Applied Radiation and Isotopes 129 (2017) 130–134

Contents lists available at ScienceDirect

Applied Radiation and Isotopes

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

Differential dose absorptions for various biological tissue equivalent MARK

materials using Gafchromic XR-QA2 film in diagnostic radiology
⁎ ⁎
A. Ahmed Alsadiga, , S. Abbasa, S. Kandaiyaa, N.A.R. Nik Noor Ashikina, , M.A. Qaeedb
a
School of Physics, Universiti Sains Malaysia, 11800 Penang, Malaysia
b
Physics department, Faculty of education, Hodeidah University, Al hodeidah, Yemen

H I G H L I G H T S G RA P H I C A L AB S T R A C T

• The differential dose absorption

several materials as substitutes to
in

human tissues was investigated using

Gafchromic XR-QA2 film.
• The XR-QA2 film was energy in-
dependent, reproducible, and showed
the ability to be scanned after 6 h of
irradiation.
• The absorbed dose increased as the
density and atomic number of the
material increased.
• Using the equation obtained from the
curve, the absorbed dose per unit
thickness for a low-density material
can be determined.
• When the atomic number is low, the
material is more likely to interact by
Compton process than by
Photoelectric absorption.

A R T I C L E I N F O A B S T R A C T

Keywords: Phantoms are devices that simulate human tissues including soft tissues, lungs, and bones in medical and health
Gafchromic XR-QA2 film physics. The purpose of this work was to investigate the differential dose absorption in several commercially
Biological tissue equivalent materials available low-cost materials as substitutes to human tissues using Gafchromic XR-QA2 film. The measurement of
Dose absorption absorbed dose by different materials of various densities was made using the film to establish the relationship
Kilovoltage energy range
between the absorbed dose and the material density. Materials investigated included soft board materials,
Perspex, chicken bone, Jeltrate, chalk, cow bone, marble, and aluminum, which have varying densities from
0.26 to 2.67 g cm−3. The absorbed dose increased as the density and atomic number of the material increased.
The absorbed dose to the density can be well represented by a polynomial function for the materials used.

1. Introduction
A phantom developed to inspect the imaging limits of a kilovoltage
radiographic system will be different from a phantom developed to
evaluate the radiation dose delivered to a patient during radiation
therapy. The purpose of the phantom will determine the physical
characteristics to design it (DeWerd and Kissick, 2014). The develop-
ment of a physical phantom requires a careful selection of tissue sub-
stitute materials. The materials used must closely match the density,
volume, and chemical composition of the particular tissue for a similar

⁎
Corresponding authors.
E-mail addresses: modyalsadig@gmail.com (A.A. Alsadig), nnashikin@usm.my (N.A.R.N.N. Ashikin).

