A - Dosimetry Calibration Reference Dosimetry

TABLE OF CONTENTS
IAEA/AFRA Training Course on Commissioning of Linear

Accelerators used in Radiotherapy
Algiers, Algeria 24-28 November 2007
Introduction
Ionization chamber based dosimetry
Determination of dose using calibrated chambers
Beam quality specification
Calibration of MV photon and electron beams
Error and uncertainty analysis for ionization chambers
Mehenna ARIB / SSDL Officer
IAEA
CRNA
Workshop on Commissioning of Linear accelerators used in Radiotherapy
INTRODUCTION
INTRODUCTION
Modern radiotherapy relies on accurate dose delivery to

the prescribed target volume.
ICRU recommends an overall accuracy in tumour dose

delivery of 5%, based on:
Accurate dose delivery to the target with external photon

or electron beams is governed by a chain consisting of
the following main links:
Basic output calibration of the beam
An analysis of dose response data.
Procedures for measuring the relative dose data.
An evaluation of errors in dose delivery in a clinical setting.
Equipment commissioning and quality assurance.
Considering all uncertainties involved in the dose delivery

to the patient, the 5% accuracy is by no means easy to
attain.
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Treatment planning
Patient set-up on the treatment machine.
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INTRODUCTION
INTRODUCTION
The basic output for a clinical beam is usually stated as:

Dose rate for a point P in
Machine basic output is usually given in:

Gy/min for kilovoltage x-ray generators and teletherapy units.
G/min or Gy/MU.
At a reference depth zref
Gy/MU for clinical linear accelerators.
(often the depth of dose

maximum zmax).
This should be determined

At a given distance from the source
In a water phantom for a

nominal source to surface
distance (SSD) or source
to axis distance (SAD).
and
For a given nominal collimator or applicator setting.
At a reference field size on

the phantom surface or the
isocentre (usually 10x10 cm2).
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INTRODUCTION
INTRODUCTION
The basic output calibration for photon and electron beams

is carried out with:
Basic output calibration of a clinical radiation beam, by

direct determination of dose or dose rate in water under
specific reference conditions, is referred to as reference
dosimetry.
Radiation dosimeters
Special dosimetry techniques.
Radiation dosimetry refers to a determination by measurement and/or calculation of Absorbed dose
Three types of reference dosimetry technique are known:

Calorimetry
at a given point in the medium.
Fricke (chemical, ferrous sulfate) dosimetry

Ionization chamber dosimetry
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INTRODUCTION
Calorimetry
INTRODUCTION
Calorimetry
Calorimetric dosimetry is the most fundamental of all

reference dosimetry techniques, since it relies on basic
definition of either electrical energy or temperature.
In principle, calorimetric dosimetry (calorimetry) is simple.
Main characteristics of calorimetic dosimetry:

Energy imparted to matter by radiation produces an increase in
temperature
thermistors.
T which is measured with thermocouples or
In practice, calorimetric dosimetry is very complex because of

the need for measuring very small temperature differences.
This complexity relegates the calorimetry to sophisticated

standards laboratories.
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INTRODUCTION
Calorimetry
INTRODUCTION
Fricke (chemical) dosimetry
The following simple relationship holds:

D=
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Ionizing radiation absorbed in certain media produces

a chemical change in the media and the amount of this
chemical change in the absorbing medium may be
used as a measure of absorbed dose.
Cp T
dE
=
dm 1
D is the average dose in the sensitive volume

Cp is the thermal capacity of the sensitive volume
is the thermal defect
T is the temperature increase
The best known chemical radiation dosimeter is the

Fricke dosimeter which relies on oxidation of ferrous
ions (Fe 2+ )into ferric ions (Fe3+ ) in an irradiated ferrous
sulfate FeSO4 solution.
Note: T(water, 1 Gy) = 2.4 10 4 K
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INTRODUCTION
INTRODUCTION
Average absorbed dose in a Fricke solution is given as:

