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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Simulation Modeling in Dosimetry</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Aleksei Zhdanov</string-name>
          <email>jjj1994@yandex.ru</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Leonid Dorosinskiy</string-name>
          <email>l.dorosinsky@mail.ru</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Ural Federal University named after the first, President of Russia B. N. Yeltsin</institution>
          ,
          <addr-line>Yekaterinburg, Russian Federation</addr-line>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2017</year>
      </pub-date>
      <fpage>69</fpage>
      <lpage>78</lpage>
      <abstract>
        <p>In this article, we present simulation modeling in dosimetry based on three experiments: dose measurement, using VERO Linear Accelerator, with different depth of solid water phantom, different dose receivers (ionization chamber and radiographic film), and different field sizes, in order to study the influential factors on the delivered dose. We present the results of the experiments, and explain the relationship between fitting result and theoretical model. Finally, we will discuss the influence of different factors on the delivered dose.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>Introduction Linear Accelerator</title>
      <p>
        3. It can interact and be scattered or deflected from its original direction and deposit part of its energy, and photon
scattering possibilities: Thompson, Compton, Rayleigh, photoelectric and pair productions. These interactions are
contribute to dose deposition in the matter. [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]
      </p>
    </sec>
    <sec id="sec-2">
      <title>Tissue Maximum Ratio (TMR) and Percent Depth Dose (PDD)</title>
      <p>(1)
(2)
(3)
In dosimetry, Tissue maximum ratio (TMR) and percent depth dose (PDD) are frequently used dosimetric quantities. PDD
is defined as follows:
,</p>
      <p>Where and are dose and dose rate at point Q, as shown in Fig.3 in the central axis, similarly and are dose
and dose rate at point P, whose depth is in the central axis. Point Q is an arbitrary point at depth in the central axis,
and P represents reference point at in the central axis. Besides depth , three parameters determine PDD: field
size A, SSD (source surface distance, also denoted as , and photon beam energy .</p>
      <p>TMR is a special case of TPR (tissue phantom ratio), and TPR is defined as follows:</p>
      <p>Where and are dose and dose rate at a reference depth in the central axis, and for TMR, the reference
distance is the depth of dose maximum , so TMR is defined as follows:
,
,
,
,
⁄
⁄</p>
    </sec>
    <sec id="sec-3">
      <title>Radiation Dosimeter</title>
      <p>A radiation dosimeter is a device, instrument or system that measures or evaluates, either directly or indirectly, the
quantities of ionized radiation. In this article, we introduce two kinds of dosimeters, ionization chamber and radiographic
film.</p>
      <p>
        Ionization chamber is basically a gas filled cavity surrounded by a conductive outer wall and having a central collecting
electrode. The vent functions of the chamber equalizes the environmental change of air outside the chamber with the air
inside the chamber. Measurements with the air vented ionization chamber requires temperature and pressure correction to
account for the change in the mass of air in the chamber volume, which changes with the ambient temperature and pressure.
[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]
      </p>
      <p>Unlike ionization chamber, radiographic film detects dosimetry based on chemical property. Unexposed film consists
of a base of thin plastic layer with a radiation sensitive emulsion coated uniformly on one or both sides. Ionization of
irradiation-sensitive grains forms a latent image in the film, which can be processed by scanner as optical density (OD),
thus OD is a function of dose and can be used to measure relative dose.</p>
    </sec>
    <sec id="sec-4">
      <title>Output Factor 2</title>
    </sec>
    <sec id="sec-5">
      <title>Method and Material</title>
    </sec>
    <sec id="sec-6">
      <title>Water Phantom</title>
      <p>Because of the use of multi-leaf collimator (MLC), not all dose delivered by LINAC can reach patient. The output factor
for a given energy is the ratio of the dose for any specific field size to the dose for a 10 by 10 cm reference applicator,
both measured at in a phantom.</p>
      <p>
        Water phantom is designed for absolute dose measurements of photon beams with horizontal beam incidence. Furthermore,
it is suitable for combination with dosimeters and make the following calibration of ionization chambers used in radiation
therapy feasible. The phantom design allows cross calibration of a field ionization chamber against a calibrated reference
chamber at the users facility. [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]
      </p>
      <p>A water phantom has two reasons to use: the first reason is water has similar interaction with soft tissue or muscle since,
water has the closest electron density with tissue. The second reason for choosing water as phantom material is that it is
universally available with reproducible radiation properties.</p>
      <p>Solid dry phantoms is tissue or water equivalent, that has similar electron density with water.</p>
      <p>In this article we used the solid water phantom, which is shown in Fig.2.</p>
    </sec>
    <sec id="sec-7">
