[en] The development of new treatment modalities such as IMRT and stereotactic radiotherapy has led to an increasing use of complex fields composed of small beams with multiple incidence angles. These new treatment conditions are very far from classical reference conditions on which international dosimetry protocols are based. In this work, we propose to realize dosimetric standards for radiation fields smaller than the standard 10 * 10 cm² field, namely 4 * 4 and 2 * 2 cm². The calibration coefficients of an ionization chamber in terms of absorbed dose to water for these radiation fields were compared in the 6 MV (with and without flattening filter) and 12 MV beams of LNHB medical linac. The references were established from a graphite calorimetry measurement. A graphite calorimeter of small sensitive volume was built specifically for the 2 * 2 cm² field. In addition, an ionization chamber suitable to this field size was looked for. We showed that, for the studied beams, the reference chamber's calibration coefficient is independent of the radiation field size between 10 * 10 and 2 * 2 cm², within uncertainties (about 0.4 % at one standard deviation). (author)

[en] Purpose: The use of a primary dosimeter larger than the radiation field gives access to the integral of dose over a specified surface normal to the beam. If a relative dose profile of the beam is well known, it is then possible to calculate the distribution of the absorbed dose at any point on the considered surface. This study aims at validating the use of EBT3 gafchromic films for the measurement of 2D dose distribution and integrals of dose in small fields for such use. Methods: New EBT3 films have been fully characterized: the response versus energy, dose-rate and dose has been investigated. Profiles measured in circular field with a diameter of 20 mm have been compared to the ones measured with a diamond detector developed at CEA/LIST/LCD. The ratio of dose area products measured with EBT3 on a 6 mm and 30 mm diameter surface has been compared to the ratio measured with primary dosimeters (calorimeters) and calculated with Monte Carlo simulations. Results: There was no significant difference between the dose-calibration curves in a 6 MV and a 60Co beam. Deviation was within uncertainty bars when the dose rate inside a pulse was divided by a factor of 80 in the 6 MV photon beam. Profiles in small fields are in good agreement with the diamond profiles. Dose area product ratios obtained with EBT3, calorimeters and simulations are within 1%. Conclusion: EBT3 films are good candidates for the measurement of relative dose distribution in small fields as long as the average of several films is considered. They can be used in association with primary measurements to determinate dosimetric references in small fields and to transfer them to the end user

[en] The LNE-LNHB has developed two primary standards to determine the absorbed dose to water under reference conditions (for 10 cm * 10 cm) in ⁶⁰Co, 6 MV, 12 MV and 20 MV photon beams: a new graphite calorimeter and a water calorimeter. This first paper presents the results obtained with the graphite calorimeter and the new associated methodology. The associated relative standard uncertainty (k = 1) of absorbed dose to water is 0.25% for ⁶⁰Co and lies between 0.32% to 0.35% for MV X-ray beams. (authors)

[en] Purpose: To establish dosimetric references of absorbed dose in water in radiation fields smaller than 2 cm used in radiotherapy thanks to a new methodology based on the use of dosimeters larger than the field size. Methods: A new graphite calorimeter was constructed with a large sensitive volume (diameter of the core: 30 mm). This primary dosimeter was fully characterized and compared to previous LNE-LNHB graphite calorimeters in a 60Co large field. A specially designed graphite parallel-plate ionization chamber with a 30 mm collecting electrode was also assembled and tested. Measurements were then conducted in two 6 MV small circular fields of 2 cm and 1 cm diameter respectively, using the new concept of dose-area product instead of punctual dose commonly used in radiotherapy. Results: The dose rate established in a large 60Co field with the new calorimeter is in agreement within 0.4% with previous calorimeters. The ionization chamber shows good characteristics except for a 0.06% drift per hour in water. The ratio of calorimetric against ionometric measurements in the 2 cm diameter field is 1.1% higher than the one in the 1 cm diameter field (with respectively 0.30% and 1.03% type A uncertainty for each field). Conclusion: Results presented here highlight the possibility of measuring dose-area products in small fields with a graphite calorimeter and a parallel-plate ionization chamber. Measurements in a 0.75 cm diameter field are already underway to confirm the trend observed in the 2 cm and 1 cm diameter fields. The last step to establish precise dosimetric references in small fields is to calculate correction factors thanks to Monte Carlo simulations

[en] LNE-LNHB is involved in a European project aiming at establishing absorbed dose-to-water standards for photon-radiation fields down to 2 x 2 cm². This requires the calibration of reference ionization chambers of small volume. Twenty-four ionization chambers of eight different types with volume ranging from 0.007 to 0.057 cm³ were tested in a ⁶⁰Co beam. For each chamber, two major characteristics were investigated: (1) the stability of the measured current as a function of the irradiation time under continuous irradiation. At LNE-LNHB, the variation of the current should be less than ±0.1% in comparison with its first value (over a 16 h irradiation time); (2) the variation of the ionization current with the applied polarizing voltage and polarity. Leakage currents were also measured. Results show that (1) every tested PTW (31015, 31016 and 31014) and Exradin A1SL chambers demonstrate a satisfying stability under irradiation. Other types of chambers have a stability complying with the stability criterion for some or none of them. (2) IBA CC01, IBA CC04 and Exradin A1SL show a proper response as a function of applied voltage for both polarities. PTW, Exradin A14SL and Exradin A16 do not. Only three types of chambers were deemed suitable as reference chambers according to LNE-LNHB requirements and specifications from McEwen (2010 Med. Phys. 37 2179-93): Exradin A1SL chambers (3/3), IBA CC04 (2/3) and IBA CC01 (1/3). The Exradin A1SL type with an applied polarizing voltage of 150 V was chosen as an LNE-LNHB reference chamber type in 2 x 2 cm² radiation fields.

