3D printing of air slab caps for correction free small field dosimetry. Benjamin Perrett, Paul Charles, Tim Markwell, Tanya Kairn, Scott Crowe

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Hector Mosley
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1 3D printing of air slab caps for correction free small field dosimetry Benjamin Perrett, Paul Charles, Tim Markwell, Tanya Kairn, Scott Crowe

range in the medium is greater than the distance from the centre to the edge of the field Field sizes less than ~30 mm considered

2 Small fields? Defined as fields sizes too small to achieve lateral electron equilibrium across the width of the field Equivalently, the electron range in the medium is greater than the distance from the centre to the edge of the field Field sizes less than ~30 mm considered small in a 6MV photon beam Dosimetry is challenging for small fields Want more information? Then read Charles et al. (2014) A practical and theoretical definition of very small field size for radiotherapy output factor measurements Med Phys 41:

is electronic disequilibrium So we use diode dosimeters: small active

3 Small field dosimetry Ionisation chambers are great for larger field sizes, but in smaller fields: the cavity volume is relatively large there is electronic disequilibrium So we use diode dosimeters: small active volume highly sensitive use an intermediate reference field (e.g. 3x3 or 5x5 sq. cm)

Diode dosimetry Diode dosimeters exhibit an overresponse that increases as field size decreases caused by density differences in the silicon active volume of the detector (with respect to water)

4 Diode dosimetry Diode dosimeters exhibit an overresponse that increases as field size decreases caused by density differences in the silicon active volume of the detector (with respect to water) Formalism to correct the over-response: f k clin f msr Qclin Q msr = D f clin w,q clin f D msr w,qmsr f /M clin Qclin f msr /MQmsr Requires values to be calculated for all field sizes and beam qualities used Want more information? Then read Scott et al. (2012) Characterizing the influence of detector density on dosimeter response in non-equilibrium small photon fields Phys Med Biol 57: Alfonso et al. (2008) A new formalism for reference dosimetry of small and nonstandard films Med Phys 35:

Air gaps An air gap upstream of the active volume of the detector introduces a field size dependent under-response in small fields Electronic disequilibrium is enhanced as electrons

(2012) The effect of very small air gaps on small field dosimetry Phys Med Biol 57: 6947-6960 Charles et al.

5 Air gaps An air gap upstream of the active volume of the detector introduces a field size dependent under-response in small fields Electronic disequilibrium is enhanced as electrons crossing the air gap have increased range Effect can be used to negate field size dependent detector over-response! Want more information? Then read Charles et al. (2012) The effect of very small air gaps on small field dosimetry Phys Med Biol 57: Charles et al. (2014) Design and experimental testing of air slab caps which convert commercial electron diodes into dual purpose, correction-free diodes for small field dosimetry Med Phys 41: Underwood et al. (2015) Validation of a prototype DiodeAir for small field dosimetry Phys Med Biol 60:

material, density close to water Can seal

6 3D printing Royal Brisbane & Women s Hospital had a filament-based 3D printer 3DTouch Heated print head extrudes a filament in layers onto a print Using ABS material, density close to water Can seal individual parts together using acetone (which evaporates)

Correction Factor Cap design Geometry was optimised using Monte Carlo simulaions EGSnrc cavity code Varied air gap size, with the effect of ABS material also modelled Correction factor plotted

7 Correction Factor Cap design Geometry was optimised using Monte Carlo simulaions EGSnrc cavity code Varied air gap size, with the effect of ABS material also modelled Correction factor plotted against several air gap sizes, for different field sizes Further simulations examined: density of extruded ABS ABS cap thickness air gap width (as opposed to depth) Air gap optimisation (sealed cap, water equivalent) Air Gap Size (mm) 5 mm 6 mm 7 mm 8 mm 9 mm 10 mm 20 mm 30 mm

(right), where the air gap was separated from the diode detector cavity printed in

8 Cap design 2 different designs were evaluated Unsealed (left), where the air gap was created by unfilled space at the end of the diode detector cavity Sealed (right), where the air gap was separated from the diode detector cavity printed in two parts, later bonded with acetone Cap designed for the IBA Stereotactic Field Diode (SFD)

9 Optimal air gap size Optimal air gap size ranges for 3D printed air caps Unsealed Unsealed(ABS) Sealed Sealed (ABS) Air Gap Size (mm)

10 Cap production Cap was modelled using Blender Converted to g-code using Axon software (made by 3DTouch vendors)

11 Cap verification Waterproof tests (checking for any change in mass after immersion in water) Dimensions evaluated using calipers and kv imaging (on the linac) magnified by placing cap on the exit window of kv beam errors observed (0.5mm)

Correction Factor Experimental verification Verified with Varian 21iX with Brainlab m3 mmlc attachment, in Sun Nuclear 3D scanner water tank Output ratios were measured for the SFD and for the

12 Correction Factor Experimental verification Verified with Varian 21iX with Brainlab m3 mmlc attachment, in Sun Nuclear 3D scanner water tank Output ratios were measured for the SFD and for the printed caps Naked SFD measurements agreed with simulated values Disagreement with caps in place: simulations suggested 3.3% (for 6mm field) measurements revealed 5.3% 6.9% Comparison of experimental and simulated output ratios Field Size (mm) SFD measured SFD simulated

Discussion Results Caps were overcorrecting equivalent to a 2mm air gap 1 likely

5mm air pocket at tip would introduce similar overcorrection density of cap not a

printed simultaneously Future work Purchased a stereolithographic printer, which has

13 Discussion Results Caps were overcorrecting equivalent to a 2mm air gap 1 likely cause air trapped between tip of detector and end of the cavity 0.5mm air pocket at tip would introduce similar overcorrection density of cap not a factor off-axis air gaps can be ignored Printing process was optimised multiple caps printed simultaneously Future work Purchased a stereolithographic printer, which has produced better prints Will adapt for other commercial diode detectors which will need larger air gap sizes

MEASUREMENT OF TMR AND PDD PROFILES IN SMALL FIELDS. SB Crowe, E Whittle, C Jones, T Kairn

MEASUREMENT OF TMR AND PDD PROFILES IN SMALL FIELDS SB Crowe, E Whittle, C Jones, T Kairn SMALL FIELD DOSIMETRY The measurement of small field tissue-maximum ratio (TMR) and percentage depth dose (PDD)