Reference radiochromic film dosimetry: Review of technical aspects

On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

PURPOSE

In this work, the potential of an innovative "edgeless" silicon diode was evaluated as a response to the still unmet need of a reliable tool for plan dosimetry verification of very high dose, non-coplanar, patient-specific radiosurgery treatments. In order to prove the effectiveness of the proposed technology, we focused on radiosurgical treatments for functional disease like tremor or pain.

METHODS

The edgeless diodes response has been validated with respect to clinical practice standard detectors by reproducing the reference dosimetry data adopted for the Treatment Planning System. In order to evaluate the potential for radiosurgery patient-specific treatment plan verification, the anthropomorphic phantom Alderson RANDO has been adopted along with three edgeless sensors, one placed in the centre of the Planning Target Volume, one superiorly and one inferiorly.

RESULTS

The reference dosimetry data obtained from the edgeless detectors are within 2.6% for output factor, off-axis ratio and well within 2% for tissue phantom ratio when compared to PTW 60,018 diode. The edgeless detectors measure a dose discrepancy of approximately 3.6% from the mean value calculated by the TPS. Larger discrepancies are obtained in very steep gradient dose regions when the sensors are placed outside the PTV.

CONCLUSIONS

The angular independent edgeless diode is proposed as an innovative dosimeter for patient quality assurance of brain functional disorders and other radiosurgery treatments. The comparison of the diode measurements with TPS calculations confirms that edgeless diodes are suitable candidates for patient-specific dosimetric verification in very high dose ranges delivered by non-isocentric stereotactic radiosurgery modalities.

Clinical utility of Gafchromic film in an MRI-guided linear accelerator

Background

The purpose of this study is to comprehensively evaluate the suitability of Gafchromic EBT3 and EBT-XD film for dosimetric quality assurance in 0.35 T MR-guided radiotherapy.

Methods

A 0.35 T magnetic field strength was utilized to evaluate magnetic field effects on EBT3 and EBT-XD Gafchromic films by studying the effect of film exposure time within the magnetic field using two timing sequences and film not exposed to MR, the effect of magnetic field exposure on the crystalline structure of the film, and the effect of orientation of the film with respect to the bore within the magnetic field. The orientation of the monomer crystal was qualitatively evaluated using scanning electron microscopy (SEM) compared to unirradiated film. Additionally, dosimetric impact was evaluated through measurements of a series of open field irradiations (0.83 × 0.83-cm² to 19.92 × 19.92-cm²) and patient specific quality assurance measurements. Open fields were compared to planned dose and an independent dosimeter. Film dosimetry was applied to twenty conventional and twenty stereotactic body radiotherapy (SBRT) patient specific quality assurance cases.

Results

No visual changes in crystal orientation were observed in any evaluated SEM images nor were any optical density differences observed between films irradiated inside or outside the magnetic field for both EBT3 and EBT-XD film. At small field sizes, the average difference along dose profiles measured in film compared to the same points measured using an independent dosimeter and to predicted treatment planning system values was 1.23% and 1.56%, respectively. For large field sizes, the average differences were 1.91% and 1.21%, respectively. In open field tests, the average gamma pass rates were 99.8% and 97.2%, for 3%/3 mm and 3%/1 mm, respectively. The median (interquartile range) 3%/3 mm gamma pass rates in conventional QA cases were 98.4% (96.3 to 99.2%), and 3%/1 mm in SBRT QA cases were 95.8% (95.0 to 97.3%).

Conclusions

MR exposure at 0.35 T had negligible effects on EBT3 and EBT-XD Gafchromic film. Dosimetric film results were comparable to planned dose, ion chamber and diode measurements.

High spatial resolution dosimetry with uncertainty analysis using Raman micro-spectroscopy readout of radiochromic films

PURPOSE

The purpose of this work is to develop a new approach for high spatial resolution dosimetry based on Raman micro-spectroscopy scanning of radiochromic film (RCF). The goal is to generate dose calibration curves over an extended dose range from 0 to 50 Gy and with improved sensitivity to low (<2 Gy) doses, in addition to evaluating the uncertainties in dose estimation associated with the calibration curves.

METHODS

Samples of RCF (EBT3) were irradiated at a broad dose range of 0.03-50 Gy using an Elekta Synergy clinical linear accelerator. Raman spectra were acquired with a custom-built Raman micro-spectroscopy setup involving a 500 mW, multimode 785 nm laser focused to a lateral spot diameter of 30 µm on the RCF. The depth of focus of 34 µm enabled the concurrent collection of Raman spectra from the RCF active layer and the polyester laminate. The preprocessed Raman spectra were normalized to the intensity of the 1614 cm^-1 Raman peak from the polyester laminate that was unaltered by radiation. The mean intensities and the corresponding standard deviation of the active layer Raman peaks at 696, 1445, and 2060 cm^-1 were determined for the 150 × 100 µm² scan area per dose value. This was used to generate three calibration curves that enabled the conversion of the measured Raman intensity to dose values. The experimental, fitting, and total dose uncertainty was determined across the entire dose range for the dosimetry system of Raman micro-spectroscopy and RCF.

RESULTS

In contrast to previous work that investigated the Raman response of RCFs using different methods, high resolution in the dose response of the RCF, even down to 0.03 Gy, was obtained in this study. The dynamic range of the calibration curves based on all three Raman peaks in the RCF extended up to 50 Gy with no saturation. At a spatial resolution of 30 × 30 µm² , the total uncertainty in estimating dose in the 0.5-50 Gy dose range was [6-9]% for all three Raman calibration curves. This consisted of the experimental uncertainty of [5-8]%, and the fitting uncertainty of [2.5-4.5]%. The main contribution to the experimental uncertainty was determined to be from the scan area inhomogeneity which can be readily reduced in future experiments. The fitting uncertainty could be reduced by performing Raman measurements on RCF samples at further intermediate dose values in the high and low dose range.

CONCLUSIONS

The high spatial resolution experimental dosimetry technique based on Raman micro-spectroscopy and RCF presented here, could become potentially useful for applications in microdosimetry to produce meaningful dose estimates in cellular targets, as well as for applications based on small field dosimetry that involve high dose gradients.

