The procedure recommended by different dosimetry protocols for the determination of the absorbed dose to air chamber factor, ND,pp, of plane-parallel chambers, comparing absorbed dose determinations in a high-energy electron beam with a reference cylindrical chamber having a known ND,cyl factor, has been investigated. Attention has been focused on the case that the chamber serving as reference has a solid aluminium central electrode. It has been found that using a wide spread Farmer-type chamber (NE 2571), together with recommendations which specifically take into account central electrode corrections for electron beam dosimetry, kcelpcel = pcel-global(IAEA) = 1.008, yields inconsistent results compared with those obtained from a fully homogeneous ionization chamber; for the NE 2571 chamber, a value kcelpcel = pcel-global(IAEA) congruent to 1.0 has been obtained. Analytical calculations of kmkatt for Farmer-type cylindrical chambers and experimental determinations of the product kmkattkcelpcel in electron beams agree within experimental uncertainties, with no evidence of statistical significance for the commonly used assumption pcel = 1, which yields a 0.8% correction (due to kcel only) for the effect of the NE 2571 aluminium electrode in electron beam dosimetry. The use of a 'NACP-chamber' specific factor (kpp or kmkatt) to obtain ND,pp from NK,pp in NACP plane-parallel chambers has been found unsatisfactory, and direct experimental determinations of ND,pp are recommended instead. It is suggested that Standard Dosimetry Laboratories provide ND,pp calibration factors in 60Co beams.

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In the present investigation, the necessary tests for implementing a quality assurance program for a commercial treatment planning system (TPS), recently installed at Sao Paulo University School of Medicine Clinicas Hospital-Brazil, was established and performed in accordance with the new IAEA publication TRS 430, and with AAPM Task Group 53. The tests recommended by those documents are classified mainly into acceptance, commissioning (dosimetric and nondosimetric), periodic quality assurance, and patient specific quality assurance tests. The recommendations of both IAEA and AAPM documents are being implemented at the hospital for photon beams produced by two linear accelerators. A Farmer ionization chamber was used in a 30 x 30 x 30 cm3 phantom with a dose rate of 320 monitor unit (MU)/min and 50 MU in the case of the dosimetric tests. The acceptance tests verified hardware, network systems integration, data transfer, and software parameters. The results obtained are in good agreement with the specifications of the manufacturer. For the commissioning dosimetric tests, the absolute dose was measured for simple geometries, such as square and rectangular fields, up to more complex geometries such as off-axis hard wedges and for behavior in the build up region. Results were analysed by the use of confidence limit as proposed by Venselaar et al. [Radio Ther. Oncol. 60, 191-201 (2001)]. Criteria of acceptability had been applied also for the comparison between the values of MU calculated manually and MU generated by TPS. The results of the dosimetric tests show that work can be reduced by choosing to perform only those that are more crucial, such as oblique incidence, shaped fields, hard wedges, and buildup region behavior. Staff experience with the implementation of the quality assurance program for a commercial TPS is extremely useful as part of a training program.

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Dedico este trabalho À minha amada Izabel Pinheiro, por todo amor, incentivo, paciência e por estar sempre presente, mesmo na ausência. AGRADECIMENTOS À Dra. Laura Natal Rodrigues, minha orientadora, pela oportunidade, conselhos e incentivo acadêmico. Aos meus avós, Francisco Edmar (in memorian) e Maria Eunice, Edmilson Moreira (in memorian) e Terezinha de Lavor, que sempre me ajudaram e orientaram muito. Aos meus pais, Marcelo e Margarida, que nunca mediram esforços para ajudar na minha formação, com certeza, eles são os melhores do mundo! Aos meus irmãos, Rafael e Pedro, por serem bons amigos e parceiros em todas as horas. À toda equipe do departamento de radioterapia do Hospital das Clínicas de São Paulo, por terem permitido o uso dos aparelhos e materiais necessários para o desenvolvimento do trabalho. Aos físicos, Marcos, Ana Paula e Marco, pelas valiosas discussões. Aos amigos de residência, Cristian, Ângela e Caroline, pelos ensinamentos e ajuda sempre que era necessário. Aos colegas de mestrado, Eduardo, Bruno e Talita, pelas horas de estudo e parcerias. Aos professores do IPEN, pelos valiosos ensinamentos. ABSTRACTIntensity modulated radiation therapy (IMRT) is currently been implemented in a rapidly growing number of centers in Brazil. As consequence many institutions are now facing the problem of performing a comprehensive quality control program before and during the implementation of IMRT in the clinical routine practice.The aim of this work is to evaluate and propose a methodology for quality assurance in IMRT treatments.An ionization chamber and a two-dimensional array detector were performed to assess the absolute value of the total dose of all fields in one specific point. The relative total dose distribution of all fields was measured with a radiochromic film and a two-dimensional array at one depth in a phantom. A comparison between measured and calculated dose distributions was performed using the gamma-index method, assessing the percentage of points that meet the criteria of ±3% dose difference and ±3 mm distance to agreement.As a result of 113 tested IMRT beams using ionization chamber and 81 using two-dimensional array, the proposal was to take an action level of about ± 5% compared to the treatment planning systems and measurements, for the verification of the dose in a single point at the low gradient dose region. Analysis of the two-dimensional array measurements showed that the gamma value was <1 for 97.7% of the data and for the film the gamma value was <1 for 96.6% of the data.This can be concluded that for an accurate delivery of dose in "slidingwindow" IMRT with micro multileaf collimator, the absolute value of the total dose and the relative total dose distribution should be checked by absolute and relative dosimetry respectively.

ObjectiveTo identify a contrast material that could be used as a dummy marker for magnetic resonance imaging.Materials and MethodsMagnetic resonance images were acquired with six different catheter-filling materials-water, glucose 50%, saline, olive oil, glycerin, and copper sulfate (CuSO4) water solution (2.08 g/L)-inserted into compatible computed tomography/magnetic resonance imaging ring applicators placed in a phantom made of gelatin and CuSO4. The best contrast media were tested in four patients with the applicators in place.ResultsIn T2-weighted sequences, the best contrast was achieved with the CuSO4-filled catheters, followed by saline- and glycerin-filled catheters, which presented poor visualization. In addition (also in T2-weighted sequences), CuSO4 presented better contrast when tested in the phantom than when tested in the patients, in which it provided some contrast but with poor identification of the first dwell position, mainly in the ring.ConclusionWe found CuSO4 to be the best solution for visualization of the applicator channels, mainly in T2-weighted images in vitro, although the materials tested presented low signal intensity in the images obtained in vivo, as well as poor precision in determining the first dwell position.