Radiation Measurements 46 (2011) 941e944

Contents lists available at ScienceDirect

Radiation Measurements
journal homepage: www.elsevier.com/locate/radmeas

Dosimetry of small radiation field in inhomogeneous medium using alanine/EPR

minidosimeters and PENELOPE Monte Carlo simulation
J.L. Vega Ramirez a,1, F. Chen b, P. Nicolucci a, O. Baffa a, *
a
Departamento de Física, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
b
Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Santo André, SP, Brazil

a r t i c l e i n f o a b s t r a c t

Article history: Alanine/K-Band EPR minidosimeters (miniALAs) were tested in the dosimetry of inhomogeneous
Received 7 December 2010 medium through the determination of percentage depth dose curves (PDD) for small radiation fields.
Received in revised form Field sizes of 3
3, 2
2, 1
1 and 0.5
0.5 cm2 were used at 100 cm source-surface distance. The
8 February 2011
minidosimeters were placed inside an inhomogeneous cylindrical phantom consisting of several slices of
Accepted 8 June 2011
cortical bone equivalent material positioned between slices of soft tissue-equivalent material. The
phantom with the minidosimeters was irradiated in a 6 MV Primus Siemens linear accelerator. EDR-2
Keywords:
Kodak radiographic film was used for comparison purposes. The PDD curves were also obtained with
Dosimetry
Alanine
PENELOPE Monte Carlo code for the same field sizes and irradiation and geometry conditions. The results
ESR show a suitable response from the miniALA dosimeters and a better match between miniALAs and MC
Radiotherapy simulation than with film in both interfaces.
Ó 2011 Elsevier Ltd. All rights reserved.

1. Introduction 2004). These heterogeneities produce a change in the dose distri-

Innovative techniques in radiotherapy such as conformal
radiotherapy (3DCRT) and intensity modulated radiation therapy
(IMRT) involve the use of modern three dimensional treatment
planning systems (TPS) (Khan, 2003; Gabel, 1994; Horwitz et al.,
1998; Boyer et al., 2001; Verhaegen and Seuntjens, 2003;
Carrasco and Jornet, 2004). To maximize the radiation dose to the
tumor while minimizing it to the healthy tissues is the main
objective of these 3D techniques. With the dose at a reference
point, the TPS makes use of dosimetric parameters, as the output
factor, beam profile and percentage depth dose (PDD), to determine
the dose elsewhere inside the irradiated volume (Khan, 2003).
These dosimetric parameters could be measured for an homoge-
neous medium, in a water-equivalent phantom, with different
types of dosimeters (TLD, radiographic film, ionization chamber,
among others) besides being determined by Monte Carlo (MC)
simulation (Verhaegen and Seuntjens, 2003).
The human body, however, is composed of a variety of tissues
and cavities with different physical and radiological properties,
representing heterogeneities inside the irradiated volume (AAPM,
bution compared to that obtained for a homogeneous medium and
therefore it is important to determine the dosimetric parameters
with high precision taking these heterogeneities into account (Petti
et al., 1987; Watanabe et al., 2004).
The objective of this work was to determine the PDD curve in an
inhomogeneous medium using alanine/EPR dosimetry and to
compare the results with Monte Carlo simulation using PENELOPE
code (Baró et al., 1995). Alanine/EPR technique was already used in
the dosimetry of inhomogeneous media using alanine films and an
X-Band EPR spectrometer (Østerås et al., 2006). In this work alanine
minidosimeters (miniALAs) and a K-Band EPR spectrometer (Chen
et al., 2007a) was used. The inhomogeneous medium was repre-
sented by a phantom composed by several slices of bone and tissue-
equivalent material and was irradiated with four small area photon
beams.
2. Materials and methods
2.1. Inhomogeneous phantom

The inhomogeneous phantom is shown in Fig. 1. Both simulated

(Fig. 1a) and experimental (Fig. 1b) phantoms have a cylindrical
* Corresponding author.
E-mail address: baffa@ffclrp.usp.br (O. Baffa).
geometry with 15 cm diameter and 20 cm total height. The experi-
1
Presente address: Departamento de Física, Universidad Nacional de San Agustín mental phantom is built with 1 cm-thick slices of both bone and soft
de Arequipa, Arequipa, Perú. tissue-equivalent materials. Three bone equivalent material slices