http://dx.doi.org/10.1016/j.apradiso.2017.08.021
Received 3 April 2017; Received in revised form 7 July 2017; Accepted 17 August 2017
Available online 18 August 2017
0969-8043/ © 2017 Elsevier Ltd. All rights reserved.
A.A. Alsadig et al.
Fig. 1. Structure of Gafchromic XR-QA2 film.
biological response at the energy of interest. For a proper choice of
materials, it must be commercially available, simple to fabricate, and
sustainable for a long period of time (Bower, 1997). Most of the tissue
equivalent materials have been created to mimic tissue attenuation
properties at high energies as required by most of the early applica-
tions. Hence, the phantoms that are constructed from these materials
are expected to respond well to high energy, but the response may not
be tissue equivalent for lower energies in diagnostic imaging
(Hintenlang et al., 2010).
Gafchromic XRQA film is a radiochromic film designed specifically
to be used in radiology and dosimetry applications. Gafchromic XRQA2
film is a newer version replacing the XRQA model. The latter film is
more sensitive to a lower dose range from 1 to 200 mGy and energy
range from 20 to 200 kVp. The film is supplied in convenient film sizes
(10 × 12 in. and 8 × 10 in.). Gafchromic XR-QA2 film is a reflective
type of films as shown in Fig. 1. It consists of five layers: a 97-µm-thick
yellow polyester layer, 15-µm-thick pressure-sensitive adhesive layer,
25-µm-thick active layer, 3-µm-thick surface layer, and 97-µm-thick
opaque white polyester layer. The atomic composition of the active
layer of the film is made up of H, N, O, C, Li, Br, Bi, and Cs. The in-
clusion of several high-Z elements such as Bi (Z = 83) increases the
photoelectric cross-section and boosts the sensitivity of the film to the
lower energy X-rays, making it suitable for dosimetric purposes in di-
agnostic radiology. The change in the optical density (OD) of the film is
directly proportional to the absorbed dose of ionizing radiation. Be-
cause of the inclusion of white opaque polyester layer, the film ne-
cessitates digitization using a reflective densitometer (Alnawaf et al.,
2010). The film is used to investigate the differential dose absorptions
in several commercially available low-cost materials as substitutes to
human tissues.
This work focused on the exposure of various biological tissue-
equivalent materials (phantoms) to diagnostic X-ray irradiation. The
dose absorptions were then investigated using Gafchromic XR-QA2 film
in diagnostic radiology as a new, easy, and low-cost treatment in the
laboratory of medical science in the School of Physics, USM.
2. Materials and method
2.1. Characterization of Gafchromic XR-QA2 film
2.1.1. General set-up
To ensure the stability of the film for dose measurements, para-
meters such as energy dependence, reproducibility, and postexposure
growth of the Gafchromic XR-QA2 film were primarily investigated.
The XR-QA2 film (lot no. A07091204) was cut into 3 × 4 cm2 pieces
from a single sheet 1 day prior to irradiation to allow the relaxation of
mechanical disturbances around the film edges. The film was then
placed on a Perspex phantom facing the radiation source. A Perspex
phantom of 5-cm thick was placed behind the film to provide sufficient
backscattering condition. To maximize the dose, the film was posi-
tioned at a source to surface distance (SSD) of 60 cm which was the
minimum distance between film and source. The field size used was 10
× 10 cm2. This allows the simultaneous placement of film and
131
Applied Radiation and Isotopes 129 (2017) 130–134
Fig. 2. Schematic diagram illustrating the general set-up.
ionization chamber in the radiation field. XR-QA2 pieces were irra-
diated at different kVp energies, i.e. 60, 80, and 100, by using a Toshiba
X-ray machine. A 1-cm3 ionization chamber type 7734 (PTW, Freiburg)
was connected to a SUPERMAX electrometer and irradiated under the
same conditions to measure the air kerma. The films were digitized and
scanned 1 day after the irradiation to acquire the response as pixel
values by using the ImageJ software. The experimental set-up is shown
in Fig. 2.
To obtain the calibration curve, the dose measured directly from the
ionization chamber is plotted against the mean pixel values (MPVs).
The MPVs were obtained from the scanning system. OD is calculated
from the MPV by using Eq. (1) (Fuss et al., 2007).
216 ⎞
OD = Log ⎛⎜ ⎟
⎝ MPV +1 ⎠ (1)
2.1.2. Reproducibility and postirradiation stability of the film
The reproducibility of different XR-QA2 films of the same batch was
studied by irradiating nine pieces (3 cm × 4 cm) with three different
doses of 77, 155, and 233 mGy by using the Toshiba X-ray machine.
The films were divided into three groups, and each group contained
three films. Each group was irradiated with a certain dose. The films
were scanned 24 h after irradiation.
The polymerization process of radiochromic films was known to
continue to change on a large time scale for some time (Blair and
Meyer, 2009; Andres et al., 2010; Zeidan et al., 2006), despite that the
initial polymerization reaction occurs within a few milliseconds after
the radiation exposure. The postexposure pixel value growth is the re-
sponse of the film in pixel values after irradiation. Many investigators
scanned the irradiated radiochromic films 24 h postirradiation to allow
for the total polymerization reaction to occur. An investigation of the
postirradiation development with time of the XR-QA2 film pieces
(which were cut into the same size dimensions as in previous tests) was
performed from 6 to 52 h after irradiation with four air kerma doses:
10, 49, 86, and 145 mGy in air.
2.1.3. Scanning system
A flatbed color scanner with 48-bit resolution or 16 bits/channel
works best with Gafchromic films (Alva et al., 2002). In this study, the
irradiated XR-QA2 films were scanned in the reflective mode using an
EPSON V700 professional flatbed scanner and scanned in 48-bit RGB
mode with a fluorescent lamp, in color mode, at 72-dpi scanner re-
solution. Data extraction was performed in the red channel as it has the
maximum sensitivity to dose response (Alva et al., 2002). The films’
images were analyzed with Image-J using 16-bit images in TIFF format.
A.A. Alsadig et al. Applied Radiation and Isotopes 129 (2017) 130–134

