Purpose: To examine the dosimetric characteristics of Gafchromic EBT3 film when measuring small fields of radiation, and compare it against other common radiation detectors. Methods and Materials: EBT3 film was placed in a solid water phantom and irradiated with 6MV photons, field sizes from 10x10cm2 down to 6x6mm2. The films were scanned with a Vidar DosimetryPRO Advantage Red scanner, and analyzed with RIT113 software. The films were also scanned at different orientations and times to quantify the discrepancies associated with scanning orientation and post-exposure darkening. The same fields were measured with a PTW TN30013 farmer chamber, an Exradin T1 cylindrical ion chamber, a PTW parallel plate ion chamber, and a Sun Nuclear Edge Detector (diode). Output factors were calculated for each detector and compared for accuracy. The output factors were measured from a Varian Clinac iX, Clinac 21EX, Trilogy, and TrueBeam; as well as a Novalis Tx. The outputs from different machines at different clinics were compared. Results: The EBT3 film and Edge Detector were the only detectors that succeeded in accurately measuring the output from all field sizes; the ion chambers were too large and failed for field sizes below 4x4cm2 due to volume averaging. The dose measured with the film increased by an average of 8.8% after one week post-irradiation. The dose measured was also reduced by an average of 4.4% by scanning the film in landscape orientation, as opposed to portrait orientation. It was shown that the output factors for the smallest field of 6x6mm2--successfully measured with film and diode--varied between 0.54-0.74 for five different machines at three different clinics. Conclusions: The feasibility of using Gafchromic EBT3 film to measure very small fields of radiation is confirmed. Of the other 4 detectors used, only the diode was shown to be capable of accurately measuring small fields of radiation. The need to optimize the film dosimetry process--including the time films are scanned post-irradiation, the consistency of the scanning orientation of the calibration and subsequent films, and the measurement procedure on the computer software--is highlighted.

Chemical Vapour Deposition (CVD) diamond detectors were modelled for dosimetry of radiotherapy beams. This was achieved by employing the EGSnrc Monte Carlo (MC) method to investigate certain properties of the detector, such as size, shape and electrode materials. Simulations were carried out for a broad 6 MV photon beam, and water phantoms with both uniform and non-uniform voxel dimensions. A number of critical MC parameters were investigated for the development of a model that can simulate very small voxels. For a given number of histories (100 million), combinations of the following parameters were analyzed: cross section data, boundary crossing algorithm and the HOWFARLESS option, with the rest of the transport parameters being kept at default values. The MC model obtained with the optimized parameters was successfully validated against published data for a 1.25 MeV photon beam and CVD diamond detector with silver/carbon/silver structure with thicknesses of 0.07/0.2/0.07 cm for the electrode/detector/electrode, respectively. The interface phenomena were investigated for a 6 MV beam by simulating different electrode materials: aluminium, silver, copper and gold for perpendicular and parallel detector orientation with regards to the beam. The smallest interface phenomena were observed for parallel detector orientation with electrodes made of the lowest atomic number material, which was aluminium. The simulated percentage depth dose and beam profiles were compared with experimental data. The best agreement between simulation and measurement was achieved for the detector in parallel orientation and aluminium electrodes, with differences of approximately 1%. In summary, investigations related to the CVD diamond detector modelling revealed that the EGSnrc MC code is suitable for simulation of small size detectors. The simulation results are in good agreement with experimental data and the model can now be used to assist with the design and construction of prototype diamond detectors for clinical dosimetry. Future work will include investigating the detector response for different energies, small field sizes, different orientations other than perpendicular and parallel to the beam, and the influence of each electrode on the absorbed dose.

