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The American Association of Physicists in Medicine ͑AAPM͒ presents a new protocol, developed by the Radiation Therapy Committee Task Group 61, for reference dosimetry of low-and mediumenergy x rays for radiotherapy and radiobiology (40 kVрtube potentialр300 kV). It is based on ionization chambers calibrated in air in terms of air kerma. If the point of interest is at or close to the surface, one unified approach over the entire energy range shall be used to determine absorbed dose to water at the surface of a water phantom based on an in-air measurement ͑the ''in-air'' method͒. If the point of interest is at a depth, an in-water measurement at a depth of 2 cm shall be used for tube potentials у100 kV ͑the ''in-phantom'' method͒. The in-phantom method is not recommended for tube potentials Ͻ100 kV. Guidelines are provided to determine the dose at other points in water and the dose at the surface of other biological materials of interest. The protocol is based on an up-to-date data set of basic dosimetry parameters, which produce consistent dose values for the two methods recommended. Estimates of uncertainties on the final dose values are also presented.

An addendum to the AAPM's TG-51 protocol for the determination of absorbed dose to water in megavoltage photon beams is presented. This addendum continues the procedure laid out in TG-51 but new k Q data for photon beams, based on Monte Carlo simulations, are presented and recommendations are given to improve the accuracy and consistency of the protocol's implementation. The components of the uncertainty budget in determining absorbed dose to water at the reference point are introduced and the magnitude of each component discussed. Finally, the consistency of experimental determination of N D,w coefficients is discussed. It is expected that the implementation of this addendum will be straightforward, assuming that the user is already familiar with TG-51. The changes introduced by this report are generally minor, although new recommendations could result in procedural changes for individual users. It is expected that the effort on the medical physicist's part to implement this addendum will not be significant and could be done as part of the annual linac calibration.

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Calculations of mass energy-transfer and mass energy-absorption coefficients for photon energies from 1 keV to 100 MeV have been developed, based on a re-examination of the processes involved after the initial photon interaction. The probabilities for the initial interaction are from the current photon interaction cross-section database at the National Institute of Standards and Technology. The calculations then take into account (1) electron binding effects on the Compton-scattered photon distribution; (2) the complete cascade of fluorescence emission after ionization events in any atomic subshell, including those associated with incoherent scattering and triplet production; and (3) the radiative energy losses of the secondary electrons and positrons slowing down in the medium, including the emission of bremsstrahlung, characteristic X rays from impact ionization, and positron in-flight as well as at-rest annihilation quanta. Consideration of the processes in (3) goes beyond the continuous-slowing-down approximation and includes the effects of energy-loss straggling. Results for the mass energy-absorption coefficient are compared with those from recent tabulations.

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