1. 輻射劑量學之品質保證 講者：蕭安成 物理師
參考資料： 1. The Physics of Radiation Therapy Faiz M. Khan 2. Introduction to Radiological Physics and Radiation Dosimetry Frank H. Attix,

2. 醫用直線加速器品質保證作業項目

3. 品保作業儀器設備
Daily : Sun Nuclear Daily QA 2

4. 品保作業儀器設備
Beam uniformity

5. 品保作業儀器設備
Output calibration

6. Measurement of Absorbed Dose

7. The Roentgen
The roentgen is an unit of exposure ( X ). The ICRU defines X as the quotient of dQ by dm where dQ is the absolute value of the total charge of the ions of one sign produced in air when all the electrons ( + or - ) liberated by photons in air of mass dm are completely stopped in air.
X = dQ / dm
The SI unit is C/kg but the special unit is roentgen ( R )
1R = 2.58 × 10-4 C/kg

8. The Roentgen
Charged Particle Equilibrium (CPE ) : Electron produced outside the collection region, which enter the ion-collecting region, is equal to the electron produced inside the collection region , which deposit their energy outside the region.

9. Radiation Absorbed Dose
Exposure: photon beam, in air, E＜3MeV
Absorbed dose: for all types of ionizing radiation
Absorbed dose is a measure of the biologically significant effects produced by ionizing radiation
Absorbed dose = dE/dm
dE is the mean energy imparted by ionizing radiation to material of dm
The SI unit for absorbed dose is the gray (Gy)
1Gy = 1 J/kg
( 1 rad=100ergs/g=10-2J/kg, 1cGy=1rad )

10. Relationship Between Kerma, Exposure, and Absorbed Dose
Kerma ( K ): Kinetic energy released in the medium.
K = dEtr / dm
dEtr is the sum of the initial kinetic energies of all the charged particles liberated by uncharged particles ( photons) in a material of mass dm
The unit for kerma is the same as for dose, that is, J/kg. The name of its SI unit is gray (Gy)

11. Relationship Between Kerma, Exposure, and Absorbed Dose
Kerma ( K ): Kcol and Krad are the collision and the radiation parts of kerma
K = Kcol + Krad
the photon energy fluence, Ψ
averaged mass energy absorption coefficient, men / r

12. Relationship Between Kerma, Exposure, and Absorbed Dose
Exposure and Kerma :
Exposure is the ionization equivalent of the collision kerma in air.
X = (Kcol)air · ( e/w )
w/e = J/C

13. Relationship Between Kerma, Exposure, and Absorbed Dose
Absorbed Dose and Kerma :

14. Relationship Between Kerma, Exposure, and Absorbed Dose
Absorbed Dose and Kerma :
Suppose D1 is the dose at a point in some material in a photon beam and another material is substituted of a thickness of at least one maximum electron range in all directions from the point, then D2 , the dose in the second material, is related to D1 by

15. Calculation of Absorbed Dose from Exposure
Absorbed Dose to Air :
In the presence of charged particle equilibrium (CPE), dose at a point in any medium is equal to the collision part of kerma.
Dair = ( Kcol )air = X · ( w/e )
Dair(rad) = ( rad/R) · X (R)

16. Calculation of Absorbed Dose from Exposure
Absorbed Dose to Any Medium :
Under CPE
Dmed / Dair = (men/r)med / (men/r )air · A
A = med / air
Dmed(rad) = fmed · X (R) · A
fmed : roentgen-to-rad conversion factor

17. Calculation of Absorbed Dose from Exposure
Absorbed Dose to Any Medium :

18. Calculation of Absorbed Dose from Exposure
Dose calculation with Ion Chamber In Air
For low-energy radiations, chamber wall are thick enough to provide CPE.
For high-energy radiation, Co-60, build-up cap + chamber wall to provide CPE.

19. Farmer Chamber

20. Parallel-Plate Chamber

21. Electrometer

22. Calculation of Absorbed Dose from Exposure
Dose calculation with Ion Chamber In Air
X = M · Nx ; D f.s. = ftissue· X · Aeq
Nx is the exposure calibration factor for the given chamber

23. Calculation of Absorbed Dose from Exposure
Dose Measurement from Exposure with Ion Chamber in a Medium
Dmed = M · Nx ·W/e ·[(men/r)med / (men/r)air] ·Am

24. The Bragg-Gray Cavity Theory
Limitations when calculate absorbed dose from exposure:
Photon only
In air only
Photon energy ＜3MeV
The Bragg-Gray cavity theory, on the other hand, may be used without such restrictions to calculate dose directly from ion chamber measurements in a medium

