IAEA TLD Postal Dose Quality Audit for X ray and Co-60 γ beams

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IAEA/WHO TLD POSTAL DOSE QUALITY AUDIT for Co-60 γ beams Megavoltage X ray beams

DATA SHEET for Radiotherapy Centres

It is of a great importance for the TLD evaluation that the information requested below be completed. Part I is mandatory. Complete Part II, if additional absorbed dose to water determination was made by ionization chamber measurements.

TLD Batch No. TLD SET No. Contact person: Family name* Given name* Position Department E-mail (individual) Telephone (individual) Name of Institution* Address: Street*

City* PO Box ZIP code Province / State Country*

E-mail (institutional) Telephone (institutional) Fax number (institutional) Form completed by:

Family name Given name Date* (dd/mm/yyyy)

TLD Irradiation performed by: Family name Given name Position Person 1* Person 2 Person 3

Previous participation in an external audit or intercomparison for this beam*: Yes* No Organiser Fields marked with (*) are mandatory

IAEA Laboratory Seibersdorf DOSIMETRY LABORATORY, DMRP SECTION, DIVISION OF HUMAN HEALTH

Reaktorstrasse 1 A-2444 Seibersdorf, Austria

Fax: +43 1 2600781662, Tel: +43 1 2600-28331 or 28351, e-mail: Dosimetry@iaea.org

IAEA TLD Postal Dose Quality Audit for X ray and Co-60 γ beams

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PART I. For hospital staff (physicist, oncologist, technician) Specifications of the irradiation unit: Co-60 unit medical accelerator The treatment unit used for this audit is of the type:

Manufacturer and model* Other treatment unit (if not on the list) Serial number Production year* Installation year* For a Co-60 unit the date of the last source For a medical accelerator the manufacturer stated X ray beam energy is MV

The beam quality is characterized by one of the following: D20/D10 = (10 cm × 10 cm at SSD = 100 cm) TPR20/10 = (10 cm × 10 cm at a const. source-to-detector distance of cm) other = conditions:

Irradiation of TLD capsules The TLD capsules were irradiated on the following date* (dd/mm/yyyy) The TLD capsules were irradiated at * cm depth in water using a field* cm × cm

at a distance* cm SSD fixed source skin distance SAD fixed source axis distance

For the different TLD capsules, the irradiation time/monitor settings and the dose delivered (in grays) were: capsule I* min MU D= Gy capsule II* min MU D= Gy Calculation of time/monitor setting Provide the data used for the calculation of time/monitor setting for the TLD irradiation Please give a detailed explanation of your procedure for the above time/monitor and dose calculation. Please provide all factors (beam output, any conversion or correction factors, etc.) you have used:

Beam output as stated for your clinical data: on the date (dd/mm/yyyy) Please explain in detail the irradiation conditions for which this clinical beam output applies(e.g. in-air or depth in water, SAD or SSD, field size):

IAEA TLD Postal Dose Quality Audit for X ray and Co-60 γ beams

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PART II. Additional request for medical physicists Determination of the absorbed dose to water by ionisation chamber Measurements were performed by: Family name Given name Physicist assignment Date (dd/mm/yyyy) The absorbed dose to water at the centre of the TLD capsules was determined using a dosimeter system composed of : an ionisation chamber and an electrometer The Co-60 calibration coefficient of the dosimetry system (ionization chamber together with electrometer) was: The above stated calibration coefficient was determined by the following laboratory/manufacturer on the following date (dd/mm/yyyy)

and refers to a temperature of oC and a pressure of The absorbed dose to water at the position of the centre of the TLD capsule was measured under the following conditions:

phantom Water Plastic if plastic phantom, select the type of plastic field size cm × cm

distance cm SSD fixed source skin distance SAD fixed source axis distance

depth of of the ionisation chamber in phantom cm

For Co-60 beams and measurements in air: build-up cap material thickness g/cm2

Please give your reading results average uncorrected reading scale units measurement performed during min MU temperature oC pressure The absorbed dose to water at the position of the centre of the TLD capsule was determined by the following code of practice (dosimetry protocol) The shutter/monitor correction (timer error/MU effect) was (if any): s MU If some of the items do not apply to your method employed (e.g. when using a calibration coefficient normalized to check source reading), please give the detailed explanations below.

