The AAPM's TG-51 Protocol for Clinical Reference Dosimetry of High-Energy Beams

D.W.O. Rogers

Ionizing Radiation Standards
Institute for National Measurement Standards
National Research Council of Canada

Refresher Course presented at 7:30 am, July 26, 1999, Nashville AAPM Meeting

Protocol Authors:  Peter R. Almond (chair), Peter J. Biggs,  B.M. Coursey,
W.F. Hanson, M.Saiful Huq, Ravinder Nath, D.W.O. Rogers

The protocol was published in Medical Physics, Volume 26 (1999) 1847 -- 1870.

These are the slides used for the above refresher course.

The slides from a talk entitled ``Why to Use TG-51 instead of TG-21'', which was presented at the Chicago 2000 World Congress on Medical Physics, are also available


Abstract of TG-51:

A protocol is prescribed for clinical reference dosimetry of external beam radiation therapy using photon beams with energies between $^{60}\mbox{Co}$  and 50 MV and electron beams with nominal energies between 4 and 50 MeV. The protocol was written by Task Group 51 (TG-51) of the Radiation Therapy Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol uses ion chambers with absorbed-dose-to-water calibration factors, ND,w60Co, which are traceable to national primary standards, and the equation: DQw= M kQND,w60Co where Q is the beam quality of the clinical beam, DQw is the absorbed dose to water at the point of measurement of the ion chamber placed under reference conditions, M is the fully corrected ion chamber reading and kQ is the quality conversion factor which converts the calibration factor for a $^{60}\mbox{Co}$ beam to that for the beam quality Q. Values of kQ are presented as a function of Q for many ion chambers. The value of M is given by $ M = P_{\rm ion}P_{TP}P_{\rm elec}P_{\rm pol}M_{\rm raw}$ where $M_{\rm raw}$ is the raw, uncorrected ion chamber reading and $P_{\rm ion}$ corrects for ion recombination, PTP for temperature and pressure variations, $P_{\rm elec}$ for inaccuracy of the electrometer if calibrated separately and $P_{\rm pol}$ for chamber polarity effects. Beam quality, Q, is specified: (i) for photon beams, by $\%dd(10)_{\sf x}$, which is the photon component of the percentage depth dose at 10 cm depth for a field size of 10$\times$10 $\mbox{cm}^{2}$  on the surface of a phantom at an SSD of 100 cm ; and, (ii) for electron beams, by $R_{\rm 50}$, the depth at which the absorbed-dose falls to 50% of the maximum dose in a beam with field size $\ge$10$\times$10 $\mbox{cm}^{2}$  on the surface of the phantom ($\ge$20$\times$20 $\mbox{cm}^{2}$  for $R_{\rm 50}> 8.5$ cm) at an SSD of 100 cm. $R_{\rm 50}$ is determined directly from the measured value of $I_{\rm 50}$, the depth at which the ionization falls to 50% of its maximum value. All clinical reference dosimetry is performed in a water phantom. The reference depth for calibration purposes is 10 cm for photon beams and 0.6 $R_{\rm 50}~-~0.1$ cm for electron beams. For photon beams clinical reference dosimetry is performed in either an SSD or SAD setup with a 10$\times$10 $\mbox{cm}^{2}$  field size defined on the phantom surface for an SSD setup or at the depth of the detector for an SAD setup. For electron beams clinical reference dosimetry is performed with a field size of $\ge$ 10$\times$10 $\mbox{cm}^{2}$  ($\ge$ 20$\times$20 $\mbox{cm}^{2}$  for $R_{\rm 50}~>~8.5$ cm) at an SSD between 90 and 110 cm. This protocol represents a major simplification compared to the AAPM's TG-21 protocol in the sense that large tables of stopping-power ratios and mass-energy absorption coefficients are not needed and the user does not need to calculate any theoretical dosimetry factors.


The protocol will be published in Medical Physics, most likely in the September 1999 issue.  The protocol provides little background information but is, by design, more of a cookbook.  For a general introduction and details about how the calculations have been done, please see the following two papers and references therein:

D.W.O. Rogers: Fundamentals of Dosimetry Based on Absorbed-Dose Standards pp 319--356 in
Teletherapy Physics, Present and Future (1996 AAPM Summer School proceedings).
and

D. W. O.  Rogers: A new  approach to electron beam reference dosimetry, Medical Physics, 25 (1998) 310-320.


If you would like a blown-up hard copy of the figures, they are available at http://www.irs.inms.nrc.ca/inms/irs/tg51_figures/tg51_figures.html



There is a pdf version (800kbytes) of the slides available (6 per page) and also a gziped postcript version (660kbytes).

People are welcome to make use of the slides for their own presentations on the condition that the NRC-CNRC logo not be covered over or removed. For individual slides, one can download the individual slide (using the right mouse button) and save it and then import into your own powerpoint presentation. If you want the whole set, it is available here but be warned, it is 848896 bytes long!.

For access to all of the IRS web site please go to our index.


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Table of Contents

The AAPM TG-51 Protocol

AAPM's TG-51 Protocol

Current Clinical Practice

Problems with current practice

Absorbed-dose standards

Absorbed-dose standards

Clinical photon dosimetry

Clinical photon dosimetry

Starts with 

Traceability 

In-water => waterproof

General formalism

Photon beams

Electron beams

Formalism summary

Measurement phantoms

Charge measurement

Pion: recombination correction

Beam quality specification

Photon beam quality

Measuring %dd(10)

Photon 0.6rcav depth-shift

Electron contamination

Electron contamination

Lead foil correction

Problems with TPR

Why use %dd(10)x

Reference Conditions: Photons

Reference Conditions: Photons

Clinical Photon Dosimetry

Measured kQ values

kQ - cylindrical chambers

kQ comparison to previous

e- beam quality

R50=1.029 I50 - 0.063 cm

Reference conditions: e-

Dref = 0.6 R50 - 0.1 cm

Electron beam dosimetry

kQ for electron beams

PPT Slide

PPT Slide

Why so complex for e-?

Why so complex for e-?

Plane-parallel chambers

Plane-parallel chambers

Dose change: 60Co (Can)

Dose change: 60CO (US)

Dose change: photons (Can)

Dose change: photons (US)

Dose change: electrons (Can)

Dose change: electrons (US)

What have we gained?

What have we gained?

What have we gained?

What have we gained?

Summary - photons

Summary -photons (cont)

Summary - electrons

Summary -electrons(cont)

Equipment Needed

Equipment Needed

Status of TG-51

Conclusions

Author: Rogers 

Email: dave@irs.phy.nrc.ca

Home Page: http://www.irs.inms.nrc.ca/inms/irs/irs.html

Other information:
These are the slides to be used for a refresher course at 7:30 am, Monday July 26 at the 1999 AAPM meeting. The course is entitled ``The AAPM's TG-51 Protocol for Clinical Reference Dosimetry of High-Energy Beams'' and is presented by D.W.O. Rogers.