Applied Radiation and Isotopes 69 (2011) 1897–1900

Contents lists available at ScienceDirect

Applied Radiation and Isotopes

journal homepage: www.elsevier.com/locate/apradiso

Quality control and quality assurance procedures at the THOR BNCT facility
Yuan-Hao Liu a,n, Pi-En Tsai a, Yi-Chun Lin b, Chun-Kai Huang c, Hong-Ming Liu a, Shiang-Huei Jiang c
a
Nuclear Science and Technology Development Center, National Tsing Hua University, HsinChu, Taiwan
b
Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, HsinChu, Taiwan
c
Institute of Nuclear Engineering and Science, National Tsing Hua University, HsinChu, Taiwan

a r t i c l e i n f o abstract

Available online 21 March 2011 Various quality control (QC) and quality assurance (QA) procedures of the boron neutron capture
Keywords: therapy (BNCT) beam at the Tsing Hua Open-pool Reactor (THOR) are established to ensure beam
Quality control availability and quality. The QC/QA methods mainly employ foil activation and paired ionization
Quality assurance chambers, respectively, for beam intensity check and dose assessment. Beam intensity is monitored
Epithermal neutron beam on-line by using three dead-time corrected fission chambers. In addition to the periodic QC/QA
THOR activities regarding beam quality and the monitoring system, the quick QC/QA performed in an all-in-
BNCT one phantom will be executed less than 70 min before the clinical treatment to guarantee beam quality.
The QC/QA procedures have been gradually established and the actual performance satisfied the preset
criteria defined for the BNCT facility at THOR.
& 2011 Elsevier Ltd. All rights reserved.

1. Introduction tolerance/uncertainty values reported in this work were evalu-

At the Tsing Hua Open-pool Reactor (THOR), the quality
control (QC), and quality assurance (QA) procedures are the
necessary means to ensure that its epithermal neutron beam
satisfies the need for the boron neutron capture therapy (BNCT).
Trustiness and correctness are the most demanded aspects that
QC/QA seeks to cover. To achieve the mentioned goals, a series of
actions were taken to establish a proper QC/QA system at the
THOR BNCT facility.
Since the second half of 2009, a series of standard operation
procedures for QC/QA have been proposed and gradually imple-
mented. The QC/QA procedures at the THOR BNCT facility cover
many different aspects concerning mostly patient safety, such as
fire inspection, emergency evacuation, power supply, BPA exam-
ination, and the most important one – beam availability and
quality. This paper aims to introduce the QC/QA procedures
performed in order to assure the validity of the epithermal
neutron beam at THOR.
2. Materials and methods
Several measuring techniques are applied for the beam QC/QA
check/calibration, among which, activation detectors and paired
ionization chambers are the most used. The following sections
introduce the two tools and the QC/QA activities. Note that, the
n
Correspondence to: Boron Neutron Capture Therapy Center, Nuclear Science and
Technology Development Center, National Tsing Hua University, No. 101, Section 2,
Kuang-Fu Road, Hsinchu City 30013, Taiwan. Tel.: þ886 3 5715131x42889.
E-mail addresses: yhl.taiwan@gmail.com, liuyh@mx.nthu.edu.tw (Y.-H. Liu).
ated from long-term observation of corresponding dosimetry
experiments performed in the epithermal neutron beam.
2.1. Beam intensity and beam spectrum check
The instrumental neutron activation analysis (INAA) is very
commonly used in reactor dosimetry to study the characteristics of
a neutron field. At THOR, a well-calibrated high purity germanium
(HPGe) detector system is used while a set of triple activation foils
are applied as activation detectors. To ensure the accuracy of the
measurements, the HPGe is periodically calibrated by standard
sources, including 60Co, 137Cs, and 152Eu. The measuring distances
are available at 8 and 14 cm away from the detector surface. The
applied triple activation foils are, in sequence, AuAl (1 wt% Au),
pure natural Cu, and MnNi (88 wt% Mn) foils. The foils are packed
in a piece of rice paper. For the beam intensity calibration, the
triple-foil package is posted at the center of the beam exit. During
the activity measurements, their dead time is kept less than 1%.
Since the reaction rate per atom, RR, is proportional to the
beam intensity, RR is used for beam intensity check. The foil set is
positioned free in air at the beam center and irradiated at 1.2 MW.
The RR of the activated foil at a given reference counting rate is
determined by
lðCBÞ
RR ¼ ð1Þ
N  e  Y  eltm ð1eltc Þ  b
where l is the decay constant of the radioactive nuclide (s  1), C
is the peak gross counts and B is the peak background counts, N is
the number of atoms of the foil, e is the peak efficiency and Y is
the branch ratio of the peak of interest, tm is the activity measur-
ing time (s), and tc is the cooling time between the end of