Fig. 3. (a) Soft board and bone are placed on the top
of 2.5-cm-deep Jeltrate layer. (b) Jeltrate phantom of
5 cm depth.

2.2. Absorbed dose of different tissue equivalent materials in Jeltrate

phantom

For soft tissue, the impression material Jeltrate powder was used.
The Jeltrate mixture was produced with a ratio of 1:5 where 20 g of
Jeltrate was mixed with 100 ml of deionized water. After the powder
and the water were properly mixed, the mixture was immediately
poured into a customized acrylic container (10 cm × 10 cm × 5 cm)
(Fig. 3). The soft board was used as a lung equivalent material with a
density of 0.26 g/cm3. It was nicely cut into a small lung shape, which
can be placed in the Jeltrate container. For the human bone, the
chicken femoral bone was used from which the ligaments and tendons
were removed. The Jeltrate mixture was filled into the container until
the thickness of the layer reached about 2.5 or half the container height.
The soft board material and the bone were then placed on the top of the
Jeltrate layer as shown in Fig. 3a. The remaining Jeltrate mixture was
filled into the container until it reached 5.0-cm thickness, and it was left
for a few more minutes to let it solidify (Fig. 3b).

2.2.1. Irradiation of Jeltrate phantom

Five sheets of Perspex (30 cm × 30 cm × 1 cm) were customized
with 10 × 10 cm2 square space at the centre where the Jeltrate
Fig. 4. Irradiation set-up of Jeltrate phantom and film arrangement.
phantom is fitted into the space, and another five sheets of Perspex
(without space) were placed under the phantom to have a maximum
backscattering (Fig. 4). Two pieces of XR-QA2 film were cut into 5 ×
10 cm2, and one of the pieces was placed on the top of the Jeltrate
surface and the other at the bottom of the Jeltrate phantom as illu-
strated in Fig. 4. The SSD was 60 cm with a field size of 10 × 10 cm2.
The irradiation was performed using 80 kVp and 640 mAs to obtain
high film contrast. Upon postirradiation, the films were inserted into a
proper envelope and were left for 24 h before being scanned.

2.3. Absorbed dose of various tissue equivalent materials at different

thicknesses

To investigate the relationship between the absorbed dose and

material thickness, the lung equivalent material (soft board material)
was cut into 10 layers with an area of 10 cm × 10 cm and a thickness of
1.2 cm each. The first layer of the soft board was exposed using the
previous exposure parameters as shown in Fig. 5. The exposure was
repeated for different thicknesses of the soft board (1.2–7.2 cm). The
same procedure was repeated for various types of tissue equivalent Fig. 5. Irradiation set-up for soft board material and arrangement of XR-QA2 film during
materials as shown in Fig. 6 (Jeltrate, Perspex, chicken bone, chalk the irradiation.

(1.24 g/cm3), cow bone (1.93 g/cm3), marble (2.16 g/cm3), and alu-
minum (2.67 g/cm3)), and the measurement was also repeated in free
air for absorbed dose comparison.

132
A.A. Alsadig et al. Applied Radiation and Isotopes 129 (2017) 130–134

Table 1
Response of XR-QA2 films irradiated with three different doses.

Dose (mGy) MPV

Film 1 Film 2 Film 3 Mean Std.dev % Deviation

77 18,309 18,296 18,436 18,347 77 0.42

155 15,705 15,432 15,692 15,610 154 0.99
233 13,880 13,785 13,904 13,856 63 0.45

Fig. 6. Various types of tissue equivalent materials.

