquid solution, thus confirming the soundness of both calculation approaches. This is especially true for Raydose, which provided an absorbed dose value within 3% of the measured dose, well within the stated uncertainties. Conclusions: Patient-specific dosimetry is possible even in a scenario with low true coincidences and high random fraction, as in 90Y–PET imaging, granted that accurate absolute PET calibration is performed and acquisition times are sufficiently long. Despite Monte Carlo calculations seeming to outperform all dose estimation algorithms, our data provide a strong argument for encouraging the use of the local deposition algorithm for routine 90Y dosimetry based on PET/CT imaging, due to its simplicity of implementation. © 2017, The Author(s).

A systematic study of the PTW microDiamond (MD) output factors (OF) is reported, aimed at clarifying its response in small fields and investigating its suitability for small field reference dosimetry. Ten MDs were calibrated under 60Co irradiation. OF measurements were performed in 6 MV photon beams by a CyberKnife M6, a Varian DHX and an Elekta Synergy linacs. Two PTW silicon diodes E (Si-D) were used for comparison. The results obtained by the MDs were evaluated in terms of absorbed dose to water determination in reference conditions and OF measurements, and compared to the results reported in the recent literature. To this purpose, the Monte Carlo (MC) beam-quality correction factor, , was calculated for the MD, and the small field output correction factors, , were calculated for both the MD and the Si-D by two different research groups. An empirical function was also derived, providing output correction factors within 0.5% from the MC values calculated for all of the three linacs. A high reproducibility of the dosimetric properties was observed among the ten MDs. The experimental values are in agreement within 1% with the MC calculated ones. Output correction factors within +0.7% and -1.4% were obtained down to field sizes as narrow as 5 mm. The resulting MD and Si-D field factors are in agreement within 0.2% in the case of CyberKnife measurements and 1.6% in the other cases. This latter higher spread of the data was demonstrated to be due to a lower reproducibility of small beam sizes defined by jaws or multi leaf collimators. The results of the present study demonstrate the reproducibility of the MD response and provide a validation of the MC modelling of this device. In principle, accurate reference dosimetry is thus feasible by using the microDiamond dosimeter for field sizes down to 5 mm. © 2017 Institute of Physics and Engineering in Medicine.

Purpose The International Commission on Radiation Units and Measurements (ICRU) in the Report 90 [1] has recommended adoption of new values for key data required for ionizing radiation dosimetry. In the framework of the EMPIR RTNORM project “kQ factors in modern external beam radiotherapy applications to update IAEA TRS 398”, beam quality correction factors, kQ, for reference dosimetry in high energy photon beams are calculated using the ICRU 90 basic data. Methods The ICRU 90 compliant EGSnrc Monte Carlo code is used to calculate kQ factors using new values for the mean excitation energies (I) for air, graphite, and water, renormalized photoelectric cross-sections and the crystalline density for graphite when evaluating the density effect (δ). Since the NE 2571 Farmer ionization chamber has long been studied, calculations were made first for this chamber so to select the most appropriate simulation parameters and techniques. The ionization chamber was modelled in details using the EGSnrc C++ geometry package and absorbed doses to the air cavity and to water were calculated using the egs_chamber user code with a target statistical uncertainty below 0.1%. Simulations were run in parallel using the ENEA CRESCO4 cluster. Results NE 2571 simulations for Co-60 and 6 MV to 25 MV photon beams showed that, while adoption of renormalized photoelectric cross-sections did not affect calculation results, variations in absorbed dose to the air cavity and absorbed dose to water due to the update of I and δ values were up to 0.5% and 0.2%, respectively. Nevertheless, changes partially offset each other and the overall effect on kQ values was below 0.2%. Work is in progress for other widely used ionization chambers. Conclusions In the range 6–25 MV ( TPR 20 , 10 of photon beams from 0.663 to 0.80), the calculated values of kQ for the NE 2571 ionization chamber tend to be lower than the current values in the IAEA TRS 398 protocol with differences up to about 0.5% at the highest TPR 20 , 10 values.