M
(O.D.)
D=
=
= 278(O.D.)
G(Fe3+ ) l G(Fe 3+ )
M

3+
is the change in molar concentration of Fe .
is the density of the Fricke solution.
(O.D.) is the increase in optical density after irradiation.

is the extinction coefficient.
l
is the thickness of the solution.
molecule/100 eV
Photon beams (ICRU 14)
Cs-137
2 MV
Co-60
4 MV
5 MV to 10 MV
11 MV to 30 MV
1 MeV to 30 MeV 15.7

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INTRODUCTION
INTRODUCTION
Ionization chamber is the most practical and most widely

used type of dosimeter for accurate measurement of
machine output in radiotherapy.
Measured charge Q and sensitive air mass mair are

related to absorbed dose in air Dair by:
Dair =
It may be used as an absolute or relative dosimeter.

Its sensitive volume is usually filled with ambient air and:
Q W air
mair e
W air /e is the mean energy required to produce an ion pair in

air per unit charge e.
The dose related measured quantity is charge Q,

The dose rate related measured quantity is current I,
Currently, the value of W air /e for dry air is 33.97 eV/ion pair or
produced by radiation in the chamber sensitive volume.
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15.3
15.4
15.5
15.5
15.6
15.7
Electron beams (ICRU 35)
G(Fe3+ ) is the chemical yield of Fe3+ in mole/J.
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Recommended G-values in
33.97 J/C.
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INTRODUCTION
Reference dosimetry with ionization chambers
The subsequent conversion of the air cavity dose

Dair to dose to medium (usually water) Dw is
based on:
Bragg-Gray cavity theory
Clinical photon and electron beams are most commonly

calibrated with ionization chambers that:
Are used as relative dosimeters.
Have calibration coefficients determined either in air or in water
and are traceable to a national primary standards dosimetry
laboratory (PSDL).
Spencer-Attix cavity theory
Dmed = Dair smed,air
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Traceability of chamber calibration coefficient to a national

PSDL implies that:
1. Either the chamber was calibrated directly at the PSDL in terms of:
Air kerma in air
Absorbed dose in water
Dosimetry protocols or codes of practice state the

procedures to be followed when calibrating a clinical
photon or electron beam.
Choice of which protocol to use is left to individual
2. Or the chamber was calibrated directly at an accredited dosimetry

calibration laboratory (ADCL) or at secondary standards dosimetry
laboratory (SSDL) that traces its calibration to a PSDL.
4. Or the chamber calibration coefficient was obtained through a
cross-calibration with another ionization chamber, the calibration
coefficient of which was measured directly at a PSDL, an ADCL or
an SSDL.
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radiotherapy departments or jurisdictions.
Dosimetry protocols are generally issued by national,

regional, or international organizations.
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IONIZATION CHAMBER BASED DOSIMETRY SYSTEMS
Ionization chambers
Examples of typical
ionization chambers:
(a) Cylindrical chambers
used for relative dosimetry.
(b) Pinpoint mini-chamber
and Co-60 buildup cap.
(c) Farmer type cylindrical
chamber and cobalt-60
buildup cap.
(d) Parallel-plate Roos type
electron beam chamber.
1987
NK - based IAEA
TRS 277
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1997
update of
TRS-277
2000
1997
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TRS-381
ND,w - based IAEA

TRS
398
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USE OF CALIBRATED IONIZATION CHAMBERS
Air kerma based protocols
Air kerma based protocols use the air kerma in air calibration coefficient NK,Co obtained for a local reference
ionization chamber in a cobalt-60 beam at a standards
laboratory.
Two steps are involved in air kerma based protocols for

calibration of megavoltage photon and electron beams.
The cavity air calibration coefficient ND,air is determined from the
air kerma in air calibration coefficient NK,Co.
Absorbed dose to water is determined using the Bragg-Gray

relationship in conjunction with the chamber signal MQ and the
cavity air calibration coefficient ND,air.
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Calibration in a cobalt-60 beam at standards laboratory:

