In vivo dosimetry using a single diode for megavoltage photon beam radiotherapy: Implementation and response characterization

The AAPM Task Group 40 reported that in vivo dosimetry can be used to identify major deviations in treatment delivery in radiation therapy. In this paper, we investigate the feasibility of using one single diode to perform in vivo dosimetry in the entire radiotherapeutic energy range regardless of its intrinsic buildup material. The only requirement on diode selection would be to choose a diode with the adequate build up to measure the highest beam energy. We have tested the new diodes from Sun Nuclear Corporation (called QED and ISORAD-p--both p-type) for low-, intermediate-, and high-energy range. We have clinically used both diode types to monitor entrance doses. In general, we found that the dose readings from the ISORAD (p-type) are closer of the dose expected than QED diodes in the clinical setting. In this paper we report on the response of these newly available ISORAD (p-type) diode detectors with respect to certain radiation field parameters such as source-to-surface distance, field size, wedge beam modifiers, as well as other parameters that affect detector characteristics (temperature and detector-beam orientation). We have characterized the response of the high-energy ISORAD (p-type) diode in the low- (1-4 MV), intermediate- (6-12 MV), and high-energy (15-25 MV) range. Our results showed that the total variation of the response of high-energy ISORAD (p-type) diodes to all the above parameters are within +/-5% in most encountered clinical patient treatment setups in the megavoltage photon beam radiotherapy. The usage of the high-energy buildup diode has the additional benefit of amplifying the response of the diode reading in case the wrong energy is used for patient treatment. In the light of these findings, we have since then switched to using only one single diode type, namely the "red" diode; manufacturer designation of the ISORAD (p-type) high-energy (15-25 MV) range diode, for all energies in our institution and satellites.