title: Quality assurance of proton beams using a multilayer ionization chamber system.
abstract: OBJECTIVE
  The measurement of percentage depth-dose (PDD) distributions for the quality assurance of clinical proton beams is most commonly performed with a computerized water tank dosimetry system with ionization chamber, commonly referred to as water tank. Although the accuracy and reproducibility of this method is well established, it can be time-consuming if a large number of measurements are required. In this work the authors evaluate the linearity, reproducibility, sensitivity to field size, accuracy, and time-savings of another system: the Zebra, a multilayer ionization chamber system.
  
  
  METHODS
  The Zebra, consisting of 180 parallel-plate ionization chambers with 2 mm resolution, was used to measure depth-dose distributions. The measurements were performed for scattered and scanned proton pencil beams of multiple energies delivered by the Hitachi PROBEAT synchrotron-based delivery system. For scattered beams, the Zebra-measured depth-dose distributions were compared with those measured with the water tank. The principal descriptors extracted for comparisons were: range, the depth of the distal 90% dose; spread-out Bragg peak (SOBP) length, the region between the proximal 95% and distal 90% dose; and distal-dose fall off (DDF), the region between the distal 80% and 20% dose. For scanned beams, the Zebra-measured ranges were compared with those acquired using a Bragg peak chamber during commissioning.
  
  
  RESULTS
  The Zebra demonstrated better than 1% reproducibility and monitor unit linearity. The response of the Zebra was found to be sensitive to radiation field sizes greater than 12.5 × 12.5 cm; hence, the measurements used to determine accuracy were performed using a field size of 10 × 10 cm. For the scattered proton beams, PDD distributions showed 1.5% agreement within the SOBP, and 3.8% outside. Range values agreed within -0.1 ± 0.4 mm, with a maximum deviation of 1.2 mm. SOBP length values agreed within 0 ± 2 mm, with a maximum deviation of 6 mm. DDF values agreed within 0.3 ± 0.1 mm, with a maximum deviation of 0.6 mm. For the scanned proton pencil beams, Zebra and Bragg peak chamber range values demonstrated agreement of 0.0 ± 0.3 mm with a maximum deviation of 1.3 mm. The setup and measurement time for all Zebra measurements was 3 and 20 times less, respectively, compared to the water tank measurements.
  
  
  CONCLUSIONS
  Our investigation shows that the Zebra can be useful not only for fast but also for accurate measurements of the depth-dose distributions of both scattered and scanned proton beams. The analysis of a large set of measurements shows that the commonly assessed beam quality parameters obtained with the Zebra are within the acceptable variations specified by the manufacturer for our delivery system.
authors.affiliation: Department of Radiation Physics and Proton Therapy Center, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 94, Houston, Texas 77030, USA. skdhanesar@mdanderson.org
authors.forename: Sandeep
authors.initials: S
authors.lastname: Dhanesar
authors.forename: Narayan
authors.initials: N
authors.lastname: Sahoo
authors.forename: Matthew
authors.initials: M
authors.lastname: Kerr
authors.forename: M Brad
authors.initials: MB
authors.lastname: Taylor
authors.forename: Paige
authors.initials: P
authors.lastname: Summers
authors.forename: X Ronald
authors.initials: XR
authors.lastname: Zhu
authors.forename: Falk
authors.initials: F
authors.lastname: Poenisch
authors.forename: Michael
authors.initials: M
authors.lastname: Gillin
mesh_terms: D016014:Linear Models; D011522:Protons; D011786:Quality Control; D011874:Radiometry / Q000295:instrumentation*; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D013997:Time Factors
chemical_list: D011522:Protons