Dynamic intensity-modulated radiotherapy (D-IMRT) using the slidingwindow technique is currently applied for selected treatments of head and neck cancer at Institute for Cancer Research and Treatment of Candiolo (Turin, Italy). In the present work, a PiXel-segmented ionization Chamber (PXC) has been used for the verification of 19 fields used for four different head and neck cancers. The device consists of a 32 × 32 matrix of 1024 parallel-plate ionization chambers arranged in a square of 24 × 24 cm 2 area. Each chamber has 0.4 cm diameter and 0.55 cm height; a distance of 0.75 cm separates the centre of adjacent chambers. The sensitive volume of each single ionization chamber is 0.07 cm 3 . Each of the 1024 independent ionization chambers is read out with a custom microelectronics chip.The output factors in water obtained with the PXC at a depth of 10 cm were compared to other detectors and the maximum difference was 1.9% for field sizes down to 3 × 3 cm 2 . Beam profiles for different field dimensions were measured with the PXC and two other types of ionization chambers; the maximum distance to agreement (DTA) in the 20-80% penumbra region of a 3 × 3 cm 2 field was 0.09 cm. The leaf speed of the multileaf collimator was varied between 0.07 and 2 cm s −1 and the detector response was constant to better than 0.6%. The behaviour of the PXC was measured while varying the dose rate between 0.21 and 1.21 Gy min −1 ; the mean difference was 0.50% and the maximum difference was 0.96%. Using fields obtained with an enhanced dynamic wedge and a staircase-like (step) IMRT field, the PXC has been tested for simple 1D modulated beams; comparison with film gave a maximum DTA of 0.12 cm. The PXC was then used to check four different IMRT plans for head and neck cancer treatment: cervical chordoma, parotid, ethmoid and skull base. In the comparison of the PXC versus film and PXC versus treatment planning system, the number of pixels with γ parameter 1 was 97.7% and 97.6%, respectively.

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A comparison of the air kerma standards for x-radiation qualities used in general diagnostic radiology and mammography, identified as EURAMET.RI(I)-S10 (EURAMET project #1221), was performed between the PTB and the IAEA. Two spherical and two parallel-plate reference-class ionization chambers of the IAEA and 12 beam qualities standardized in the IEC standard 61267:2005 plus additional 7 standard beam qualities established at both laboratories were selected for the comparison. The calibration coefficients were determined for the transfer chambers at the PTB in September 2012 and before and after this at the IAEA Dosimetry Laboratory. The results show the calibration coefficients of both laboratories to be in good agreement within the standard uncertainty of the comparison of about 0.47 %.

A feasibility study for mailed film dosimetry has been performed. The global reproducibility of the method is better than 2%. It is shown that the normalized sensitometric curve does not depend on photon beam quality in the range from Co-60 gamma-rays to 18 MV x-rays, although the dose per optical density decreases when the energy increases. The fading of the latent image before film processing is only 3% per month and the normalized sensitometric curve is not modified after a period of 51 days between irradiation and processing. Sets of films were mailed to three different institutes for irradiation and returned for processing and evaluation after more than two months in order to verify that mailing of irradiated and unprocessed films does not produce unwanted artefacts. Finally the feasibility of external audits with mailed film dosimetry is illustrated by comparison of beam profiles measured with films and ionization chambers in a polystyrene phantom.