Kojima Hideki, Ishikawa Masayori, Takigami Makoto
Department of Radiation Oncology, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan.
Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Med Phys. 2023 Nov;50(11):7281-7293. doi: 10.1002/mp.16641. Epub 2023 Aug 1.
Although flattening filter free (FFF) beams are commonly used in clinical treatment, the accuracy of dose measurements in FFF beams has been questioned. Higher dose per pulse (DPP) such as FFF beams from a linear accelerator may cause problems in dose profile measurements using an ionization chamber due to the change of the charge collection efficiency. Ionization chambers are commonly used for percent depth dose (PDD) measurements. Changes of DPP due to chamber movement during PDD measurement can vary the ion collection efficiency of ionization chambers. In the case of FF beams, the DPP fluctuation is negligible, but in the case of the FFF beams, the DPP is 2.5 ∼ 4 times larger than that of the FF beam, and the change in ion collection efficiency is larger than that of the FF beam. PDD profile normalized by maximum dose depth, 10 cm depth for example, may therefore be affected by the ion collection efficiency.
In this study, we investigate the characteristics of the ion collection efficiency change depending on the DPP of each ionization chamber in the FFF beam. We furthermore propose a method to obtain the chamber- independent PDD by applying a DPP-dependent ion recombination correction.
Prior to investigating the relationship between DPP and charge collection efficiency, Jaffe-plots were generated with different DPP settings to investigate the linearity between the applied voltage and collected charge. The absolute dose measurement using eight ionization chambers under the irradiation settings of 0.148, 0.087, and 0.008 cGy/pulse were performed. Applied voltages for the Jaffe-plots were 100, 125, 150, 200, 250, and 300 V. The ion recombination correction factor P was calculated by the two-voltage analysis (TVA) method at the applied voltages of 300 and 100 V. The DPP dependency of the charge collection efficiency for each ionization chamber were evaluated from the DPP- P plot. PDD profiles for the 10 MV FFF beam were measured using Farmer type chambers (TN30013, FC65-P, and FC65-G) and mini-type chambers (TN31010, TN31021, CC13, CC04, and FC23-C). The PDD profiles were corrected with ion recombination correction at negative and positive polar applied voltages of 100 and 300 V.
From the DPP-P relation for each ionization chamber with DPP ranging from 0.008 cGy/pulse to 0.148 cGy/pulse, all Farmer and mini-type chambers satisfied the requirements described in AAPM TG-51 addendum. However, P for the CC13 was most affected by DPP among tested chambers. The maximum deviation among PDDs using eight ionization chambers for 10 MV FFF was about 1%, but the deviation was suppressed to about 0.5% by applying ion recombination correction at each depth.
In this study, the deviation of PDD profile among the ionization chambers was reduced by the ion recombination coefficient including the DPP dependency, especially for high DPP beams such as FFF beams. The present method is particularly effective for CC13, where the ion collection efficiency is highly DPP dependent.
尽管无均整器(FFF)束流在临床治疗中被广泛应用,但FFF束流中剂量测量的准确性一直受到质疑。较高的每脉冲剂量(DPP),如直线加速器产生的FFF束流,由于电荷收集效率的变化,可能会在使用电离室进行剂量分布测量时引发问题。电离室常用于百分深度剂量(PDD)测量。在PDD测量过程中,由于电离室移动导致的DPP变化会改变电离室的离子收集效率。对于均整滤过(FF)束流,DPP波动可忽略不计,但对于FFF束流,其DPP比FF束流大2.5至4倍,离子收集效率的变化也比FF束流更大。因此,例如以最大剂量深度(如10 cm深度)归一化的PDD分布可能会受到离子收集效率的影响。
在本研究中,我们研究了FFF束流中每个电离室的离子收集效率变化随DPP的特性。此外,我们还提出了一种通过应用依赖于DPP的离子复合校正来获得与电离室无关的PDD的方法。
在研究DPP与电荷收集效率之间的关系之前,通过不同的DPP设置生成Jaffe图,以研究施加电压与收集电荷之间的线性关系。在0.1⁴⁸、0.0⁸⁷和0.0⁰⁸ cGy/脉冲的照射设置下,使用八个电离室进行绝对剂量测量。Jaffe图的施加电压为100、125、150、200、250和300 V。通过双电压分析(TVA)方法在300和100 V的施加电压下计算离子复合校正因子P。从DPP - P图评估每个电离室的电荷收集效率对DPP的依赖性。使用 Farmer型电离室(TN30013、FC65 - P和FC65 - G)和微型电离室(TN31010、TN31021、CC13、CC04和FC23 - C)测量10 MV FFF束流的PDD分布。在100和300 V的正负极性施加电压下,用离子复合校正对PDD分布进行校正。
对于DPP范围从0.0⁰⁸ cGy/脉冲到0.1⁴⁸ cGy/脉冲的每个电离室的DPP - P关系,所有Farmer型和微型电离室均满足AAPM TG - 51附录中所述的要求。然而,在测试的电离室中,CC13的P受DPP影响最大。对于10 MV FFF,使用八个电离室的PDD之间的最大偏差约为1%,但通过在每个深度应用离子复合校正,偏差被抑制到约0.5%。
在本研究中,包括DPP依赖性的离子复合系数降低了电离室之间PDD分布的偏差,特别是对于FFF束流等高DPP束流。本方法对离子收集效率高度依赖于DPP的CC13特别有效。