25. The Bragg-Gray Cavity Theory
Bragg-Gray theory
The ionization produced in a gas-filled cavity placed in a medium is related to the energy absorbed in the surrounding medium.
When the cavity is sufficiently small, electron fluence does not change.
Dmed / Dgas = ( S / r )med / ( S / r )gas
(S / r)med / (S / r)gas = mass stopping power ratio for the electron crossing the cavity

26. The Bragg-Gray Cavity Theory
Bragg-Gray theory
Dmed / Dgas = ( S / r )med / ( S / r )gas
Jgas : the ionization charge of one sign produced per unit mass of the cavity gas

27. The Bragg-Gray Cavity Theory
The Spencer-Attix formulation of the Bragg-Gray cavity theory
Φ(E) is the distribution of electron fluence in energy
L/r is the restricted mass collision stopping power with Δ as the cutoff energy

28. Effective Point of Measurement
Plane Parallel Chambers
at the inner surface of the proximal collecting plate
Cylindrical Chambers
Shift proximal to the chamber axis by
0.75r for an electron beam (TG-21)
0.5r for an electron beam (TG-25)
0.6r for photon beams, 0.5r for electron beams(TG-51)

29. CALIBRATION OF MEGAVOLTAGE BEAMS: TG-21 PROTOCOL

30. Cavity-Gas Calibration Factor (Ngas)
The AAPM TG-21 protocol for absorbed dose calibration introduced a factor (Ngas ) to represent calibration of the cavity gas in terms of absorbed dose to the gas in the chamber per unit charge or electrometer reading.
For an ionization chamber containing air in the cavity and exposed to a Go-60 g ray

31. Cavity-Gas Calibration Factor (Ngas)
Ngas is derived from Nx and
other chamber-related parameters, all determined for the calibration energy, e.g., Co-60

32. Cavity-Gas Calibration Factor (Ngas)
Once Ngas, is determined, the chamber can be used as a calibrated Bragg-Gray cavity to determine absorbed dose from photon and electron beams of any energy and in phantoms of any composition
Ngas, is unique to each ionization chamber, because it is related to the volume of the chamber

33. Cavity-Gas Calibration Factor (Ngas)
Nx = XM-1
Dgas = Jgas ( W/e )
Ngas = D gas Aion M-1
Assume Aion =1
Ngas = D gas M-1
D gas = M × ( W/e ) / (rair × Vc )
Ngas = ( W/e ) / (rair × Vc )
if the volume of the chamber is 0.6 cm3, its Ngas will be 4.73 × 107 Gy/C

34. Cavity-Gas Calibration Factor (Ngas)

35. Chamber as a Bragg-Gray Cavity
Photon Beams
Suppose the chamber, with its build-up cap removed (it is recommended not to use buildup cap for in-phantom dosimetry), is placed in a medium and irradiated by a photon beam of given energy

36. Chamber as a Bragg-Gray Cavity
Photon Beams
Dose to medium at point P corresponding to the center of the chamber will then be
P’ corresponding to the chamber's effective point of measurement

37. Chamber as a Bragg-Gray Cavity
Photon Beams
Pion
correction factor for ion recombination losses
Prepl
corrects for perturbation in the electron and photon fluences at point P as a result of insertion of the cavity in the medium
Pwall
accounts for perturbation caused by the wall being different from the medium

38. Chamber as a Bragg-Gray Cavity
Photon Beams
The AAPM values for Prepl and Pwall have been derived with the chamber irradiated under the conditions of transient electronic equilibrium (on the descending exponential part of the depth dose curve )

39. Chamber as a Bragg-Gray Cavity
Electron Beams
When a chamber, with its build-up cap removed, is placed in a medium and irradiated by an electron beam
usually assumed that the chamber wall does not introduce any perturbation of the electron fluence
thin-walled (≦0.5 mm) chambers composed of low atomic number materials (e.g., graphite, acrylic)
Pwall = 1

40. Chamber as a Bragg-Gray Cavity
Electron Beams
For an electron beam of mean energy Ez , at depth Z of measurement

41. Chamber as a Bragg-Gray Cavity
Electron Beams
Prepl
fluence correction
increases the fluence in the cavity since electron scattering out of the cavity is less than that expected in the intact medium
Gradient correction
Displacement in the effective point of measurement, which gives rise to a correction if the point of measurement is on the sloping part of the depth dose curve

42. Chamber as a Bragg-Gray Cavity
Electron Beams
Recommends that the electron beam calibration be made at the point of depth dose maximum
Because there is no dose gradient at that depth, the gradient correction is ignored
Prepl , then, constitutes only a fluence correction
for cylindrical chambers as a function of mean electron energy at the depth of measurement and the inner diameter of ion chamber

43. Chamber as a Bragg-Gray Cavity
Electron Beams
a depth ionization curve can be converted into a depth dose curve using A A A B B B