3. Results and discussion

3.1. Characterization of Gafchromic XR-QA2 Fig. 8. Postexposure time dependancy: the relative MPV against time (in h) is shown for
four different doses.

3.1.1. Dose response calibration curve

Dose (mGy) as a function of OD is shown Fig. 7 in. The figure clearly
shows that a polynomial function displays the best fitting curve for the
OD-dose relationship with the quadratic equation as shown in Eq. (2).
The same dose at different beam qualities gave approximately a similar
response, which led to a conclusion that the response of the film is
energy independent. The lowest dose measured with the ionization
chamber is 10.0 mGy.
Dose (mGy ) = 975.69(OD)2 + 29.216(OD) + 8.3252
3.1.2. Reproducibility of the film
The experimental data from XR-QA2 films irradiated with three
different doses were analyzed using MPV values as shown in Table 1,
the XR-QA2 films were reproducible within a percentage standard de-
viation not exceeding 1% for the three different dose values.
3.1.3. Postirradiation time dependency
The film response in MPV against postexposure time for four dose
values of 11, 49, 85, and 145 mGy is shown in Fig. 8. The MPV values
for all doses relatively stabilized after 6 h. Thus, the films can be
scanned and digitized after 6 h after irradiation. The variation in the
film response was less than 1% for all the doses.
(soft tissue, lung, and bone). As Perspex is a well-known soft tissue
equivalent material, the absorbed dose in Jeltrate layer was compared
to that in Perspex for the same thickness. The absorbed dose in 1-cm
Jeltrate was 19.05 mGy, which was slightly higher than that in 1-cm
Perspex. As the densities of both materials are similar within the un-
certainty, the difference could be due to the composition of the two
materials. Jeltrate is known to have a small percentage of high atomic
number elements whilst Perspex has only carbon, oxygen and hydrogen
(2)
in its composition. As shown in (Table 2)
The absorbed dose in the soft board material was lower than those
in the bone, Perspex, and Jeltrate because its density was relatively low.
Less photons were absorbed by the material, and more photons were
transmitted and reached the film. Hence, the region of lung appeared
darker with a higher OD value compared to the surrounding soft tissues.
Hence, the lung can be clearly distinguished from the soft tissue in
diagnostic imaging. The bone showed the highest absorbed dose among
all the materials because of the presence of high atomic number ma-
terial (high composition of calcium within the bone). Thus, high ab-
sorption of the photons occurred within the bone as they interact
dominantly by photoelectric effect. The dependence of the photo-
electric absorption on the atomic number of the interacting material at
low energy gave rise to the high absorbed dose in the bone.

3.2. Absorbed dose of different tissue equivalent materials in Jeltrate

3.3. Absorbed dose of tissue equivalent materials at different thicknesses
phantom
Fig. 9 shows that the absorbed dose increases linearly with the in-
The Jeltrate phantom is composed of three different components
crease in material thickness except for chicken bone. The absorbed dose
within 1 cm of material can be determined by substituting the value
into the equation of a straight line to compare the value obtained from
the phantom. Fig. 9(d) shows that the graph for bone had two straight

Table 2
Absorbed dose in three different materials of the Jeltrate phantom.

Material Density (g/cm3) Absorbed dose per unit thickness (mGy/cm)

Jeltrate 1.22 ± 0.05 19.05

Perspex 1.18 15.96
Soft board 0.26 ± 0.01 9.57
Bone 1.2 ± 0.15 34.43
Fig. 7. Dose response of XR-QA2 film as a function of optical density (OD).

