PMP. Use of Cylindrical Chambers as Substitutes for Parallel- Plate Chambers in Low-Energy Electron Dosimetry. Original Article.

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Original Article PMP Progress in Medical Physics 29(1), March 218 https://doi.org/1.14316/pmp.218.29.1.16 pissn 258-4445, eissn 258-4453 Use of Cylindrical Chambers as Substitutes for Parallel- Plate Chambers in Low-Energy Electron Dosimetry Minsoo Chun*, Hyun Joon An*, Seong-Hee Kang, Jin Dong Cho, Jong Min Park*,,,ΙΙ, Jung-in Kim*,, *Department of Radiation Oncology, Seoul National University Hospital, Seoul, Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Biomedical Research Institute, Seoul National University Hospital, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, ΙΙ Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Korea Received 28 February 218 Revised 28 March 218 Accepted 29 March 218 Corresponding author Jung-in Kim (madangin@gmail.com) Tel: 82-2-272-3573 Fax: 82-2-765-3317 Current dosimetry protocols recommend the use of parallel-plate chambers in electron dosimetry because the electron fluence perturbation can be effectively minimized. However, substitutable methods to calibrate and measure the electron output and energy with the widely used cylindrical chamber should be developed in case a parallel-plate chamber is unavailable. In this study, we measured the correction factors and absolute dose-to-water of electrons with energies of 4, 6, 9, 12, 16, and 2 MeV using Farmer-type and Roos chambers by varying the dose rates according to the AAPM TG-51 protocol. The ion recombination factor and absolute dose were found to be varied across the chamber types, energy, and dose rate, and these phenomena were remarkable at a low energy (), which was in good agreement with literature. While the ion recombination factor showed a difference across chamber types of less than.4%, the absolute dose differences between them were largest at at approximately 1.5%. We therefore found that the absolute dose with respect to the dose rate was strongly influenced by ion-collection efficiency. Although more rigorous validation with other types of chambers and protocols should be performed, the outcome of the study shows the feasibility of replacing the parallel-plate chamber with the cylindrical chamber in electron dosimetry. Keywords: Electron dosimetry, AAPM TG-51, Parallel plate chamber, Farmer chamber Introduction The various international dosimetry protocols have recommended the use of parallel plate ionization chamber in electron beam calibration, and especially in case of low energy electron (R 5 <4 g/cm 2 or <1 MeV). 1-4) This is mainly because the replacement correction factor was not well defined in cylindrical chamber, although several previous studies have reported about these issues but still controversial. 5-7) In electron dosimetry with parallel plate chamber, the replacement correction factor can be taken as unity due to the design of the parallel plate chamber consisting of thin-foiled entrance window and the airfilled cavity, which could effectively minimize the electron fluence perturbations. 8,9) However, there should be another substitute method to measure electron beam output and energy in case of unavailability of parallel plate chamber, or for the convenience of experimental set-up. This interchangeable approach could be done with widely-used cylindrical chamber, such as Farmer-type or thimble chamber, their cross calibration of course should be pre-verified. A Copyright 218 Korean Society of Medical Physics CC This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Progress in Medical Physics Vol. 29, No. 1, March 218 17 previous study has verified the temporal use of cylindrical chamber in the measurement of electron beam with International Atomic Energy Agency (IAEA), Technical Reports Series No. 398 (TRS-398) protocols, but those with American Association of Physicists in Medicine (AAPM) Task Group (TG)-51 protocol was not reported yet. 1) In this study, we measured the electron beams of six energies (4, 6, 9, 12, 16, and 2 MeV) according to AAPM TG-51 protocols with Farmer-type (TN 313, PTW- Freiburg, Freiburg, Germany) and Roos chamber (TN 341, PTW-Freiburg, Freiburg, Germany). By varying the dose rate, the impact of dose rate on electron dosimetry was rigorously investigated to validate its clinical appropriateness. Materials and Methods 1. Experimental setup Electron beams of six energies (4, 6, 9, 12, 16, and 2 MeV) were measured with a linear accelerator (Trilogy, Varian Medical Systems, Palo Alto, CA). Small one dimensional water phantom (WP1D Phantom, IBA Dosimetry, Schwarzenbruck, Germany) of 42 36 36 cm 3 was setup, and source-to-surface distance (SSD) was set to 1 cm. The 1 1 cone was used in accordance with an initial beam modeling. Two types of ion chambers,.6 cc Farmer chamber and.35 cc Roos chamber were used in this study as shown in Fig. 1. Their corresponding absorbed dose to water Co calibration factor ( N 6, ) were provided by the secondary D w standards dosimetry laboratories (SSDL) within an year. An UNIDOS-E electrometer (PTW-Freiburg, Freiburg, Germany) was used to read collected charge for each measurement. 2. Electron beam calibration and measurement All measurements in this study were performed according to AAPM TG-51 protocols as following Eq. (1) D W 6 Co D, w Mk N (1) Where, M and k denote fully corrected reading, and chamber-specific beam quality correction factor, respectively. The fully corrected reading M was acquired by multiplication of M raw with ion recombination factors (P ion ), polarization correction factor (P pol ), electrometer correction factor (P elec ), and corrections for standard environmental conditions (P TP ). All collection factors were obtained at reference depth P ion =.6 R 5.1 (cm) with respect to each energy regardless of chamber type. The P ion were measured by varying dose rate with 1, 3,, and 1 MU/min according to the Eq. (2), where V H be the normal operating voltage and V L be the bias reduced by the factor 2, and M raw * be the chamber reading for each bias. P pol was measured with reference dose-rate ( MU/min) where the reference dosimetry was being a b Fig. 1. Used ion chambers (a) Farmer-type chamber, and (b) Roos chamber.