High-energy electron beams generated by linear accelerators, typically in the range 6 to 20 MeV, are used in small field sizes for radiotherapy of localized superficial tumors. Unshielded silicon diodes (Si-D) are commonly considered suitable detectors for relative dose measurements in small electron fields due to their high spatial resolution. Recently, a novel synthetic single crystal diamond diode (SCDD) showed suitable properties for standard electron beams and small photon beams dosimetry. The aim of the present study is twofold: to characterize 6 to 15 MeV small electron beams shaped by using commercial tubular applicators with 2, 3, 4 and 5 cm diameter and to assess the dosimetric performance under such irradiation conditions of the novel SCDD dosimeter by comparison with commercially available dosimeters, namely a Si-D and a plane-parallel ionization chamber. Percentage depth dose curves, beam profiles and output factors (OFs) were measured. A good agreement among the dosimeters was observed in all of the performed measurements. As for the tubular applicators, two main effects were evidenced: (i) OFs larger than unity were measured for a number of field sizes and energies, with values up to about 1.3, that is an output 30% greater than that obtained at the 10 × 10 cm 2 reference field; (ii) for each diameter of the tubular applicator a noticeable increase of the OF values was observed with increasing beam energy, up to about 100% in the case of the smaller applicator. This OF behavior is remarkably different from what typically observed for small blocked fields having the same size and energy as those used in this study. OFs for tubular applicators depend considerably on the field size, so interpolation is unadvisable to predict the linear accelerator output for such applicators whereas reliable high-resolution detectors, as the silicon and diamond diodes used in this work allow OF measurements with uncertainties of about 1%. © 2013 Institute of Physics and Engineering in Medicine. Printed in the UK & the USA.

Purpose New promising detectors are available for measuring small field size output factors (OFs). This study focused on a multicenter evaluation of two new generation detectors for OF measurements on CyberKnife systems. Methods PTW-60019 microDiamond and W1 plastic scintillation detector (PSD) were used to measure OFs on eight CyberKnife units of various generations for 5–60 mm fixed cones. MicroDiamond and PSD OF were compared to routinely used silicon diodes data corrected applying published Monte Carlo (MC) factors. PSD data were corrected for Cerenkov Light Ratio (CLR). The uncertainties related to CLR determination were estimated. Results Considering OF values averaged over all centers, the differences between MC corrected diode and the other two detectors were within 1.5%. MicroDiamond exhibited an over-response of 1.3% at 7.5 mm and a trend inversion at 5 mm with a difference of 0.2%. This behavior was consistent among the different units. OFs measured by PSD slightly under-responded compared to MC corrected diode for the smaller cones and the differences were within 1%. The observed CLR variability was 2.5% and the related variation in OF values was 1.9%. Conclusion This study indicates that CyberKnife microDiamond OF require corrections below 2%. The results are enhanced by the consistency observed among different units. Scintillator shows a good agreement to MC corrected diode but CLR determination remains critical requiring further investigations. The results emphasized the value of a multi-center validation over a single center approach.

This report presents the results of the first international comparison of primary measurement standards of absorbed dose to water for the medium-energy X-ray range. Three of the participants (VSL, PTB, LNE-LNHB) used their existing water calorimeter based standards and one participant (ENEA) recently developed a new standard based on a water-graphite calorimeter. The participants calibrated three transfer chambers of the same type in terms of absorbed dose to water (N Dw) and in addition in terms of air kerma (NK ) using the CCRI radiation qualities in the range 100 kV to 250 kV. The additional NK values were intended to be used for a physical analysis of the ratios N Dw/NK . All participants had previously participated in the BIPM.RI(I)-K3 key comparison of air kerma standards. Ratios of pairs of NMI's NK results of the current comparison were found to be consistent with the corresponding key comparison results within the expanded uncertainties of 0.6 % - 1 %. The N Dw results were analysed in terms of the degrees of equivalence with the comparison reference values which were calculated for each beam quality as the weighted means of all results. The participant's results were consistent with the reference value within the expanded uncertainties. However, these expanded uncertainties varied significantly and ranged between about 1-1.8 % for the water calorimeter based standards and were estimated at 3.7 % for the water-graphite calorimeter. It was shown previously that the ratios N Dw/NK for the type of ionization chamber used as transfer chamber in this comparison were very close (within less than 1 %) to the calculated values of (μ̄en/ρ)w,a d, the mean values of the water-to-air ratio of the mass-energy-absorption coefficients at the depth d in water. Some of the participant's results deviated significantly from the expected behavior. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