Absorbed dose to air in the cavity Dair,Co is determined from
the total air kerma in air (Kair)air as follows:
Dair,Co = (K air )air (1 g ) km katt kcel

g
km
katt
kcel
is the radiative fraction, i.e., the fraction of the total transferred

energy expended in radiation interactions on slowing down of
the secondary electrons in air.
corrects for the non-air equivalence of the chamber wall and
buildup cap needed for an air kerma in air measurement.
corrects for attenuation and scatter in the chamber wall.
corrects for non-air equivalence of chamber central electrode.
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Under these special conditions, according to the B-G

cavity theory, the dose to the medium Dmed is related to
the dose to the cavity Dcav as:
Dmed = Dcav (S / )med,cav
(S/ )med,cav is the ratio of the average unrestricted mass
collision stopping powers medium to cavity.
The Spencer-Attix (S-A) cavity theory is more general

and accounts for creation of secondary (delta) electrons.
The dose to medium is given as:
Dmed = Dcav (smed.cav )
With a known value of the cavity air calibration coefficient ND,air for a
specific chamber, the chamber signal corrected for influence quantities
MQ at a point in phantom allows determination of absorbed dose to
water Dw,Q:
Dw,Q = Dair,Q (sw,air )Q pQ = MQ ND,air (sw,air )Q pQ
Dw,Q = MQ NK (1 g ) km katt kcel (sw,air )Q ( pdis pwall pcel pcav )Q

(sw,air )Q is the ratio of average restricted collision stopping powers
of water to air for a radiation beam of quality Q.
is the perturbation correction factor which corrects for
effects that cause deviations from Bragg-Gray behaviour:
pQ
(smed.cav )
is the ratio of the average restricted mass collision

stopping powers medium to cavity.
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Absorbed dose to water based protocols
DETERMINATION OF
ABSORBED DOSE TO WATER
Calibration in a cobalt-60 beam at standards laboratory:
Using ND,w (TRS 298)
Recent developments have provided support for a

change in the quantity used to calibrate ionization
chambers and provide calibration coefficients ND,w,Q in
o
terms of absorbed dose to water at beam quality Qo .
at the calibration quality Qo:
Dw,Qo =MQo ND,w,Qo
At standards laboratory Dw,Q , absorbed dose to water at

o
the reference depth zref in water for a reference beam

Qo (usually cobalt-60) is known and used to determine
the water dose calibration coefficient ND,w,Q .
at any other user quality Q:
Dw,Q=MQ ND,w,Qo kQ,Qo
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beam
quality
factor
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Steps in the determination of Dw at the reference point using the NK ND,air formalism and the ND,w - formalism

Photon beams
(1)
(2 )
(3 )
Kair,Qo
NK ,Qo
ND ,air,Q =
o
(4 )
(5 )
kQ,Qo is given as a function of a quality index

TPR20,10
Dw,Qo
Kair,Qo
MQo
ND,w,Qo =
Dw,Qo
MQo
Dair,Qo
MQo
= NK ,Qo ( 1 - g ) katt km kcel
Need to experimentally determine

TPR20,10
ND,air,Q = ND,air,Qo
Dw,Q = Dair,Q ( sw,air )Q pQ
6 Dw,Q = MQ ND,air (sw,air )Q pQ
Dw,Q = MQ ND,w,Qo k Q,Qo

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Beam quality factor

Andreo Phys Med Biol 45 (2000)
Why TPR20,10 ?
1.01
NE 2571
1.00
Co-60
0.99
kQ
0.98
LPRI (Delaunay)
0.97
Palm
NPL (Sharpe)
NRC soft (Seuntjens)
0.96
(BEL) Palmans
ENEA (Guerra)
PTB (Shortt)
0.95
Andreo et al (IAEA CoP 2000)