Hydrogels for Three-Dimensional Ionizing-Radiation Dosimetry

Radiation-sensitive gels are among the most recent and promising developments for radiation therapy (RT) dosimetry. RT dosimetry has the twofold goal of ensuring the quality of the treatment and the radiation protection of the patient. Benchmark dosimetry for acceptance testing and commissioning of RT systems is still based on ionization chambers. However, even the smallest chambers cannot resolve the steep dose gradients of up to 30-50% per mm generated with the most advanced techniques. While a multitude of systems based, e.g., on luminescence, silicon diodes and radiochromic materials have been developed, they do not allow the truly continuous 3D dose measurements offered by radiation-sensitive gels. The gels are tissue equivalent, so they also serve as phantoms, and their response is largely independent of radiation quality and dose rate. Some of them are infused with ferrous sulfate and rely on the radiation-induced oxidation of ferrous ions to ferric ions (Fricke-gels). Other formulations consist of monomers dispersed in a gelatinous medium (Polyacrylamide gels) and rely on radiation-induced polymerization, which creates a stable polymer structure. In both gel types, irradiation causes changes in proton relaxation rates that are proportional to locally absorbed dose and can be imaged using magnetic resonance imaging (MRI). Changes in color and/or opacification of the gels also occur upon irradiation, allowing the use of optical tomography techniques. In this work, we review both Fricke and polyacrylamide gels with emphasis on their chemical and physical properties and on their applications for radiation dosimetry.

Calibration of Gafchromic XR-RV3 film under interventional radiology conditions

Introduction: The purpose of the study was the calibration of Gafchromic films in clinical interventional radiology conditions and the assessment of the influence of dose range, the shape of the fitting curve, and its practical application. The aim of the work was to show how practically perform calibration in a wide range of doses.

Material and methods: Gafchromic XR–RV3 films were included in the study. The calibration was performed for A and B film series separately. Doses from the range of 0 – 8 Gy were used. Film dosimeters were read out in reflective mode with a commercial flatbed scanner.

Results: Among various degrees of a polynomial function, the best fit, which fulfilled the chosen criterion of 95% agreement between measured and reconstructed doses and simple equation criterion, was observed for third-degree polynomial. The fitting curve where the dose is the function of optical density (logMPV) was demonstrated to be more precise than the fitting curve based on MPV only. To minimize the difference between dose absorbed by the film and dose reconstructed from the fitting curve below 5% it is necessary to divide the calibration range of 0 – 8 Gy into two subranges for use in interventional radiology. This difference was set at a maximum level of 3.8% and 1.9% for the lowand high-dose range, respectively. Each series of films may have a slightly different calibration curve, especially for the low dose range. A deviation of up to 36% between two batches of Gafchromic film was observed.

Conclusions: For the third-degree polynomial fitting function (one of the recommended in the literature) calibration should be done into low and high dose ranges and for each batch separately. A systematic error higher than 20% could be introduced when the fitting curve from one film batch is applied to the other film batch.

Radiochromic film dosimetry for protons up to 10 MeV with EBT2, EBT3 and unlaminated EBT3 films

Passive dosimetry with radiochromic films is widely used in proton radiotherapy, both in clinical and scientific environments, thanks to its simplicity, high spatial resolution and dose-rate independence. However, film under-response for low-energy protons, the so-called linear-energy transfer (LET) quenching, must be accounted and corrected for. We perform a meta-analysis on existing film under-response data with EBT, EBT2 and EBT3 GAFchromic™ films and provide a common framework to integrate it, based on the calculation of dose-averaged LET in the active layer of the films. We also report on direct measurements with the 10 MeV proton beam at the Center for Microanalysis of Materials (CMAM) for EBT2, EBT3 and unlaminated EBT3 films, focusing on the 20-80 keVμm^-1LET range, where previous data was scarce. Measured film relative efficiency (RE) values are in agreement with previously reported data from the literature. A model on film RE constructed with combined literature and own experimental values in the 5-80 keVμm^-1LET range is presented, supporting the hypothesis of a linear decrease of RE with LET, with no remarkable differences between the three types of films analyzed.

Dosimetry with gafchromic films based on a new micro-opto-electro-mechanical system

This work presents the first tests performed with radiochromic films and a new Micro‒Opto‒Electro-Mechanical system (MOEMS) for in situ dosimetry evaluation in radiotherapy in real time. We present a new device and methodology that overcomes the traditional limitation of time-delay in radiochromic film analysis by turning a passive detector into an active sensor. The proposed system consists mainly of an optical sensor based on light emitting diodes and photodetectors controlled by both customized electronic circuit and graphical user interface, which enables optical measurements directly. We show the first trials performed in a low‒energy proton cyclotron with this MOEMS by using gafchromic EBT3 films. Results show the feasibility of using this system for in situ dose evaluations. Further adaptation is ongoing to develop a full real‒time active detector by integrating MOEM multi‒arrays and films in flexible printed circuits. Hence, we point to improve the clinical application of radiochromic films with the aim to optimize radiotherapy treatment verifications.

Visible colorimetric dosimetry of UV and ionizing radiations by a dual-module photochromic nanocluster

Radiation dosimeters displaying conspicuous response of irradiance are highly desirable, owing to the growing demand of monitoring high-energy radiation and environmental exposure. Herein, we present a case of dosimetry based on a discrete nanocluster, [Th6(OH)4(O)4(H2O)6](TPC)8(HCOO)4∙4DMF∙H2O (Th-SINAP-100), by judiciously incorporating heavy Th6 polynuclear centers as radiation attenuator and organic linkers as photo-responsive sensor. Interestingly, dual-module photochromic transitions upon multiple external stimuli including UV, β-ray, and γ-ray are integrated into this single material. The striking color change, and more significantly, the visible color transition of luminescence in response to accumulating radiation dose allow an on-site quantitative platform for naked-eye detection of ionization radiations over a broad range (1-80 kGy). Single crystal X-ray diffraction and density functional theory calculations reveal that the dual-module photochromism can be attributed to the π(TPC) → π*(TPC) intermolecular charge transfer driven by enhanced π-π stacking interaction between the adjacent TPC moieties upon irradiation.

Dosimetry investigation of a prototype of 169Yb seed brachytherapy for use in circular stapler

This study aims to investigate dosimetry parameters for the new design of ¹⁶⁹Yb seed in the form of a surgical staple for circular staplers commonly used in the abdominal incision and the esophageal and gastric surgery, which facilitates the precise placement. This seed includes a titanium tube with the inner diameter and outer diameter 0.68 mm and 2.2 mm, respectively, and length of 0.8 mm. Both sides of the tube are closed by titanium wires with the thickness of 0.65 mm by the laser. Natural ytterbium oxide is used after the thermal neutron activation; it is necessary for cooling time of 40 days. The dosimetry parameters were calculated based on the TG-43U1 using Monte Carlo MCNP5 code. The experimental dosimetry was performed by EBT3 radiochromic film to determine 2D dosimetry at near distance of the source and validate the MC code. The dose rate constant of MC calculation was obtained at 1.39cGyh^-1U^-1 ± 4% with the difference of 5% compared to another study. The dose distribution was symmetrical along the Z-axis and Y-axis (around the seed) and there was a uniform activity inside the tube. The distinction of dose rate was not noticeable at the 90 and 270 degrees on the Z-axis, which indicated a slight effect on staple legs in the matter of delivery dose. However, to understand dose distribution and introduce this source in a pre-clinical study, 3D dosimetry as well as further studying the heterogeneous function is required.