For photon beam sizes lower than 2 cm × 2 cm no absorbed-dose-to-water (Dw) primary standards are available for determining the possible influence of field size on the dosimeter response. In this work, Dw measurements performed in 1 cm × 1 cm photon beams at PTB using alanine and synthetic diamond dosimeters were compared in order to assess the reliability of the two dosimetric systems in such a small field size. The ratio of Dw values measured by diamond dosimeters to Dw values measured by alanine was 0.991 ± 1.5% (1 SD) and 1.007 ± 1.3% (1 SD) for 6 MV and 10 MV photon beams, respectively. This shows that both systems are capable of accurately measuring Dw in small fields.

Low-intensity radioactive sources emitting low-energy photons are used in the clinic for low dose-rate brachytherapy treatments of tumours. The dosimetry of these sources is based on reference air kerma rate measurements. The absorbed dose rate to water at the reference depth d0?=?1?cm, , is then obtained by a conversion procedure with a large relative standard uncertainty of about 5%. This paper describes a primary standard developed at ENEA-INMRI to directly measure due to LDR sources. The standard is based on a large-angle and variable-volume ionization chamber, embedded in a graphite phantom and operating under ?wall-less air chamber? conditions. A set of correction and conversion factors, based on experiments and Monte Carlo simulations, are determined to obtain the value of Dw,1 cm from measurements of increment of ionization current with increasing chamber volume. The relative standard uncertainty on is 2.6%, which is appreciably lower than the current uncertainty. Characteristics of the standard, its associated uncertainty budget, and some experimental results are given for 125I BEBIG I25.S16.C brachytherapy seeds. Finally, results of the experimental determination of the dose-rate constant ?1 cm, traceable to the Dw,1 cm and the low-energy air kerma ENEA-INMRI standards, are given. The relative standard uncertainty on ?1 cm is 2.9%, appreciably lower than the typical uncertainty (4.8%) of the values available in the literature.

Purpose Evaluating the level of agreement of measurements by different types of ionization chambers and solid state detectors in IORT electron beams with high dose per pulse. Methods Two electron beams (R50 2.59 and 3.05 cm) by a Novac7 Hitesys linac were used. Absorbed dose to water (Dw) and output factors (OF) were determined for the reference applicator of diameter 10 cm and the clinical applicators of diameter from 4 to 7 cm. The dose per pulse ranged between 29 and 77 mGy. Six types of plane parallel ionization chambers (PTW Markus, Advanced Markus and Roos; IBA PPC05, PPC40 and NACP02) were utilized. OF measurements were also made using a PTW microDiamond type 60019 and silicon diodes PTW type 60017 and IBA-EFG-3D. The IAEA TRS-398 dosimetry protocol was applied except for the saturation corrections applied to the ionization chambers that were determined according to [1] . Results The PPC05 and the Advanced Markus chambers exhibited the lowest ion recombination effects, being the corrections to be applied lower than 0.5% and 1.5%, respectively. Corrections larger than 15% were obtained for the Roos, the and PPC40 and the NACP02. Agreement among ionization chamber OF values was generally better than 1.5% except for the largest chambers in the smallest beams, where beam non uniformity likely caused dose underestimation, and for some discrepancies relevant to the Markus and the NACP02 chambers. OF values obtained using the solid state detectors typically agreed within 1.5%, while differences from PPC05 and Advanced Markus OFs were within 2%. Dw measurements by means of different ionization chambers agree to each other within the stated uncertainties (2.5%, 1SD). Conclusions Results of this work show that, at the high dose per pulse of NOVAC7 beams, dosimetry based on ionimetric measurements is feasible, if ion recombination effects are properly taken into account, and the studied solid state detectors are suitable for relative dosimetry.

