A dosimetric quality audit of photon beams by the Belgian Hospital Physicist Association

Since 1987, a dosimetric standardization process has been started by the Belgian Hospital Physicist Association (BHPA). As part of this project, on-site visits were performed by a voluntary team, by request of the local physicist. They included mechanical checks on treatment machines and simulators and a dosimetric intercomparison of photon beams, following the EORTC methodology. Until now 16 centres have participated. Dose measurements were performed in order to evaluate the uniformity in dosimetry after the adoption by the BHPA members of the Nederlandse Commissie voor Stralingsdosimetrie (NCS) code of practice for photon beams. Doses were measured with an ionization chamber in water under NCS reference conditions and under other conditions in 13 cobalt beams and 24 high energy X-ray beams from 4 to 25 MV. Under reference conditions, the mean ratio of measured to stated dose is 0.999 (+/- 0.010) and 1.006 (+/- 0.23) for cobalt and X-ray beams, respectively, with a difference between the extreme values (delta) of 0.042 for cobalt beams and 0.084 for X-ray beams. In other conditions, the spread is a little larger for all beams. The results are comparable, but with a smaller dispersion, with those of other national and international similar dose intercomparisons and show the importance of applying a common protocol. The results of mechanical checks show some large deviations in digital displays and indicate the need for a systematic mechanical and beam alignment quality assurance programme.