Monte Carlo simulation of conical collimators for stereotactic radiosurgery with a 6 MV flattening-filter-free photon beam

PURPOSE

Conical collimators, or cones, are tertiary collimators that attach to a radiotherapy linac and are suited for the stereotactic radiosurgery treatment of small brain lesions. The small diameter of the most used cones makes difficult the acquisition of the dosimetry data needed for the commissioning of treatment planning systems. Although many publications report dosimetric data of conical collimators for stereotactic radiosurgery, most of the works use different setups, which complicates comparisons. In other cases, the cone output factors reported do not take into account the effect of the small cone diameter on the detector response. Finally, few data exist on the dosimetry of cones with flattening-filter-free (FFF) beams from modern linac models. This work aims at obtaining a dosimetric characterization of the conical collimators manufactured by Brainlab AG (Munich, Germany) in a 6 MV FFF beam from a TrueBeam STx linac (Varian Medical Systems).

METHODS

Percentage depth dose curves, lateral dose profiles and cone output factors were obtained using Monte Carlo simulations for the cones with diameters of 4, 5, 6, 7.5, 8, 10, 12.5, 15, 17.5, 20, 25, and 30 mm. The simulation of the linac head was carried out with the PRIMO Monte Carlo software, and the simulations of the cones and the water phantom were run with the general-purpose Monte Carlo code PENELOPE. The Monte Carlo model was validated by comparing the simulation results with measurements performed for the cones of 4, 5, and 7.5 mm of diameter using a stereotactic field diode, a microDiamond detector and EBT3 radiochromic film. In addition, for those cones, simulations and measurements were done for comparison purposes, by reproducing the experimental setups from the available publications.

RESULTS

The experimental data acquired for the cones of 4, 5, and 7.5 mm validated the developed Monte Carlo model. The simulations accurately reproduced the experimental depths of maximum dose and the dose ratio at 20- and 10-cm depth (PDD_20/10 ). A good agreement was obtained between simulated and experimental lateral dose profiles: The differences in the full-width at half-maximum were smaller than 0.2 mm, and the differences in the penumbra 80%-20% were smaller than 0.25 mm. The difference between the simulated and the average of the experimental output factors for the cones of 4, 5, and 7.5 mm of diameter was 0.0%, 0.0%, and 3.0%, respectively, well within the statistical uncertainty of the simulations (4.4% with coverage factor k = 2). It was also found that the simulated cone output factors agreed within 2% with the average of output factors reported in the literature for a variety of setup conditions, detectors, beam qualities, and cone manufacturers.

CONCLUSION

A Monte Carlo model of cones for stereotactic radiosurgery has been developed and validated. The cone dosimetry dataset obtained in this work, consisting of percentage depth doses, lateral dose profiles and output factors, is useful to benchmark data acquired for the commissioning of cone-based radiosurgery treatment planning systems.

Fluorescent Nanogel Sensors for X-ray Dosimetry

X-ray dosimeters are of significance for detecting the levels of ionizing radiation exposure in cells and phantoms; thus, they can further optimize X-ray radiotherapy in the clinic. In this paper, we designed a polyacrylamide-based nanogel sensor that is capable of measuring X-ray doses. The dosimeters were prepared by anchoring an X-ray-responsive probe (aminophenyl fluorescein, APF) to poly(acrylamide-co-N-(3-aminopropyl) methyl acrylamide) nanogels. The premise behind the dose measurement is the transition of APF to fluorescence in the presence of hydroxyl radicals that are caused by the radiolysis of water molecules under X-rays. Therefore, the dose of X-rays can be readily detected by measuring the fluorescence intensity of the resultant nanogel immediately after irradiation using fluorescence spectroscopy principles. Using an RS2000 X-ray biological irradiator, our dosimeters showed good linearity responsivity at X-ray doses ranging from 0 to 15 Gy, with a limit of detection (LOD) of 0.5 Gy. Additionally, the signals showed temperature stability (25-65 °C), durability (5 weeks), and dose-rate (1.177 and 6 Gy/min) and energy independence (160 kVp and 6 MV). As a proof-of-concept, we used our sensors to fluorescently detect X-ray doses in A549 tumor cells and 3D-printed eye phantoms. The results showed that our dosimeters were able to accurately predict doses similar to those used by treatment plan systems.

Dose measurements in a thorax phantom at 3DCRT breast radiation therapy

Background

The anthropomorphic and anthropometric phantom developed by the research group NRI (Núcleo de Radiações Ionizantes) can reproduce the effects of the interactions of radiation occurring in the human body. The whole internal radiation transport phenomena can be depicted by film dosimeters in breast RT. Our goal was to provide a dosimetric comparison of a radiation therapy (RT) plan in a 4MV 3D-conformal RT (4MV-3DCR T) and experimental data measured in a breast phantom.

Materials and methods

The RT modality was two parallel opposing fields for the left breast with a prescribed dose of 2.0 Gy in 25 fractions. The therapy planning system (TPS) was performed on CA T3D software. The dose readings at points of interest (POI) pre-established in TPS were recorded. An anthropometric thorax-phantom with removal breast was used. EBT2 radiochromic films were inserted into the ipisilateral breast, contralateral breast, lungs, heart and skin. The irradiation was carried out on 4/80 Varian linear accelerator at 4MV.

Results

The mean dose at the OAR's presented statistically significant differences (p < 0.001) of 34.24%, 37.96% and 63.47% for ipsilateral lung, contralateral lung, and heart, respectively. The films placed at the skin-surface interface in the ipsilateral breast also showed statistically significant differences (p < 0.001) of 16.43%, -10.16%, -14.79% and 15.67% in the four quadrants, respectively. In contrast, the PTV dosimeters, representative of the left breast volume, encompassed by the electronic equilibrium, presented a non-significant difference with TPS, p = 0.20 and p = 0.90.

Conclusion

There was a non-significant difference of doses in PTV with electronic equilibrium; although no match is achieved outside electronic equilibrium.