133
A.A. Alsadig et al.
Table 3
Absorbed dose per unit thickness of different materials measured in phantom and in air.
Material Absorbed dose per unit thickness of material (mGy/cm)
In phantom In air
Jeltrate 19.05 ± 0.99 19.92 ± 1.03
Perspex 15.96 ± 0.83 16.15 ± 0.84
Soft board 9.57 ± 0.5 7.3 ± 0.39
Bone 34.43 ± 1.78 32.01 ± 1.66
Fig. 10. Absorbed dose of materials with different densities.
lines with two different equations. It can be seen that the first straight
line is valid only until about 2.3 cm of the bone thickness. Beyond a
thickness of 2.3 cm, a second straight line with a more gradual slope
was fitted into data. This situation is influenced by the beam hardening
effect of the high atomic number material inside the bone. As the X-ray
photons pass through 2.3 cm of the bone, low-energy photons are re-
moved or absorbed by the bone atoms, and only high-energy photons
can pass through the material. The X-ray beam has been hardened by
the material. Therefore, for a thickness beyond 2.3 cm, the hard X-rays
are less attenuated by the bone material.
From Table 3, it can be concluded that the absorbed dose of the
materials measured in the phantom is in agreement with that measured
in air, except for soft board material where it shows a higher absorbed
dose in phantom than that in air. The soft board material used as a lung-
mimicking material is a type of water-absorbing material. As the Jel-
trate mixture is poured on the top of the material, some portion of the
water may be absorbed by the material, which adds to the material's
density. This would then contribute to the higher absorbed dose by the
soft board material in phantom than that in air.
134
Applied Radiation and Isotopes 129 (2017) 130–134
Fig. 9. Absorbed dose of (a) Jeltrate, (b) Perspex, (c)
soft board, and (d) bone at different thicknesses
measured in air.
Fig. 10 shows the relationship between the material density and the
absorbed dose per unit length for each material. Within the first 1 cm of
the material, the absorbed dose increases as the density of the material
increases. The high density materials do have high atomic numbers too.
The absorbed dose per unit thickness can be obtained for tissues of
known densities from the given relationship.
4. Conclusion
The differential dose absorption in eight commercially available
low-cost materials as substitutes to human tissues was investigated
using Gafchromic XR-QA2 film. The film was energy independent and
allowed easy placement of the film at various depths of the tissue-
equivalent materials. The dose absorption in the materials, namely
Jeltrate, Perspex, soft board material, chicken bone, CaCO3, cow bone,
marble, and aluminum, was influenced both by the density and the
atomic number of the materials. At low atomic number, probability of
interaction by the Compton process is more dominant whilst at high
atomic number the photoelectric effect is more dominant at diagnostic
energy range. The materials studied were cheap and can simulate the
different tissue materials at these low energies.
Acknowledgments
We thank the Universiti Sains Malaysia (203/PSF/6721002) for
supporting this work.
References
Alnawaf, H., et al., 2010. Scanning orientation and polarization effects for XRQA radio-
chromic film. Phys. Med. 26 (4), 216–219.
Alva, H., Mercado-Uribe, H., Brandan, M., 2002. The use of a reflective scanner to study
radiochromic film response. Phys. Med. Biol. 47 (16), 2925.
Andres, C., et al., 2010. A comprehensive study of the Gafchromic EBT2 radiochromic
film. A comparison with EBT. Med. Phys. 37 (12), 6271–6278.
Blair, A., Meyer, J., 2009. Characteristics of Gafchromic® XR-RV2 radiochromic film.
Med. Phys. 36 (7), 3050–3058.
Bower, M.W., 1997. A Physical Anthropomorphic Phantom of a One Year Old Child With
Real-time Dosimetry.
DeWerd, L.A., Kissick, M., 2014. The Phantoms of Medical and Health Physics: Devices for
Research and Development, Biological and Medical Physics, Biomedical Engineering.
Springer Science+Business Media, New York, pp. 1 (ISBN 978-1-4614-8303-8).
Fuss, M., et al., 2007. Dosimetric characterization of GafChromic EBT film and its im-
plication on film dosimetry quality assurance. Phys. Med. Biol. 52 (14), 4211.
Hintenlang, D.E., Moloney, W.E., Winslow, J., 2010. Physical Phantoms for Experimental
Radiation Dosimetry. Handbook of Anatomical Models for Radiation Dosimetry.
Zeidan, O.A., et al., 2006. Characterization and use of EBT radiochromic film for IMRT
dose verification. Med. Phys. 33 (11), 4064–4072.