On the use of unshielded cables in ionization chamber dosimetry for total-skin electron therapy.

The dosimetry of total-skin electron therapy (TSET) usually requires ionization chamber measurements in a large electron beam (up to 120 cm x 200 cm). Exposing the chamber's electric cable, its connector and part of the extension cable to the large electron beam will introduce unwanted electronic signals that may lead to inaccurate dosimetry results. While the best strategy to minimize the cable-induced electronic signal is to shield the cables and its connector from the primary electrons, as has been recommended by the AAPM Task Group Report 23 on TSET, cables without additional shielding are often used in TSET dosimetry measurements for logistic reasons, for example when an automatic scanning dosimetry is used. This paper systematically investigates the consequences and the acceptability of using an unshielded cable in ionization chamber dosimetry in a large TSET electron beam. In this paper, we separate cable-induced signals into two types. The type-I signal includes all charges induced which do not change sign upon switching the chamber polarity, and type II includes all those that do. The type-I signal is easily cancelled by the polarity averaging method. The type-II cable-induced signal is independent of the depth of the chamber in a phantom and its magnitude relative to the true signal determines the acceptability of a cable for use under unshielded conditions. Three different cables were evaluated in two different TSET beams in this investigation. For dosimetry near the depth of maximum buildup, the cable-induced dosimetry error was found to be less than 0.2% when the two-polarity averaging technique was applied. At greater depths, the relative dosimetry error was found to increase at a rate approximately equal to the inverse of the electron depth dose. Since the application of the two-polarity averaging technique requires a constant-irradiation condition, it was demonstrated than an additional error of up to 4% could be introduced if the unshielded cable's spatial configuration were altered during the two-polarity measurements. This suggests that automatic scanning systems with unshielded cables should not be used in TSET ionization chamber dosimetry. However, the data did show that an unshielded cable may be used in TSET ionization chamber dosimetry if the size of cable-induced error in a given TSET beam is pre-evaluated and the measurement is carefully conducted. When such an evaluation has not been performed, additional shielding should be applied to the cable being used, making measurements at multiple points difficult.