Alkali Metal Salts of 10,12-Pentacosadiynoic Acid and Their Dosimetry Applications

Wide-dose-range 2D radiochromic films for radiotherapy, such as GAFchromic EBT, are based on the lithium salt of 10,12-pentacosadiynoic acid (Li-PCDA) as the photosensitive component. We show that there are two solid forms of Li-PCDA-a monohydrated form A and an anhydrous form B. The form used in commercial GAFchromic films is form A due to its short needle-shaped crystals, which provide favorable coating properties. Form B provides an enhanced photoresponse compared to that of form A, but adopts a long needle crystal morphology, which is difficult to process. The two forms were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, CP-MAS ¹³C solid-state NMR spectroscopy, and thermogravimetric analysis. In sum, these data suggest a chelating bridging bidentate coordination mode for the lithium ions. The sodium salt of PCDA (Na-PCDA) is also reported, which is an ionic cocrystal with a formula of Na⁺PCDA^-·3PCDA. The PCDA and PCDA^- ligands display monodentate and bridging bidentate coordination to the sodium ion in contrast to the coordination sphere of the Li-PCDA forms. In contrast to its lithium analogues, Na-PCDA is photostable.

Alkali Metal Salts of 10,12-Pentacosadiynoic Acid and Their Dosimetry Applications

Wide-dose-range 2D radiochromic films for radiotherapy, such as GAFchromic EBT, are based on the lithium salt of 10,12-pentacosadiynoic acid (Li-PCDA) as the photosensitive component. We show that there are two solid forms of Li-PCDA-a monohydrated form A and an anhydrous form B. The form used in commercial GAFchromic films is form A due to its short needle-shaped crystals, which provide favorable coating properties. Form B provides an enhanced photoresponse compared to that of form A, but adopts a long needle crystal morphology, which is difficult to process. The two forms were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, CP-MAS 13C solid-state NMR spectroscopy, and thermogravimetric analysis. In sum, these data suggest a chelating bridging bidentate coordination mode for the lithium ions. The sodium salt of PCDA (Na-PCDA) is also reported, which is an ionic cocrystal with a formula of Na+PCDA-·3PCDA. The PCDA and PCDA- ligands display monodentate and bridging bidentate coordination to the sodium ion in contrast to the coordination sphere of the Li-PCDA forms. In contrast to its lithium analogues, Na-PCDA is photostable.

Monte Carlo simulation and dosimetry measurements of an experimental approach for in vitro HDR brachytherapy irradiation

Irradiation of tumor cell lines is a useful way to investigate the effects of ionizing radiation on biological molecules. We designed an easy and reproducible approach for in vitro experimental high dose rate brachytherapy, which was simulated by a Monte Carlo code and dosimetrically characterized by experimental methods to evaluate the correspondence between planned doses and doses absorbed by the cells. This approach is an acrylic platform containing T25 tissue culture flasks and multiwell tissue culture plates. It allows nine parallel needles carrying an ¹⁹²Ir source to irradiate the adherent cells. The whole system composed of the acrylic platform, tissue culture flasks and ¹⁹²Ir source tracking was simulated by the Monte Carlo N-Particle transport code (MCNPX). Dosimetric measurements were taken by well ionization chamber and radiochromic films. There was a slight difference, averaging from 2% to 7%, between the MCNPX results and film dosimetry results regarding uniform radiation created by the source arrangement. The results showed different values for planned and measured doses in each cell culture plate, which was attributed to the non-equivalent water material used and to the lack of full scattering coming from the top of the platform. This last contribution was different for each tissue culture plate and an individual dose correction factor was calculated. The dose correction factor must be applied to match the planned dose and the actual doses absorbed by the cells. The designed approach is an efficient tool for in vitro brachytherapy experiments for most commercial cell culture plates.

The relation between XR-QA2 and RT-QA2 GafchromicTMfilm optical density and absorbed dose in water produced by radionuclides

Purpose. In this study, Monte Carlo (MC) simulations were done to relate the dose-response of the film to that in water. The effect of backscattering materials (PMMA, lead, polystyrene, and air) was investigated on its influence on film density for radionuclides including Am-241, Tc-99m, I-131, Cs-137.Methods. A BEAMnrc MC simulation was designed to score a phase-space file (PSF) below the container of the radionuclide under consideration to use as an input file for the subsequent DOSXYZnrc MC simulation. The geometry of the container holding the radionuclide was built using the component modules available in BEAMnrc. BEAMDP was used to investigate the container effect on the radionuclide spectrum as well as the fluence. The DOSXYZnrc simulation produced the absorbed dose in XR-QA2 and RT-QA2 Gafchromic^TMfilms. The DOSXYZnrc simulations were repeated for the Gafchromic^TMfilm now replaced with water to get the absorbed dose in water. From these results, conversion factors for the dose in water to the film dose for the different radionuclides, Am-241, Tc-99m, I-131, and Cs-137 were obtained. The actual film dose was calculated using the specific gamma exposure constant (Γ) at a distance of 50 cm for a point source approximation. From the BEAMnrc simulations, the particle fluence was extracted from PSFs to correct for the fluence at 0.1 cm below the sources from the fluence 50 cm away since the inverse square law will not apply to finite-size sources. The absorbed dose profiles in the film were compared to the absorbed dose profiles from the MC simulations.Results. A fitting function based on the neutron depletion model fits the optical density versus absorbed film dose data well and can be used as a calibration tool to obtain the film dose from its optical density. Lead as a backscatter material results in a higher optical density change but a lower absorbed dose. The XR-QA2 Gafchromic^TMfilm is more sensitive than the RT-QA2 Gafchromic^TMfilm, showing a more responsive optical density (OD) change in the energy range of radionuclides used in this study. Conversion factors were determined to convert the dose in water to the dose in Gafchromic^TMfilm. The Am-241 and I-131 simulated absorbed dose in the film to dose in water does not fluctuate as much as the simulated absorbed dose in film and water when using Tc-99m and Cs-137. Validation was shown for the comparison of the film and MC simulation absorbed dose profiles.Conclusions. MC BEAMnrc simulations are useful to simulate radionuclides and their containers. BEAMDP extracted energy spectra showed that the radionuclide containers produced a Compton effect on the energy spectra and added filtration on the lower spectral photon components. Extracted fluence ratios from PSFs were used to calculate the absorbed dose value at 0.1 cm distance from the source. By using the fit function, the dose in the film can be determined for known optical density values. The effect of the backscatter materials showed that the XR-QA2 Gafchromic^TMfilm results in higher optical density values than the RT-QA2 Gafchromic^TMfilm. The absorbed dose in both the films is comparable but not for a radionuclide such as Am-241 with an activity of 74MBq. The lead backscatter material showed to be the most prominent in optical density enhancement, and the air equivalent material was the least prominent. The XR-QA2 Gafchromic^TMfilm is the most sensitive and will be the best option if working with low energies. The absorbed dose in the XR-QA2 Gafchromic^TMfilm also showed a good comparison to the absorbed dose in water for the Am-241 radionuclide with an activity of 74MBq. The absorbed dose in the films compares well to the MC simulated doses.