      <title>Comparison of Dose Measurement with Constant SSD and SAD</title>
      <p>In this article, we use ionization chamber for comparison the dose measurement of constant SDD and SAD as in Fig.3. We
choose 6 MV beams at field size a 10 by 10 cm and 100MU.</p>
      <p>For experiment with constant SSD, we set the distance from beam source to solid water surface to be constant (1m is
the machine isocenter), and change beam depth by adding and removing solid-water slabs (every single solid-water slab
provides the same attenuation as fluid water of 1cm). In order to maintain the constant distance, we modify the height of
table every time, we add new slab (only in PDD setting).</p>
      <p>For experiment with constant SAD, general setting is similar to that of PDD experiment, and the difference is that we
constrain the distance from beam source to the center of ionization center is constant, and variation of water depth is also
accomplished by adding and removing solid-water slabs over the ionization chamber. For both dose measurements
(PDD,TMR), we choose equivalent water depth from 1cm to 10cm, with general variation of 1cm.</p>
    </sec>
    <sec id="sec-8">
      <title>Film Calibration</title>
      <p>To compare different dose response of ionization chamber and radiographic film, we repeat dosimetric measurement with
constant SSD with EBT radiographic film as detector, and other parameters are the same (6MV beam, 4cm*4cm field size,
6 different values of MU). We place detector film in between two solid water slabs (PDD setting).</p>
      <p>We exposed the film to six different dose values, we choose different values of monitor units (86, 260, 346, 519, 692,
and 865 MU). The result represents the relationship between the monitor unit values and delivered dose. The result is film
with six different areas with different dose values, so we extract from the six areas of the film the optical density values
(OD). Next step is to estimate a function which represents the relation between the optical density (OD) and the delivered
dose. The estimated curve is the key for our report because it is the reference to estimate the doses of the other tasks and
verify our calculations. We fit the data to rational polynomial function as follows:</p>
      <p>General model Rat21:
6104 ;
4696
;
162.8 ;</p>
    </sec>
    <sec id="sec-9">
      <title>The Effect of Field Size on the Dose Using Ionization Chamber</title>
      <p>We measure the dose deposited by a photon beam for different quadratic field sizes (2*2, 4*4, 5*5, 7*7, 10*10, 12*12,
15*15, and 5*15 cm) using an ionization chamber and PDD setting. We study the relationship between the field size and
dose. The dependence between field size and dose is proportional that when the field size increases the dose increases.</p>
    </sec>
    <sec id="sec-10">
      <title>Film Dosimetry 3</title>
    </sec>
    <sec id="sec-11">
      <title>Result and Discussion</title>
      <p>We measure the dose deposited by a photon beam for different quadratic field sizes (2*2, 4*4, 5*5, 7*7, 10*10, 12*12,
15*15, and 5*15 cm) using an ionization chamber and PDD setting. We study the relationship between the field size and
dose. The dependence between field size and dose is proportional that when the field size increases the dose increases.</p>
    </sec>
    <sec id="sec-12">
      <title>Dose Measured with Constant SSD and SAD</title>
      <p>Result of two experiment are listed below (Fig.4). We can see that dose curve of constant SSD(source surface distance)
and SAD(source to axis distance) share similar trend, that relative dose increases with depth z until it reaches zmax and
then decline.used in radiation therapy feasible. The phantom design allows cross calibration of a field ionization chamber
against a calibrated reference chamber at the users facility.</p>
      <p>In the article, we conduct two measurements using ionization chamber, which set SSD and SAD separately. According
to the definition of TMR and PDD, constant SSD means constant , so dose measured with constant SSD should
represent PDD. Similarly, constant SAD indicates that total dose is constant, which means is constant through the
experiment, so dose measured with constant SAD can represent the variation of TMR.</p>
    </sec>
    <sec id="sec-13">
      <title>Relationship between PDD and TMR</title>
      <p>As before, doses measured with constant SSD can represent the variation of PDD, and doses measured with constant SAD
can represent TMR, so we use doses measured in two separate experiment to study the relationship between PDD and
TMR.</p>
      <p>According to the property of attenuation along central axis in the slabs, doses of certain depth and from the same source
are inversely proportional to the field size at that depth, thus we get:
,
1</p>
      <p>Where and denotes dose at point Q and at the surface of the water slabs, denotes distance from source to water
slab, and z denotes depth of Q. For constant SDD measurement, is constant and in this experiment:
(5)
(6)
(7)
(8)
(9)
(10)</p>
      <sec id="sec-13-1">
        <title>And for constant SAD dosimetric measurement, is constant and similarly:</title>
        <p>′
1
′</p>
      </sec>
      <sec id="sec-13-2">
        <title>In this case,</title>
        <p>and ′</p>
        <p>refer to different surfaces and their relationship:
By displacing ′
we can get the relationship between
and ′</p>
        <p>:
1
1
′
′
1</p>
        <p>1
1
1
′
1
1
1
1</p>
        <p>From (Fig.5, Table 2), we can see that, within in the error range calibration line fits measurement in the experiment,