Chemical Vapour Deposition (CVD) diamond detectors were modelled for dosimetry of radiotherapy beams. This was achieved by employing the EGSnrc Monte Carlo (MC) method to investigate certain properties of the detector, such as size, shape and electrode materials. Simulations were carried out for a broad 6 MV photon beam, and water phantoms with both uniform and non-uniform voxel dimensions. A number of critical MC parameters were investigated for the development of a model that can simulate very small voxels. For a given number of histories (100 million), combinations of the following parameters were analyzed: cross section data, boundary crossing algorithm and the HOWFARLESS option, with the rest of the transport parameters being kept at default values. The MC model obtained with the optimized parameters was successfully validated against published data for a 1.25 MeV photon beam and CVD diamond detector with silver/carbon/silver structure with thicknesses of 0.07/0.2/0.07 cm for the electrode/detector/electrode, respectively. The interface phenomena were investigated for a 6 MV beam by simulating different electrode materials: aluminium, silver, copper and gold for perpendicular and parallel detector orientation with regards to the beam. The smallest interface phenomena were observed for parallel detector orientation with electrodes made of the lowest atomic number material, which was aluminium. The simulated percentage depth dose and beam profiles were compared with experimental data. The best agreement between simulation and measurement was achieved for the detector in parallel orientation and aluminium electrodes, with differences of approximately 1%. In summary, investigations related to the CVD diamond detector modelling revealed that the EGSnrc MC code is suitable for simulation of small size detectors. The simulation results are in good agreement with experimental data and the model can now be used to assist with the design and construction of prototype diamond detectors for clinical dosimetry. Future work will include investigating the detector response for different energies, small field sizes, different orientations other than perpendicular and parallel to the beam, and the influence of each electrode on the absorbed dose.

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The thesis aims to improve treatment dose accuracy in brachytherapy using a high dose rate (HDR) Ir-192 stepping source and in external beam therapy using intensity modulated radiation therapy (IMRT). For HDR brachytherapy, this has been achieved by investigating dose errors in the near field and the transit dose of the HDR brachytherapy stepping source. For IMRT, this study investigates the volume effect of detectors in the dosimetry of small fields, and the clinical implementation and dosimetric verification of a 6MV photon beam for IMRT. For the study of dose errors in the near field of an HDR brachytherapy stepping source, the dose rate at point P at 0.25 cm in water from the transverse bisector of a straight catheter was calculated with Monte Carlo code MCNP 4.A. The Monte Carlo (MC) results were used to compare with the results calculated with the Nucletron Brachytherapy Planning System (BPS) formalism. Using the MC calculated radial dose function and anisotropy function with the BPS formalism, 1% dose calculation accuracy can be achieved even in the near field with negligible extra demand on computation time. A video method was used to analyse the entrance, exit and the inter-dwell transit speed of the HDR stepping source for different path lengths and step sizes ranging from 2.5 mm to 995 mm. The transit speeds were found to be ranging from 54 to 467 mm/s. The results also show that the manufacturer has attempted to compensate for the effects of inter-dwell transit dose by reducing the actual dwell time of the source. A well-type chamber was used to determine the transit doses. Most of the measured dose differences between stationary and stationary plus inter-dwell source movement were within 2%. The small-field dosimetry study investigates the effect of detector size in the dosimetry of small fields and steep dose gradients with a particular emphasis on IMRT measurements. Due to the finite size of the detector, local discrepancies of more than 10 % are found between calculated cross profiles of intensity modulated beams and intensity modulated profiles measured with film. A method to correct for the spatial response of finite sized detectors and to obtain the

Two innovative radiotherapy (RT) approaches are under development at the ID17 Biomedical Beamline of the European Synchrotron Radiation Facility (ESRF): microbeam radiation therapy (MRT) and minibeam radiation therapy (MBRT). The two main distinct characteristics with respect to conventional RT are the use of submillimetric field sizes and spatial fractionation of the dose. This PhD work deals with different features related to small-field dosimetry involved in these techniques. Monte Carlo (MC) calculations and several experimental methods are used with this aim in mind. The core of this PhD Thesis consisted of the development and benchmarking of an MC-based computation engine for a treatment planning system devoted to MRT within the framework of the preparation of forthcoming MRT clinical trials. Additional achievements were the definition of safe MRT irradiation protocols, the assessment of scatter factors in MRT, the further improvement of the MRT therapeutic index by injecting a contrast agent into the tumour and the definition of a dosimetry protocol for preclinical trials in MBRT.

