Dosimetry of small static fields used in external photon beam radiotherapy: Summary of TRS-483, the IAEA–AAPM international Code of Practice for reference and relative dose determination

Abstract

Purpose: A joint IAEA/AAPM international working group has developed a Code of Practice (CoP) for the dosimetry of small static fields used in external megavoltage photon beam radiotherapy, published by the IAEA as TRS-483. This summary paper introduces and outlines the main aspects of the CoP. Methods: IAEA TRS-483 is a condensation of the wide range of different approaches that have been described in the literature for the reference dosimetry of radiotherapy machines with nominal accelerating potential up to 10 MV that cannot establish the conventional 10 cm × 10 cm reference field, and for the determination of field output factors for relative dosimetry in small static photon fields. The formalism used is based on that developed by Alfonso et al. [Med Phys. 2008;35:5179–5186] for this modality. Results: Three introductory sections describe the rationale and context of the CoP, the clinical use of small photon fields, and the physics of small-field dosimetry. In the fourth section, definitions of terms that are specific to the CoP (as compared to previous CoPs for broad-beam reference dosimetry, such as IAEA TRS-398 and AAPM TG-51) are given; this section includes a list of the symbols and equivalences between IAEA and AAPM nomenclature to facilitate the practical implementation of the CoP by end users of IAEA TRS-398 and AAPM TG-51. The fifth section summarizes the equations and procedures that are recommended in the CoP and the sixth section provides an overview of the methods used to derive the data provided in IAEA TRS-483. Conclusions: This is the first time an international Code of Practice for the dosimetry of small photon fields based on comprehensive data and correction factors has been published. This joint IAEA/AAPM CoP will ensure consistent reference dosimetry traceable to the international System of Units and enable common and internationally harmonized procedures to be followed by radiotherapy centers worldwide for the dosimetry of small static megavoltage photon fields.