Dosimetry. Dr. Manfred Sassowsky Cantonal Hospital Lucerne (KSL) Institute for Radio-Oncology

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1 Kantonsspital Luzern Dosimetry Dr. Manfred Sassowsky Cantonal Hospital Lucerne (KSL) Institute for Radio-Oncology Introduction Metrological traceability; the dosimetry chain Absolute / relative dosimetry Ionisation chambers Thermoluminescent Detectors (TLD) Film dosimetry Portal dosimetry Small field dosimetry Dosimetry / / Dr. M. Sassowsky / KSL 1

2 Literature 1. E.B. Podgorsak (Technical Editor): Radiation Oncology Physics: A Handbook for Teachers and Students, IAEA, Vienna, 2005, ISBN , 2. TRS 398: Absorbed Dose Determination in External Beam Radiotherapy, IAEA, Vienna, H. Reich (Hrsg.): Dosimetrie ionisierender Strahlung, B.G. Teubner, Stuttgart, ISBN (out of print) 4. H. Krieger: Strahlenphysik, Dosimetrie und Strahlenschutz (2 volumes), B.G. Teubner, 2001, ISBN X and ISBN Recommendations of the Swiss Society of Radiobiology and Medical Physics ( Dosimetry / / Dr. M. Sassowsky / KSL 2

3 Introduction (1) Dosimetry = dose measurement - Dose, here: amount of radiation - Metrology: science and technique of measurement (... not to be confused with meteorology...) A dosimeter is a device that measures (directly or indirectly) - Exposure - Kerma - Absorbed dose - Equivalent dose - or other related quantities Dosimeter system = detector + reader (+ auxiliary equipment) e.g.: Ionisation chamber + electrometer + check source Dosimetry / / Dr. M. Sassowsky / KSL 3

4 Introduction (2) Absorbed dose is the deposited energy per mass: D = de dm SI unit is the gray (Gy): [ E] [ D] = [ m] = J = kg Gy 1 Gy = 1 J kg Dose rate ist the absorbed dose per unit of time: D = dd dt SI unit is the gray per second (Gy/s): [ D] = [ D] [ t] = Gy s Water is commonly used as reference material (Properties similar to tissue, availability, physical properties well defined) Dosimetry / / Dr. M. Sassowsky / KSL 4

5 Introduction (3) Ideally a dosimeter system should have the following properties: - High accuracy and reproducibility - Linearity of signal with dose - Adequate spatial resolution - Large dynamic range - Small dependence of signal on o Dose rate o Beam quality o Direction Not all requirements can be fulfilled by a single dosimeter system For a given application, the most suitable system must be chosen Dosimetry / / Dr. M. Sassowsky / KSL 5

6 Introduction (4) Accuracy: Reproducibility: Proximity of measured values to the true value Degree of agreement between repeated measurements Our Target : measure the true value Accuracy versus reproducibility: Reproducibility High High Low Low Accuracy High Low High Low Dosimetry / / Dr. M. Sassowsky / KSL 6

7 Introduction (5) The true value is not known Accuracy and reproducibility of a measurement are expressed by its Measurement uncertainty ISO standard Guide to the expression of uncertainty in measurement (GUM) - Procedure for characterizing the quality of a measurement - Generally accepted in many fields - Defines uncertainty as a quantifiable attribute of a measurement Dosimetry / / Dr. M. Sassowsky / KSL 7

8 Introduction (6) Ionising radiation can not be measured directly - - but only by its interaction with matter Different types of fundamental interactions have been treated in the lecture Basic radiation physics Dosimetry methods presented in this lecture: Methods... Physical effect... - Calorimetry Heating of water - Ionisation chambers Ionisation of air - TLDs Excitation of energy levels in crystals - Film dosimetry Ionisation of AgBr crystals in radiographic film Dosimetry / / Dr. M. Sassowsky / KSL 8

9 Metrological traceability:... What s that??? Dose prescription in PTV, e.g.: 30 2 Gy = 60 Gy How do you know that the delivered dose per fraction is indeed 2 Gy? The Linac displays MU (monitor units), this must be calibrated. How and against what? => Against a dosimeter (ionisation chamber) in a phantom This dosimeter must also be calibrated How and against what?... Dosimetry / / Dr. M. Sassowsky / KSL 9

