Dosimetry evaluation of the GammaPod stereotactic radiosurgery device based on established AAPM and IAEA protocols

Purpose The GammaPod is a novel dedicated prone breast stereotactic radiosurgery (SRS) device recently developed at the University of Maryland Medical Center. This device utilizes multiple rotating Co-60 sources to create highly conformal dose distributions for breast treatments, including boosts, partial breast irradiation, or presurgery SRS. However, due to its small field sizes and nonstandard geometry, existing calibration protocols cannot be directly applied. In this study, we adapt and implement the American Association of Physicists in Medicine Task Group 21 (TG-21) and International Atomic Energy Agency (IAEA) Technical Report Series 483 (TRS 483) protocols for reference dose measurements for the GammaPod. This represents the first published dosimetric investigation GammaPod and is meant to serve as a reference to future users commissioning and calibrating these devices. Methods Reference dose measurements were performed following the TG-21/IAEA TRS 483 protocols using an ADCL-calibrated Exradin A1SL thimble chamber in a polymethyl methacrylate (PMMA) breast-mimicking phantom. Monte Carlo calculations and measurements were also performed in water to determine chamber-specifickPMMAQmsr,Q0fmsr,frefquality conversion factor converting reference field size (f(ref)) to machine-specific field sizes (f(msr)) (25-mm) as well askPMMAfclin,fmsr, the conversion factor from the (f(msr)) to the clinical field size (f(clin)) (15mm). Verification was performed using the thermoluminescent dosimeter remote monitoring service from the Imaging and Radiation Oncology Core (IROC) in Houston, TX. Results The (f(ref)) to (f(msr)) chamber-specific factorkPMMAQmsr,Q0fmsr,frefwas 0.992 while the (f(msr)) to (f(clin)) chamber-specifickPMMAfclin,fmsrfactor was 1.014. The radiation absorbed dose to water measured in the PMMA phantom based on the TG-21/IAEA TRS 483 formalism agreed with IROC values to within 1% and 2% for the 25- and 15-mm collimators, respectively. Conclusion We successfully implemented the TG-21 and TRS 483 reference dosimetry protocols for the GammaPod. These results show agreement between measurements performed with different reference dosimetry protocols and independent thermoluminescent measurements.