The aim of this work was to investigate the dosimetric characteristics of radiophotoluminescent glass dosimeter (RPLGD) for high energy photon beams in both flattening filter mode and flattening filter free (FFF) mode. The dosimetric characteristics of RPLGD model GD-302M were studied in 6 MV photon beams for the reproducibility of dosimeter reader, uniformity and reproducibility of RPLGD, dose linearity (range from 1 to 20 Gy), repetition rate, and angular dependence. In addition, the energy responses were observed in flattening filter mode (6 MV, 10 MV, and 15 MV) from Varian Clinac Cseries and FFF mode (6 MV_FFF and 10 MV_FFF) from Varian TrueBEAM system. The FGD-1000 reader system exhibited stable readout. The entire number of 100 RPLGDs showed good uniformity and reproducibility within ±1.5%. Furthermore, the signal from RPLGD demonstrated a linear proportion to the radiation dose (r = 0.999), and no energy dependence was observed. For repetition rate response of flattening filter mode and FFF mode, the maximum error of relative response to 400 MU/min were 0.977 ±0.006 and 0.986±0.017, respectively. The response of RPLGD reached 1.00 at ±30°g antry angle while at +90°gantry angle, the RPLGD response was 8% lower compared to-90°gantry angle because the attenuation effect was more pronounced. We conclude that the RPLGD is capable to measure radiation dose since it provides desirable dosimetric properties such as good uniformity and reproducibility of RPLGD including the reader system. Besides, RPLGD is available with small active readout area which adds benefit for clinical implementation in radiotherapy, especially for advanced techniques.

The commercial flat bolus cannot form perfect contact with the irregular surface of the patient’s skin, resulting in an air gap. The purpose of this study was to evaluate the feasibility of using a 3D customized bolus from silicone rubber. The silicone rubber boluses were studied in basic characteristics. The 3D customized bolus was fabricated at the nose, cheek and neck regions. The point dose and planar dose differences were evaluated by comparing with virtual bolus. The hardness, thickness, density, Hounsfield unit (HU) and dose attenuation of the customized bolus were quite similar to a commercial bolus. When a 3D customized bolus was placed on the RANDO phantom, it can significantly increase buildup region doses and perfectly fit against the irregular surface shape. The average point dose differences of 3D customized bolus were −1.1%, while the commercial bolus plans showed −1.7%. The average gamma results for planar dose differences comparison of 3D customized bolus were 93.9%, while the commercial bolus plans were reduced to 91.9%. Overall, A silicone rubber bolus produced the feasible dosimetric properties and could save cost compared to a commercial bolus. The 3D printed customized bolus is a good buildup material and could potentially replace and improve treatment efficiency.

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Background: Alanine dosimeters are generally used in high-dose industrial applications (kGy). Later, research into employing alanine as a dosimeter in radiotherapy (1-20 Gy) has increased, since alanine may be an alternative transfer dosimeter for quality control, postal audit, and intercomparison between laboratories. However, several factors such as the dosimeter’s characteristic should be investigated while utilizing alanine in radiotherapy. In addition, the optimal electron paramagnetic resonance (EPR) reader should be configured to match the absorbed dose range. Objectives: This study aims to optimize the EPR setting parameters, study the characteristics of alanine dosimeters, and estimate the uncertainty of the 6MV-FFF linear accelerator in a dose ranging from 1 to 20 Gy. The output measurements from different facilities were also investigated. Materials and methods: The alanine dosimeters were irradiated with a 6MV-FFF beam using linear accelerator, Varian TrueBeam (Varian Medical Systems, Inc, CA, USA), 100 cm SSD, with a field size of 10x10 cm2 at 1 to 30 Gy. The EPR operation parameter has been optimized for these dose ranges. The characteristics of alanine dosimeters were then investigated, along with the estimation of uncertainty in using alanine. Finally, the alanine dosimeter proficiency was validated using 9 distinct linear accelerator machines. Results: The EPR parameters were found to be optimized at 1.589 mW of MP, 7.018 G of MA, and 40.96 ms of TC. The expanded uncertainty (k=2) was reported at 2.68% in the 1-20 Gy dose range. The alanine dosimeters’ characteristics were found to have good uniformity and reproducibility, low fading, and angle-and dose-independence. Although the investigation was performed in 9 different linear accelerator machines, the difference of delivered dose output was measured and reported with difference percentages within ±1%. Conclusion: This study reports the feasibility of using alanine dosimeters in radiotherapy. The important EPR parameter setting, and alanine dosimetry characteristics were investigated, whose results suggest that alanine can be used at a dose range of 1-30 Gy. This especially benefits the SRS treatment which uses a high dose per fraction, and this dosimeter can be an alternative transfer dosimeter. Nonetheless, various factors should be explored using an appropriate phantom prior to clinical application.

