DAVID - a translucent multi-wire transmission ionization chamber for in vivo verification of IMRT and conformal irradiation techniques

Permanent in vivo verification of IMRT photon beam profiles by a radiation detector with spatial resolution, positioned on the radiation entrance side of the patient, has not been clinically available so far. In this work we present the DAVID system, which is able to perform this quality assurance measurement while the patient is treated. The DAVID system is a flat, multi-wire transmission-type ionization chamber, placed in the accessory holder of the linear accelerator and constructed from translucent materials in order not to interfere with the light field. Each detection wire of the chamber is positioned exactly in the projection line of a MLC leaf pair, and the signal of each wire is proportional to the line integral of the ionization density along this wire. Thereby, each measurement channel essentially presents the line integral of the ionization density over the opening width of the associated leaf pair. The sum of all wire signals is a measure of the dose-area product of the transmitted photon beam and of the total radiant energy administered to the patient. After the dosimetric verification of an IMRT plan, the values measured by the DAVID system are stored as reference values. During daily treatment the signals are re-measured and compared to the reference values. A warning is output if there is a deviation beyond a threshold. The error detection capability is a leaf position error of less than I mm for an isocentric I cm x I cm field, and of I mm for an isocentric 20 cm x 20 cm field

The dose response functions of ionization chambers in photon dosimetry - Gaussian or non-Gaussian?

This study is concerned with the spatial resolution of air-filled ionization chambers in photon-beam dosimetry, i.e. with their dose response functions. These act as convolution kernels K(x,y), transforming true dose profiles D(x,y) into the measured signal profiles M(x,y). One-dimensional dose response functions have been experimentally determined for nine types of cylindrical ionization chambers both in their lateral and longitudinal directions, as well as across two plane-parallel chambers and for the single chambers of two 2D arrays. All these 1D dose response functions are closely described by Gaussian functions. The associated energy-dependent values of the standard deviations a have been measured for 6 and 15 MV photons with an uncertainty of 0.02 mm. At depths beyond secondary electron fluence build-up, there was no detectable depth dependence of the a values. The general occurrence of Gaussian dose response functions, their extension beyond the geometrical boundaries of the chambers, and the energy dependence of their standard deviations can be understood by considering the underlying system of convolutions, which is the origin of the influences of secondary electron transport. Monte-Carlo simulations of the convolution kernels for a cylindrical, a square, and a flat ionization chamber and their Fourier analysis have been employed to show that the Gaussian convolution kernels are approximations to the true dose response functions, valid in the clinically relevant domain of the spatial frequency. This paper is conceived as the starting point for the deconvolution methods to be described in a further publication

Dosimetric characteristics of an unshielded p-type Si diode: linearity, photon energy dependence and spatial resolution

The unshielded Si diode PTW 60012, used for accurate measurements of the transversal close profiles of narrow photon beams, has been investigated with regard to its linearity, photon energy dependence and spatial resolution. The diode shows a slight supralinearity, i.e. increase of the response with pulse dose, by 3% over the pulse dose range 0.1 to 0.8 mGy. In p-type silicon, supralinearity results from the increased chance for radiation-induced electrons to escape recombination when the pulse dose increases. Over the energy range from 6 to 15 MV, the response decreases by about 4%. This small variation of the response results front partial compensation between the influences of the secondary electron energy oil the mass stopping power ratio silicon/water and on electron backscattering from the silicon chip. The lateral response function of the examined diode has a full half width of 1.3 mm. Dose profiles of 5 tent half-width can still he recorded with negligible error.PTW Freibur

Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma

Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin's lymphoma with a favorable prognosis remains unclear. We therefore conducted a multicenter, randomized trial comparing four treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels