Radiochromic Film Dosimetry                                                     

See the review paper: Butson, M.J., Yu, P.K.N., Cheung, T., Metcalfe, P.E., "Radiochromic Film for Medical Radiation Dosimetry", 2003, Materials Science & Engineering R, 41, 61-120. (download pdf version). 

Radiation dosimetry for medical radiotherapy requires detectors which have a selection of physical and radiation properties specific to the needs of human tissue absorbed dose determination. Some of these characteristics are the need for high spatial resolution in measurement, low spectral energy dependence, relative insensitivity to ambient light conditions and the appropriate measurement accuracy at absorbed dose levels encountered in radiotherapy. Radiochromic film has been shown to provide such characteristics and has become an essential tool in radiotherapy dosimetry technique. Radiochromic films produce an immediate color change from clear to blue, red green etc. when exposed to x-ray and electron beam radiation. The image is formed by a polyermerization reaction to the incident radiation and is characterized by the energy transfer from the x-ray or electron to the radiochromic leucodye or photomonomer.

One type of radiochromic film has become the main dosimeter of choice in radiotherapy in recent years, this being Gafchromic TM MD-55. It provides a useful dosimetric range in medical applications for doses ranging from 3Gy up to 100Gy as a single layer dosimeter. By stacking the layers together, even more sensitive dosimeters can be produced. MD-55 film has found applications in many areas of radiotherapy. Some of these include the following:

Penumbral dosimetry (Galvin et al. Int. J. Radiat. Oncol. Biol. Phys., 1993, 25, 181-92; Carolan et al., Australas. Phys. Eng. Sci. Med., 1997, 20, 183-5). Radiochromic film can be used to investigate the dose distributions around areas of high dose gradient such as the penumbral regions of radiotherapy beams. In these regions there is often a change in the spectral components of the x-ray beam, which in turn, can cause other more energy dependent detectors such as the silver halide film to provide inaccurate penumbral dose information. This information can be quite useful in multileaf collimator edge dosimetry and applications such as Intensity Modulated Radiotherapy beam accuracy determination.

Stereotactic radiosurgery dosimetry (Bjarnard et al., Med. Phys., 1990, 17, 794-9) and Gamma knife dosimetry (Cheung et al., Med. Phys., 1999, 26, 1252-1256). Radiochromic film has been shown to a useful dosimeter in areas of electronic disequilibrium where other detectors are unable to perform accurate measurements. This is especially true for treatments such as gamma knife and radiosurgery where beams with radii smaller than 1 cm can be used. Radiochromic film can be used not only for central axis output but can also measure profiles and isodose curves with a high spatial resolution.

Interface dosimetry such as tissue metal dental interfaces (Niroomand-Rad et al., Int. J. Radiat. Oncol. Biol. Phys., 1996, 34, 475-80) has been studied where radiochromic film was used to measure the enhanced dose delivered to soft tissue close to a high density material such as gold or amalgam alloy.

Surface and skin dosimetry has been extensively studied and many measurements performed. The skin region is another area where there is a high electron disequilibrium and requires detectors with special properties for measurement. Butson et al. (Phys. Med. Biol., 2002, 47, N145-51) and Cheung et al. (Phys. Med. Biol., 2002, 47, N31-7) have provided insight into skin dose delivered from open fields, blocked fields and with the use of patient positioning devices.

Brachytherapy dosimetry requires dosimeters with a high spatial resolution due to the steep dose gradients around their sources. Radiochromic film provides this characteristic along with other characteristics, which has made it useful in brachytherapy dosimetry. Muench et al. (Med. Phys., 1991, 18, 769-75) began work in radiochromic film dosimetry around brachytherapy sources and continual work has been performed since then in many areas.

Radiochromic film has become a major dosimetry tool for radiotherapy due to its many enhanced characteristics over conventional dosimeters. As technology advances and with the production of newer and more sensitive variations of the currently available radiochromic film, more niche areas of applications will be explored in the near future further enhancing dosimetry accuracy in radiotherapy.

Journal Publications (see here for impact factors):

1. Butson, M. and Yu, P.K.N., “Comments on ‘Qualitative evaluation of radiochromic film response for two-dimensional dosimetry’”, 1998, Medical Physics, 25 (5), 793.
2. Butson, M. and Yu, P.K.N., Metcalfe, P.E., “Effects of read-out light sources and ambient light on radiochrmic film”, 1998, Physics in Medicine and Biology, 43, 2407-2412.
3. Butson, M. and Yu, P.K.N., Metcalfe, P.E., “Measurement of off-axis and peripheral skin dose using radiochromic film”, 1998, Physics in Medicine and Biology, 43, 2647-2650.
4. Butson, M.J., Yu, P.K.N., Metcalfe, P.E., “Incident contamination lepton doses measured using radiochromic film in radiotherapy”, 1998, Radiation Measurements, 29, 605-609.
5. Butson, M.J., Yu, P.K.N., Metcalfe, P.E., “Extrapolated surface dose measurements with radiochromic film”, 1999, Medical Physics, 26, 485-488.
6. Butson, M.J., Yu, P.K.N., Cheung, T., Carolan, M.G., Quach, K.Y., Amold, A. and Metcalfe, P.E., “Dosimetry of Blood Irradiation with Radiochromic Film”, 1999, Transfusion Medicine, 9, 205-208.
7. Butson, M.J., Cheung, T., Yu, P.K.N., Metcalfe, P.E., "Assessment of large single fraction low energy x-ray dose in-vivo using radiochromic film", 2000, International Journal of Radiation Oncology Biology and Physics, 46, 1071-1075.
8. Butson, M.J., Cheung, T., Yu, P., Metcalfe, P.E., "Effects on skin dose from unwanted air gaps under bolus in photon beam radiotherapy", 2000, Radiation Measurements, 32, 201-204.
9. Butson, M.J., Cheung, T., Yu, P.K.N., Abatti, D., Greenoak, G., "Ultraviolet radiation dosimetry with radiochromic film", 2000, Physics in Medicine and Biology, 45, 1863-1868.
10. Butson, M.J., Cheung, T., Yu, P.K.N., "Radiochromic film dosimetry in water phantoms", 2001, Physics in Medicine and Biology, 46, N27-N31.
11. Cheung, T., Butson, M.J., Yu, P.K.N., "Use of multiple layers of Gafchromic film to increase sensitivity", 2001, Physics in Medicine and Biology, 46, N235–N240.
12. Cheung, T., Butson, M.J., Yu, P.K.N., "Validation of blood product irradiation doses", 2001, Physics in Medicine and Biology, 46, N241–N244.
13. Butson, M.J., Cheung, T., Yu, P.K.N., "Spatial resolution of a stacked radiochromic film dosimeter", 2001, Radiotherapy and Oncology, 61, 211-213.
14. Butson, M.J., Cheung, T., Yu, P.K.N., B. Webb, "Variations in skin dose associated with linac bed material at 6 MV x-ray range", 2002, Physics in Medicine and Biology, 47, N25-N30.
15. Cheung, T., Butson, M.J., Yu, P.K.N., "Evaluation of a fluorescent light densitometer for radiochromic film analysis", 2002, Radiation Measurements, 35, 13-16.
16. Cheung, T., Butson, M.J., Yu, P.K.N., "Multilayer Gafchromic film detectors for breast skin dose determination in vivo", 2002, Physics in Medicine and Biology, 47, N31-37.
17. Butson, M.J., Cheung, T., Yu, P.K.N., "Calculation of electron contamination doses produced using blocking trays for 6 MV X-rays", 2002, Radiation Measurements, 35, 99-102.
18. Butson, M.J., Cheung, T., Yu, P.K.N., Metcalfe, P., "Measurement of skin dose variations produced by a silicon-based protective dressing in radiotherapy", 2002, Physics in Medicine and Biology, 47, N145-N151.
19. Cheung, T., Butson, M.J., Yu, P.K.N., “Use of a blood glucose meter for radiochromic film analysis in blood irradiation”, 2002, Physics in Medicine and Biology, 47, N259-263.
20. Butson, M.J., Cheung, T., Yu, P.K.N., “Corresponding dose response of radiographic film with layered Grafchromic film”, 2002, Physics in Medicine and Biology, 47, N285-N289.
21. Butson, M.J., Yu, P.K.N., Cheung, T., Metcalfe, P., “High sensitivity radiochromic film dose comparisons”, 2002, Physics in Medicine and Biology, 47, N291-N295.
22. Butson, M.J., Yu, P.K.N., Cheung, T., Inwood, D., “Polarization effects on a high sensitivity radiochromic film”, 2003, Physics in Medicine and Biology, 48, N207-211.
23. Butson, M.J., Yu, P.K.N., Cheung, T., “Rounded end multi-leaf penumbral measurements with radiochromic film”, 2003, Physics in Medicine and Biology, 48, N247-252.
24. Butson, M.J., Yu, P.K.N., Cheung, T., Metcalfe, P.E., "Radiochromic Film for Medical Radiation Dosimetry", 2003, Materials Science & Engineering R, 41, 61-120.
25. Yu, P.K.N., Cheung, T., Butson, M.J., "Prostate dosimetry in an anthropomorphic phantom", 2004, Australasain Physical & Engineering Sciences in Medicine, 27, 60-62.
26. Butson, M.J., Cheung, T., Yu, P.K.N., "Visible absorption properties of radiation exposed XR type T radiochromic film", 2004, Physics in Medicine and Biology, 49, N347-351.
27. Cheung, T., Butson, M.J., Yu, P.K.N., "Experimental energy response verification of XR type T radiochromic film", 2004, Physics in Medicine and Biology, 49, N371-N376.
28. Butson, M.J., Cheung, T., Yu, P.K.N., "Absorption spectra analysis of exposed FWT-60 radiochromic film", 2004, Physics in Medicine and Biology, 49, N377-N381.
29. Butson, M.J., Cheung, T., Yu, P.K.N., "Radiochromic film: the new x-ray dosimetry and imaging tool", 2004, Australasian Physical & Engineering Sciences in Medicine, 27, 230.
30. Cheung, T., Butson, M.J., Yu, P.K.N., "Reflection spectrometry analysis of irradiated GAFCHROMIC XR type R radiochromic films", 2005, Applied Radiation and Isotopes, 63, 127-129. 
31. Butson, M.J., Cheung, T., Yu, P.K.N., "Absorption spectra variations of EBT radiochromic film from radiation exposure", 2005, Physics in Medicine and Biology, 50, N135-N140.
32. Butson, M.J., Cheung, T., Yu, P.K.N., "XR type R radiochromic film x-ray energy response", 2005, Physics in Medicine and Biology, 50, N195-N199.
33. Butson, M.J., Cheung, T., Yu, P.K.N., "Fluorescent light effects on FWT-60 radiochromic film", 2005, Physics in Medicine and Biology, 50, N209-N213.
34. Cheung, T., Butson, M.J., Yu, P.K.N., "Post irradiation coloration of Gafchromic EBT radiochromic film", 2005, Physics in Medicine and Biology, 50, N281-N285.
35. Cheung, T., Yu, P.K.N., Butson, M.J., "Measurements of centi-Gray x-ray dose levels with radiochromic film" 2005, IEEE Transactions on Nuclear Science, 52, 1271-1273.
36. Cheung, T., Butson, M.J., Yu, P.K.N., "Weak energy dependence of EBT Gafchromic film dose response in the 50 kVp - 10 MVp X-ray range", Applied Radiation and Isotopes, 2006, 64, 60-62.
37. Butson, M.J., Cheung, T., Yu, P.K.N., "Absorption spectra of irradiated XRCT Radiochromic film", 2006, Physics in Medicine and Biology, 51, 3099-3103. 
38. Cheung, T., Butson, M.J., Yu, P.K.N., "Independence of calibration curves for EBT Gafchromic films of the size of high-energy x-ray fields", 2006, Applied Radiation and Isotopes, 64, 1027-1030.
39. Cheung, T., Butson, M.J., Yu, P.K.N., "Measurement of high energy x-ray beam penumbra with Gafchromic^TM EBT radiochromic film", 2006, Medical Physics, 33, 2912-2914.
40. Butson, M.J., Cheung, T., Yu, P.K.N., "Measurement of energy dependence for XRCT Radiochromic film", 2006, Medical Physics, 33, 2923-2925.
41. Yu, K.N., Butson, M.J., Cheung, T., "Does mechanical pressure on radiochromic film affect optical absorption and dosimetry?", 2006, Australasian Physical and Engineering Sciences in Medicine, 29, 1-3.
42. Butson, M.J., Cheung, T., Yu, P.K.N., "Scanning orientation effects on EBT Gafchromic film dosimetry", 2006, Australasian Physical and Engineering Sciences in Medicine, 29, 281-284.
43. Butson, M.J., Cheung, T., Yu, P.K.N., "Visible absorption spectra of radiation exposed SIRAD dosimeters", 2006, Physics in Medicine and Biology, 51, N417-N421.
44. Cheung T., Butson M.J., Yu, P.K.N., "X-Ray energy dependence of the dose response of SIRAD radiation dosimeters", 2007, Applied Radiation and Isotopes, 65, 814-817.
45. Butson, M.J., Cheung, T., Yu, P.K.N., "Megavoltage x-ray skin dose variation with an angle using grid carbon fibre couch tops", 2007, Physics in Medicine and Biology, 52, N485-N492.
46. Butson, M.J., Cheung, T., Yu, P.K.N., "Radiochromic film for verification of superficial x-ray backscatter factors", 2007, Australasian Physical and Engineering Sciences in Medicine, 30, 269-273.
47. Butson, M.J., Cheung, T., Yu, P.K.N., Price, S., Bailey, M., "Measurement of radiotherapy superficial x-ray dose under eye shields with radiochromic film", 2008, Physica Medica, 24, 29-33.
48. Butson, M.J., Cheung, T., Yu, P.K.N., "Measurement of dose reductions for superficial x-rays backscattered from bone interfaces", 2008, Physics in Medicine and Biology, 53, N329–N336.
49. Butson, M.J., Cheung, T., Yu, P.K.N., "Measuring energy response for RTQA Radiochromic film to improve quality assurance procedures", 2008, Australasian Physical and Engineering Sciences in Medicine, 31, 203-206.
50. Butson, M.J., Cheung, T., Yu, P.K.N., "Evaluation of the magnitude of EBT Gafchromic film polarization effects", 2009, Australasian Physical and Engineering Sciences in Medicine, 32, 21-25.
51. Butson, M.J., Cheung, T., Yu, P.K.N., Alnawaf, H., 2008. Dose response of irradiated XRCT radiochromic film. Iranian Journal of Science & Technology, Transaction A, 32, No. A3, 161-165.
52. Butson, M.J., Cheung, T., Yu, P.K.N., Alnawaf, H., 2009. Dose and absorption spectra response of EBT2 Gafchromic film to high energy x-rays. Australasian Physical and Engineering Sciences in Medicine, 32, 196-202. 
53. Alnawaf, H., Cheung, T., Butson, M.J., Yu, P.K.N., 2010. Absorption spectra response of XRQA radiochromic film to x-ray radiation. Radiation Measurements, 45, 129-132.
54. Butson, M.J., Yu, P.K.N., Cheung, T., Alnawaf, H., 2010. Energy response of the new EBT2 radiochromic film to x-ray radiation. Radiation Measurements, 45, 836-839.
55. Butson, E.T., Cheung, T., Yu, P.K.N., Butson, M.J., 2010. Measuring solar UV radiation with EBT radiochromic film. Physics in Medicine and Biology 55, N487-N493.
56. Alnawaf, H., Butson, M.J., Cheung, T., Yu, P.K.N., 2010. Scanning orientation and polarization effects for XRQA Radiochromic film. Physica Medica 26, 216-219.
57. Alnawaf, H., Butson, M.J., Yu, P.K.N., 2012. Comparison of Epson scanner quality for radiochromic film evaluation. Journal of Applied Clinical Medical Physics, 13, 314-321.