Purpose The high dose per pulse of electron beams produced by some mobile accelerators for intraoperative radiotherapy can affect output factor (OF) measurements, since the dose rate increases by a factor larger than two from the reference to the smallest radiation field. Aim of this work was to assess the capability of different types of detectors to measure OFs at high dose per pulse by comparison with alanine dosimeters, which are independent of dose rate. Methods Measurements were made in 9 and 7 MeV electron beams produced by a Novac 7 accelerator. PMMA cylindrical applicators with diameter of 100 mm (reference field), 70 mm, 60 mm, 50 mm and 40 mm were used. The dose per pulse varied from about 30 mGy, for the 100 mm applicator, to about 70 mGy, for the 40 mm applicator. OFs were determined using four types of plane-parallel ionization chambers (PTW Advanced Markus and Roos, IBA PPC40 and PPC05), two types of silicon diodes (PTW 60017 and IBA 3FG-3D), a PTW microDiamond and alanine dosimeters. Ionization chamber signals were corrected for ion recombination effects using a modified two-voltage-analysis method that includes the free-electron component. Results A fairly good agreement was found between OFs measured by the three types of solid-state detectors and those measured by alanine. Differences were generally below 1% and maximum discrepancies around 2%. For the Advanced Markus and the PPC05 chambers differences from alanine results were below 1.7%. For the Roos and the PPC40 chambers agreement with alanine was within 2.3% down to the 50 mm applicator, while differences of several percent were found for the smallest applicator, most likely due to volume averaging effect. The variation of ion recombination correction factor with field size was below 1% for the Advanced Markus and the PPC05 chambers and up to about 10% for the Roos and the PPC40 chambers. Conclusions Comparison with alanine measurements demonstrated that all the detectors considered in this work can be used to measure OFs in high-dose-per-pulse electron beams with an accuracy of 2%, provided that appropriate corrections for ion recombination effects are applied when using ionization chambers.

The central dogma of radiation biology, that biological effects of ionizing radiation are a direct consequence of DNA damage occurring in irradiated cells, has been challenged by observations that genetic/epigenetic changes occur in unexposed “bystander cells” neighboring directly-hit cells, due to cell-to-cell communication or soluble factors released by irradiated cells. To date, the vast majority of these effects are described in cell-culture systems, while in vivo validation and assessment of biological consequences within an organism remain uncertain. Here, we describe the neonatal mouse cerebellum as an accurate in vivo model to detect, quantify, and mechanistically dissect radiation-bystander responses. DNA double-strand breaks and apoptotic cell death were induced in bystander cerebellum in vivo . Accompanying these genetic events, we report bystander-related tumor induction in cerebellum of radiosensitive Patched-1 ( Ptch1 ) heterozygous mice after x-ray exposure of the remainder of the body. We further show that genetic damage is a critical component of in vivo oncogenic bystander responses, and provide evidence supporting the role of gap-junctional intercellular communication (GJIC) in transmission of bystander signals in the central nervous system (CNS). These results represent the first proof-of-principle that bystander effects are factual in vivo events with carcinogenic potential, and implicate the need for re-evaluation of approaches currently used to estimate radiation-associated health risks.

