Skin dose is one of the key issues for clinical dosimetry in radiation therapy. Currently planning computer systems are unable to accurately predict dose in the buildup region, leaving ambiguity as to the dose levels actually received by the patient's skin during radiotherapy. This is one of the prime reasons why in vivo measurements are necessary to estimate the dose in the buildup region. A newly developed metal-oxide-semiconductor-field-effect-transistor (MOSFET) detector designed specifically for dose measurements in rapidly changing dose gradients was introduced for accurate in vivo skin dosimetry. The feasibility of this detector for skin dose measurements was verified in comparison with plane parallel ionization chamber and radiochromic films. The accuracy of a commercial treatment planning system (TPS) in skin dose calculations for intensity-modulated radiation therapy treatment of nasopharyngeal carcinoma was evaluated using MOSFET detectors in an anthropomorphic phantom as well as on the patients. Results show that this newly developed MOSFET detector can provide a minimal but highly reproducible intrinsic buildup of 7 mg cm(-2) corresponding to the requirements of personal surface dose equivalent Hp (0.07). The reproducibility of the MOSFET response, in high sensitivity mode, is found to be better than 2% at the phantom surface for the doses normally delivered to the patients. The MOSFET detector agrees well with the Attix chamber and the EBT Gafchromic film in terms of surface and buildup region dose measurements, even for oblique incident beams. While the dose difference between MOSFET measurements and TPS calculations is within measurement uncertainty for the depths equal to or greater than 0.5 cm, an overestimation of up to 8.5% was found for the surface dose calculations in the anthropomorphic phantom study. In vivo skin dose measurements reveal that the dose difference between the MOSFET results and the TPS calculations was on average -7.2%, ranging from -4.3% to -9.2%. The newly designed MOSFET detector encapsulated into a thin water protective film has a minimal reproducible intrinsic buildup recommended for skin dosimetry. This feature makes it very suitable for routine IMRT QA and accurate in vivo skin dosimetry.

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When treating prostate cancer using high dose rate (HDR) brachytherapy, overdosing the rectal wall may lead to post-treatment rectal complications. An area of concern is related to how the rectal wall dose is calculated by treatment planning systems (TPSs). TPSs are used to calculate the dose delivered to the rectal wall, but they assume that the rectum is a water-equivalent homogeneous medium of infinite size and do not consider the effect that an air-filled "empty" rectal cavity would have on the dose absorbed along the rectal wall. The aim of this research is to quantify the effect that an air cavity has on the rectal wall dose, as its presence changes the backscatter conditions in the region. The MO Skin and RADFET dosimeters proved capable of measuring absolute dose with increasing distance from the HDR Ir-192 brachytherapy source. However, the anterior rectal wall doses measured by the MOSkin and RADFET in an empty rectal cavity were 14.7 +/- 0.2% and 13.7 +/- 0.6% lower than the dose measured in a homogeneous rectal phantom. Monte Carlo simulations corroborated the experimentally obtained results, reporting a -13.2 +/- 0.6% difference. The dose measured at the posterior wall of an empty rectal cavity was between 22% and 26% greater than the dose measured in a full rectal cavity. The heterogeneity of the rectal volume appears to have a significant effect on the rectal dose when compared to calculated rectal dose.

In HDR prostate brachytherapy, post-treatment complications occur due to overdosing the rectum wall and urethra. An area of concern regarding treatment is related to how the rectal wall dose is calculated using treatment planning systems. Treatment planning systems can calculate the dose delivered to the rectal wall, assuming that the rectum is filled with water equivalent material. This assumption is not always correct, as the rectum is emptied before treatment begins. The aim of this research is to quantify the difference in the dose measured in an 'empty' rectal phantom, and in a rectal phantom filled with water equivalent material. Results indicate that the dose measured by the MOSkin and RadFET in an empty rectum is approximately 10-15% lower than the dose measured dose in a full rectum, and the dose calculated by the PLATO TPS, which assumes that the rectum is full. This could have implications on the design of HDR treatment plans.

In radiotherapy, interest in real-time dosimetry stems from the desire to monitor the dose delivered to the target volume and the surrounding normal tissue to enable clinicians to track the progress of the treatment, and prevent surrounding tissue from receiving too much radiation dose. In this study, the dosimetric performance of the new MOSkin dosimeter and a Bicron BCF-20 scintillating fiber was compared to depth dose measurements taken with a Farmer-type ionization chamber. The performance of the MOSkin and BCF-20 detectors in the build-up region of the depth dose curve, where the dose gradient is steep, is also compared to readings taken with an Attix chamber. At depths greater than 15 mm, the MOSkin readings deviated from the ion chamber readings by up to 4%, while the fiber optic dosimeter always remained within 3% of the ionization chamber reading. In the build-up region, the MOSkin proved quite capable of measuring the dose at build up when compared to the Attix chamber results, while the fiber optic dosimeter was not able to measure the dose in this region with a high level of precision due to the thick sensitive volume of the scintillating crystal.