Other Medical Physics Research

Journal Publications (see here for impact factors):                     

1. Cheung,Y.C., Yu, P.K.N., Young,E.C.M., Chan, C.L., Ng,M.F., Tang, F.N.F., “The dose distribution close to an ¹⁹²Ir wire source: EGS4 Monte Carlo calculations”, 1997, Physics in Medicine and Biology, 42, 401-406.
2. Cheung,Y.C., Yu, P.K.N., Young,E.C.M., Chan,C.L., Ng,M.F., Tang,F.N.F., Wong,T.P.Y., “The electron-dose distribution surrounding an ¹⁹²Ir wire brachytherapy source investigated using EGS4 simulations and GafChromic^TM film”, 1997, Applied Radiation and Isotopes, 48 (7), 985-990.
3. Butson, M.J., Yu, P., Kan, M.W.K., Carlon, M., Young, E.C.M., Mathur, J.N., Metcalfe, P.E., “Skin dose reduction by a clinically viable magnetic deflector”, 1997, Australasian Physical and Engineering Sciences in Medicine, 20 (2), 107-111.
4. Butson, M.J., Cheung, T., Yu, P., Metcalfe, P.E., "Evaluation of a radiotherapy electron contamination deflection system", 2000, Radiation Measurements, 32, 101-104.
5. Butson, M.J., Cheung, T., Yu, P.K.N., Metcalfe, P.E., "Simulation and Measurement of Air Generated Electron Contamination in Radiotherapy", 2000, Radiation Measurements, 32, 105-111.
6. Butson, M.J., Cheung, T., Yu, P.K.N., Stokes, M.J., "Blood irradiation with accelerator produced electron beams", 2000, Physics in Medicine and Biology, 45 (11), N139-N142.
7. Butson, M.J., Elfernick, R., Cheung, T., Yu, P.K.N., Stokes, M.J., Quach, K.Y., Metcalfe, P., "Verification of lung dose in an anthropomorphic phantom calculated by the collapsed cone convolution method", 2000, Physics in Medicine and Biology, 45 (11), N143-N149.
8. Butson, M.J., Cheung, T., Yu, P.K.N., "Skin dose delivered in megavoltage external beam therapeutic radiology", 2001, Recent Advances and Research Updates, 2, 63-68.
9. Cheung, T., Butson, M.J., Yu, P.K.N., "Visible dye light absorption properties of processed radiographic film", 2001, Physics in Medicine and Biology, 46, N197-N201.
10. Butson, M.J., Cheung, T., Yu, P.K.N., "Lepton contamination and photon scatter produced by open field 18 MV X-ray beams in the build up region", 2002, Radiation Measurements, 35, 103-107.
11. Cheung, T., Butson, M.J., Yu, P.K.N., "Evaluation of build up dose from 6 MV x-rays under pelvic an abdominal patient immobilization devices", 2002, Radiation Measurements, 35, 235-238.
12. Cheung, T., Butson, M.J., Yu, P.K.N., Metcalfe, P., “Effects of water light absorption properties of a radiographic film”, 2002, Physics in Medicine and Biology, 47, 279-284.
13. Yu, P.K.N., Cheung, T., Butson, M.J., “Variations in skin dose using 6MV or 18MV x-ray beams”, 2003, Australasain Physical & Engineering Sciences in Medicine, 26, 78-80.
14. Cheung, T., Butson, M.J., Yu, P.K.N., “MOSFET dosimetry in-vivo at superficial and orthovoltage x-ray energies”, 2003, Australasain Physical & Engineering Sciences in Medicine, 26, 81-83.
15. Butson, M.J., Yu, P.K.N., Cheung, T., “Polarity Effect on Surface Dose Measurement for an Attix parallel plate ionisation chamber”, 2003, Australasain Physical & Engineering Sciences in Medicine, 26, 84-86.
16. Butson, M.J., Cheung, T., Yu, P.K.N., “Variations in 6MV x-ray radiotherapy build up dose with treatment distance”, 2003, Australasain Physical & Engineering Sciences in Medicine, 26, 87-89.
17. Cheung, T., Yu, P.K.N., Butson, M.J., “Source and detector polarization effects on radiographic film dosimetry”, 2003, Physics in Medicine and Biology, 48, N329-N334.
18. Cheung, T., Butson, M.J., Yu, P.K.N., “Effects of temperature variation on MOSFET dosimetry”, 2004, Physics in Medicine and Biology, 49, N191-N196.
19. Butson, M.J., Cheung, T., Yu, P.K.N., Currie, M., “Surface dose extrapolation measurements with radiographic film”, 2004, Physics in Medicine and Biology, 49, N197-N201.
