Experimental validation of recommended msr-correction factors for the calibration of Leksell Gamma Knife^® Icon^tm unit following IAEA TRS-483

Currently, the American Association of Physicists in Medicine (AAPM) TG-21 is the conventional protocol currently used for the calibration of the Leksell Gamma Knife^® (LGK) (despite the publication of the AAPM TG-51 protocol). However, this protocol is based on the air-kerma standards requiring an elaborate conversion process resulting in an increase in the possibility of errors in the clinic. The International Atomic Energy Agency (IAEA) Technical Reports Series (TRS)-483 Code of Practice provides new recommendations on the dosimetry of small static fields and correction factor data for the calibration of the LGK unit. The purpose of this study is to experimentally validate previously calculated factors for the calibration of the LGK Perfexion/Icon unit in the context of the TRS-483 protocol. An experimental comparison between three protocols (TG-51, TG-21 and TRS-483 with the aforementioned correction factors) for calibration of the LGK unit is provided.

Dose-rate measurements were performed on a LGK Icon unit using three ionization chambers and three phantoms with different orientations of the chambers with respect to the LGK unit. The dose rate was determined following the three calibration protocols. The standard deviation on the mean dose rate over all phantoms and chambers in different orientations determined using TG-51, TG-21 and TRS-483 protocols were 0.9%, 0.5% and 0.4%, respectively.

The mean dose rate calculated using TG-51 protocol was 1.6% and 1.2% lower comparing to the TG-21 and TRS-483 protocols respectively. Applying the values calculated in Mirzakhanian et al (2018) to the measured dose rates in LGK unit for all chambers and phantoms resulted in dose rates that are consistent to within 0.4%. The TRS-483 protocol improves the consistency of the results especially when the chamber was positioned in different orientations with respect to the LGK (from 1.6% when using TG-51 or TG-21 protocols to 0.2% when using TRS-483 protocol) since the other protocols do not correct for the different chamber orientations. (paper)