Dosimetry in Radiotherapy

Question 1

State and explain the three ways to measure ionising radiation used in radiotherapy.

Answer 1

Ionisation - collect ion-pairs produced in air.
Calorimetry - ionising particle shares its energy with many others and eventually ions recombine. Energy ends up as heat.
Chemical effects - Free radicals produced by ionising particles cause chemical changes.

Question 2

How does a Free-Air ionisation chamber measure dose?

Answer 2

• Photon beam passes between parallel plates with a high polarising voltage between then
• • Voltage must be high enough to separate +ve and -ve ions before they recombine.
• X-Ray produce electrons which cause ionisation
• Mas f air in collecting volume, dm, defined by guard plate and beam geometry
• Ion (not electrons0 are collected and measured.
• Energy to create ion pair is known, so dose can be calculated.

Question 3

What will happen if the voltage between the plates is not high enough?

Answer 3

The measured charge will be proportional to the voltage.

Question 4

What beam energies are Free-Air ionisation chambers suitable for?

Answer 4

kV beam qualities. Rance of photo- and Compton electrons from MV energies would require a 4m plate separation to reach electronic equilibrium.

Question 5

Where is the primary standard kept?

Answer 5

At the NPL

Question 6

What does a primary standard do?

Answer 6

A primary standard makes and absolute measurement from first principles. All other devices are calibrated to the primary standard through a traceability chain.

Question 7

What advantage does a thimble chamber have compared to a free-air chamber when measuring MV beam qualities?

Answer 7

Smaller (air shell “compressed” to solid “air-equivalent” graphite) so more practicable.

Question 8

What are large ionisation chambers used for and why?

Answer 8

Used for environmental monitoring.

Very sensitive, but poor spatial resolution.

Question 9

What are small ionisation chambers used for and why?

Answer 9

Used for fine resolution scanning.

Good spatial resolution, but small signal.

Question 10

When would a parallel plate chamber be used?

Answer 10

Parallel plate chambers are thin in the gradient direction for better resolution, but with a large detecting volume for decent signal.
Used for measurements in high dose gradient fields (e.g. electron beams, kV beams, build up regions of MV beams)
Thimble chamber would be too big and would measure contributions from other parts of the high gradient field.

Question 11

How do calorimeters measure dose?

Answer 11

Dose = Energy/Mass = E/m
E=mc x dT
E/m = specific heat capacity x temperature rise = Dose
Temperature rise measured using very sensitive thermistors.

Question 12

What advantage do calorimeters have over ionisation chambers?

Answer 12

Directly measure absorbed dose.

Question 13

What type of calorimeter does the NPL use for their primary standard?

Answer 13

Graphite

Question 14

Why isn’t a water calorimeter used?

Answer 14

• Specific heat capacity too high (1Gy ~ 0.24mK temperature increase)
• Difficulties with impurities adding heat defects.

Question 15

How is the dose in the graphite calorimeter converted into a dose in water?

Answer 15

Uses ratio of electron densities (Photon fluence scaling theorem)

Question 16

What temperature rise is caused by a dose of 1Gy in a graphite calorimeter?

Answer 16

1.5mK

Question 17

Describe one modern way of measuring the temperature rise in a graphite calorimeter.

Answer 17

Core temperature kept constant by reducing current in a heating circuit.
D=VIt/M

Question 18

What is a secondary standard?

Answer 18

High-quality dosemeter owned by hospitals that is sent to be calibrated against the NPL primary standard
NPL provide correction factor to convert dose readings made with secondary standard to accurate dose measurements
All other field instruments in the hospital are cross-calibrated against this

Question 19

How is a field instrument cross-calibrated?

Answer 19

• Field instrument and secondary standard placed at 10cm in same perspex phantom
• Both irradiated with the same beam (should receive the same dose)
• Ratio of reading from field instruments and secondary standard taken
• Repeated 12 times with position of the chambers swapped after each three readings

Question 20

What is the quality dependent factor?

Answer 20

Due to chamber construction, response varies with beam energy (or quality). The secondary standard chamber is calibrated against the NPL chamber at a number of different beam qualities and a calibration curve is produced

Question 21

What is the quality index of a beam?

Answer 21

Same as the TPR (20/10) (i.e. Tissue Phantom Ratio a depths of 20cm and 10cm)

Question 22

What other correction factors are applied to calibrations of chambers?

Answer 22

k(tp) - correction for temperature and pressure (1013.25/P x T/293.15)
k(ion) - correction for ion recombination
k(elec) - correction for electometer reading
k(lin) - correction for linearity wrt dose

Question 23

How is k(ion) quantified?

Answer 23

Measure charge collected at different polarising voltages as recombination increases at low voltages

Question 24

How do TLDs record the absorbed dose?

Answer 24

• TLDs contain lattice impurities which give additional energy levels to the electrons in the lattice
• These energy levels are meta-stable so act as traps for the electrons
• When irradiated the electrons jump from the valence to the conduction band and then some fall into the traps
• Heating the material releases the electrons from the traps where they initially move to the conduction band before falling into the valence band and emit light
• The light recorded from the TLD is proportional to the absorbed dose

Question 25

What are advantages of TLDs over other dose-measuring devices?

Answer 25

• linear response over wide range (0.001-1Gy)
• sensitivity is almost energy independent (MV) range
• small size provides high resolution
• no leads, batteries or connectors required

Question 26

What are disadvantages of TLDs over other dose-measuring devices?

Answer 26

• must be calibrated
• fade with time after irradiation (typically <10%/yr)
• careful annealing is required between uses to ensure TD returns to the original condition (wrt e-traps)
• affected by previous thermal and radiation history
• reader constancy difficult to maintain over long periods

Question 27

What is the most commonly used material for TLDs?

Answer 27

lithium fluoride

Question 28

What are some uses for TLDs?

Answer 28

Commissioning and QA

• small fields
• surface dose/high-dose gradients
• superficial x-ray therapy backscatter
• internal dose in phantoms

Patient Dosimetry

• total body irradiation
• total skin irradiation
• eye dose estimates

Personal Dosimetry

• multi-chip badges
• single chip finger holders

Question 29

What are advantages of film dosimetry?

Answer 29

• good spatial resolution (grains ~ 100um, only limited by aperture of scanner)
• convenient for aspects of LINAC comissionin & QC
• can be calibrated of absolute dose measurement
• geometry well suited for dose mapping (thin, flat, large area)

Question 30

What are disadvantages of film dosimetry?

Answer 30

• Silver Halide film requires wet processing (must be well controlled and consistent)
• Silver Halide film sensitivity is energy dependent (high Z - preferential absorption of photons < 150kV)
• Radiochromic film: dose sensitive to scan parameters

Question 31

What are the four parts of radiographic film?

Answer 31

• Supercoat: protect emulsion from damage
• Emulsion: contains Silver Halide
• Adhesive
• Base: provides stability

Question 32

How does Radiochromic film differ from radiographic?

Answer 32

• radiochromic is self-developing
• sensitivity is independent of photon energy
• more expensive per sheet, but no processing costs
• tissue equivalent
• can be immersed in water