Radiochromic Films for the Two-Dimensional Dose Distribution Assessment

Radiochromic films are mainly used for two-dimensional dose verification in photon, electron, and proton therapy treatments. Moreover, the radiochromic film types available today allow their use in a wide dose range, corresponding to applications from low-medical diagnostics to high-dose beam profile measurements in charged particle medical accelerators. An in-depth knowledge of the characteristics of radiochromic films, of their operating principles, and of the dose reading techniques is of paramount importance to exploit all the features of this interesting and versatile radiation detection system. This short review focuses on these main aspects by considering the most recent works on the subject.

A protocol for absolute dose verification of SBRT/SRS treatment plans using Gafchromic™ EBT-XD films

PURPOSE

To provide a practical protocol for absolute dose verification of stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) treatment plans, based on our clinical experience. It aims to be a concise summary of the main aspects to be considered when establishing an accurate film dosimetry system.

METHODS

Procedures for film calibration and conversion to dose are described for a dosimetry system composed of Gafchromic™ EBT-XD films and a flatbed document scanner. Factors that affect the film-scanner response are also reviewed and accounted for. The accuracy of the proposed methodology was assessed by taking a set of strips irradiated to known doses and its applicability is illustrated for ten SBRT/SRS treatment plans. The film response was converted to dose using red and triple channel dosimetry. The agreement between the planned and measured dose distributions was evaluated using global gamma analysis with criteria of 3%/2mm 10% threshold (TH), 2%/2mm 10% TH, and 2%/2mm 20% TH.

RESULTS

The differences between the expected and determined doses from the strips analysis were 0.9 ± 0.6% for the red channel and 1.1 ± 0.7% for the triple channel method. Regarding the SBRT/SRS plans verification, the mean gamma passing rates were 99.5 ± 1.0% vs 99.6 ± 1.0% (3%/2mm 10% TH), 96.9 ± 3.5% vs 99.1 ± 1.3% (2%/2mm 10% TH) and 98.4 ± 1.8% vs 98.8 ± 1.5% (2%/2mm 20% TH) for red and triple channel dosimetry, respectively.

CONCLUSIONS

The proposed protocol allows for accurate absolute dose verification of SBRT/SRS treatment plans, applying both single and triple channel methods. It may work as a guide for users that intend to implement a film dosimetry system.

THE CONCEPT OF X-RAY CT DOSE EVALUATION METHOD USING RADIOCHROMIC FILM AND FILM-FOLDING PHANTOM

In this paper, we propose a novel radiochromic film (RCF)-based computed tomography (CT) dosimetry method, which is different from the method based on CT dose index. RCF dosimetry using Gafchromic QA2 films was performed using two lengths of film-folding phantoms. The phantom was exposed to X-ray CT through a single scan, while the RCF was sandwiched between the phantoms. We analysed the dose profile curve in two directions to investigate the dose distribution. We observed a difference in the dose distribution as the phantom size changed. Our results contradict with the results of previous studies such as Monte Carlo simulation or direct measurement. The ability to visually evaluate 2D dose distributions is an advantage of RCF dosimetry over other methods. This research investigated the ability of 2D X-ray CT dose evaluation using RCF and film-folding phantom.

In vivo dosimetry in low-voltage IORT breast treatments with XR-RV3 radiochromic film

PURPOSE

The objectives of the study were to establish a procedure for in vivo film-based dosimetry for intraoperative radiotherapy (IORT), evaluate the typical doses delivered to organs at risk, and verify the dose prescription.

MATERIALS AND METHODS

In vivo dose measurements were studied using XR-RV3 radiochromic films in 30 patients with breast cancer undergoing IORT using the Axxent® device (Xoft Inc.). The stability of the radiochromic films in the energy ranges used was verified by taking measurements at different depths. The stability of the scanner response was tested, and 5 different calibration curves were constructed for different beam qualities. Six pieces of film were placed in each of the 30 patients. All the pieces were correctly sterilized and checked to ensure that the process did not affect the outcome. All calibration and dose measurements were analyzed using the Radiochromic.com software application.

RESULTS

The doses were measured for 30 patients. The doses in contact with the applicator (prescription zone) were 19.8 ± 0.9 Gy. In the skin areas, the doses were as follows: 1-2 cm from the applicator, 1.86 ± 0.77 Gy; 2-5 cm, 0.73 ± 0.14 Gy; and greater than 5 cm, 0.28 ± 0.17 Gy. The dose delivered to the pectoral muscle (tungsten shielding disc) was 0.51 ± 0.27 Gy.

CONCLUSIONS

The study demonstrated the viability of XR-RV3 films for in vivo dose measurement in the dose and energy ranges applied in a complex procedure, such as breast IORT. The doses in organs at risk were far below the tolerances for cases such as those studied.

Optimized method for in vivo dosimetry with small films in pelvic IOERT for rectal cancer

PURPOSE

Intra-Operative Electron Radiation Therapy (IOERT) is used to treat rectal cancer at our institution, and in vivo measurements with Gafchromic EBT3® films were introduced as quality assurance. The purpose of this work was to quantify the uncertainties associated with digitization of very small EBT3 films irradiated simultaneously, in order to optimize in vivo dosimetry for IOERT.

METHODS

Film samples of different sizes - M1 (5×5cm²), M2 (1.5×1.5 cm²), M3 (1.0×1.5 cm²) and M4 (0.75×1.5 cm²) - were used to quantify typical variations (uncertainties) due to scanner fluctuations, misalignment, film inhomogeneity, long-term effect of film cutting, small rotations, film curling, edge effects and the influence of opaque templates. Fitting functions and temporal validity of sensitometric curves were also assessed.

RESULTS

Film curling, intra-film variability and scanner fluctuations are important effects that need to be minimized or considered in the uncertainty budget. Small rotations, misalignments and film cutting have little or no influence on the readings. Most fitting functions perform well, but the quantity used for dose quantification determines over- or under-valuation of dose in the long term. Edge effects and the influence of opaque templates need to be well understood, to allow optimization of methodology to the intended purpose.

