Investigating ion recombination effects in a liquid-filled ionization chamber array used for IMRT QA measurements.

Purpose: PTW’s Octavius 1000 SRS array performs IMRT quality assurance (QA) measurements with liquid-filled ionization chambers (LICs) to allow closer detector spacing and higher resolution, compared to air-filled QA devices. However, reduced ion mobility in LICs relative to air leads to increased ion recombination effects and reduced collection efficiencies that are dependent on Linac pulse frequency and pulse dose. These pulse parameters are variable during an IMRT delivery, which affects QA results. In this study, (1) 1000 SRS collection efficiencies were measured as a function of pulse frequency and pulse dose, (2) two methods were developed to correct changes in collection efficiencies during IMRT QA measurements, and the effects of these corrections on QA pass rates were compared. Methods: To obtain collection efficiencies, the OCTAVIUS 1000 SRS was used to measure open fields of varying pulse frequency, pulse dose, and beam energy with results normalized to air-filled chamber measurements. Changes in ratios of 1000 SRS to chamber measured dose were attributed to changing collection efficiencies, which were then correlated to pulse parameters using regression analysis. The usefulness of the derived corrections was then evaluated using 6 MV and 10FFF SBRT RapidArc plans delivered to the OCTAVIUS 4D system using a TrueBeam (Varian Medical Systems) linear accelerator equipped with a high definition multileaf collimator. For the first correction, matlab software was developed that calculates pulse frequency and pulse dose for each detector, using measurement and DICOM RT Plan files. Pulse information is converted to collection efficiency, and measurements are corrected by multiplying detector dose by ratios of calibration to measured collection efficiencies. For the second correction the MU/min in the daily 1000 SRScalibration was chosen to match the average MU/min of the volumetric modulated arc therapy plan. Effects of the two corrections on QA results were examined by performing 3D gamma analysis comparing predicted to measured dose, with and without corrections. Results: Collection efficiencies correlated linearly to pulse dose, while correlations with pulse frequency were less defined, generally increasing as pulse frequency decreased. After complex matlab corrections, average 3D gamma pass rates improved by [0.07%,0.40%,1.17%] for 6 MV and [0.29%,1.40%,4.57%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. Maximum changes in gamma pass rates were [0.43%,1.63%,3.05%] for 6 MV and [1.00%,4.80%,11.2%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. On average, pass rates of simple daily calibration corrections were within 1% of complex matlab corrections. Conclusions: OCTAVIUS 1000 SRS ion recombination effects have little effect on 6 MV measurements. However, the effect could potentially be clinically significant for higher pulse dose unflattened beams when using tighter gamma tolerances, especially when small aperture sizes are used, as is common for SRS/SBRT. In addition, ion recombination effects are strongly correlated to changing MU/min, therefore MU/min used in daily 1000 SRScalibrations should be matched to the expected average MU/min of the IMRT plan.