20. Butson, M.J., Cheung, T., Yu, P.K.N., "Peripheral dose measurement with a MOSFET detector", 2005, Applied Radiation and Isotopes, 62, 631-634. 
21. Cheung, T., Yu, P.K.N., Butson, M.J., "Low dose measurement with a MOSFET in high energy radiotherapy applications", 2005, Radiation Measurements, 39, 91-94.
22. Butson, M.J., Cheung, T., Yu, P.K.N., "Solid water phantom heat conduction: heating and cooling rates", 2008, Journal of Medical Physics, 33, 24-28.
23. Cheung, T., Butson, M.J., Yu, P.K.N., "Energy dependence corrections to MOSFET dosimetric sensitivity", 2009, Australasian Physical and Engineering Sciences in Medicine, 32, 16-20.
24. Alnawaf, H., Butson, M.J., Yu, P.K.N., Cheung, T., 2011. SIRAD - Personal radiation detectors. Radiation Measurements 46, 1826-1828.
25. Kan, M.W.K., Cheung, J.Y.C., Leung, L.H.T., Lau, B.M.F., Yu, P.K.N., 2011. The accuracy of dose calculations by anisotropic analytical algorithms for stereotactic radiotherapy in nasopharyngeal carcinoma. Physics in Medicine and Biology, 56, 397-413.
26. Kan, M.W.K., Leung, L.H.T., Yu, P.K.N., 2012. Verification and dosimetric impact of Acuros XB algorithm on intensity modulated stereotactic radiotherapy for locally persistent nasopharyngeal carcinoma. Medical Physics, 39, 4705-4714.
27. Kan, M.W.K., Wong, W., Leung, L.H.T., Yu, P.K.N., So, R. W.K., Cheng, A. C.K., 2012. A comprehensive dosimetric evaluation of using RapidArc volumetric-modulated arc therapy for the treatment of early-stage nasopharyngeal carcinoma. Journal of Applied Clinical Medical Physics, 13, 189-202.
28. Alnawaf, H., Butson, M., Yu, P. K. N., 2012. Measurement and effects of MOSKIN detectors on skin dose during high energy radiotherapy treatment. Australasian Physical & Engineering Sciences in Medicine 35, 321-328.
29. Ceylan, A., Butson, M., Cullen, A., Yu, P.K.N., Alnawaf, H., 2012. Variations in daily quality assurance dosimetry from device levelling, feet position and backscatter material. Australasian Physical & Engineering Sciences in Medicine 35, 485-489.
30. Kan, M.W.K., Leung, L.H.T., Yu, P.K.N., 2013. Dosimetric impact of using the Acuros XB algorithm for IMRT and RapidArc planning in nasopharyngeal carcinomas. International Journal of Radiation Oncology, Biology, Physics, 85, e73-e80.
31. Yu, P.K.N., Butson, M.J., 2013. Measurement of effects of nasal and facial shields on delivered radiation dose for superficial x-ray treatments. Physics in Medicine and Biology, 58, N95-N102.
32. Kan, M.W.K., Leung, L.H.T., So, R.W.K., Yu, P.K.N., 2013. Experimental verification of the Acuros XB and AAA dose calculation adjacent to heterogeneous media for IMRT and RapidArc of nasopharygeal carcinoma. Medical Physics, 031714 (http://dx.doi.org/10.1118/1.4792308).
33. Kan, M.W.K., Leung, L.H.T., Yu, P.K.N., The effect of the target-organ geometric complexity on the choice of delivery between Rapid Arc and sliding-window IMRT for nasopharyngeal carcinoma. Medical Dosimetry, 2013, 38, 337-343.
34. Kan, M.W.K., Yu, P.K.N., Leung, L.H.T., A Review on the Use of Grid-Based Boltzmann Equation Solvers for Dose Calculation in External Photon Beam Treatment Planning. BioMed Research International, 2013, Article ID 692874, 10 pages.
35. Kan, M.W.K., Leung, L.H.T., Yu, P.K.N., 2013. The performance of the progressive resolution optimizer (PRO) for RapidArc planning in targets with low-density media. Journal of Applied Clinical Medical Physics, 14 (6), 205-221. 

Nuclear Radiation Unit Department of Physics and Materials Science City University of Hong Kong Tat Chee Ave, Kowloon Tong, Hong Kong Email: apnru@cityu.edu.hk

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