CCode: AuditType: RTFormStatus: UnknownFormErrorMessage: SetID: TLDDataID: OperatorID: LabCode: SetNo: BatchNo: ContactTitle: [Off]ContactFamilyName: ContactFirstName: ContactPosition: ContactDepartment: ContactEmail: ContactTelephone1: ContactTelephone2: OperatorName: Street: City: POBox: Zip: State: Country: [Off]InstitutionalEmail: InstitutionalTelephone1: InstitutionalFax: CompletedByPersonFamilyName: CompletedDate: CompletedByPersonFirstName: btnFormCompletedToday: IrradiatedByPersonTitle: [Off]IrradiatedByPersonFamilyName: IrradiatedByPersonFirstName: IrradiatedByPersonPosition: [Off]IrradiatedByPersonTitle2: [Off]IrradiatedByPersonFamilyName2: IrradiatedByPersonFirstName2: IrradiatedByPersonPosition2: [Off]IrradiatedByPersonTitle3: [Off]IrradiatedByPersonFamilyName3: IrradiatedByPersonFirstName3: IrradiatedByPersonPosition3: [Off]ParticipationOrganiserOther: PreviousParticipation: OffParticipationOrganiser: [Off]EquipmentLinac: [Off]Equipment: EquipmentCo60: [Off]EquipmentSerialNumber: EquipmentProductionYear: [Off]EquipmentOther: EquipmentLastSourceReplacementYear: [Off]lbCo60Line1: For a Co-60 unit the date of the last source replacement isEquipmentInstallationYear: [Off]EquipmentEnergy: lbLinacLine2: The beam quality is characterized by one of the following:BeamQuality: OfflbLinacLine3_1: D20/D10 =BeamQualityD20D10: lbLinacLine3_2: (10 cm × 10 cm at SSD = 100 cm)lbLinacLine4_1: TPR20/10 =BeamQualityTPR20: lbLinacLine4_2: (10 cm × 10 cm at a const. source-to-detector distance of BeamQualityTPR20Distance: lbLinacLine5_1: other =BeamQualityOther: lbLinacLine5_2: conditions: BeamQualityOtherConditions: IrradiationDepth: 10IrradiationDate: IrradiationFieldSize1: 10IrradiationFieldSize2: 10IrradiationDistance: IrradiationDistanceType: OffIrradiationSetting1: IrradiationUnits1: OffUserDose1: IrradiationSetting2: IrradiationUnits2: OffUserDose2: Factors: BeamOutput: BeamUnits: [Off]BeamOutputDate: Conditions: MeasuredByPersonFamilyName: MeasuredByPersonFirstName: MeasuredDate: MeasuredByPosition: [Off]IonisationChamber: [Off]IonisationChamberOther: Electrometer: [Off]ElectrometerOther: CalibrationType: [Off]CalibrationValue: CalibrationUnit: [Off]CalibrationLaboratory: CalibrationDate: Temperature: Pressure: PressureUnit: [Off]PhantomMaterial: [Off]PhantomType: OffChamberIrradiationFieldSize1: 10ChamberIrradiationFieldSize2: 10ChamberIrradiationDistance: ChamberIrradiationDistanceType: OffChamberIrradiationMeasuringPoint: [Off]lbCo60Line2: For Co-60 beams and measurements in air:ChamberIrradiationDepth: 10lbCo60Line3_1: build-up cap material CapMaterial: [Off]lbCo60Line3_2: thicknessCapThickness: ReadingUncorrected: ReadingMeasurementSetting: ReadingMeasurementSettingUnits: OffReadingTemperature: ReadingPressure: ReadingPressureUnit: [Off]DosimetryProtocol: [Off]CorrectionSetting: CorrectionUnits: OffDetailedExplanations: btnValidate: btnSubmit: LastUpdate: ParticipationYear: [Off]lbLinacLine1: For a medical accelerator the manufacturer stated X ray beam energy islbLinacLine1Star: *SetBeamType: OffSetBeamTypeInfo: Off