10 Metrological traceability: The metrological Pyramid National standards Primary Secondary e.g. for MV photons: Water calorimeter Ionisation chambers METAS Sent to METAS for verification at least every 4 years Local reference standards Working standards Field instruments Dosimeter system Radio-oncology departments Traceability: The result of a measurement can be related to a (primary) standard through an unbroken chain of calibrations all having stated measurement uncertainties. Dosimetry / / Dr. M. Sassowsky / KSL 10

11 Metrological traceability: Intercomparisons Primary standards are compared internationally with other primary standards Interlaboratory comparisons with several participants or bilaterally Assure that the primary standards agree within their measurement uncertainties National dosimetry intercomparisons organised by SSRMP TLDs sent to radio oncology departments for irradiation Results evaluated centrally and published in anonymised form Dosimetry / / Dr. M. Sassowsky / KSL 11

12 Metrological traceability: Primary standards Measurement setups with highest metrological quality, lowest uncertainty Measurement results deduced from "first principles", or simple physical relations Can eventually be traced back to fundamental constants Can obviously not be calibrated (as they are supposed to serve as the origin in the metrological pyramid) Require significant time and effort; not suitable for clinical environment Examples: - Superficial X rays: parallel plate ionisation chamber - MV photon beams: water calorimeter - MV electron beams: Fricke dosimetry Dosimetry / / Dr. M. Sassowsky / KSL 12

13 Metrological traceability: Water calorimeter (1) Primary standard for MV photon beams Measures temperature increase caused by deposited energy D W = ΔT D W ΔT W c W k hd W c W 1 1 k hd = Absorbed dose to water = Measured temperature increase = Specific heat capacity of water = Correction for heat defect NTC Glass capillary Vessel with ultra-pure water and 2 miniature temperature probes NTC: temperature dependent resistance Measured with bridge circuit 0.25 mm 0.5 mm Connection wires Epoxy resin Insulation Dosimetry / / Dr. M. Sassowsky / KSL 13

14 Metrological traceability: Water calorimeter (2) Vessel embedded in water phantom Temperature stabilised at 4 o C (maximum density of water) Heat exchanger Thermal insulation (styrofoam) Pt100 temperature probes Air Glass vessel Thermistors Beam Water phantom Thermal insulation (styrofoam) Stirrer Heat exchanger Monitor chambers Monitor chambers Glass vessel Beam Dosimetry / / Dr. M. Sassowsky / KSL 14

15 Metrological traceability: Water calorimeter (3) One calorimeter run Note: ΔU 24 μv ΔT W 1.2 mk = o C Typical measurement series needs about 100 calorimeter runs Measurement uncertainty ( 60 Co): ΔD W /D W =0.41% (k=1) Bridge Brückenspannung voltage [μv] [μv] m 1, b U 2 = m 2 t + b 2 ΔU m 2, b U 1 = m 1 t + b Time Zeit [s] Dosimetry / / Dr. M. Sassowsky / KSL 15

16 Absolute / relative dosimetry Absolute dosimetry - Measurement of absolute dose at a reference point on the central ray of a beam - Accomplished using primary standards, secondary standards and local reference standards - Secondary and local reference standards: ionisation chambers Relative dosimetry - Measurement of dose relative to reference point o Depth dose curve on central ray of the beam o Transverse dose distributions in different depths Dosimetry / / Dr. M. Sassowsky / KSL 16

17 Ionisation chamber: Principle Cavity filled with gas (usually air) Two electrodes on HV (U) Beam ionises air molecules Charge separation in electric field Current (I) => Dose rate Charge (Q= I dt) => Dose Sensitive volume open to ambient air (p, T vary) Beam I U Variety of different shapes: Dosimetry / / Dr. M. Sassowsky / KSL 17

18 Ionisation chamber: Cylindrical (thimble) chamber Insulator Housing Outer electrode Central collecting electrode Most popular design Signal independent of radial beam direction Typical sizes: - Length: mm - Radius: mm - Volume: cm 3 Thin walls: ~0.1 g/cm 2 Used for photon and electron beams PTW Farmer chamber Dosimetry / / Dr. M. Sassowsky / KSL 18

19 Ionisation chamber: Parallel plate chamber Recommended for dosimetry of electron beams Useful for depth dose measurements Useful for measurements in build-up region of MV photon beams Cut A-B 1 Polarising electrode 2 Collectingelectrode 3 Guard ring PTW Roos chamber Dosimetry / / Dr. M. Sassowsky / KSL 19