CONCLUSION

The proposed method allows practical and simultaneous digitization of up to ten small irradiated film samples, with an experimental uncertainty of 1%.

A new approach to radiochromic film dosimetry based on non-local means

Radiochromic film in conjunction with flatbed scanners are frequently employed as dosimeters for advanced techniques in radiotherapy. Their strengths are as follows: light element composition, low energy dependence, near biological tissue equivalence and high spatial resolution. However, they have some weaknesses as well: non-uniformities, read out noise, and scanning artifacts. Several processing protocols have been proposed intending to correct the perturbations these weaknesses produce. The aim of this paper is to present a new processing protocol for radiochromic film dosimetry based on a non-local means denoising algorithm. Three dose distributions of open square fields and a spatial combination of these fields using different angles of incidence and monitor units have been employed to validate the protocol. The dose distributions are traceable to ionization chamber measurements. Additionally, a real dose distribution of a treatment was used to simulate scanning data with noise and scanning lateral artifact, and to study how the protocol behaves under these perturbations. The same measured raw data have been processed by means of an implementation of the multichannel protocol (multigaussian method). It has been found that the proposed protocol reduces dose uncertainty even though it uses fewer scans than the multichannel protocol.

Positional and angular tracking of HDR 192 Ir source for brachytherapy quality assurance using radiochromic film dosimetry

PURPOSE

To quantify and verify the dosimetric impact of high-dose rate (HDR) source positional uncertainty in brachytherapy, and to introduce a model for three-dimensional (3D) position tracking of the HDR source based on a two-dimensional (2D) measurement. This model has been utilized for the development of a comprehensive source quality assurance (QA) method using radiochromic film (RCF) dosimetry including assessment of different digitization uncertainties.

METHODS

An algorithm was developed and verified to generate 2D dose maps of the mHDR-V2 ¹⁹² Ir source (Elekta, Veenendaal, Netherlands) based on the AAPM TG-43 formalism. The limits of the dosimetric error associated with source (0.9 mm diameter) positional uncertainty were evaluated and experimentally verified with EBT3 film measurements for 6F (2.0 mm diameter) and 4F (1.3 mm diameter) size catheters at the surface (4F, 6F) and 10 mm further (4F only). To quantify this uncertainty, a source tracking model was developed to incorporate the unique geometric features of all isodose lines (IDLs) within any given 2D dose map away from the source. The tracking model normalized the dose map to its maximum, then quantified the IDLs using blob analysis based on features such as area, perimeter, weighted centroid, elliptic orientation, and circularity. The Pearson correlation coefficients (PCCs) between these features and source coordinates (x, y, z, θ_y , θ_z ) were calculated. To experimentally verify the accuracy of the tracking model, EBT3 film pieces were positioned within a Solid Water® (SW) phantom above and below the source and they were exposed simultaneously.

RESULTS

The maximum measured dosimetric variations on the 6F and 4F catheter surfaces were 39.8% and 36.1%, respectively. At 10 mm further, the variation reduced to 2.6% for the 4F catheter which is in agreement with the calculations. The source center (x, y) was strongly correlated with the low IDL-weighted centroid (PCC = 0.99), while the distance to source (z) was correlated with the IDL areas (PCC = 0.96) and perimeters (PCC = 0.99). The source orientation θ_y was correlated with the difference between high and low IDL-weighted centroids (PCC = 0.98), while θ_z was correlated with the elliptic orientation of the 60-90% IDLs (PCC = 0.97) for a maximum distance of z = 5 mm. Beyond 5 mm, IDL circularity was significant, therefore limiting the determination of θ_z (PCC ≤ 0.48). The measured positional errors from the film sets above and below the source indicated a source position at the bottom of the catheter (-0.24 ± 0.07 mm).

CONCLUSIONS

Isodose line features of a 2D dose map away from the HDR source can reveal its spatial coordinates. RCF was shown to be a suitable dosimeter for source tracking and dosimetry. This technique offers a novel source QA method and has the potential to be used for QA of commercial and customized applicators.

Comparison of VMAT complexity-reduction strategies for single-target cranial radiosurgery with the Eclipse treatment planning system

Complexity in MLC‐based radiosurgery treatment delivery can be characterized by the efficiency of monitor unit (MU) utilization and the average MLC leaf separation distance for a treatment plan. A reduction in plan complexity may be desirable if plan quality is not impacted. In this study, a number of strategies are explored to determine how plan quality is affected by efforts to reduce plan complexity. Ten radiosurgery cases of varying complexity are retrospectively planned using six optimization strategies: an unconstrained volumetric modulated arc therapy (VMAT) technique, a MU‐constrained VMAT technique, three techniques using various strengths of the aperture shape controller (ASC), and a hybrid technique consisting of a final‐stage VMAT optimization applied to a dynamic conformal arc leaf sequence (ODCA). The plans are compared in terms of MU efficiency, MLC leaf‐separation, conformity index (CI), gradient index (GI), and QA measurement results. The five VMAT techniques exhibited only minor differences in CI and GI values, though the ASC and MU‐constrained techniques did require 6–20% fewer MU and had mean field apertures 5–19% larger. On average, the ODCA technique had CI values 3.5% lower and GI values 1.0–2.5% higher than the VMAT techniques, but also had a mean field aperture 24–47% larger and required 16–32% fewer MU. The QA measurement results showed a 0.61% variation in mean per‐field 2%/1 mm gamma passing rates across all techniques (range 96.81%–97.42%), with no observed correlation between passing rate and technique. For simple targets, the ODCA technique achieved CI results that were equivalent to the unconstrained VMAT technique with an average 30% reduction in required MU, an average 50% increase in mean leaf separation distance, and brain V12_Gy values within 0.38 cc of the VMAT technique for targets up to approximately 2 cm diameter. For MLC‐based single‐target radiosurgery, plan complexity can often be significantly reduced without an equivalent reduction in plan quality.

