Response to Ralph Christensen’s Letter “An operational issue of absorbed dose versus dose equivalent in TG-45

In this study the dosimetric properties of Plastic Water™ and Solid Water™ phantom materials are evaluated using Monte Carlo photon transport simulations. In particular, their water-equivalence with respect to absorption and attenuation of photons in the brachytherapy energy range are examined. For the given chemical compositions of the materials, the linear attenuation coefficients were calculated for photons of 1 keV-2 MeV. Moreover, absorbed doses to water in each phantom material were calculated at distances of 0.5-12,0 cm from point sources of 20 keV to ⁶⁰Co gamma rays. These results show that at low photon energies (below 100 keV), there are substantial differences (up to a factor of 5) between the absorbed dose in Plastic Water and that in liquid water. The differences decrease as photon energy increases, and they become insignificant at ⁶⁰Co gamma rays, as claimed by the manufacturer. In contrast, calculations show that the difference in absorbed dose in Solid Water from that in liquid water, over the entire range of photon energies employed in this study, is less than 25%. The results of this study demonstrate the necessity of careful dosimetric evaluation of a new phantom material, before its clinical application, particularly in energy ranges outside those referred to by the manufacturer.