按照TRS-398和TG-51报告采用平行板电离室测量电子线剂量率的差异

美国医学物理学家协会（AAPM）和国际原子能机构（IAEA）分别在1999和2000年发表了针对治疗用射线束进行临床剂量测量的TG-51和TRS-398报告。这两大体上报告的特点是：在^60Co辐射场下得出对水的吸收校准因子ND，w^60Co，然后通过相应的射线质校正因子kQ，Q0（TRS-398）或k0（TG-51）算出相应的吸收剂量。另外，两报告都建议利用指型电离室在高能电子线辐射场下校准平行板电离室，得到对水的吸收校准因子ND，w^60Co，主要是避免平行板电离室在^60Co辐射场下校准的误差。TG-21和TRS-277只限于在^60Co辐射场下得出照射量校准因子的NX或空气比释动能校准因子NK，需要经过复杂的查表与计算过程方能得出某能量对水的吸收剂量，增加了查表与计算过程之误差。目前国内的剂量测量规范主要是依据IAEA TRS-277号报告制定。在此，尝试依据TG-51和TRS-398号报告所建议的方法测量直线加速器的电子线输出剂量并比较其差异。

Risk Management of Clinical Reference Dosimetry of a Large Hospital Network Using Statistical Process Control

Managing TG-51 reference dosimetry in a large hospital network can be a challenging task. The objectives of this study are to investigate the effectiveness of using Statistical Process Control (SPC) to manage TG-51 workflow in such a network. All the sites in the network performed the annual reference dosimetry in water according to TG-51. These data were used to cross-calibrate the same ion chambers in plastic phantoms for monthly QA output measurements. An energy-specific dimensionless beam quality cross-calibration factor, , was derived to monitor the process across multiple sites. The SPC analysis was then performed to obtain the mean, , standard deviation, σk, the Upper Control Limit (UCL) and Lower Control Limit (LCL) in each beam. This process was first applied to 15 years of historical data at the main campus to assess the effectiveness of the process. A two-year prospective study including all 30 linear accelerators spread over the main campus and seven satellites in the network followed. The ranges of the control limits (±3σ) were found to be in the range of 1.7% - 2.6% and 3.3% - 4.2% for the main campus and the satellite sites respectively. The wider range in the satellite sites was attributed to variations in the workflow. Standardization of workflow was also found to be effective in narrowing the control limits. The SPC is effective in identifying variations in the workflow and was shown to be an effective tool in managing large network reference dosimetry.

Variation in patient dose due to differences in calibration and dosimetry protocols

For precise and accurate patient dose delivery,the dosimetry system must be calibrated properly according to the recommendations of standard dosimetry protocols such as TG-51 and TRS-398. However, the dosimetry protocol followed by a calibration laboratory is usually different from the protocols that are followed by different clinics, which may result in variations in the patient dose.Our prime objective in this study was to investigate the effect of the two protocols on dosimetry measurements.Dose measurements were performed for a Co-60 teletherapy unit and a high-energy Varian linear accelerator with 6 and 15 MV photon and 6, 9, 12, and 15 MeV electron beams, following the recommendations and procedures of the AAPM TG-51 and IAEA TRS-398 dosimetry protocols. The dosimetry systems used for this study were calibrated in a Co-60 radiation beam at the Secondary Standard Dosimetry Laboratory(SSDL) PINSTECH,Pakistan, following the IAEA TRS-398 protocol. The ratio of the measured absorbed doses to water in clinical setting,D_w(TG-51/TRS-398), was 0.999 and 0.997 for 6 and15 MV photon beams,whereas these ratios were 1.013,1.009, 1.003, and 1.000 for 6, 9, 12, and 15 MeV electron beams, respectively. This difference in the absorbed dosesto-water D_w ratio may be attributed mainly due to beam quality(K_Q) and ion recombination correction factor.