0969-8043/$ - see front matter & 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.apradiso.2011.03.012
1898 Y.-H. Liu et al. / Applied Radiation and Isotopes 69 (2011) 1897–1900

irradiation and the start of the counting (s). And
tirr   the collimator to avoid back scattering contributions. The dead-
X FCðti Þ
b¼  ð1el Þ  elðtirr ti Þ
i¼1
FCref
where tirr is the irradiation time (s), and FC(ti) is the counting rate
at the ith second of the irradiation, read from one of the beam
monitoring channels and FCref is the reference counting rate of
that channel. Eq. (2) accounts for normalization of the time
dependent beam intensity to the reference condition. The RR
measured at different time with the same conditions should be
constant or within an acceptable range.
At the THOR, the ratio of the reaction rate per atom of AuAl foil
(RRAu) to that of MnNi foil (RRMn) is used as a check indication of
neutron spectrum due to their different sensitivities to thermal
and epithermal neutrons. At THOR, this ratio is 60.1 72% (toler-
ance level) for the free-in-air measurement (at 0 cm). The ratio of
MnNi foil to Cu foil is used as a quality check of the performed
measurement. Generally, the ratio should be 3.14 72%.
2.2. Paired ionization chambers
Paired ionization chambers technique is used to determine
gamma-ray and neutron doses (ICRU Report no. 45, 1989).
A magnesium-walled ionization chamber with argon gas (denoted
as Mg(Ar)) is used for photon component measurement. The other
ionization chamber walled with A-150 tissue-equivalent plastic
and filled with methane tissue-equivalent gas (denoted as TE(TE))
is used to determine total neutron and photon absorbed doses. In
the QC/QA procedure, the gas ionization can be derived from the
electrometer reading, corrected by temperature, pressure as well as
time-dependent beam intensity. The corresponding neutron and
gamma-ray doses are determined by the paired algebraic equa-
tions defined in ICRU 45 report.
Both chamber systems, including their cables and electro-
meters MAX4001 made by Standard Imaging Inc., are annually
calibrated in a primary standard 60Co beam at the Institute of
Nuclear Energy Research in Taiwan.
2.3. On-line neutron monitoring system and its calibration
The THOR epithermal neutron beam is equipped with an on-line
neutron monitoring system consisting of three miniature 235U
loaded fission chambers. The fission chambers were installed inside
ð2Þ time influence was calibrated using a low counting rate fission
chamber, whose dead-time influence can be ignored, as described
in the previous study (Liu et al., 2006). For clinical irradiation, the
system is controlled by a dedicated computer program named
OMS-BNCT. According to fission chambers readings as well as an
input function of boron concentration, this program calculates the
real-time dose delivered to the patient and indicates the percentage
of accumulated dose. Furthermore, OMS-BNCT plays an important
role in the QC/QA procedures; it has a check list covering commu-
nication, reactor status, dose information, personnel evacuation,
and all of the other relevant QC/QA items, that must be double
checked one by one, by the on-site scientist and the corresponding
clinician before the monitor can be turned on.
One of the most important QC/QA activities is the calibration of
the online neutron monitoring system. The on-line neutron mon-
itoring system determines when the irradiation should stop and
thus it is crucial to the correctness of dose delivery. To guarantee
the system functions correctly, the previously mentioned triple
activation detectors are utilized in the calibration work. The
monitor calibration factor k derived from RR is defined as
k ¼ ðRR=ðFCref ÞÞ ð3Þ
The monitor calibration factor can be viewed as the induced
reaction rate per atom of a specific activation detector per count
read from a given fission chamber.
2.4. Periodical and quick QC/QA activities
The QC/QA procedures, concerning the epithermal neutron
beam availability and quality, are periodically performed. For
different QC/QA terms, the execution period is different. Table 1
lists the corresponding QC/QA activities and their execution
period. All of the performed QC/QA checks/calibrations have been
well documented via electronic files and hard copies. Each
document is checked and approved by an independent supervisor.
In addition to the periodic checks/calibrations, one day before a
clinical irradiation, the QC/QA checks for beam intensity and dose
as well as the on-line monitoring system calibration will be
performed. As long as a deviation of any measured detector
response is larger than 3%, the whole procedure and system will

Table 1
The QC/QA items for THOR BNCT and their execution period.