20 Ionisation chamber: Used for brachytherapy sources (=> Lecture "Brachytherapy") High sensitivity Large volumes Can be designed to accommodate various source sizes Well type chamber Source holder Outer electrode Collecting electrode To electrometer PTW well type chamber Dosimetry / / Dr. M. Sassowsky / KSL 20

21 Ionisation chamber: Segmented chamber Many individual chambers arranged in an array Used to measure 2D dose distributions in a plane Application: IMRT quality assurance Dosimetry / / Dr. M. Sassowsky / KSL 21

22 Ionisation chamber: Electrometer Currents / charges to be measured are very low (Currents in the range of na; 1 na= 10-9 A) Device to measure such low currents / charges: electrometer Operational Amplifier with high input impedance Feedback with resistor for current measurement Feedback with capacitor for charge measurement I in U in - + R I in U out U = R out C I in - I in t = U out C + U in U out PTW Unidos E electrometer Dosimetry / / Dr. M. Sassowsky / KSL 22

23 Ionisation chamber: Dose determination D W, Q = NW, Q kq, Q C C M Q D W, Q N W, Q C k Q, Q C M Q = Absorbed dose to water at beam quality Q = Calibration factor at calibration beam quality Q c = Correction factor for (eventual) difference between Q and Q c = Corrected instrument reading at beam quality Q [ D W,Q ] [ N W, QC [ M Q ] = Gy Gy ] = C = C Favourable situation in CH: Q c very close to Q => k Q, Q C very close to 1 Dosimetry / / Dr. M. Sassowsky / KSL 23

24 Ionisation chamber: Correction factors M Q = M k Tp k S M Q = Corrected instrument reading at beam quality Q [ M Q ] = C k Tp = Air density correction factor k S = Ion recombination correction factor M = Uncorrected instrument reading at beam quality Q [M ] = C k Tp = p p 0 T T 0 p 0, T 0 p, T = Pressure and temperature at reference conditions = Pressure and temperature at measurement conditions [ 0 T0 p] = [ p ] = hpa ; [ T ] = [ ] = K Dosimetry / / Dr. M. Sassowsky / KSL 24

25 Ionisation chamber: Reference conditions (1) MV Photons: Temperature T 0 = K = 20 o C Pressure p 0 = hpa Relative humidity 50 % Beam quality Q C = TPR 20,10 (calibration) Source chamber distance 100 cm Depth in water (d) 5 cm ( 60 Co) 10 cm (MV Photons) Field size (50% isodose) 10 x 10 cm 2 at depth d SCD = 100 cm d Field size = cm 2 Dosimetry / / Dr. M. Sassowsky / KSL 25

26 Ionisation chamber: Reference conditions (2) Calibration beam qualities Q C available in CH for MV Photons Dosimetry / / Dr. M. Sassowsky / KSL 26

27 Ionisation chamber: Reference conditions (3) Electrons: SSD = 100 cm Temperature T 0 = K = 20 o C Pressure p 0 = hpa Relative humidity 50 % Beam quality Q C = R 50 (calibration) Source surface distance 100 cm d Field size = cm 2 Depth in water (d) d = 0.6 R gcm -2 Field size (50% isodose) 15 x 15 cm 2 at phantom surface Dosimetry / / Dr. M. Sassowsky / KSL 27

28 Ionisation chamber: Reference conditions (4) Calibration beam qualities Q C available in CH for MV Electrons Dosimetry / / Dr. M. Sassowsky / KSL 28

29 Ionisation chamber: Advantages / Disadvantages High accuracy and reproducibility Necessary correction factors well understood Instant readout Finite measurement volume Dosimetry / / Dr. M. Sassowsky / KSL 29

30 Thermoluminescent detectors (TLD) Principle (1) Upon absorption of radiation, some materials retain part of the absorbed energy in meta-stable states When this energy is subsequently released in the form of light, this phenomenon is called luminescence Light may be ultraviolet, visible or infrared depending on the material Two types of luminescence, distinguished by time delay between stimulation and emission of light: - Fluorescence: time delay s - Phosphorescence: time delay > 10-8 s Most commonly used materials in clinical dosimetry: -LiF:Mg,Ti - LiF:Mg,Cu,P -Li 2 B 4 O 7 :Mn Dosimetry / / Dr. M. Sassowsky / KSL 30