which support our derivation of relationship between exposure with constant SSD and constant SAD.</p>
        <p>Ignoring the effects of point spreading function (PSF), we can also get easily from (9) the relationship between TMR
and PDD from this:</p>
      </sec>
    </sec>
    <sec id="sec-14">
      <title>Film Calibration</title>
      <p>
        We irradiate six different doses to six areas of the film based on six different monitor unites as in Fig.6. We calculate the
mean value of each interested area of the film and for the background as well [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. Then we calculate the optical density
(OD) using the equation (11), I represents the mean value of the dose and I0 represents the mean value of the background:
log
(11)
      </p>
    </sec>
    <sec id="sec-15">
      <title>The Effect of Field Size on the Dose Using Ionization Chamber</title>
      <p>Beams used for radiotherapy have various shapes that usually represent a compromise between the actual target shape and
the need for simplicity and efficiency in beam shaping. Four general groups of field shape are used in radiotherapy: square,
rectangular, circular and irregular.</p>
      <p>We present in this section the result of changing the field size and its effect on the delivered dose. We perform the
experiment by varying the field size (2*2, 4*4, 5*5, 7*7, 10*10, 12*12, 15*15, and 5*15 cm) and record the delivered dose
of ionization chamber. We notice that with increasing the field size the dose increases as well, and this is because we are
increasing the exposed area of radiation, which accumulated into larger dose, which means higher recorded dose as we can
see in Fig.9 and table 5. For any arbitrary radiation field an equivalent square may be found, meaning that the arbitrary
field and the equivalent square will be characterized with similar beam parameters and functions that are of importance in
radiation dosimetry. An arbitrary rectangular field with sides a and b will be approximately equivalent to a square radiation
field with sides ( ) when both fields have the same area/perimeter ratio (Day’s rule):
2</p>
      <p>4</p>
      <p>We will discuss based on eq.12, that if we have field size with dimensions 5x20 cm what will be the result?. We can
answer this question from the mathematical side. equals to 8 based on eq.12. The area of this field ( ) is 64 cm*cm,
then the dose of this field is 648.4269 mGy as it was estimated from Fig.9. If we have field size with dimensions 5x15 cm
what will be the result? We can answer this question from the mathematical side. equals to 7.5. The area of this field
( ) is 56.2 cmxcm, then the dose of this field is 650.5464 mGy as it was estimated from Fig.9.</p>
    </sec>
    <sec id="sec-16">
      <title>Film Calibration</title>
      <p>We measure the calibration curve for film dosimetry using 10*10 field size in 10 cm depth (solid water) after rotating the
source of radiation 90 degree around the film. The idea of this setup is to analyze the dose distribution in the film and see
the difference between the film outside the solid water slabs and inside them and compare it to the result of ionization
chamber using PDD setting. We notice that the dose is increasing from the starting point of the film until it reaches the
maximum value. Then the curve decreases because the last part of the film exposed by less radiation as we can see in
Fig.11. We use smoothing spline function for the fitting step and it is f1(x) = piecewise polynomial computed from p
(coefficient structure p=0.9357) and after that we performed smoothing step. In Fig.12, we can see the PDD values of
ionization chamber and radiographic film in the same figure.
We verify the result of the radiographic film and ionization chamber as we can see in Fig.12 by calculating the error
between the two graphs for different depth values (1, 1.5, 2, 3, 4, 5, 6, 7, 8, 9, and 10 cm). The maximum error is 3.49% as
we can see in Table 6, which is acceptable based on the chosen curves fitting.
4</p>
    </sec>
    <sec id="sec-17">
      <title>Conclusion</title>
      <p>
        During radiation, the absorbed dose in the patient varies with depth. This variation depends on many conditions: beam
energy, depth, field size, distance from source, and beam collimation system. These parameters must be considered when
calculating the dose in the patient. Percentage Depth Dose (PDD) and Tissue Maximum Ratio (TMR) are dosimetric
quantities defined for this purpose. Percentage depth dose increases with increased SSD because as the SSD is increased,
the volume of the area irradiated is decreased and the interactions are more concentrated.It is more practical to use
dosimetric quantities that are independent on SSD such as TMR for isocentric treatment planning. [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]
      </p>
      <p>For a small field size, the contribution of the scattered photons to the depth dose in this case is negligibly small or 0.
But as the field size is increased, the contribution of the scattered radiation to the absorbed dose increases. Because this
increase in scattered dose is greater at larger depths, the percent depth dose increases with increasing field size.</p>
    </sec>
    <sec id="sec-18">
      <title>5 Acknowledgements</title>
      <p>All dates and images were taken by Brainlab Vero Linac of Erlangen University Clinic. The experiments which is shown
in this article was supported by Prof. Dr. rer. nat. Christoph Bert of Friedrich-Alexander University Erlangen-Nürnberg,
Erlangen.</p>
    </sec>
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