1350-4487/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.radmeas.2011.06.008
942 J.L. Vega Ramirez et al. / Radiation Measurements 46 (2011) 941e944
Fig. 1. Inhomogeneous phantoms of soft tissue-bone-soft tissue-equivalent materials: (a) simulated with PENELOPE and (b) experimental.
were placed between four slices of tissue-equivalent material on the
top and thirteen slices of tissue-equivalent material at the bottom to
compose the phantom. The phantom, thus, have two interfaces, the
first at 4 cm depth and the second at 7 cm depth. Poly-
methylmethacrylate (r ¼ 1.19 g/cm3 and Zeff ¼ 7) was used as a soft
tissue-equivalent material due to its similar attenuation character-
istics in high energy beams. The attenuation coefficient for acrylic
and soft tissue differ by less than 2% for the range of energies present
in the energy spectrum used in this work. The bone equivalent
material was obtained from powdered cortical bovine bone samples
bonded with epoxy resin to produce cylindrical slices with 1 cm-
thick. The resulting bone equivalent material presents a density of
1.68 g/cm3 while cortical bone has a density of 1.92 g/cm3 (ICRU,
1992). A computed tomography (CT) of the bone equivalent mate-
rial showed that the attenuation characteristics of the slices
produced were suitable for the application and were comparable to
cortical bone (756 HU). Three small holes where drilled at the central
region of each slice to allow the positioning of the alanine mini-
dosimeters (miniALAs) during irradiation as shown in Fig. 2. The
holes had the same dimensions of the minidosimeters (3 mm depth)
and were drilled in the axial direction maintaining the rod-shaped
dosimeters parallel to the cylinder axis.
2.2. Alanine minidosimeters (miniALAs)
The composition of the miniALAs was 95% of L-alanine plus 5% of
PVA (binder). Desrosiers et al., 1993 studied pure PVA as a dosim-
eter and the critical dose values were above 100 Gy, in the present
case PVA is a binder material and considering its mass and relative
sensitivity the possible contribution to the overall signal of this
material is 100 times weaker than alanine. The miniature cylin-
drical pellets of nominal dimensions of 1 mm diameter and 3 mm
height were obtained by mechanical pressure of the mixture. A
batch of approximately 600 minidosimeters was prepared for this
work. The EPR measurements were carried out with a K-Band
spectrometer. There are several uncertainty sources in EPR
dosimetry and as is well know, the uncertainty increases with
decreasing radiation dose (Bartolotta et al., 1993; Chen et al.,
2007b). Taken into account these uncertainty sources, a previous
study with these minidosimeters showed reproducibility better
than 2% for the delivered dose used in this work (20 Gy). For
comparison purposes, an EDR-2 Kodak radiographic film was used
along with a CQ-01-PIW Densix optical densitometer (2 mm
diameter aperture).
2.3. Phantom and dosimeters irradiation
The miniALAs and the film were irradiated together using the
inhomogeneous phantom in a 6 MV Primus Siemens linear accel-
erator. Four small area irradiation photon fields were employed:
3
3, 2
2, 1
1 and 0.5
0.5 cm2 at 100 cm source-surface
distance. During irradiation three miniALAs were placed in the
holes drilled in each slice of the phantom, as shown in Fig. 2, to
provide an average reading at each depth (around 9 mm).
Measurements prior and after the interfaces were performed by
positioning minidosimeters before and after the first (around 4 cm)
and second (around 7 cm) interfaces. A dose of 20 Gy was deposited
at the build-up depth during irradiation. The central ray of the
incident beam was parallel to the cylindrical phantom central axis,
where the miniALAs were positioned for the PDD curve determi-
nation. For the irradiation of the film, another identical cylindrical
inhomogeneous phantom was prepared with a proper cut to place
the film vertically in the middle of the phantom, parallel to the
beam’s central ray. For film irradiation a dose of 0.68 Gy at the
build-up depth was used.
2.4. PENELOPE Monte Carlo simulation
The simulation was carried out with the PENELOPE code 2008
version. The simulated phantom had the same dimensions of the
experimental one as can be seen in Fig. 1. The minidosimeters were
not represented in the simulation geometry. The data for soft tissue
and cortical bone for the simulation were based on ICRU database
(ICRU, 1992). The radiation spectrum from Primus Siemens linear
Fig. 2. Position of the miniALAs inside the phantom during irradiation. The incident
beam’s central ray is parallel to the cylindrical phantom central axis.
 J.L. Vega Ramirez et al. / Radiation Measurements 46 (2011) 941e944 943

a 110
2
field 3x3 cm Siemens 6 MV b 110 2
field 2x2 cm Siemens 6 MV
100
100
PENELOPE Simul. PENELOPE Simul.
90
90 epr L-alanine EPR L-alanine
planning system 80 Kodak Film EDR2
80
Kodak film EDR2
70
70
PDD (%)