Comparison of three film analysis softwares using EBT2 and EBT3 films in radiotherapy

Introduction The purpose of the study was to compare the results of gamma value based film analysis according to the used type of self-developer film and software product. Material and methods The films were irradiated with different treatment techniques such as 3D conformal and intensity modulated radiotherapy with static and rotational delivery. Stereotactic plans with conformal and intensity modulated arc techniques, using coplanar and non-coplanar beam setup were also evaluated. The data of irradiated film were compared with the planned planar dose distribution exported from the treatment planning system. Three film analysis software programs were evaluated: PTW Mephysto (PTW), FilmQA Pro (FQP) and radiohromic.com(RC). Both EBT2 and EBT3 types of films were examined. The comparisons of dose distributions were performed with gamma analysis using 10% cut-off level. Results The results of the gamma analysis for larger fields were between 78.3% and 98.3%, 75.7% and 100%, 80.2% and 98.8% with PTW, FQP and RC, respectively. The results of evaluation in case of stereotactic measurements were 76.8%-99.2% for PTW, 95.7%-100% for FQP and 91.2%-99.9% for RC. Conclusions All the three software programs are suitable for calibrating and evaluating films, performing gamma analysis, and can be used for patient specific quality assurance measurements. There is no direct connection between gamma passing rate and absolute accuracy or software quality, it is just a feature of the software. The interpretation of own results has to be defined on an institutional level according to given workflow and preliminary results.

The crystal engineering of radiation-sensitive diacetylene cocrystals and salts

In this work we develop photoreactive cocrystals/salts of a commercially-important diacetylene, 10,12-pentacosadiynoic acid (PCDA, 1) and report the first X-ray crystal structures of PCDA based systems. The topochemical reactivity of the system is modified depending on the coformer used and correlates with the structural parameters. Crystallisation of 1 with 4,4'-azopyridine (2), 4,4'-bipyridyl (3), and trans-1,2-bis(4-pyridyl)ethylene (4) results in unreactive 2 : 1 cocrystals or a salt in the case of 4,4'-bipiperidine (5). However, salt formation with morpholine (6), diethylamine (7), and n-butylamine (8), results in highly photoreactive salts 12·7 and 1·8 whose reactivity can be explained using topochemical criteria. The salt 1·6 is also highly photoreactive and is compared to a model morpholinium butanoate salt. Resonance Raman spectroscopy reveals structural details of the photopolymer including its conformational disorder in comparison to less photoactive alkali metal salts and the extent of solid state conversion can be monitored by CP-MAS NMR spectroscopy. We also report an unusual catalysis in which amine evaporation from photopolymerised PCDA ammonium salts effectively acts as a catalyst for polymerisation of PCDA itself. The new photoreactive salts exhibit more reactivity but decreased conjugation compared to the commercial lithium salt and are of considerable practical potential in terms of tunable colours and greater range in UV, X-ray, and γ-ray dosimetry applications.

Comparison of the 2-D Dose Distribution Calculated by Planning System and Measured by Gafchromic Film Physical Dosimetry for 60Co and 192Ir Brachytherapy Sources

Background:

High Dose Rate (HDR) brachytherapy sources with high photon energy have been widely used in treating tumors. Dosimetric parameter of these brachytherapy sources should be determined according to the AAPM TG-43 recommendation. Gafchoromic films are reliable tools for this evaluation.

Objective:

The aim of this study is to evaluate and compare dose accuracy of the two-brachytherapy sources in a dedicated phantom.

Material and Methods:

In this analytical study, two common sources, including Cobalt and Iridium, were loaded into the dedicated phantom. The two-dimensional dose distribution around the source was calculated by TPS system for certain activities and geometries around the sources. Then, the experimental dose measured by Gafchromic film dosimetry was reported for different angles ranging from 0 to 180 degrees.

Results:

The difference between calculated and measured doses was less than 6 percent (-5 to +6 percent) for all of the channels and angles. These errors are smaller and mainly more than zero (D_film>D_TPS) for angles less than 20 and larger than 110 degrees. There is no statistically significant discrepancy in dose calculation by treatment planning system.

Conclusion:

Although the estimated error in dose calculation is not significant, there is still an opportunity to increase the treatment precision. The correlation between the error and the angle should be considered in further plans of brachytherapy. The present study showed comparable errors compared to results of other research studies.

Methodology for radiochromic film analysis using FilmQA Pro and ImageJ

Radiochromic film (RCF) has several advantageous characteristics which make it an attractive dosimeter for many clinical tasks in radiation oncology. However, knowledge of and strict adherence to complicated protocols in order to produce accurate measurements can prohibit RCF from being widely adopted in the clinic. The purpose of this study was to outline some simple and straightforward RCF fundamentals in order to help clinical medical physicists perform accurate RCF measurements. We describe a process and methodology successfully used in our practice with the hope that it saves time and effort for others when implementing RCF in their clinics. Two RCF analysis software programs which differ in cost and complexity, the commercially available FilmQA Pro package and the freely available ImageJ software, were used to show the accuracy, consistency and limitations of each. The process described resulted in a majority of the measurements across a wide dose range to be accurate within ± 2% of the intended dose using either FilmQA Pro or ImageJ.

Radiochromic film dosimetry in synchrotron radiation breast computed tomography: a phantom study

This study relates to the INFN project SYRMA-3D for in vivo phase-contrast breast computed tomography using the SYRMEP synchrotron radiation beamline at the ELETTRA facility in Trieste, Italy. This peculiar imaging technique uses a novel dosimetric approach with respect to the standard clinical procedure. In this study, optimization of the acquisition procedure was evaluated in terms of dose delivered to the breast. An offline dose monitoring method was also investigated using radiochromic film dosimetry. Various irradiation geometries have been investigated for scanning the prone patient's pendant breast, simulated by a 14 cm-diameter polymethylmethacrylate cylindrical phantom containing pieces of calibrated radiochromic film type XR-QA2. Films were inserted mid-plane in the phantom, as well as wrapped around its external surface, and irradiated at 38 keV, with an air kerma value that would produce an estimated mean glandular dose of 5 mGy for a 14 cm-diameter 50% glandular breast. Axial scans were performed over a full rotation or over 180°. The results point out that a scheme adopting a stepped rotation irradiation represents the best geometry to optimize the dose distribution to the breast. The feasibility of using a piece of calibrated radiochromic film wrapped around a suitable holder around the breast to monitor the scan dose offline is demonstrated.

Multichannel Film Dosimetry for Quality Assurance of Intensity Modulated Radiotherapy Treatment Plans Under 0.35 T Magnetic Field

Purpose

To evaluate the intensity modulated radiotherapy (IMRT) quality assurance (QA) results of the multichannel film dosimetry analysis with single scan method by using Gafchromic™ EBT3 (Ashland Inc., Covington, KY, USA) film under 0.35 T magnetic field.

Methods

Between September 2018 and June 2019, 70 patients were treated with ViewRay MRIdian^® (ViewRay Inc., Mountain View, CA) linear accelerator (Linac). Film dosimetry QA plans were generated for all IMRT treatments. Multichannel film dosimetry for red, green and blue (RGB) channels were compared with treatment planning system (TPS) dose maps by gamma evaluation analysis.