Energy and angular distributions of electron beams with different energies were simulated by Monte Carlo calculations. These beams were generated by the NOVAC7 system (Hitesys, Italy), a mobile electron accelerator specifically dedicated to intra-operative radiation therapy (IORT). The electron beam simulations were verified by comparing the measured dose distributions with the corresponding calculated distributions. As expected, a considerable difference was observed in the energy and angular distributions between the IORT beams studied in the present work and the electron beams produced by conventional accelerators for non-IORT applications. It was also found that significant differences exist between the IORT beams used in this work and other IORT beams with different collimation systems. For example, the contribution from the scattered electrons to the total dose was found to be up to 15% higher in the NOVAC7 beams. The water-to-air stopping power ratios of the IORT beams used in this work were calculated on the basis of the beam energy distributions obtained by the Monte Carlo simulations. These calculated stopping power ratios, s(w,air), were compared with the corresponding s(w,air) values recommended by the TRS-381 and TRS-398 IAEA dosimetry protocols in order to estimate the deviations between a dosimetry based on generic parameters and a dosimetry based on parameters specifically obtained for the actual IORT beams. The deviations in the s(w,air) values were found to be as large as up to about 1%. Therefore, we recommend that a preliminary analysis should always be made when dealing with IORT beams in order to assess to what extent the possible differences in the s(w,air) values have to be accounted for or may be neglected on the basis of the specific accuracy needed in clinical dosimetry.

Purpose The aim of the present work was to evaluate small field size output factors (OFs) using the latest diamond detector commercially available, PTW-60019 microDiamond, over different CyberKnife systems. OFs were measured also by silicon detectors routinely used by each center, considered as reference. Methods Five Italian CyberKnife centers performed OFs measurements for field sizes ranging from 5 to 60 mm, defined by fixed circular collimators (5 centers) and by Iris ™ variable aperture collimator (4 centers). Setup conditions were: 80 cm source to detector distance, and 1.5 cm depth in water. To speed up measurements two diamond detectors were used and their equivalence was evaluated. MonteCarlo (MC) correction factors for silicon detectors were used for comparing the OF measurements. Results Considering OFs values averaged over all centers, diamond data resulted lower than uncorrected silicon diode ones. The agreement between diamond and MC corrected silicon values was within 0.6% for all fixed circular collimators. Relative differences between microDiamond and MC corrected silicon diodes data for Iris ™ collimator were lower than 1.0% for all apertures in the totality of centers. The two microDiamond detectors showed similar characteristics, in agreement with the technical specifications. Conclusions Excellent agreement between microDiamond and MC corrected silicon diode detectors OFs was obtained for both collimation systems fixed cones and Iris ™ , demonstrating the microDiamond could be a suitable detector for CyberKnife commissioning and routine checks. These results obtained in five centers suggest that for CyberKnife systems microDiamond can be used without corrections even at the smallest field size.

The purpose of this study was to compare the dosimetric properties of small field electron beams shaped by circular Cerrobend blocks and stainless steel tubular applicators. Percentage depth dose curves, beam profiles, and output factors of small‐size circular fields from 2 to 5 cm diameter, obtained either by tubular applicators and Cerrobend blocks, were measured for 6, 10, and 15 MeV electron beam energies. All measurements were performed using a PTW microDiamond 60019 premarket prototype. An overall similar behavior between the two collimating systems can be observed in terms of PDD and beam profiles. However, Cerrobend collimators produce a higher bremsstrahlung background under irradiation with high‐energy electrons. In such irradiation condition, larger output factors are observed for tubular applicators. Similar dosimetric properties are observed using circular Cerrobend blocks and stainless steel tubular applicators at lower beam energies. However, Cerrobend collimators allow the delivery of specific beam shapes, conformed to the target area. On the other hand, in high‐energy irradiation conditions, tubular applicators produce a lower bremsstrahlung contribution, leading to lower doses outside the target volume. In addition, the higher output factors observed at high energies for tubular applicators lead to reduced treatment times. PACS number: 87.53.Bn, 87.55.Qr, 87.56.Fc

International audience; Cette publication traite des avancées effectuées pendant le cours du projet HLT09 subventionné par EMRP (European Metrology Research Program). Ce projet avait pour objectif global d'améliorer la traçabilité, à des références nationales, de la dose absorbée délivrée à la tumeur dans la cadre d'un traitement par radiothérapie. Les recherches couvrent l'établissement de références absolues en termes de dose absorbée dans l'eau pour les photons d'énergie moyenne, la mise en oeuvre du concept de produit dose surface dans la cadre de l'utilisation des faisceaux de photons de haute énergie, la caractérisation des faisceaux produit par de nouveaux générateurs de rayons X pour la thérapie de contact incluant les étalon primaire et de transfert, l'étude des caractéristiques des détecteurs ponctuels, 2D et 3D en tant qu'étalon de transfert et moyen de contrôle des plans de traitement.