44. Chamber as a Bragg-Gray Cavity
Electron Beams
The gradient correction, however, is best handled by shifting the point of measurement toward the surface through a distance of 0.5r
For well designed plane-parallel chambers with adequate guard rings, both fluence and gradient corrections are ignored, i.e., Prep, = 1; the point of measurement is at the front surface of the cavity

45. Calibration Phantom
The TG-21 protocol recommends that calibrations be expressed in terms of dose to water
polystyrene, or acrylic phantoms may be used, but, requires that the dose calibration be reference to water
Scaling factors
SF = d plastic / d water = m water / m plastic

46. Calibration Phantom
A calibration phantom must provide at least 5 cm margin laterally beyond field borders
and at least 10 cm margin in depth beyond the point of measurement
Calibration depths for a megavoltage photon beams are recommended to be between 5- and 10-cm depth, depending on energy
For electron beams, the calibration depth recommended by TG-21 is the depth of dose maximum for the reference cone

47. 品保作業儀器設備
Monthly :
Keithley electrometer + NE Farmer chamber
Victoreen 530 electrometer + PTW N30001 Farmer chamber
Solid phantom : Acrylic, Polystyrene, and solid water
Sun Nuclear Daily QA 2
et al.

48. 品保作業儀器設備
Annual :
Keithley electrometer + NE Farmer chamber
Victoreen 530 electrometer + PTW N30001 Farmer chamber
Solid phantom : Acrylic, Polystyrene, and solid water
Sun Nuclear Daily QA 2
WellHoffer water phantom + IC 10 chamber
et al.

49. 品質保證計畫
醫用直線加速器
每月及年度品質保證作業
物理師執行

50. INTRODUCTION
AAPM TG-51 has recently developed a new protocol for the calibration of high-energy photon and electron beams used in radiation therapy. The formalism and the dosimetry procedures recommended in this protocol are based on the used of an ionization chamber calibrated in terms of absorbed dose-to-water in a standards laboratory’s Co-60 gamma ray beam. This is different from the recommendations given in the AAPM TG-21 protocol, which are based on an exposure calibration factor of an ionization chamber in a Co-60 beam. The purpose of this work is to compare the determination of absorbed dose-to-water in reference conditions in high-energy photon and electron beams following the recommendations given in the two protocols.

51. METHODS AND MATERIALS
Calibrations of photon beams ( nominal energy of 6 and 10 MV ) and electron beams ( nominal energy of 6, 8, 10, 12, 15 and 18 MeV ), generated by a Siemens KDS-2 linac, are performed.
Farmer-type ( NE 2571 ) ionization chamber was used for photon beam dosimetry and plane parallel ( PTW Markus ) chambers was used for electron beam dosimetry.
Absorbed-dose-to-water calibration factor, ND,w , and exposure calibration factor, Nx , for Farmer-type chamber were provided by NATIONAL RADIATION STANDARD LABORATORY INER.
Plane-parallel chamber was calibrated against calibrated cylindrical chamber in a 18 MeV electron beam, as recommended in TG-21, TG-39 and TG-51.
60Co

52. METHODS AND MATERIALS
ND,w = cGy/nC , expanded uncertainty = 1% ( k=2 ). Date of report : 2001/12/24, report No. : NRSL –
Nx = R/nC , expanded uncertainty = 1% ( k=2 ).
Date of report : 2001/10/17, report No. : NRSL –
Keithley electrometer and Nucleartron water phantom were used in this study.
The depth of clinical dosimetry for electron beams was performed at dref , dref = 0.6R50 – 0.1 ( cm ), as recommended in TG-51.
Depth ionization measurements along the central axis were made by using the Markus chamber and referenced to that of a 0.12 cm3 RK chamber mounted on the head of the machine.
60Co

53. RESULTS
60Co pp
60Co

54. RESULTS

55. RESULTS

56. RESULTS

57. RESULTS

58. RESULTS

59. RESULTS

60. RESULTS

61. Discussion and Conclusion
The doses at 10 cm in water for 6 MV and 10 MV photon beams and the doses at dref in water for 6 to 18 MeV electron beams determined with TG-51 and TG-21 are within 0.3% and 1.4% .
According to TG-51, P-P chambers must be used for reference dosimetry in electron beams of energies 6 MeV or less. In the meantime, NRSL provided ND,W factor for Farmer-type chamber only. So, the ND,W factor of a P-P chamber should be determined by using the cross calibrating method.
Measurements at the IAEA Dosimetry Lab. have shown that at Co-60, the absorbed dose to water determined by using the ND,W is about 1% higher than that by using the Nx. But, it is different in this study. Detailed analysis should be done including the data given in the two protocols and the calibration factors provided from air-kerma and absorbed dose to water.
Co-60
Co-60
Co-60