Recent developments of new therapy techniques using small photon beams, such as stereotactic radiotherapy, require suitable detectors to determine the delivered dose with a high accuracy. The dosimeter has to be as close as possible to tissue equivalence and to exhibit a small detection volume compared to the size of the irradiation field, because of the lack of lateral electronic equilibrium in small beam. Characteristics of single crystal diamond (tissue equivalent material Z = 6, high density) make it an ideal candidate to fulfil most of small beam dosimetry requirements. A commercially available Element Six electronic grade synthetic diamond was used to develop a single crystal diamond dosimeter (SCDDo) with a small detection volume (0.165 mm(3)). Long term stability was studied by irradiating the SCDDo in a (60)Co beam over 14 h. A good stability (deviation less than ± 0.1%) was observed. Repeatability, dose linearity, dose rate dependence and energy dependence were studied in a 10 × 10 cm(2) beam produced by a Varian Clinac 2100 C linear accelerator. SCDDo lateral dose profile, depth dose curve and output factor (OF) measurements were performed for small photon beams with a micro multileaf collimator m3 (BrainLab) attached to the linac. This study is focused on the comparison of SCDDo measurements to those obtained with different commercially available active detectors: an unshielded silicon diode (PTW 60017), a shielded silicon diode (Sun Nuclear EDGE), a PinPoint ionization chamber (PTW 31014) and two natural diamond detectors (PTW 60003). SCDDo presents an excellent spatial resolution for dose profile measurements, due to its small detection volume. Low energy dependence (variation of 1.2% between 6 and 18 MV photon beam) and low dose rate dependence of the SCDDo (variation of 1% between 0.53 and 2.64 Gy min(-1)) are obtained, explaining the good agreement between the SCDDo and the efficient unshielded diode (PTW 60017) in depth dose curve measurements. For field sizes ranging from 0.6 × 0.6 to 10 × 10 cm(2), OFs obtained with the SCDDo are between the OFs measured with the PinPoint ionization chamber and the Sun Nuclear EDGE diode that are known to respectively underestimate and overestimate OF values in small beam, due to the large detection volume of the chamber and the non-water equivalence of both detectors.

Monte Carlo simulations of emission tomography have proven useful to assist detector design and optimize acquisition and processing protocols. The more realistic the simulations, the more straightforward the extrapolation of conclusions to clinical situations. In emission tomography, accurate numerical models of tomographs have been described and well validated under specific operating conditions (collimator, radionuclide, acquisition parameters, count rates, etc). When using these models under these operating conditions, the realism of simulations mostly depends on the activity distribution used as an input for the simulations. It has been proposed to derive the input activity distribution directly from reconstructed clinical images, so as to properly model the heterogeneity of the activity distribution between and within organs. However, reconstructed patient images include noise and have limited spatial resolution. In this study, we analyse the properties of the simulated images as a function of the properties of the reconstructed images used to define the input activity distributions in (18)F-FDG PET and (131)I SPECT simulations. The propagation through the simulation/reconstruction process of the noise and spatial resolution in the input activity distribution was studied using simulations. We found that the noise properties of the images reconstructed from the simulated data were almost independent of the noise in the input activity distribution. The spatial resolution in the images reconstructed from the simulations was slightly poorer than that in the input activity distribution. However, using high-noise but high-resolution patient images as an input activity distribution yielded reconstructed images that could not be distinguished from clinical images. These findings were confirmed by simulated highly realistic (131)I SPECT and (18)F-FDG PET images from patient data. In conclusion, we demonstrated that (131)I SPECT and (18)F-FDG PET images indistinguishable from real scans can be simulated using activity maps with spatial resolution higher than that used in routine clinical applications.

Recent use of very small photon beams (down to 4 mm) in stereotactic radiotherapy requires new detectors to accurately determine the delivered dose. Diamond detectors have been presented in the literature as an attractive candidate for this application, due to their small detection volume and the diamond atomic number (Z = 6) which is close to water effective atomic number (Zeff ∼ 7.42). However, diamond exhibits a density 3.51 times greater than that of water and recent studies using Monte Carlo simulations have demonstrated the drawback of a high-density detector on small beam output factors. The current study focuses on geometrical parameters of diamond detector, namely, the diamond dimensions and the electrode geometry, in order to solve the dosimetric issues still observed in small photon beams with diamond detectors. To give better insights to these open questions, we have used both computational method and experimental analysis. This study highlighted that reducing diamond dimensions is crucial for small beam output factor measurements and to limit the influence of its high density. Furthermore, electrodes covering the whole diamond surface were essential for a dose rate independence of the diamond detector. The optimal dosimeter derived from this work presented small diamond dimensions of approximately 1 × 1 × 0.15 mm 3 , with diamond-like-carbon electrodes covering the whole diamond surface. A dose rate independence of this diamond detector (better than 0.5% over a wide range of dose rates available on a stereotactic dedicated facility) was obtained due to the electrode geometry. Concerning the output factor measurements, a good agreement (better than 1.1%) was observed between this carbon material detector and two types of passive dosimeters (LiF microcubes and EBT2 radiochromic films) for all beam sizes except the smallest field of 0.6 × 0.6 cm 2 with a deviation of 2.6%. This new study showed the high performance of this diamond detector in small photon beams, in comparison with various commercially available passive and active dosimeters.