18 Minsoo Chun, et al:cylindrical Chamber in Low Energy Electron Dosimetry performed. 1) P ion ( VH ) M H raw 1 V / M H L raw / VL V H / V Beam quality conversion factor (k ) was provided by Eq. (3), and acquired by chamber-specific manner. L (2) After all calibration and conversion factors were obtained, the measured dose was normalized by reference percent depth dose (PDD) at d ref to present the absolute dose at d max. The absolute differences in P ion and absolute dose were calculated, and their relationships were observed. k PgrkR 5 (3) Results where, P gr and k R indicates gradient correction factor for 5 cylindrical chamber and beam quality-dependent absolute dose calibration factor specified by R 5, respectively. The gradient correction factor for parallel-plate chamber is not necessary, and for cylindrical chamber, P gr was presented by a function of the radius of the chamber cavity, r cav, as following Eq. (4). P gr M raw( dref. 5rcav) M ( d ) (4) raw ref k R 5 was presented by the product of photon-electron conversion factor (k ecal ) and electron beam quality conversion factor ( k ' R5 ). k ecal was chamber-specific, and.896 for Farmber chamber, and.91 for Roos chamber in this study. k ' R was also provided according to the 5 chamber-type and beam quality (R 5 ) as shown in Eq. (5) and (6). k' R ( cyl) 71 5 ( R5 / 3.67).995. e (5).214 k' ( pp ) 1.2239.145( R ) R 5 5 (6) 1. Ion recombination factor Ion recombination factor according to the six electron energies and chamber types were provided in Table 1, and also the P ion differences between chambers were presented in Fig. 2(a) by 1 folds numerical value. The largest magnitude of P ion differences across two chambers were at 4, and 1 showing less than.4. P ion difference ( 1) according to the energy in certain dose rate were.43,.35,.23, and.26, for 1, 3,, and MU/min respectively. The closest differences in P ion across two chambers was acquired where the reference dosimetry was being performed ( MU/min). 2. Absolute dose to water The absolute dose with respect to each dose rate and energies were presented in Table 1, and dose difference across two chambers were provided in Fig. 2(b). The largest dose differences across two chambers were definitely observed at showing 1.497,.577,.336,.724, Table 1. Numerical values for ion recombination factor (P ion ), and dose according to the chamber-type, energy, and dose rate. Dose rate Ion recombination factor (P ion ) Dose (cgy) 1 2 MeV 1 2 MeV Farmer chamber 1 MU/min 1.6 1.12 1.9 1.9 1.8 1.1 1.355 1.8 99.676 99.735 99.661 99.72 3 MU/min 1.8 1.12 1.1 1.1 1.8 1.11 1.748 1.156 99.776 99.91 99.635 99.277 MU/min 1.7 1.11 1.1 1.1 1.8 1.1 1.799 1.154 99.875 1.32 99.79 99.174 MU/min 1.9 1.11 1.11 1.1 1.1 1.11 11.219 1.32 1.176 1.14 1.78 99.325 Roos chamber 1 MU/min 1.8 1.11 1.9 1.1 1.8 1.1 11.852 99.62 1.12 1.459 1.39 98.962 3 MU/min 1.9 1.1 1.9 1.11 1.9 1.11 12.6 99.579 1.12 1.539 1.196 99.283 MU/min 1.11 1.12 1.11 1.11 1.12 1.13 12.434 1.64 1.45 1.697 1.73 99.565 MU/min 1.9 1.12 1.1 1.9 1.11 1.12 12.222 1.64 1.327 1.496 1.623 99.441

i Progress in Medical Physics Vol. 29, No. 1, March 218 19 a Differences in on recombination factor ( P ion ).4.3.2.1..1.2.3.4 4MeV 6MeV Energy 1 MU/min 3 MU/min MU/min MU/min 9MeV 16MeV 2 MeV b Dose difference (cgy) 1..5..5 1. 1.5 2. 4MeV Energy 1 MU/min 3 MU/min MU/min MU/min 6MeV 9MeV 16MeV 2 MeV Fig. 2. Differences in (a) ion recombination factors (P ion ), and (b) dose across two different chamber types..681, and.229 for 4, 6, 9, 12, 16, and 2 MeV. Absolute dose difference according to the energy in certain dose rate were.394,.361,.454, and.328, for 1, 3,, and MU/min respectively. Although absolute dose difference in was relatively higher than those of energies equal or greater than, those with MU/ min were less than 1% while larger than 1.3% in other dose rate. By closely examining Eq (1). and other correction factors, the absolute dose to water could be determined by multiplication of the raw reading, P ion, P pol, P TP, P elec, k, Co and N 6,. Among them, the dose-rate dependent variables D w were raw reading and P ion, while other factors cannot influence the absolute dose to water by varying dose rate. Fig. 3 showed