Radiotherapy is used in clinics to treat cancer with highly energetic ionizing particles. The radiation dose can be measured indirectly by means of radiation detectors or dosimeters. The dose deposited in a detector can be related to dose deposited in a point within the patient. In theory, however, this is only possible under charged particle equilibrium (CPE). The motivation behind the dissertation was driven by the difficult, yet crucial, dosimetry in non-CPE regions. Inaccurate dose assessment performed with standard dosimetry using ionization chambers may significantly impact the outcomes of radiotherapy treatments. Therefore, advanced dosimetry methods tailored specifically to suit non-CPE conditions must be used. This work aims to improve dosimetry in two types of non-CPE conditions that pose dosimetric challenges: regions near interfaces of tissues with low- and high- density media and in small photon fields. To achieve the main dissertation objectives, an enhanced film dosimetry protocol with a novel film calibration approach was implemented. This calibration method is based on the percent depth dose (PDD) tables and was shown to be efficient and accurate. As a result, the PDD calibration method was used for the film dosimetry process throughout the dissertation work. Monte Carlo (MC) calculations for the small field dosimetry were performed using phase-space files (PSFs) provided by Varian for TrueBeam linac. The MC statistical uncertainty in these types of calculations is limited by the number of particles (due to latent variance) in the used PSFs. This study investigated the behaviour of the latent variances (LV) with beam energy, depth in phantom, and calculation resolution (voxel size). LV was evaluated for standard 10x10 cm2 fields as well as small fields (down to 1.3 mm diameter). The results showed that in order to achieve sub-percent LV in open 10x10 cm2 field MC simulations a single PSF can be used, whereas for small SRS fields (1.3—10 mm) more PSFs (66—8 PSFs) would have to be summed. The first study in this dissertation compared the performance of several dosimetric methods in three multi-layer heterogeneous phantoms with water/air, water/lung, and water/steel interfaces irradiated with 6 and 18 MV photon beams. MC calculations were used, along with Acuros XB, anisotropic analytical algorithm (AAA), GafChromic EBT2 film, and MOSkin dosimeters. PDDs were calculated and measured in these heterogeneous phantoms. The result of this study showed that Acuros XB, AAA, and MC calculations were within 1% in the regions with CPE. At media interfaces and buildup regions, differences between Acuros XB and MC were in the range of +4.4% to -12.8%. MOSkin and EBT2 measurements agreed to MC calculations within ~ 2.5%-4.5%. AAA did not predict the backscatter dose from the high-density heterogeneity. For the third, multilayer lung phantom, 6 MV beam PDDs calculated by all treatment planning system (TPS) algorithms were within 2% of MC. 18 MV PDDs calculated by Acuros XB and AAA differed from MC by up to 3.2 and 6.8%, respectively. MOSkin and EBT2 each differed from MC by up to 3%. All dosimetric techniques, except AAA, agreed within 3% in the regions with particle equilibrium. Differences between the dosimetric techniques were larger for the 18 MV than the 6 MV beam. This study provided a comparative performance evaluation of several advanced dosimeters in heterogeneous phantoms. This combination of experimental and calculation dosimetry techniques was used for the first time to evaluate the dose near these interfaces. The second study in the dissertation aims to improve dose measurement accuracy in small radiotherapy fields. Field output factors of 6 MV beams from TrueBeam linear accelerator (linac) collimated with 1.27-40 mm diameter cones were calculated and measured using MC and EBT3 films. A set of detector specific correction factors for two widely used dosimeters (EFD-3G diode and PTW-60019 microDiamond detectors) were determined based on GafChromic EBT3 film measurements and calculated using MC methods. MC calculations were performed for microDiamond detector in parallel and perpendicular orientations relative to the beam axis. The result of this study showed that the measured OFs agreed within 2.4% for fields ≥10 mm. For the cones of 1.27, 2.46, and 3.77 mm diameter maximum differences were 17.9%, 1.8% and 9.0%, respectively. MC calculated OF in water agreed with those obtained using EBT3 film within 2.2% for all fields. MC calculated output correction factors for microDiamond detector in fields ≥10 mm ranged within 0.975-1.020 for perpendicular and parallel orientations. MicroDiamond detector correction factors calculated for the 1.27, 2.46 and 3.77 mm fields were 1.974, 1.139 and 0.982 with detector in parallel orientation, and these factors were 1.150, 0.925 and 0.914 in perpendicular orientation. EBT3 and MC obtained correction factors agreed within 3.7% for fields of ≥3.77 mm and within 5.9% for smaller cones. This work provided output correction factors for microDiamond and EFD-3G detectors in very small fields of 1.27 – 3.77 mm diameter and demonstrated over and under-response of these detectors in such fields. These correction factors allow improve the accuracy of dose measurements in small photon fields using these detectors. / Graduate / 2019-08-30