The change of response of ionization chambers in the penumbra and transmission regions: impact for IMRT verification

Significant deviations from the expected dose have been reported in the absolute dosimetry validation of an intensity modulated radiation therapy treatment when individual segments are analyzed. However, when full treatment is considered and all segment doses are added together, these discrepancies fade out, leading to overall dose deviations below a 5% action level. This contradictory behavior may be caused by a partial compensation between detector over-responding and under-responding for measurement conditions far from radiation equilibrium. We consider three treatment verification scenarios that may lead to ionization chamber miss-responding, namely: narrow beam irradiation, field penumbra location and multi-leaf collimator transmission contribution. In this work we have analyzed the response of three different ionization chambers with different active volume under these conditions by means of Monte Carlo (MC) simulation methods. Correction factors needed to convert the detector readout into actual dose to water were calculated by inserting the specific detector geometry (carefully modeled) into the simulations. This procedure required extensive use of parallel computing resources in order to achieve the desired level of uncertainty in the final results. The analysis of the simulations shows the relative contribution of each of the three previously mentioned miss-responding scenarios. Additionally, we provide some evidence on dose deviation compensation in multi-segment radiotherapy treatment verification.

[1]  A. Nahum Simulation of Dosimeter Response and Interface Effects , 1988 .

[2]  D. Rogers,et al.  AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams. , 1999, Medical physics.

[3]  Marta Paiusco,et al.  Uncertainty estimation in intensity-modulated radiotherapy absolute dosimetry verification. , 2007, International journal of radiation oncology, biology, physics.

[4]  W. Laub,et al.  The volume effect of detectors in the dosimetry of small fields used in IMRT. , 2003, Medical physics.

[5]  Monte Carlo correction factors for a Farmer 0.6 cm3 ion chamber dose measurement in the build-up region of the 6 MV clinical beam. , 2006, Physics in medicine and biology.

[6]  L Grimaldi,et al.  Portal dose measurements by a 2D array. , 2007, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[7]  F. Verhaegen Interface perturbation effects in high-energy electron beams. , 2003, Physics in medicine and biology.

[8]  A. Sethi,et al.  Comparison of ionization chambers of various volumes for IMRT absolute dose verification. , 2003, Medical physics.

[9]  J. Seuntjens,et al.  Ionization chamber-based reference dosimetry of intensity modulated radiation beams. , 2004, Medical physics.

[10]  D. Low,et al.  Tumor response and salivary function sparing in patients with oropharyngeal squamous cell carcinoma treated with intensity modulated radiation therapy (IMRT) with/without chemotherapy: the mallinckrodt institute of radiology initial results , 2000 .

[11]  P. Andreo,et al.  Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water , 2001 .

[12]  C. De Wagter,et al.  The value of the PinPoint ion chamber for characterization of small field segments used in intensity-modulated radiotherapy. , 2000, Physics in medicine and biology.

[13]  G. Ibbott,et al.  Dosimetric considerations for validation of a sequential IMRT process with a commercial treatment planning system. , 2002, Physics in medicine and biology.

[14]  James A. Purdy,et al.  Intensity-modulated radiotherapy: current status and issues of interest. , 2001, International journal of radiation oncology, biology, physics.

[15]  F. Sánchez-Doblado,et al.  Ionization chamber dosimetry of small photon fields: a Monte Carlo study on stopping-power ratios for radiosurgery and IMRT beams. , 2003, Physics in medicine and biology.

[16]  F. Sánchez-Doblado,et al.  Automatic determination of primary electron beam parameters in Monte Carlo simulation. , 2007, Medical physics.

[17]  M Stasi,et al.  The behavior of several microionization chambers in small intensity modulated radiotherapy fields. , 2004, Medical physics.

[18]  G. Hartmann,et al.  Micro ionization chamber dosimetry in IMRT verification: clinical implications of dosimetric errors in the PTV. , 2005, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[19]  G. Hartmann,et al.  An EGSnrc Monte Carlo study of the microionization chamber for reference dosimetry of narrow irregular IMRT beamlets. , 2004, Medical physics.

[20]  S Cora,et al.  Use of a new type of radiochromic film, a new parallel-plate micro-chamber, MOSFETs, and TLD 800 microcubes in the dosimetry of small beams. , 1998, Medical physics.

[21]  C. Ma,et al.  BEAM: a Monte Carlo code to simulate radiotherapy treatment units. , 1995, Medical physics.

[22]  D Low,et al.  Intensity-modulated radiation therapy (IMRT) reduces small bowel, rectum, and bladder doses in patients with cervical cancer receiving pelvic and para-aortic irradiation. , 2001, International journal of radiation oncology, biology, physics.

[23]  I. Kawrakow,et al.  Large efficiency improvements in BEAMnrc using directional bremsstrahlung splitting. , 2004, Medical physics.

[24]  J. Cygler,et al.  Commissioning and quality assurance of treatment planning computers. , 1993, International journal of radiation oncology, biology, physics.

[25]  G. Hartmann,et al.  Microionization chamber for reference dosimetry in IMRT verification: clinical implications on OAR dosimetric errors , 2005, Physics in medicine and biology.

[26]  Frank Verhaegen,et al.  Evaluation of the EGSnrc Monte Carlo code for interface dosimetry near high-Z media exposed to kilovolt and 60Co photons. , 2002, Physics in medicine and biology.