the impact of dose rate on the measurement of P ion, raw reading, and absolute dose across chambers. It can be showed that an almost linear patterns on absolute dose with respect to dose rate were mainly influenced by the collected charge not by P ion for both chambers. Discussion This study investigated the electron reference dosimetry with Farmer-type and Roos chamber, and the impact of dose rate on dosimetric parameters. Including AAPM TG- 51 and IAEA TRS-398 protocols, various studies have been made to verify the appropriateness of chamber types in electron dosimetry. Although other literatures have still argued about them, it is noticeable that they commonly recommended using parallel plate chamber in low electron energies rather than cylindrical chamber. 5,6,8,11) All acceptance with recommendations has been made, but substitutable methods should be prepared in case of unavailability of parallel plate chamber, such as with widely-used cylindrical chamber. The variations on ion recombination factor could reflect different extent of incomplete ion collection, and this discrepancy was dominant in as shown in Fig. 2(a). However, P ion difference on with MU/ min was relatively small, thus the dose difference could be minimized less than 1% by the selection of dose rate on calibration circumstances ( MU/min). The dose difference across chambers were higher especially in 4 MeV as shown in Fig. 2(b). The dose difference between two chambers were 1.32,.42,.22,.58,.54, and.6 cgy on averages, and 1.5,.58,.34,.72,.68, and.22 on maximum magnitude. The relatively large dose difference on across chamber types was shown, and this is mainly because of the appreciable perturbation in cylindrical chambers. Also necessities to extrapolate the beam quality factors in the energy range of R 5 less than 2 cm (<) could boost the dose difference relatively high. Because the other correction factors were acquired with fixed dose rate, the dose difference according to dose rate were only influenced by P ion and ion collection efficiency with respect to the different dose rate. These verification results could suggest that the reference elec tron dosimetry in even with Farmer chamber

2 Minsoo Chun, et al:cylindrical Chamber in Low Energy Electron Dosimetry a P ion 1.2 1.15 1 2 MeV b P ion 1.2 1.15 1 2 MeV 1.1 1.1 1.5 4 1.5 4 2.5 13. 2. M raw M raw 12.5 19.5 19. 4 1 2 MeV 12. 4 1 2 MeV Absolute dose (cgy) 12. 1. 98. 4 1 2 MeV Absolute dose (cgy) 12. 1. 98. 4 1 2 MeV Fig. 3. The impact of dose rate on dosimetric parameters with an order of ion recombination factor (P ion ), collected charge, and the absolute dose. Measurements with (a) Farmer-type chamber, and (b) Roos chamber. can be reached less than 1% difference with Roos chamber when the user measured the beam with dose-rate where the reference dosimetry were being performed. Ion collection efficiency was strongly influenced by the dose rate of the pulsed beam, which can be determined by both dose per pulse and pulse repetition frequency. 12) Lang et al. 12) investigated the impacts of dose per pulse in ion collection efficiency, and reported that the ion collection efficiency could be decreased by 6% at the maximum dose rate. Takei et al. 13) reported that influences of pulse repetition frequency in ion collection, and they claimed that there were decreases in the collected charge within 1% for electron dosimetry. By summarizing the previous studies, the ion collection efficiency can be influenced by the dose rate of the pulsed beam. As shown in Fig. 3, the graphs on middle row could present the linear pattern of collected charge by increasing the dose rate, which is consistent with the previous literatures. However, ion