31 TLD: Principle (2) Irradiation Crystals contain impurities (type 1) They lead to meta-stable energy levels ( Storage traps ) Upon irradiation, electrons are shifted to conduction band They may either recombine directly or become trapped Readout Crystals contain impurities (type 2) They facilitate recombination of electrons with holes ( recombination centers ) Upon heating, electrons are shifted to conduction band They release light when they combine with a hole at the recombination center Conduction band Conduction band Ionising radiation Direct recombination Storage trap Heat Storage trap Recombination center Light emission Valence band Valence band Dosimetry / / Dr. M. Sassowsky / KSL 31

32 TLD: TLD reader Heater Photo-multiplier tube (PM) - detects light from TLD - converts it to an amplified electrical signal Electrometer records PM signal Display of signal vs. temperature: Glow curve Dose determined from area below peak - Calibration - Energy correction - Non-linearity correction - Fading Dosimetry / / Dr. M. Sassowsky / KSL 32

33 TLD: Applications In-vivo dosimetry Monitoring for radiation protection Dose distributions TLD intercomparisons organised by SSRMP Dosimetry / / Dr. M. Sassowsky / KSL 33

34 TLD: Advantages / disadvantages TLDs are available in various geometric shapes Can be made small in size => point dose measurements Many TLDs may be used in a single exposure Cheap No instant readout Readout time consuming Accurate results require careful calibration and handling, as well as significant time and effort Signal erased during readout Dosimetry / / Dr. M. Sassowsky / KSL 34

35 Film dosimetry: Radiographic film: Base layer covered with a sensitive emulsion of AgBr crystals in gelatine Irradiation: AgBr is ionised: Ag + ions are reduced to elementary Ag: Ag + + e - Ag Ag is black and forms a latent image Development: other Ag + ions in one crystal are reduced, if elementary Ag is present Fixation: rest of AgBr (in undeveloped grains) is washed away => Permanent image of dose distribution Principle Coating Emulsion (10 20 μm) Base (typ. 200 μm) Electron micrograph of AgBr grains in gelatine Typical size μm Dosimetry / / Dr. M. Sassowsky / KSL 35

36 Film dosimetry: Optical density Light transmission through the film is a function of the film opacity Can be measured in terms of Optical density (OD) with a densitometer Optical density is defined as: I0 I0 OD = log10 I I = Initial light intensity = Intensity transmitted through the film Relationship between dose and OD: - Not strictly linear - Depends on film and processing - Described by sensitometric curve - Must be established before use of film for dosimetry Dosimetry / / Dr. M. Sassowsky / KSL 36

37 Film dosimetry: Sensitometric curve Regions / parameters: OD Fog: OD of unexposed film Speed: exposure required to 7 produce an OD>1 over the fog Toe: transition to linear part 6 5 Shoulder Gamma: slope of the linear part 4 Latitude: range of exposures that fall in the linear part Shoulder: Saturation of OD for high exposures Fog Toe Linear part Exposure Dosimetry / / Dr. M. Sassowsky / KSL 37

38 Film dosimetry: Applications Portal imaging Qualitative dose measurements Quantitative dose measurements: need careful calibration, use and analysis Quality control of radiotherapy machines, e.g.: - Congruence of light and radiation fields - Dose profile at given depth in a phantom - Verification of treatment techniques in phantoms Dosimetry / / Dr. M. Sassowsky / KSL 38

39 Film dosimetry: Advantages / Disadvantages Film can be archived High 2D resolution Very thin: does not disturb beam Processing facilities (development, fixation) required Not trivial to achieve reproducible processing of the film Variation between films and production batches Quantitative dosimetry needs careful calibration Useful dose range of film is limited Energy dependence, in particular for lower photon energies Dosimetry / / Dr. M. Sassowsky / KSL 39

40 Film dosimetry: Radiochromic film More recent development: Radiochromic film Principle: contains dye that is polymerised and develops a blue color upon exposure to radiation Self-developing, requires neither development nor fixation Sensitometric curve must be measured with densitometer Advantages with respect to radiographic film: - No film processing => no quality control of film processing - Grain-less material => higher resolution - Can be used in regions with high dose gradients - Energy dependence less pronounced Disadvantage: less sensitive than radiographic film Dosimetry / / Dr. M. Sassowsky / KSL 40

