Background: Inorganic scintillation detectors (ISDs) are promising for in vivo dosimetry in brachytherapy (BT). ISDs have fast response, providing time resolved dose rate information, and high sensitivity, attributed to high atomic numbers. However, the conversion of the detector signal to absorbed dose-to-water is highly dependent on the energy spectrum of the incident radiation. This dependence is comprised of absorbed dose energy dependence, obtainable with Monte Carlo (MC) simulation, and the absorbed dose-to-signal conversion efficiency or intrinsic energy dependence requiring measurements. Studies have indicated negligible intrinsic energy dependence of ZnSe:O-based ISDs in Ir-192 BT. A full characterization has not been performed earlier.Purpose: This study characterizes the intrinsic energy dependence of ZnSe:O-based ISDs for kV X-ray radiation qualities, with energies relevant for BT.Methods: Three point-like ISDs made from fiber-coupled cuboid ZnSe:O-based scintillators were calibrated at the Swedish National Metrology Laboratory for ionizing radiation. The calibration was done in terms of air kerma free-in-air, K-air, in 13 X-ray radiation qualities, Q, from 25 to 300 kVp (CCRI 25-250 kV and ISO 4037 N-series), and in terms of absorbed dose to water, D-w, in a Co-60 beam, Q(0).The mean absorbed dose to the ISDs, relative to K-air and D-w, were obtained with the MC code TOPAS (Geant4) using X-ray spectra obtained with SpekPy software and laboratory filtration data and a generic Co-60 source.The intrinsic energy dependence was determined as a function of effective photon energy, E-eff, (relative to Co-60).The angular dependence of the ISD signal was measured in a 25 kVp (0.20 mm Al HVL) and 135 kVp beam (0.48 mm Cu HVL), by rotating the ISDs 180 degrees around the fiber's longitudinal axis (perpendicular to the beam). A full 360 degrees was not performed due to setup limitations. The impact of detector design was quantified with MC simulation.ResultsAbove 30 keV E-eff the intrinsic energy dependence varied with less than 5 +/- 4% from unity for all detectors (with the uncertainty expressed as the mean of all expanded measurement uncertainties for individual E-eff above 30 keV, k = 2). Below 30 keV, it decreased with up to 17% and inter-detector variations of 13% were observed, likely due to differences in detector geometry not captured by the simulations using nominal geometry. In the 25 kVp radiation quality, the ISD signal varied with 24% over a similar to 45 degrees rotation. For 135 kVp, the corresponding variation was below 3%. Assuming a 0.05 mm thicker layer of reflective paint around the sensitive volume changed the absorbed dose with 6.3% at the lowest E-eff, and with less than 2% at higher energies.ConclusionThe study suggests that the ISDs have an intrinsic energy dependence relative to Co-60 lower than 5 +/- 4% in radiation qualities with E-eff > 30 keV. Therefore, they could in principle be calibrated in a Co-60 beam quality and transferred to such radiation qualities with correction factors determined only by the absorbed dose energy dependence obtained from MC simulations. This encourages exploration of the ISDs' applications in intensity modulated BT with Yb-169 or other novel intermediate energy isotopes.