NRC soft (Shortt)
NRC soft (Ross)
0.94
fit to all experimental data

NRC hard (Ross)
0.93
0.55
0.60
0.65
0.70
0.75
0.80
0.85
photon beam quality (TPR20,10)

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Beam quality factor
Beam quality factor
1.01
1.01
1.00
0.99
0.99
0.98
0.98
kQ
kQ
PR-06C
PTW 30001
1.00
0.97
0.97
PTB (Short)
0.96
0.96
NRC soft (Ross)

Palm
0.95
0.95
Palm
0.94
0.93
0.55
0.94

fit to all experimental data excl NRC high-E soft
0.60
Vanitsky
NRC soft (Shortt)
ENEA (Guerra)
Vatnitsky
0.65

NRC hard (Ross)
fit to all experimental data
0.70
0.75
0.80
0.93
0.55
0.85
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0.60
0.65
0.70
0.75
0.80
0.85
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Beam Quality: determination of TPR20,10
photon beams (High energy X-rays)

TPR20,10 is given by a ratio of dose (ionization) at two
depths, for constant SCD,
(independent of electron contamination)
M 10
SCD
100 cm
M 20
20 g/cm2
Attenuation property
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TPR20,10 =
10 g/cm2
D20 M20
D10 M10
10 cm x 10 cm
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Cross-calibration of field ionization chambers
Beam Quality: determination of TPR20,10
M 10
SSD
100 cm
M 20
10 cm x 10 cm
PDD20,10 =
D20 M20
D10 M10
10 g/cm2
TPR20,10
20 g/cm2
= 1.2661PDD20,10 - 0.0595
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ref
N Dfield
,w = N D,w
M ref
M field
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Electron beams
Electron beams
The beam quality index is the half-value depth in water R50. This is
the depth in water (in g/cm2) at which the absorbed dose is 50% of
its value at the absorbed dose maximum.
SSD = 100 cm
Field size at the phantom surface of at least 10 cm 10 cm for
R50 7 g/cm2 and at least 20 cm 20 cm for R50 > 7 g/cm2
The choice of R50 as the beam quality index is a change from the
current practice of specifying beam quality in terms of the mean
energy at the phantom surface Eo.
As Eo = f(R50), this change in beam quality index is merely a
simplification which avoids the need for a conversion to energy.
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R50 = 1.029 R50,ion - 0.06 g/cm2
(R50,ion 10 g/cm2)
R50 = 1.059 R50,ion - 0.37 g/cm2
(R50,ion 10 g/cm2)
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Beam quality factor
Electron beams
Electron beams
Plane parallel chamber
cylindrical chamber
This depth has been shown to reduce significantly the influence of

spectral differences between different accelerators as well as that of
electron and photon contamination in clinical electron beams.
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Cross Calibration of Ionisation Chambers

Problem: the water absorbed dose has to be determined in a beam with
R50 4 g/cm2.
the Co-60 calibration factor of the plane-parallel chamber is
not sufficiently reliable
cylindrical chamber

@ Zref
Zref
Solution: Cross-calibration of the user plane-parallel chamber by direct

comparison against a cylindrical reference chamber calibrated
in a Co-60 gamma radiation
N Dx ,w ,Qcross =
MQrefcross x
N D ,w ,Q kQrefcross ,Q
MQxcross
0
The highest energy electron beam available should be used;

R50 > 7 g/cm2 (Eo 16 MeV) is recommended
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Experimental determination Dw (TRS 398)

Photon beams
Dw ,Q = M Qx N Dx ,w ,Qcross k Qx ,Qcross
k Qx ,Qcross =
k Qx ,Q
int
k Qxcross ,Q
int
kQ,Qcross(R50) are determined from Table 19 (TRS398)

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Photon beams
REFERENCE CONDITIONS FOR DE-TERMINATION OF

DW IN HIGH-ENERGY PHOTONS
Influence quantity
Reference value or reference characteristics
Phantom material
water
Chamber type
cylindrical
Measurement depth zref
for TPR20,10 < 0.7, 10 g/cm2 (or 5 g/cm2)
Reference point of chamber
on central axis at centre of the cavity volume
Position of reference
point of chamber
SSD / SCD
at the measurement depth zref