Item Period Tool Tolerance

Beam quality
Beam intensity Quarterlya Triple foils 3%b
Beam spectrum Annually Multiple foils 3%b
Neutron spatial distribution Quarterly Imaging plateþ Cu sheet N/A
Neutron and gamma-ray doses Quarterlya Twin ionization chambers 3%c

Monitoring system
On-line monitor check Half-yearly Oscilloscope þpulser N/A
On-line Monitor Calibration Quarterlya Triple foils 3%b
Monitor dead-time calibration Annually Low sensitivity fission chamber N/A
Area monitor calibration Annually Secondary 137Cs source N/A

Instrument
Ionization chamber calibration Annually Primary 60Co source o1%d
HPGe calibration Quarterly Standard sources o3%d
Imaging plate reader check Half-yearly Maintained by Fujifilm N/A
Laser Weeklya Laser tool kit o1 mm
Communication system Half-yearlya Cameraþ microphone N/A

a
These items will also be performed one day before the clinical treatment.
b
Compared to the standard reaction rate per atom of each activation foil, separately.
c
Compared to the given standard current of each chamber, separately.
d
Uncertainty of the calibration factor.
 Y.-H. Liu et al. / Applied Radiation and Isotopes 69 (2011) 1897–1900
be thoroughly examined and a redundant measurement will be
performed. If the system has been carefully checked and the
second measurement result agree with the first one, then the
clinical irradiation will be normally performed and the beam
status will be correspondingly updated.
On the day of irradiation, a quick QC/QA check will be
performed in the morning by using an all-in-one, 20  20 
20 cm3 PMMA phantom. The quick QC/QA employs a set of AuAl
and Cu foils, paired ionization chambers, and a miniature fission
chamber, as shown in Fig. 1, which all accommodate in the
PMMA phantom. The all-in-one phantom is placed against the
beam port. Phantom central axis and beam central axis are
coincident. The whole quick QC/QA procedure is designed to be
completed in 70 min by just one well-trained person when
necessary.
Following the irradiation day flow chart, the quick QC/QA
check result should be reported in the technical debriefing meet-
ing held half an hour prior to the BPA infusion. If the QC/QA
results do not pass the criteria, i.e. deviations of RR are larger than
3% the infusion will be postponed or canceled.
Fig. 1. The all-in-one, 20  20  20 cm3 PMMA phantom used for the quick QC/QA.
Fig. 2. The history of the measured reaction rate per atom of the triple foils (the dash lines represents the corresponding 7 3% uncertainty bands.).
1899
3. Beam QC/QA records
3.1. Measured reaction rate per atom
Fig. 2 shows the history of the measured free-in-air RR of the
triple activation foils. The average reaction rates are 1.70  10  13 7
0.95%, 9.0  10  16 71.03%, and 2.83  10  15 71.21% s  1 atom  1,
respectively, for Au, Cu, and Mn. All of the measured reaction rates
were within 72.5%, which show that the beam intensity was in a
stable state with quite small fluctuations. Besides the reaction rates,
the ratio of RRAu to RRMn as well as the ratio of RRMn to RRCu are of
our high concern. The ratio of RRAu to RRMn was 60.171.1% and the
ratio of RRMn to RRCu was 3.1471.3%; both variations are satisfac-
torily slight that can guarantee the beam stabilization and the
measurement quality.
3.2. Monitor dead-time calibration
Due to the replacement of Timer/Counter, the dead time of the
neutron monitoring system was recalibrated. The dead-time calibra-
tion curve is shown in Fig. 3. According to the calibration, the dead
time is less than 1% while the counting rate of the fission chamber is
less than 5600 cps, and the dead time is near 3% at 1.2 MW with
counting rates around 11,000 cps. The dead-time influence is real-
time compensated using a built-in correction equation as a function
of the measured counting rate in the OMS-BNCT.
3.3. Monitor calibration
Fig. 4 presents the calibration history of the monitoring system
from January 2009 until July 2010. During July 2009, parts of the
monitor hardware as well as the control interface were renewed
and upgraded; two of the fission chambers were replaced and the