Background: The study of radiophotoluminescent glass dosimeters (RGDs) in the clinical usage of proton beams is limited. The aim of this study was to investigate the dosimetric characteristics of RGDs for pencil beam scanning proton therapy. The feasibility of using an RGD in end-to-end testing of intensity-modulated proton therapy (IMPT) plans at various treatment sites was also evaluated. Materials and methods: The dosimetric characteristics of the GD-302M type glass dosimeter were studied in terms of uniformity, short-term and long-term reproducibility, stability of the magazine position readout, dose linearity in the range from 0.2-20 Gy, energy response in 70-220 MeV, MU/spot, dose rate response, and fading effect. The reference conditions of the spot scanning beam from the Varian ProBeam Compact system were operation at 160 MeV, a 2 cm water equivalent depth in a solid water phantom, a 10×10 cm field size at the isocenter, and 2 Gy dose delivery. End-to-end testing of IMPT plans for the head, abdomen, and pelvis was verified by using the Alderson Rando phantom. The overall uncertainty analysis was confirmed in this study. Results: The relative response of RGDs for the uniformity test was within 0.95-1.05. The %CVs of the short-term and long-term reproducibility were 1.16% and 1.50%, respectively. The FGD-1000 automatic reader showed stable magazine position readout. The dose linearity was found to have an obviously good linear relationship, with R2 = 0.9988. The energy response relative to 160 MeV was approximately within 4.0%. The MU/spot and dose rate had less effect on the RGD readout. The fading effect was relatively stable for 10 weeks of storage, within 2.4%. For the end-to-end test, the maximum difference between the treatment plan and RGD measurement showed a very good result that was within 1.0%. The overall uncertainty of the RGD measurement for the proton beam was 4.6%. Conclusion: RGDs have confirmed the potential for proton dosimetry, including in end-to-end testing. The appropriate correction factor for the energy response can be applied for dose verification of scanning proton beams.

Background: The Monte Carlo (MC) simulation is an effective tool for determining the absorbed dose in small field sizes. To calculate accurate results, the MC simulation requires precise geometric and material descriptions of the linear accelerator head. Due to proprietary information issues, the description of the Varian TrueBeam™ linear accelerator (Varian Medical Systems, Palo Alto, CA) head geometry and material information are not available. Instead, the manufacturer provided a phase-space file just above the jaw for each photon energy level. Although several studies have validated the accuracy of this phase-space file, to the best of our knowledge, there are no reported data for a small field size (<2x2 cm2) of 6 MV photon beams. Objectives: The purpose of this study was to evaluate the Varian TrueBeam™ phase-space file of the 6 MV photon beam provided by the manufacturer for the Monte Carlo (MC) simulation in small field dosimetry. Materials and methods: The TrueBeam™ linear accelerator was simulated using an EGSnrc MC code with a Varian phase-space file as the input. The simulation was compared with the measurement using percent depth dose (PDD) and beam profile, and the field output factor (FOF) for the 0.6x0.6, 1x1, 2x2, 3x3, 4x4, 6x6, and 10x10 cm2 field sizes. Results: The agreement between the measurements and simulated PDD data was under 2.2% beyond the buildup region. The distance to agreement (DTA) in the buildup region was within 1.0 mm. The simulation data presented identical profiles with the measurement within 1.0% of the dose difference or 1.2 mm of the DTA. The mean dose difference in the radiation field was ≤1.5% for the ≥1x1 cm2 field size. The largest deviation was observed in the 0.6x0.6 cm2 inline beam profile. The deviation of the penumbra and full width at half maximum (FWHM) between simulation and measurement was <2 mm. The agreement of the simulated and measured FOF was within 1.0%, except for the 0.6x0.6 cm2 field size. Conclusion: Overall, the MC simulation demonstrates data that is consistent with the measurement for the ≥1x1 cm2 field sizes. These data assure that the 6 MV Varian phase-space file can be used as a radiation source for accurate MC dose calculation in a small field. However, a large discrepancy in beam profiles was observed at the 0.6x0.6 cm2 field size due to the different primary source sizes among TruebeamTM machines.