Spencer-Attix water/medium stopping-power ratios for the dosimetry of proton pencil beams

This paper uses Monte Carlo simulations to calculate the Spencer-Attix water/medium stopping-power ratios (s(w, med)) for the dosimetry of scanned proton pencil beams. It includes proton energies from 30 to 350 MeV and typical detection materials such as air (ionization chambers), radiochromic film, gadolinium oxysulfide (scintillating screens), silicon and lithium fluoride. Track-ends and particles heavier than protons were found to have a negligible effect on the water/air stopping-power ratios (s(w, air)), whereas the mean excitation energy values were found to carry the largest source of uncertainty. The initial energy spread of the beam was found to have a minor influence on the s(w, air) values in depth. The water/medium stopping-power ratios as a function of depth in water were found to be quite constant for air and radiochromic film-within 2.5%. Also, the s(w, med) values were found to have no clinically relevant dependence on the radial distance-except for the case of gadolinium oxysulfide and proton radiography beams. In conclusion, the most suitable detection materials for depth-dose measurements in water were found to be air and radiochromic film active layer, although a small correction is still needed to compensate for the different s(w, med) values between the plateau and the Bragg peak region. Also, all the detection materials studied in this work-except for gadolinium oxysulfide-were found to be suitable for lateral dose profiles and field-specific dose distribution measurements in water.