[en] During the Euramet project JRP7 'External Beam Cancer Therapy', PTB and LNE-LNHB used primary standards to determine the absorbed dose to water under IMRT conditions (in small fields). PTB used a water calorimeter to determine the absorbed-dose-to-water references in 6 MV and 10 MV beams for field sizes of 10 cm * 10 cm and 3 cm * 3 cm while LNE-LNHB used graphite calorimeters in 6MV and 12MV beams for field sizes of 10 cm * 10 cm, 4 cm * 4 cm and 2 cm * 2 cm. The purpose of this study is to compare PTB and LNE-LNHB new absorbed-dose-to-water references. LNE-LNHB sent an Exradin A1SL ionization chamber traceable to its primary standard to the PTB for calibration in ⁶⁰Co and in linac beams and PTB sent a PTW 31010 ionization chamber traceable to its primary standard to LNE-LNHB for calibration in ⁶⁰Co and in linac beams. Calculated Sw,air will be used as beam quality specifier for the ionization chamber comparison at different field sizes. The standard uncertainties (k = 1) of PTB and LNE-LNHB calibration coefficients lie respectively between 0.25% (⁶⁰Co) and 0.40% (linac) and between 0.29% and 0.46%. PTB and LNE-LNHB absorbed-dose-to-water references developed for this project, based respectively on water calorimetry and on graphite calorimetry, agree within 1.5 standard deviations for field size of 10 cm * 10 cm down to 2 cm * 2 cm and for beams of 6 MV to 10 MV. (authors)

[en] To extend the dosimetric reference system to field sizes smaller than 2 cm  ×  2 cm, the LNE-LNHB laboratory is studying an approach based on a new dosimetric quantity named the dose-area product instead of the commonly used absorbed dose at a point. A graphite calorimeter and a plane parallel ion chamber with a sensitive surface of 3 cm diameter were designed and built for measurements in fields of 2, 1 and 0.75 cm diameter. The detector surface being larger than the beam section, most of the issues linked with absolute dose measurements at a point could be avoided. Calibration factors of the plane parallel ionization chamber were established in terms of dose-area product in water for small fields with an uncertainty smaller than 0.9%. (paper)

[en] A comparison of the dosimetry for accelerator photon beams was carried out between the Laboratoire National de Metrologie et d'Essais - Laboratoire National Henri Becquerel (LNE-LNHB) and the Bureau International des Poids et Mesures (BIPM) in March 2012. The comparison was based on the determination of absorbed dose to water for three radiation qualities at the LNE-LNHB. The comparison result, reported as a ratio of the LNE-LNHB and the BIPM evaluations, is 0.995 at 6 MV and 12 MV; 0.994 at 20 MV, with a combined standard uncertainty of 5 parts in 10³ at all three energies. This result is the fourth in the on-going BIPM.RI(I)-K6 series of comparisons. (authors)

[en] Recent developments of new therapy techniques using small photon beams, such as stereotactic radiotherapy, require suitable detectors to determine the delivered dose with a high accuracy. The dosimeter has to be as close as possible to tissue equivalence and to exhibit a small detection volume compared to the size of the irradiation field, because of the lack of lateral electronic equilibrium in small beam. Characteristics of single crystal diamond (tissue equivalent material Z = 6, high density) make it an ideal candidate to fulfil most of small beam dosimetry requirements. A commercially available Element Six electronic grade synthetic diamond was used to develop a single crystal diamond dosimeter (SCDDo) with a small detection volume (0.165 mm³). Long term stability was studied by irradiating the SCDDo in a ⁶⁰Co beam over 14 h. A good stability (deviation less than ± 0.1%) was observed. Repeatability, dose linearity, dose rate dependence and energy dependence were studied in a 10 × 10 cm² beam produced by a Varian Clinac 2100 C linear accelerator. SCDDo lateral dose profile, depth dose curve and output factor (OF) measurements were performed for small photon beams with a micro multileaf collimator m3 (BrainLab) attached to the linac. This study is focused on the comparison of SCDDo measurements to those obtained with different commercially available active detectors: an unshielded silicon diode (PTW 60017), a shielded silicon diode (Sun Nuclear EDGE), a PinPoint ionization chamber (PTW 31014) and two natural diamond detectors (PTW 60003). SCDDo presents an excellent spatial resolution for dose profile measurements, due to its small detection volume. Low energy dependence (variation of 1.2% between 6 and 18 MV photon beam) and low dose rate dependence of the SCDDo (variation of 1% between 0.53 and 2.64 Gy min⁻¹) are obtained, explaining the good agreement between the SCDDo and the efficient unshielded diode (PTW 60017) in depth dose curve measurements. For field sizes ranging from 0.6 × 0.6 to 10 × 10 cm², OFs obtained with the SCDDo are between the OFs measured with the PinPoint ionization chamber and the Sun Nuclear EDGE diode that are known to respectively underestimate and overestimate OF values in small beam, due to the large detection volume of the chamber and the non-water equivalence of both detectors. (paper)