The use of small fields in radiotherapy techniques has increased substantially, in particular in stereotactic treatments and large uniform or nonuniform fields that are composed of small fields such as for intensity modulated radiation therapy (IMRT). This has been facilitated by the increased availability of standard and add-on multileaf collimators and a variety of new treatment units. For these fields, dosimetric errors have become considerably larger than in conventional beams mostly due to two reasons; (i) the reference conditions recommended by conventional Codes of Practice (CoPs) cannot be established in some machines and (ii) the measurement of absorbed dose to water in composite fields is not standardized. In order to develop standardized recommendations for dosimetry procedures and detectors, an international working group on reference dosimetry of small and nonstandard fields has been established by the International Atomic Energy Agency (IAEA) in cooperation with the American Association of Physicists in Medicine (AAPM) Therapy Physics Committee. This paper outlines a new formalism for the dosimetry of small and composite fields with the intention to extend recommendations given in conventional CoPs for clinical reference dosimetry based on absorbed dose to water. This formalism introduces the concept of two new intermediate calibration fields: (i) a static machine-specific reference field for those modalities that cannot establish conventional reference conditions and (ii) a plan-class specific reference field closer to the patient-specific clinical fields thereby facilitating standardization of composite field dosimetry. Prior to progressing with developing a CoP or other form of recommendation, the members of this IAEA working group welcome comments from the international medical physics community on the formalism presented here.

A minimally perturbing plastic scintillation detector has been developed for the dosimetry of high-energy beams in radiotherapy. The detector system consists of two identical parallel sets of radiation-resistant optical fibre bundles, each connected to independent photomultiplier tubes (PMTs). One fibre bundle is connected to a miniature water equivalent plastic scintillator and so scintillation as well as Cerenkov light generated in the fibres is detected at its PMT. The other 'background' bundle is not connected to the scintillator and so only Cerenkov light is detected by its PMT. The background signal is subtracted to yield only the signal from the scintillator. The water-equivalence of plastic scintillation detectors is studied for photon and electron beams in the radiotherapy range. Application of Burlin cavity theory shows that the energy dependence of such detectors is expected to be better than the commonly used systems (ionization chambers, LiF thermoluminescent dosimeters, film and Si diodes). It is also shown that they are not affected by temperature variations and exhibit much less radiation damage than either photon or electron diode detectors.

Second-harmonic generation (SHG) imaging can help reveal interactions between collagen fibers and cancer cells. Quantitative analysis of SHG images of collagen fibers is challenged by the heterogeneity of collagen structures and low signal-to-noise ratio often found while imaging collagen in tissue. The role of collagen in breast cancer progression can be assessed post acquisition via enhanced computation. To facilitate this, we have implemented and evaluated four algorithms for extracting fiber information, such as number, length, and curvature, from a variety of SHG images of collagen in breast tissue. The image-processing algorithms included a Gaussian filter, SPIRAL-TV filter, Tubeness filter, and curvelet-denoising filter. Fibers are then extracted using an automated tracking algorithm called fiber extraction (FIRE). We evaluated the algorithm performance by comparing length, angle and position of the automatically extracted fibers with those of manually extracted fibers in twenty-five SHG images of breast cancer. We found that the curvelet-denoising filter followed by FIRE, a process we call CT-FIRE, outperforms the other algorithms under investigation. CT-FIRE was then successfully applied to track collagen fiber shape changes over time in an in vivo mouse model for breast cancer.

The properties of a new scintillation detector system for use in dosimetry of high-energy beams in radiotherapy have been measured. The most important properties of these detectors are their hgh spatial resolution and their nearly water-equivalence. Measurements have shown that they have excellent reproducibility and stability, and a linear response versus dose-rate. It is also shown that they have better spatial resolution than ionization chambers and have much less energy or depth dependence in electron fields due to the removal of the influence of the polarization effect. Dose distributions in water, using miniature plastic scintillation detectors, have been measured for different high-energy photon and electron beams.