A survey of radiation oncology medical physics departments across Australia and New Zealand was conducted to assess the usage, commissioning and quality assurance of modulated radiotherapy techniques such as IMRT and VMAT. Survey responses were collected in April-May 2015 to snapshot current practice and historical implementation. The survey asked 142 questions, and is the most detailed survey of its kind published to date. Analysis of results at overall department level, as well as sub-analysis for different equipment and techniques in use, was performed. Results show a high prevalence of IMRT and VMAT in use, and demonstrate the large heterogeneity in clinical practice and experience across the region.

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Radiochromic film is a good dosimeter choice for patient QA for complex treatment techniques because of its near tissue equivalency, high spatial resolution and established method of use. Commercial scanners are typically used for film dosimetry, with Epson scanners being the most common. Radiochromic film dosimetry is not straightforward having some well-defined problems which must be considered, one of the main ones being the Lateral Response Artefact (LRA) effect. Previous studies showed that the contributing factors to LRA are from the structure of the active ingredients of the film and the components and construction of the flatbed scanner. This study investigated the effect of the scanner lens on the LRA effect, as part of a wider investigation of scanner design effects and uncertainties. Gafchromic EBT3 films were irradiated with 40 × 40 cm2 field size 6 MV beams. Films were analysed using images captured by a Canon 7D camera utilising 18 mm, 50 mm and 100 mm focal length lenses compared to images scanned with a conventional Epson V700 scanner. The magnitude of the LRA was observed to be dependent on the focal length of the lens used to image the film. A substantial reduction in LRA was seen with the use of the 50 mm and 100 mm lenses, by factors of 3–5 for the 50 mm lens and 4–30 for the 100 mm lens compared to conventional desktop scanner techniques. This is expected to be from the longer focal length camera lens system being able to collect more light from distant areas compared to the scanner-based system. This provides an opportunity to design film dosimetry systems that minimise this artefact.

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This work outlines a method for using Gafchromic film for dosimetry purposes, by scanning it with currently available commercial scanners. The scanners used were: Epson V800, Epson V700, Epson V37 series, specifically a V370 and a Canon multi-function office printer/scanner. The Epson scanners have 16 bit RGB resolution, the Canon has 8 bit RGB (Red Green Blue) resolution, and the V800 and V700 allow scanning in transmission mode. The V700 uses an Epson White Cold Cathode Florescent Lamp; the recently released V800 uses an Epson light emitting diode (LED) light source, while the V37 series uses a reflective mode and the Epson LED light source. The Epson V37 series scanners are designed for non-professional use so the cost has been kept at a low "entry level" point, so they would be a suitable option for a department wanting to use Gafchromic film or with limited needs that did not justify a more sophisticated and expensive unit. Note that the V800 or V700 scanners are not expensive in context, costing approximately the same as a 25 sheet box of Gafchromic film. The Canon was included to demonstrate that a scanner with 8 bit RGB resolution can be used for dosimetry. These general multi-function units are available in most departments, and they would allow Gafchromic film to be evaluated as a dosimetry tool without a significant investment. Furthermore, they are generally capable of scanning large format film (425 × 350 mm) in one part. Although this is not necessary for dosimetry, it is often useful for machine QA, where dividing the film into two parts to ensure accurate measurements is not practical. Moreover, this analytical method uses software that is freely or commonly available, particularly the image processing package ImageJ. Note ImageJ v1.48 was the version used. The results demonstrate that this method used with the scanners evaluated is a practical method of using Gafchromic film as a dosimeter for IMRT QA.