60

PDD (%)
60

50 50

40 40

30 30

20 20
bone acrylic acrylic
10
10
acrylic acrylic bone
0 0
0 4 8 12 16 20 0 4 8 12 16 20

Depth (cm) Depth (cm)

c 110
2
field 1x1 cm Siemens 6 MV d 2
110 field 0,5x0,5 cm Siemens 6 MV
100
PENELOPE Simul. 100
90 EPR L-alanine 90 PENELOPE Simul.
80 Kodak Film EDR2 EPR L-alanine
80
Kodak Film EDR2
70
70
PDD (%)

60
60
PD D (% )

50 50
40 40

30 30

20 20
acrylic acrylic
10 10 acrylic acrylic
bone bone
0 0
0 4 8 12 16 20 0 4 8 12 16 20

Depth (cm) Depth (cm)

Fig. 3. PDD curves obtained for field sizes of: (a) 3
3 cm2; (b) 2
2 cm2; (c) 1
1 cm2 and (d) 0.5
0.5 cm2.

accelerator was based on Monte Carlo simulation with the BEAM
code (Sheikh-Bagheri and Rogers, 2002). For each simulation the
number of primary particles was chosen to maintain the statistical
uncertainty in the deposited dose lower than 1% and the results
were used to calculate the PDDs.
3. Results and discussion
The PDD curves for the irradiation fields and heterogeneous
phantom used in this work are presented in Fig. 3. Fig. 3a presents
PDD curves for the 3
3 cm2 irradiation field obtained with the
miniALAs compared with film dosimetry, the data obtained from
Siemens Oncor treatment planning system and Monte Carlo
simulation when soft tissue and bone equivalent materials are
present in the irradiation volume. The phantoms and materials
used with the TPS matched those used with PENELOPE (only done
for this field size). The error bars showed for the minidosimeters
data in Fig. 1 represent the standard deviation for the averaged
reading (for the three miniALAs) at each depth. For the interfaces,
the maximum differences between the simulated results and the
treatment planning system, miniALAs and film data were 4.3%, 1.6%
and 2.8%, respectively for the first interface, and 2.9%, 2.1% and 7.5%,
respectively for the second interface. For the 2
2 cm2 radiation
field shown in Fig. 3b, the maximum differences between simu-
lated PDDs to the miniALA and film data are 3.3% and 7.3%,
respectively in the first interface, and 1.6% and 7.8%, respectively in
the second interface. The data from Fig. 3c shows that the
maximum differences found for the 1
1 cm2 irradiation field are
3.6% and 8.9% for the first interface and 2.3% and 7.7% for the second
interface, respectively between simulated data to miniALA and film
dosimetry. Fig. 3d shows the PDD for the 0.5
0.5 cm2 irradiation
field and maximum differences between simulation data and
miniALAs and film dosimetry are 0.2% and 5.2%, respectively for the
first interface, and 4.8% and 7.6%, respectively for the second
interface. For all the field sizes used, the film dosimetry presented
the largest differences among the methods used for the PDD
determination inside the bone region of the phantom due to its
largest response dependence with photon and electron energy
fluence when compared to the water-equivalent miniALAs dosim-
eters. In the soft tissue regions of the phantom, the largest differ-
ences between simulation and miniALAs results were found for the
0.5
0.5 cm2 radiation field (10.5% in a depth of 12.5 cm) due to the
diameter of the miniALA dosimeters in comparison to the field size.
Although the differences between simulation and the miniALAs in
the interfaces are lower than 3.6%, showing that the accuracy of
these dosimeters can be suitable to clinical use, the precision of the
minidosimeters has to be further investigated.
4. Conclusions
The dosimetry in tissue interfaces demand the use of small-sized
dosimeters presenting tissue-equivalent response characteristics in
