Characterization of the ZAP-X® Peripheral Dose Fall-Off.

Various small-field radiation dose detectors were systematically compared and their impact on measured beam performance of the ZAP-X® dedicated stereotactic radiosurgery system (ZAP Surgical Systems, Inc., San Carlos, CA, USA) was determined. Three Physikalische Technische Werkstaetten (PTW) diodes, i.e., the microSilicon, the microDiamond, and the Stereotactic Radiosurgery (SRS) diode detectors of (PTW-Freiburg, Freiburg, Germany), as well as Gafchromic™ External Beam Therapy 3 (EBT) film (Ashland, Inc., Wilmington, DE, USA), were used and compared to arrive at a recommended standard for this critical component of small-field beam measurements. Beam profiles, including the dose fall-off region near the edge of the beam, were measured with the PTW diodes and EBT3 film and subsequently contrasted. The impact of detector physical and dosimetric characteristics on the results of the measurements was investigated and compared with film measurements. The beam penumbra was used to quantify the dose fall-off. The measurement acquired with the diodes and film showed the most significant differences in the fall-off region near the field edge. The film-based measurements clearly showed the steepest dose gradient verified by the penumbra value of 1.21 mm, followed by the SRS diode with 1.60 mm, the microSilicon diode with 1.67 mm, and the microDiamond diode with 1.83 mm. A clear correlation of each detector's sensitive area with the penumbra was found, with the microDiamond detector at 2.2 mm diameter sensitive area having the largest penumbra, followed by the microSilicon and SRS diodes. Beam measurements for the purposes of system characterization or treatment planning system beam data acquisition depend, to a large extent, on detector characteristics. This is especially true for small-field dosimetry performed during stereotactic radiosurgery beam measurements. Careful consideration should be practiced which allows for the measurements to represent true beam characteristics and minimize the impact of the detector on the measurements. We conclude that film should be considered the reference method for such measurements with the ZAP-X due to its smallest physical measurement resolution of 23.1 µm. Potential drawbacks to this methodology are the need to calibrate the film relative to the dose and possible problems with saturation and non-linear film response for very high and very low optical densities.