Purpose: To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. Methods: The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.).The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. Results: A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under 60Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. Conclusions: The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. © 2015 Associazione Italiana di Fisica Medica.

The correction for charge recombination was determined for different plane-parallel ionization chambers exposed to clinical electron beams with low and high dose per pulse, respectively. The electron energy was nearly the same (about 7 and 9 MeV) for any of the beams used. Boag's two-voltage analysis (TVA) was used to determine the correction for ion losses, k(s), relevant to each chamber considered. The presence of free electrons in the air of the chamber cavity was accounted for in determining k(s) by TVA. The determination of k(s) was made on the basis of the models for ion recombination proposed in past years by Boag, Hochhäuser and Balk to account for the presence of free electrons. The absorbed dose measurements in both low-dose-per-pulse (less than 0.3 mGy per pulse) and high-dose-per-pulse (20-120 mGy per pulse range) electron beams were compared with ferrous sulphate chemical dosimetry, a method independent of the dose per pulse. The results of the comparison support the conclusion that one of the models is more adequate to correct for ion recombination, even in high-dose-per-pulse conditions, provided that the fraction of free electrons is properly assessed. In this respect the drift velocity and the time constant for attachment of electrons in the air of the chamber cavity are rather critical parameters because of their dependence on chamber dimensions and operational conditions. Finally, a determination of the factor k(s) was also made by zero extrapolation of the 1/Q versus 1/V saturation curves, leading to the conclusion that this method does not provide consistent results in high-dose-per-pulse beams.

A project dedicated to stereotactic body radiotherapy (SBRT) dosimetric aspects started in the framework of the Italian Association of Medical Physics (AIFM) SBRT working group. Its main objectives are manifold but sharing the knowledge between different clinics is the one of the most important. More than 30 centres, equipped with Varian, Elekta, Siemens or CyberKnife linac were enrolled. The project was divided in several work-packages, the first one evaluated the relative measurements with detectors routinely used by individual centers and in the following different detectors run in various centre. Each centre in the same work-package performed dose profile of field size ranging from 0.6 × 0.6 cm 2 to 5.0 × 5.0 cm 2 , and relative output factors (ROF) measurements with a diamond or silicon diode or scintillator detector. In workpackage-1 ROF values measured in the first phase were compared with the ones measured with a microdiamond showing a higher inter-center consistency with this dosimeter compared to routine detectors. In workpackage-2 a silicon diode of new generation was used also to develop a mathematical relation from multicentric experimental data, which describes and predicts the ROF as a function of effective field size for TrueBeam Varian and Elekta linacs. Workpackage-3 used a plastic scintillator for TPR20, 10 and ROF; the latter showed a greater variability. Workpackage-4 used diamond and plastic scintillator with Cyberknife beams, to evaluate if microDiamond could be a suitable alternative to silicon diodes for OF determination and to validate the feasibility of using the scintillator as a reference detector in consideration of the CerenkovLightRatio and experimental uncertainties. The results of the study for all the detectors emphasized the usefulness of a multi-center validation over a single center approach.

In the present work, the correlated sampling technique in Monte Carlo calculations related to diamond dosimetry and graphite calorimetry will be described. The egs_chamber and DOSRZnrc user-codes included in the EGSnrc package are used. Egs_chamber is already provided with routines enabling the use of correlated sampling while an in-house implementation of this technique was made in the original version of DOSRZnrc. Both codes have been used for calculating perturbation factors needed for absorbed dose measurements in radiotherapy dosimetry. Correlated sampling turned out to be a reliable method, allowing to determine, in reasonable times, accurate correction factors, even in unfavourable conditions as when absorbed dose is scored in very small volumes.