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Title: Cherenkov emission-based external radiotherapy dosimetry: II. Electron beam quality specification and uncertainties.
Author: Zlateva Y, Muir BR, Seuntjens JP, El Naqa I.
Journal: Med Phys; 2019 May; 46(5):2383-2393. PubMed ID: 30706493.
Abstract:
PURPOSE: Cherenkov emission (CE) is ubiquitous in external radiotherapy. It is also unique in that it carries the promise of 3D, micrometer-resolution, perturbation-free, in-water dosimetry with a beam quality-independent detector response calibration. Our aim is to bring CE-based dosimetry into the clinic and we motivate this here with electron beams. We Monte Carlo (MC) calculate and characterize broad-beam CE-to-dose conversion factors in water for a clinically representative library of electron beam qualities, address beam quality specification and reference depth selection, and develop a preliminary uncertainty budget based on our MC results and relative experimental work of a companion study (Paper I). METHODS: Broad electron beam CE-to-dose conversion factors k C θ ± δ θ include CE generated at polar angles θ ± δθ on beam axis in water. With modifications to the EGSnrc code SPRRZnrc, k C θ ± δ θ factors are calculated for a total of 20 electron beam qualities from four BEAMnrc models (Varian Clinac 2100C/D, Clinac 21EX, TrueBeam, and Elekta Precise). We examine beam quality, depth, and detection angle dependence for θ ± δ θ = 90 ∘ ± 90 ∘ (4π detection), 90 ∘ ± 5 ∘ , 45 ∘ ± 45 ∘ , and 90 ∘ ± 45 ∘ . As discussed in Paper I, 4π detection offers the strongest CE-dose correlation and θ = 90 ∘ with small δθ is most practical. The two additional configurations are considered as a compromise between these two extremes. We address beam quality specification and reference depth selection in terms of the electron beam quality specifier R 50 , obtained from the depth of 50% CE C 50 , and derive a best-case uncertainty budget for the CE-based dosimetry formalism proposed in Paper I at each detection configuration. RESULTS: The k C θ ± δ θ factor was demonstrated to capture variations in the beam spectrum, angle, photon contamination, and electron fluence below the CE threshold (∼260 keV in the visible) in accordance with theory. The root-mean-square deviation and maximum deviation of a second-order polynomial fit of simulated R 50 values in terms of C 50 were 0.05 and 0.11 mm at 4π and 0.20 and 0.33 mm at 90 ∘ ± 5 ∘ detection, respectively. The fit performance on experimental data in Paper I was in agreement with these values within experimental uncertainties (±1.5 mm, 95% CI). A two-term power function fit of k C θ ± δ θ in terms of R 50 at a reference depth d ref = a R 50 + b resulted in total d ref -dependent dose uncertainty contribution estimate of 0.8% and 1.1% and preliminary best-case estimate of the combined standard dose uncertainty of 1.1% and 1.3% at 4π and 90 ∘ ± 5 ∘ detection, respectively. The results and corresponding uncertainties with the two intermediate apertures were generally of the same order as the 4π case. In addition, a theoretically consistent downstream shift of the percent-depth CE (PDC) by the difference between R 50 and C 50 improved the depth dependence of the 4π conversion by an order of magnitude (±2.8%). Therefore, a large aperture centered on a θ value between 45 ∘ and 90 ∘ combined with a downstream PDC shift may be recommended for beam-axis CE-based electron beam dosimetry in water. CONCLUSIONS: By delivering R 50 -based CE-to-dose conversion data and demonstrating the potential for dosimetric uncertainty on the order of 1%, we bring CE-based electron beam dosimetry closer to clinical realization.

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