41 Portal dosimetry Dose measurement / imaging in treatment beam - Verify treatment portals, compare with simulator radiographs - Verify patient setup Traditional method: film dosimetry using dedicated film types - Drawbacks: o Image quality poor compared to conventional X ray images o Requires time and effort o Offline evaluation More recent development and nowadays a standard: EPID = Electronic portal imaging device Dosimetry / / Dr. M. Sassowsky / KSL 41

42 Portal dosimetry EPID system consists of: Suitable radiation detector - Fluoroscopic detector - Segmented ionisation chamber - Amorphous silicon detector Data acquisition system to transfer detector information to a computer Software to process information and convert it to an image Dosimetry / / Dr. M. Sassowsky / KSL 42

43 Portal dosimetry Amorphous Silicon Detector Array of typ pixels Pixel pitch: typ. 0.8 mm Cut through one pixel: MV photon Beam Copper plate Typ. 500 columns Typ. 400 rows Light Phosphor a-si Photodiode Glass substrate FET transistors for readout Electron Dosimetry / / Dr. M. Sassowsky / KSL 43

44 Small field dosimetry Smallest standard photon fields have transverse field size down to approximately 4 x 4 cm 2 Certain advanced radiotherapy techniques use the superposition of multiple small fields, e.g. - IMRT - Stereotactic radiosurgery (see lectures Treatment planning systems, Special techniques ) Issues with small fields: - Penumbra regions overlap - Multiple steep gradients at individual field edges - Modelling in treatment planning systems - Dose measurement (small volumes / steep gradients) Dosimetry / / Dr. M. Sassowsky / KSL 44

45 Small field dosimetry Overlapping of penumbra regions Transverse dose profile (see lecture Beam production ) D rel (%) 100 D 0 50 Field size x Penumbra region Dosimetry / / Dr. M. Sassowsky / KSL 45

46 Small field dosimetry Overlapping of penumbra regions D rel (%) x Dosimetry / / Dr. M. Sassowsky / KSL 46

47 Small field dosimetry Overlapping of penumbra regions D rel (%) x Dosimetry / / Dr. M. Sassowsky / KSL 47

48 Small field dosimetry Overlapping of penumbra regions D rel (%) Slight reduction of output factor x Dosimetry / / Dr. M. Sassowsky / KSL 48

49 Small field dosimetry Overlapping of penumbra regions D rel (%) Significant reduction of output factor x Dosimetry / / Dr. M. Sassowsky / KSL 49

50 Small field dosimetry Dose measurement (small volumes / steep gradients) - Sensitive volume of detector should be small compared to field size - Positioning of detector - Disturbance of radiation field by detector - No secondary electron equilibrium in transverse field direction - No standard approach yet; ongoing investigations / research PTW pinpoint ionisation chamber V sens = 16 mm³ PTW silicon diode detector V sens : disc of 1mm 2 area PTW diamond detector V sens = 1 6 mm³ Dosimetry / / Dr. M. Sassowsky / KSL 50

51 Small field dosimetry Dose measurement in fluence modulated fields (IMRT): -Film - Segmented ionisation chamber Dosimetry / / Dr. M. Sassowsky / KSL 51

52 Small field dosimetry Dose measurement in fluence modulated fields (IMRT): Gamma method Dose Reference distribution Measured distribution γ = min ΔD ΔD 2 2 max + Δd Δd 2 2 max ΔD max Δd max Acceptance criteria ΔD max (e.g. 3 %) Δd max (e.g. 3 mm) γ < 1 => Position γ > 1 => Dosimetry / / Dr. M. Sassowsky / KSL 52

53 Small field dosimetry Dose measurement in fluence modulated fields (IMRT): Gamma method Dose Reference distribution Measured distribution ΔD max Δd max Position Dosimetry / / Dr. M. Sassowsky / KSL 53

54 Small field dosimetry Dose measurement in fluence modulated fields (IMRT): Gamma method Dose Reference distribution Measured distribution ΔD max Δd max Position Dosimetry / / Dr. M. Sassowsky / KSL 54

55 Small field dosimetry Dose measurement in fluence modulated fields (IMRT): Gamma method Dose Reference distribution Measured distribution ΔD max Δd max Position Dosimetry / / Dr. M. Sassowsky / KSL 55

56 The end... Thank you for your attention! Questions? Dosimetry / / Dr. M. Sassowsky / KSL 56

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