944 J.L. Vega Ramirez et al. / Radiation Measurements 46 (2011) 941e944
order to provide accuracy to the dose determination. In radio-
therapy techniques employing small radiation fields, as IMRT or
radiosurgery, the size and precision provided by the chosen
dosimeter are of paramount importance. The agreement in the PDD
results obtained between Monte Carlo simulation and the alanine
minidosimeters results showed that the minidosimeters developed
in this work can be suitable for accurate dose determination in
tissue interfaces and small radiation fields although further inves-
tigations on precision of the minidosimeters have to be performed.
References
American Association of Physicists in Medicine, AAPM Report 85, 2004. Tissue
Inhomogeneity Corrections for Megavoltage Photon Beams. Medical Physics
Publishing, USA.
Baró, J., Sempau, J., Fernández-Varea, J.M., Salvat, F., 1995. PENELOPE: an algorithm
for Monte Carlo simulation of the penetration and energy loss of electrons and
positrons in matter. Nucl. Instrum. Methods Phys. Res. B. 100, 31e46.
Bartolotta, A., Fattibene, P., Onori, S., Pantaloni, M., Petetti, E., 1993. Sources of
uncertainty in therapy level alanine dosimetry. Appl. Radiat. Isot. 44 (1e2),
13e17.
Boyer, A.L., et al., 2001. Intensity modulated radiation therapy collaborative working
group. Intensity-modulated radiotherapy: current status and issues of interest.
Int. J. Radiat. Oncol. Biol. Phys. 51, 880e914.
Carrasco, P., Jornet, N., 2004. Comparison of dose calculation algorithms in phan-
toms with lung equivalent heterogeneities under conditions of lateral electronic
disequilibrium. Med. Phys. 31, 2899e2911.
Chen, F., Guzmán Calcina, C.S., de Almeida, A., de Almeida, C.E., Baffa, O., 2007a.
Relative output factor and beam profile measurements of small radiation
fields with an L-alanine/K-Band EPR minidosimeter. Med. Phys. 34 (5),
1573e1582.
Chen, F., Graeff, C.F.O., Baffa, O., 2007b. Response of L-alanine and 2-methylalanine
minidosimeters for K-Band (24 GHz) EPR dosimetry. Nucl. Instrum. Methods
Phys. Res. B. 264, 277e281.
Desrosiers, M.F., Puhl, J.M., McLaughlin, W.L., 1993. A new EPR dosimeter based on
polyvinylalcohol. JARI 44, 325e326.
Gabel, D., 1994. Present status and perspectives of boron neutron-capture therapy.
Radiother. Oncol. 30 (3), 199e205.
Horwitz, E.M., Hanlon, A.L., Hanks, G.E., 1998. Update on the treatment of prostate
cancer with external beam irradiation. The Prostate 37 (3), 195e206.
International Commission on Radiation Units and Measurements. ICRU report 46,
1992. Photon, Electron, Proton and Neutron Interaction Data for Body Tissues.
Bethesda.
Khan, F.M., 2003. The Physics of Radiation Therapy. Lippincott Williams &
Wilkins, USA.
Østerås, B.H., Hole, E.O., Olsent, D.R., 2006. EPR dosimetry of radiotherapy photon
beams in inhomogeneous media using alanine films. Phys. Med. Biol. 51,
6315e6328.
Petti, P.L., Rice, R.K., Mijnheer, B.J., Chin, L.M., Bjärngard, B.E., 1987. A heterogeneity
model for photon beams incorporating electron transport. Med. Phys. 14 (3),
349e354.
Sheikh-Bagheri, D., Rogers, D.W.O., 2002. Monte Carlo calculation of nine mega-
voltage photon beam spectra using the BEAM code. Med. Phys. 29 (3), 391e402.
Verhaegen, F., Seuntjens, J., 2003. Monte Carlo modeling of external radiotherapy
photon beams. Phys. Med. Biol. 48, R107eR164.
Watanabe, Y., Mooij, R., Perera, G.M., Maryanski, M.J., 2004. Heterogeneity phan-
toms for visualization of 3D dose distributions by MRI-based polymer gel
dosimetry. Med. Phys. 31 (5), 975e984.