100 cm
Field size
10 cm x 10 cm
for TPR20,10 0.7, 10 g/cm2
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REFERENCE CONDITIONS FOR DETERMINATION OF

DW IN HIGH-ENERGY ELECTRONS
Determination of absorbed dose to water
Reference conditions are the same as with the determination of R50
Dw,Q (Zref) =MQ ND,w,Qo kQ,Qo
PHOTONS
Positioning the chamber at reference depth
zref = 0.6 R50 0.1 g/cm2 (R50 in g/cm2)
Dw ,Q ( Zref ) = MQx NDx ,w ,Qcross kQx ,Qcross
ELECTRONS
Zref
Absorbed dose at zmax

D(zmax) determined from PDD or TMR distribution
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SSD
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Note: zref may beWorkshop
deeper on
than
zmax, cavityofperturbation
for cyl
chamber
may then be larger
Commissioning
Linear accelerators
used
in Radiotherapy
IAEA
Stabilization time for ionization chambers
( 273.2+T) Po T0 =20 C
kTP =
( 273.2+To ) P P0 =101.325kPa
1.000
0.999
M+ + M
2M
M
M
ps = ao + a1 1 + a2 1
M
2
M2
Recombination (not all charge

produced is collected)
IAEA TECDOC in press
1.001
Q/Qmax
kpol =
Polarity effect
0.998
0.997
WDIC70 # 141
0.996
WDIC70 # 039
PTW 30001 # 1245
0.995
NACP02 # 33.11
NE 2611 # 149
0.994
0
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10
15
20
25
Time (min)
M1 V1 , M2 V2
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PRACTICAL CONSIDERATIONS (2)
Stabilization time for a chamber and electrometer
Temperature measurements in air and in water
1.005
I
nw
IAEA TECDOC 1455

1.003
Q/Qmax
SAD
Corrections to the dosimeter reading, MQ

Temperature and pressure
Dmax = Dw TMR ( Z ref )
Dmax = Dw PDD ( Z ref )
cylindrical chamber
at e
r ?
1.001
ree
F
ir ?
in a
0.999
0.997
0.995
0
10
20
30
40
50
60
In
e
sle
?
ve
I
nc
avit
yc
ham
ber
?
Time (min)
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Temperature measurements in air and in water
Phantom window bowing
filling
removing
3
TG51 PHANTOM
deflection (mm)
2.5
IAEA TECDOC 1455
2
1.5
1
0.5
0
-9
-4
1
Distance to the center of the window (cm)
-14
filling
removing
0.07
IAEA CUBIC PHANTOM

0.06
Deflection mm
0.05
0.04
0.03
0.02
0.01
0
-2
10
12
14
Distance to the center of the window (cm)
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Use of IAEA Worksheet (HE x-rays)

Effect of waterproofing sleeve thickness
Use the same sleeve used for chamber calibration

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Use of IAEA Worksheet (HE electrons)
These worksheets are available at:

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http://www-naweb.iaea.org/nahu/dmrp/codeofpractice.shtm
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Estimated uncertainty in Dw (HE X-rays) (Q0 = 60Co

Physical quantity or procedure
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Estimated uncertainty in Dw (HE electrons) (Q0 = 60Co)

User chamber
type :
Relative stand. uncertainty (%) Cyl

PP
Rel. std uncertainty (%)

Step 1: Standards laboratory
Step 1: Standards Laboratory

ND,w calibration of secondary standard at PSDL
Long term stability of secondary standard
ND,w calibration of the user dosimeter at the standard laboratory
Combined uncertainty of Step 1
0.5
0.1
0.4
0.6
ND,w calibration of secondary standard at PSDL
0.5
Long term stability of secondary standard
0.1
0.1
ND,w calibration of user dosimeter at SSDL
0.4
0.4
0.6
0.6
Combined uncertainty of step 1b
0.5
Step 2: User electron beam
Step 2: User high-energy photon beam

