Absolute calibration of the Gamma Knife® Perfexion™ and delivered dose verification using EPR/alanine dosimetry

Purpose: Elekta Leksell Gamma Knife (R) (LGK) is a radiotherapy beam machine whose features are not compliant with the international calibration protocols for radiotherapy. In this scope, the Laboratoire National Henri Becquerel and the Pitie-Salpetriere Hospital decided to conceive a new LKG dose calibration method and to compare it with the currently used one. Furthermore, the accuracy of the dose delivered by the LGK machine was checked using an "end-to-end" test. This study also aims to compare doses delivered by the two latest software versions of the Gammaplan treatment planning system (TPS). Methods: The dosimetric method chosen is the electron paramagnetic resonance (EPR) of alanine. Dose rate (calibration) verification was done without TPS using a spherical phantom. Absolute calibration was done with factors calculated by Monte Carlo simulation (MCNP-X). For "end-to-end" test, irradiations in an anthropomorphic head phantom, close to real treatment conditions, are done using the TPS in order to verify the delivered dose. Results: The comparison of the currently used calibration method with the new one revealed a deviation of +0.8% between the dose rates measured by ion chamber and EPR/alanine. For simple fields configuration (less than 16 mm diameter), the "end-to-end" tests showed out average deviations of -1.7% and -0.9% between the measured dose and the calculated dose by Gammaplan v9 and v10, respectively. Conclusions: This paper shows there is a good agreement between the new calibration method and the currently used one. There is also a good agreement between the calculated and delivered doses especially for Gammaplan v10. (C) 2014 American Association of Physicists in Medicine.