positions of fission chambers were adjusted as well. Therefore,
the calibration factors before July 2009 were different from the
subsequent ones since the calibration factor is dependent on
the reference counting rate of a given fission chamber. However,
the calibration factors still agreed with each other with deviations
less than 3% within the time period from January 2009 to June
2009 and from August 2010 until the present, respectively. Since
the calibration factor k is derived from the measured reaction
rates of the activation detectors, it is reasonable to have a 73%
variation as expected for the measured reaction rates.
1900 Y.-H. Liu et al. / Applied Radiation and Isotopes 69 (2011) 1897–1900
Fig. 3. The dead time calibration results of the BNCT neutron monitoring system.
Fig. 4. The calibration history of the neutron monitoring system of the THOR
BNCT beam.
3.4. Quick QC/QA checks
Both of the RRAu and RRCu, corrected by three channels of the
neutron monitor separately, agree with each other among four
tests with differences smaller than 3%. The deviations of the
measured k values are all within 3%. As to the paired chambers,
the corrected currents were 50.27 2.2% and 40.270.42% pA,
respectively for the Mg(Ar) and TE(TE) chambers. The derived
photon and neutron doses were 5.8 72.2% and 0.80714% Gy/h.
All of them passed the criteria of beam QC/QA checks.
4. Conclusions
This paper presents the QC/QA process performed at the THOR
BNCT facility. The calibration history demonstrates that the BNCT
beam was very stable; the fluctuation of reaction rates was within
72.5%. In addition, a quick QC/QA procedure has been established,
using the all-in-one phantom. All these procedures have been
documented as the standard operation procedures in the THOR BNCT
facility instruction.
The accuracy and reliability of an epithermal neutron beam,
including its intensity and dose level, directly affects doses delivered
to patients. Since boron neutron capture reactions occurred in tumor
is determined by both boron concentration and thermal neutron flux,
tumor dose is straight proportional to beam intensity, and therefore
its accuracy is related to beam variation. In some cases, irradiation
time and tumor dose are limited by normal tissue dose whose
faithfulness highly relies on the trustiness of beam intensity. Hence,
beam QC/QA must be carefully carried out to ensure patient safety
and dose delivery. In addition, a tolerance level should be chosen
within a reasonable range. A loose range will increase undesired risk
to patient health while an over restriction will not conspicuously
improve the beam reliability but will cause unnecessary obstacles to
treatment procedure. In this work, the tolerance levels were set
according to long-term observation of corresponding dosimetry
measurements performed in the beam, which can be treated as the
unavoidable intrinsic fluctuation of the beam as well as the dosi-
metry method. Hence, these values were believed to be reasonable.
The treatment planning consequently takes the possible variation
into consideration and the clinicians are well informed accordingly.
Acknowledgments
This work was supported by the National Science Council, ROC
(Taiwan) under Contract number 99-2218-E-007-009. The
authors would like to express their sincere appreciation to the
Nuclear Reactor Division of the Nuclear Science and Technology
Development Center, National Tsing Hua University for their kind
assistance in the reactor operation.
References
ICRU, 1989. Clinical Neutron Dosimetry Part I: Determination of Absorbed Dose in
a Patient Treated by External Beams of Fast Neutrons, ICRU Report 45,
International Commission on Radiation Units and Measurement.
Liu, Y.-H., Jiang, S.-H., Liu, H.Y.-W., Liu, H.-M., 2006. On-line neutron monitoring
system of epithermal neutron beam for BNCT at THOR, In: Nakagawa, Y.,
Kobayashi, T., Fukuda, H. (Eds.), Proceedings of the 12th Congress on Neutron
Capture Therapy. International Society of Neutron Capture Therapy, Takamatsu,
Kagawa, Japan.