Results

The mean gamma passing rates of RGB channels are 97.3% ± 2.26%, 96.0% ± 3.27% and 96.2% ± 3.14% for gamma evaluation with 2% DD/2 mm distance to agreement (DTA), respectively. Moreover, the mean gamma passing rates of RGB channels are 99.7% ± 0.41%, 99.6% ± 0.59% and 99.5% ± 0.67% for gamma evaluation with 3% DD/3 mm DTA, respectively.

Conclusion

The patient specific QA using Gafchromic™ EBT3 film with multichannel film dosimetry seems to be a suitable tool to implement for MR-guided IMRT treatments under 0.35 T magnetic field. Multichannel film dosimetry with Gafchromic™ EBT3 is a consistent QA tool for gamma evaluation of the treatment plans even with 2% DD/2 mm DTA under 0.35 T magnetic field presence.

Custom-designed Small Animal focal iRradiation Jig (SARJ): design, manufacture and dosimetric evaluation

OBJECTIVE

Preclinical animal models allow testing and refinement of novel therapeutic strategies. The most common preclinical animal irradiators are fixed source cabinet irradiators, which are vastly inferior to clinical linear accelerators capable of delivering highly conformal and precise treatments. The purpose of this study was to design, manufacture and test an irradiation jig (small animal focal irradiation jig, SARJ) that would enable focal irradiation of subcutaneous tumours in a standard fixed source cabinet irradiator.

METHODS AND MATERIALS

A lead shielded SARJ was designed to rotate animal holders about the longitudinal axis and slide vertically from the base plate. Radiation dosimetry was undertaken using the built-in ion chamber and GAFChromic RTQA2 and EBT-XD films. Treatment effectiveness was determined by irradiating mice with subcutaneous melanoma lesions using a dose of 36 Gy in three fractions (12 Gy x 3) over three consecutive days.

RESULTS

The SARJ was tested for X-ray shielding effectiveness, verification of dose rate, total dose delivered to tumour and dose uniformity. Accurate and uniform delivery of X-ray dose was achieved. X-ray doses were limited to the tumour site when animal holders were rotated around their longitudinal axis to 15o and 195o, allowing sequential dose delivery using parallel-opposed tangential beams. Irradiation of subcutaneous melanoma tumour established on the flanks of mice showed regression.

CONCLUSION

SARJ enabled delivery of tangential parallel-opposed radiation beams to subcutaneous tumours in up to five mice simultaneously. SARJ allowed high throughput testing of clinically relevant dose delivery using a standard cabinet-style fixed source irradiator.

ADVANCES IN KNOWLEDGE

A custom designed jig has been manufactured to fit into conventional cabinet irradiators and is dosimetrically validated to deliver clinically relevant dose distributions to subcutaneous tumours in mice for preclinical studies.

An Empirical Model for Describing the Small Field Penumbra in Radiation Therapy

Purpose

We developed a mathematic empirical model for describing the small field penumbra in order to analyze the potential dose perturbation caused by overlapping field to avoid the dose calculation errors in linear accelerator-based radiosurgery.

Materials and methods

A ball phantom was fabricated for measuring penumbra at 4 different gantry angles in the coplanar plane. A least square root estimation (LSRE) Model was created to fit the measured penumbra dose profile and to predict the penumbra dose profile at any gantry angles. The Sum of Squared Errors (SSE) was used for finding the parameters n and t for the best fitting of the LSRE model. Geometric and mathematical methods were used to derive the model parameters.

Results

The results showed that the larger the gantry angle of the field, the more the expansion of the penumbra dose profile. The least square root estimation model for describing small field penumbra is as follows: PenumbraDš=T·1/2·1−š/n+š2+t where Penumbra_D(š) denotes the dose profile D(š) at the penumbra region, T is the penumbra height (usually in scalar 100), n is the parameter for curvature, š = x − W_d/2 (x and š are the values in cm on x-axis), and t is the radiation transmission of the collimator. Geometric analysis establishes the correlation between the penetration depth of the exposure and its effect on the penumbra region in ball phantom. The penumbra caused by an exposure at any arbitrary angles can be geometrically derived by using a one-variable quadratic equation.

Conclusion

The dose distribution in penumbra region of small field can be created by the LSRE model and the potential overdosage or underdosage owing to overlapping field perturbation can be estimated.

Dose distribution comparison in volumetric-modulated arc therapy plans for head and neck cancers with and without an external body contour extended technique

Aim

This study compared volumetric-modulated arc therapy (VMAT) plans for head and neck cancers with and without an external body contour extended technique (EBCT).

Background

Dose calculation algorisms for VMAT have limitations in the buildup region.

Materials and methods

Three VMAT plans were enrolled, with one case having a metal artifact from an artificial tooth. The proper dose was calculated using Eclipse version 11.0. The body contours were extended 2 cm outward from the skin surface in three-dimensional space, and the dose was recalculated with an anisotropic analytical algorithm (AAA) and Acuros XB (AXB). Monitor units (MUs) were set, and the dose distributions in the planning target volume (PTV), clinical target volume, and organ at risk (OAR) and conformity index (CI) with and without an EBCT were compared. The influence of a metal artifact outside of the thermoplastic head mask was also compared.

Results

The coverage of PTV by the 95% dose line near the patient's skin was increased drastically by using an EBCT. Plan renormalization had a negligible impact on MUs and doses delivered to OARs. CI of PTV with a 6-MV photon beam was closer to 1 than that with a 10-MV photon beam when both AAA and AXB were used in all cases. Metal artifacts outside the head mask had no effect on dose distribution.

Conclusions

An EBCT is needed to estimate the proper dose at object volumes near the patient's skin and can improve the accuracy of the calculated dose at target volumes.

Determination of topographical radiation dose profiles using gel nanosensors

Despite the emergence of sophisticated technologies in treatment planning and administration, routine determination of delivered radiation doses remains a challenge due to limitations associated with conventional dosimeters. Here, we describe a gel-based nanosensor for the colorimetric detection and quantification of topographical radiation dose profiles in radiotherapy. Exposure to ionizing radiation results in the conversion of gold ions in the gel to gold nanoparticles, which render a visual change in color in the gel due to their plasmonic properties. The intensity of color formed in the gel was used as a quantitative reporter of ionizing radiation. The gel nanosensor was used to detect complex topographical dose patterns including those administered to an anthropomorphic phantom and live canine patients undergoing clinical radiotherapy. The ease of fabrication, operation, rapid readout, colorimetric detection, and relatively low cost illustrate the translational potential of this technology for topographical dose mapping in radiotherapy applications in the clinic.