Long-term stability of user dosimeter
Establishment of reference conditions
Dosimeter reading MQ relative to beam monitor
Correction for influence quantities ki
Beam quality correction MQ (calculated values)
Combined uncertainty of Step 2
0.3
0.4
0.6
0.4
1.0
1.4
Combined standard uncertainty of Dw,Q (steps 1+2)
1.5
0.3
0.4
0.4
0.6
0.6
0.6
0.4
0.5
Beam quality correction kQ (calculated values)
1.2
1.7
Combined uncertainty of step 2

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Long term stability of user dosimeter
1.5
2.0
1.6
2.1
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Estimated uncertainty in Dw (HE electrons) (Q0 = electrons)

Relative standard uncertainty (%)
User chamber type:
Cyl
PP
0.7
0.7
0.7
0.7
0.3
0.4
Step 1: PSDL
ND,w calibration of user dosimeter at PSDL
Combined uncertainty in step 1
THANK YOU FOR YOUR

ATTENTION
Step 2: User electron beam

Long term stability of user dosimeter
0.4
0.6
0.6
0.6
0.4
0.5
Beam quality correction kQ,Qo (calculated values)
0.9
0.6
Combined uncertainty in step 2

1.3
1.2
1.4
1.4
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TABLE OF CONTENTS

IAEA/AFRA Training Course on Commissioning of Linear

Mehenna ARIB / SSDL Officer

Modern radiotherapy relies on accurate dose delivery to

ICRU recommends an overall accuracy in tumour dose

Accurate dose delivery to the target with external photon

An analysis of dose response data.

Procedures for measuring the relative dose data.

An evaluation of errors in dose delivery in a clinical setting.

Equipment commissioning and quality assurance.

Considering all uncertainties involved in the dose delivery

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Workshop on Commissioning of Linear accelerators used in Radiotherapy

The basic output for a clinical beam is usually stated as:

Machine basic output is usually given in:

At a reference depth zref

Gy/MU for clinical linear accelerators.

(often the depth of dose

This should be determined

In a water phantom for a

For a given nominal collimator or applicator setting.

At a reference field size on

The basic output calibration for photon and electron beams

Basic output calibration of a clinical radiation beam, by

Radiation dosimetry refers to a determination by measurement and/or calculation of Absorbed dose

Three types of reference dosimetry technique are known:

at a given point in the medium.

Fricke (chemical, ferrous sulfate) dosimetry

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Calorimetric dosimetry is the most fundamental of all

Main characteristics of calorimetic dosimetry:

T which is measured with thermocouples or

In practice, calorimetric dosimetry is very complex because of

This complexity relegates the calorimetry to sophisticated

Workshop on Commissioning of Linear accelerators used in Radiotherapy

The following simple relationship holds:

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Ionizing radiation absorbed in certain media produces

D is the average dose in the sensitive volume

The best known chemical radiation dosimeter is the

Note: T(water, 1 Gy) = 2.4 10 4 K

Average absorbed dose in a Fricke solution is given as:

is the density of the Fricke solution.

(O.D.) is the increase in optical density after irradiation.

is the thickness of the solution.

1 MeV to 30 MeV 15.7

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Ionization chamber is the most practical and most widely

Measured charge Q and sensitive air mass mair are

It may be used as an absolute or relative dosimeter.

W air /e is the mean energy required to produce an ion pair in

The dose related measured quantity is charge Q,

produced by radiation in the chamber sensitive volume.

Electron beams (ICRU 35)

G(Fe3+ ) is the chemical yield of Fe3+ in mole/J.

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Workshop on Commissioning of Linear accelerators used in Radiotherapy

Reference dosimetry with ionization chambers

The subsequent conversion of the air cavity dose

Clinical photon and electron beams are most commonly

Spencer-Attix cavity theory