title: Validation of OSLD and a treatment planning system for surface dose determination in IMRT treatments.
abstract: OBJECTIVE
  To evaluate the accuracy of skin dose determination for composite multibeam 3D conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) treatments using optically stimulated luminescent dosimeters (OSLDs) and Eclipse treatment planning system.
  
  
  METHODS
  Surface doses measured by OSLDs in the buildup region for open field 6 MV beams, either perpendicular or oblique to the surface, were evaluated by comparing against dose measured by Markus Parallel Plate (PP) chamber, surface diodes, and calculated by Monte Carlo simulations. The accuracy of percent depth dose (PDD) calculation in the buildup region from the authors' Eclipse system (Version 10), which was precisely commissioned in the buildup region and was used with 1 mm calculation grid, was also evaluated by comparing to PP chamber measurements and Monte Carlo simulations. Finally, an anthropomorphic pelvic phantom was CT scanned with OSLDs in place at three locations. A planning target volume (PTV) was defined that extended close to the surface. Both an 8 beam 3DCRT and IMRT plan were generated in Eclipse. OSLDs were placed at the CT scanned reference locations to measure the skin doses and were compared to diode measurements and Eclipse calculations. Efforts were made to ensure that the dose comparison was done at the effective measurement points of each detector and corresponding locations in CT images.
  
  
  RESULTS
  The depth of the effective measurement point is 0.8 mm for OSLD when used in the buildup region in a 6 MV beam and is 0.7 mm for the authors' surface diode. OSLDs and Eclipse system both agree well with Monte Carlo and/or Markus PP ion chamber and/or diode in buildup regions in 6 MV beams with normal or oblique incidence and across different field sizes. For the multiple beam 3DCRT plan and IMRT plans, the differences between OSLDs and Eclipse calculations on the surface of the anthropomorphic phantom were within 3% and distance-to-agreement less than 0.3 mm.
  
  
  CONCLUSIONS
  The authors' experiment showed that OSLD is an accurate dosimeter for skin dose measurements in complex 3DCRT or IMRT plans. It also showed that an Eclipse system with accurate commissioning of the data in the buildup region and 1 mm calculation grid can calculate surface doses with high accuracy and has a potential to replace in vivo measurements.
authors.affiliation: Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033.
authors.forename: Audrey H
authors.initials: AH
authors.lastname: Zhuang
authors.affiliation: Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033 and Department of Radiation Oncology, Children's Hospital Los Angeles, Los Angeles, California 90027.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Olch
mesh_terms: D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D009010:Monte Carlo Method; D062791:Optically Stimulated Luminescence Dosimetry / Q000295:instrumentation / Q000379:methods*; D010388:Pelvis; D019047:Phantoms, Imaging; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000295:instrumentation / Q000379:methods*; D012867:Skin / Q000528:radiation effects; D014057:Tomography, X-Ray Computed; D035501:Uncertainty