Progress in Medical Physics Vol. 29, No. 1, March 218 21 recombination factor (P ion ) had no statistical founding with dose rate regardless of energy and chamber type. It can be interpreted that the different types of chamber could influence the P ion less than only.4%. Although we concluded that the usage of Farmer chamber in electron dosimetry could provide output difference less than 1% with dose-rate for reference dosimetry, this does not mean Farmer chamber could replace the parallel-plate chamber directly. For more accurate output measurement with Farmer chamber, the cross calibration between two chambers should be made in each clinic one by one. This can be regarded as our limitation of our study, and measurements with other combinations of parallel plate chambers should be preceded to generalize the use of cross factor such as Markus chamber, Advanced-Markus, and others. Also, there exists the necessity of more rigorous and wide experiments with IAEA TRS-398. While other feasibility studies of using cylindrical chamber in low energy electron dosimetry has been made infrequently, we believe that the combination and comparison between AAPM TG- 51 and IAEA TRS-398 protocols with Monte Carlo based simulations could effectively support the use of cylindrical chamber in electron beam dosimetry and thereby boost the convenience of the radiation quality assurance routine. 1) Nonetheless, our study results showed a possibility to use cylindrical chamber in low energy dosimetry with a medium dose rate. Conclusion We observed the close relationship between ion collection efficiency and absolute dose regardless of chamber type suggesting the proper selection of the dose rate could influence on electron dosimetry. The study results could suggest that the cylindrical chamber can be used in electron dosimetry with dose rate for reference dosimetry as a substitute of parallel plate chamber. Acknowledgements This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No.217M2A2A7A22641 and 217M2A2A7A22643). Conflicts of Interest The authors have nothing to disclose. Availability of Data and Materials All relevant data are within the paper and its Supporting Information files. References 1. Almond PR, Biggs PJ, Coursey BM, Hanson WF, Huq MS, Nath R, et al. AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams. Med Phys. 1999;26: 1847-7. 2. Andreo P, Burns D, Hohlfeld K, Huq MS, Kanai T, Laitano F, et al. Absorbed dose determination in external beam radiotherapy: an international code of practice for dosimetry based on standards of absorbed dose to water. IAEA TRS. ;398. 3. Party IW, Thwaites D, DuSautoy A, Jordan T, McEwen M, Nisbet A, et al. The IPEM code of practice for electron dosimetry for radiotherapy beams of initial energy from 4 to 25 MeV based on an absorbed dose to water calibration. Phys Med Biol. 3;48: 2929. 4. DIN 6-2. Procedures of dosimetry with probe type detectors for photon and electron radiation - Part 2: Ionization chamber dosimetry of high energy photon and electron radiation, Corrigendum to DIN 6-2:8-3; 8. 5. Gerbi BJ, Antolak JA, Deibel FC, Followill DS, Herman MG, Higgins PD, et al. Recommendations for clinical electron beam dosimetry: supplement to the recommendations of Task Group 25. Med Phys. 9;36: 3239-79. 6. Laitano RF, Guerra AS, Pimpinella M, Caporali C, Petrucci A. Charge collection efficiency in ionization chambers exposed to electron beams with high dose per pulse. Phys Med Biol. 6;51: 6419-36. 7. Piermattei A, Canne SD, Azario L, Russo A, Fidanzio A, Micelit R, et al. The saturation loss for plane parallel

22 Minsoo Chun, et al:cylindrical Chamber in Low Energy Electron Dosimetry ionization chambers at high dose per pulse values. Phys Med Biol. ;45: 1869-83. 8. Burns DT, McEwen MR. Ion recombination corrections for the NACP parallel-plate chamber in a pulsed electron beam. Phys Med Biol. 1998;43: 233-45. 9. Martisikova M, Ackermann B, Jakel O. Analysis of uncertainties in Gafchromic EBT film dosimetry of photon beams. Phys Med Biol. 8;53: 713-27. 1. Kim SH, Huh H, Choi SH, Choi J, Kim HJ, Lim C, Shin DO. The Study on the Use of a Cylindrical Ionization Chamber for the Calibration of a Electron Beam. Korean J Med Phys 9;2: 317-323. 11. Sathiyan S, Ravikumar M. Absolute dose determination in high-energy electron beams: Comparison of IAEA dosimetry protocols. J Med Phys India. 8;33: 18. 12. Lang S, Hrbacek J, Leong A et al. Ion-recombination correction for different ionization chambers in high dose rate flatteningfilterfree photon beams. Phys Med Biol 212;57: 2819 27. 13. Takei, Hideyuki, et al. General ion recombination effect in a liquid ionization chamber in high-dose-rate pulsed photon and electron beams. J Radiat Res. 218.