Effect of scanning parameters on dose-response of radiochromic films irradiated with photon and electron beams

Response of the modified GAFCHROMIC EBT2 radiochromic film to DC glow discharge plasma

The response of the modified GAFCHROMIC EBT2 radiochromic film to DC Oxygen glow discharge plasma was investigated using a flatbed scanner and an UV-Vis spectrophotometer. The film was modified by removing the polyester overlaminate, adhesive, and topcoat layers with a total thickness of 80 µm, and is now referred to as EBT2-M. The EBT2-M films were exposed to DC Oxygen plasma for different durations: 0, 0.5, 1, 2, 3, 4, 7, and 10 min. The exposed films exhibit coloration homogeneity with an average variation of (1.6 ± 0.3) × 10-4 pixel values/µm, irrespective of the applied exposure time. The pixel values of the red-and-green channels and weighted grayscale images decreased exponentially with different sensitivity amounts to [Formula: see text] 39.67, 49.69, and 42.11 min-1, respectively, as the exposure time increased. The two absorption peaks at 580 ± 4 nm and 632 ± 4 nm in the UV-Vis absorption spectra of the exposed GAFCHROMIC EBT2-M radiochromic films are increasing with increasing exposure time up to 4 min, thereafter saturated for prolonged exposure time. The integrated absorbance in the range from 400 to 700 nm is linearly correlated with the exposure time. The indirect and direct optical energy band gaps and Urbach energy of the modified GAFCHROMIC EBT2 film are weakly correlated with the exposure time. These findings suggest the utilization of the modified GAFCHROMIC EBT2 radiochromic film as a novel and simple technique for plasma diagnostics.

Evaluation of cutout factors with small and narrow fields using various dosimetry detectors in electron beam keloid radiotherapy

BACKGROUND

The inherent problems in the existence of electron equilibrium and steep dose fall-off pose difficulties for small- and narrow-field dosimetry.

OBJECTIVE

To investigate the cutout factors for keloid electron radiotherapy using various dosimetry detectors for small and narrow fields.

METHOD

The measurements were performed in a solid water phantom with nine different cutout shapes. Five dosimetry detectors were used in the study: pinpoint 3D ionization chamber, Farmer chamber, semiflex chamber, Classic Markus parallel plate chamber, and EBT3 film.

RESULTS

The results demonstrated good agreement between the semiflex and pinpoint chambers. Furthermore, there was no difference between the Farmer and pinpoint chambers for large cutouts. For the EBT3 film, half of the cases had differences greater than 1%, and the maximum discrepancy compared with the reference chamber was greater than 2% for the narrow field.

CONCLUSION

The parallel plate, semiflex chamber and EBT3 film are suitable dosimeters that are comparable with pinpoint 3D chambers in small and narrow electron fields. Notably, a semiflex chamber could be an alternative option to a pinpoint 3D chamber for cutout widths≥3 cm. It is very important to perform patient-specific cutout factor calibration with an appropriate dosimeter for keloid radiotherapy.

Commissioning Validation of a Brachytherapy Treatment Planning System with EGSnrc Monte Carlo Code and EBT3 GAFChromic Film

Aims

Most brachytherapy treatment planning system (TPS) commissioning requires data input based on the American Association of Physicists in Medicine Task Group-43 formalism. The commissioning accuracy is very important for dose calculation. The aim of this study is the implementation of a brachytherapy TPS into a clinical environment and check the TPS calculated dose accuracy.

Subjects and Methods

After introducing data of the different catheters (CIS Bio International, Saclay, France), composed of several Cesium-137 Eckert and Ziegler BEBIG CSM-11 radioactive sources; for XiO (CMS, St. Louis) brachytherapy TPS, the TPS dose calculation accuracy was investigated by comparing between the TPS calculated dose distribution (DD) for all the catheters with (1) the measuring DD using EBT3 GAFChromic film and (2) calculating DD by egs_brachy (Electron Gamma Shower, National Research Council of Canada) Monte Carlo simulation. The phantom used for this study consists of six PTW slabs 30 cm × 30 cm × 1 cm of polymethyl methacrylate with a Delouche MEDpro applicator on the top. The TPS DD was calculated on the computed tomography scan of this phantom.

Statistical Analysis Used

PTW VeriSoft version 6.0.1.7 (PTW-Freiburg, Germany) software was used for analyzing scanned films and to perform the comparison based on the gamma index distribution.

Results

For each catheter, the gamma index distribution showed agreement >95% of all pixels in both verification methods, with gamma ≤1.

Conclusions

We confirm the commissioning accuracy and that the TPS can be used for clinical purposes.

Role of water in the crystal structure of LiPCDA monomer and the radiotherapy dose response of EBT-3 film

Purpose

Radiochromic material used in recent commercial films has been suggested as a candidate for in vivo dosimetry because of its dose sensitivity, real‐time response, and atomic composition. It was observed that its sensitive material, lithium pentacosa‐10,12‐diynoate (LiPCDA), can have two distinct forms, with main absorbance peaks at ∼635 and ∼674 nm. The spectrum of the latter is similar to that of pentacosa‐10,12‐diynoic acid (PCDA) used in the commercial predecessor, obtained through desiccation of the commercial film. Water was suggested to be a part of the crystal structure and thus its presence or absence would affect dosimetric parameters. The objective of this study is to: (a) investigate how desiccated commercial films compared to the native form in terms of macroscopic crystal structure, dose–response, signal linearity, and post‐exposure kinetics; (b) demonstrate proof‐of‐concept that the two versions can be combined into one optical dosimeter and measured simultaneously.

Methods

Commercial radiochromic film, EBT‐3, was desiccated for 10 days at 45°C. Using a 6 MV LINAC beam and standard setup of 100 Source to Axis Distance (SAD), 10 cm × 10 cm field size, and 1.5 cm depth, commercial and desiccated films were irradiated to 50, 100, 200, 500, 1000, 2000, 3000 cGy and the latter to 4000, 5000, and 7000 cGy. A custom phantom equipped with optical fibers for real‐time read‐out was used for all measurements. Absorbance spectra were collected at ∼1 Hz before, during, and after irradiation. Data were collected for ∼1 h after the end of irradiation for 200 cGy experiments. The radiation‐induced change in optical density (∆OD) was calculated with a 10 nm band around the primary absorbance peak. The post‐exposure percent optical density change was calculated and compared to ∆OD at the end of irradiation. Both commercial and desiccated films were also irradiated and measured simultaneously as proof‐of‐concept for using two materials within one optical path. For electron microscopy imaging, active materials from commercial and desiccated films were imaged on a scanning electron microscope at an accelerating voltage of 10 kV.

Results

Scanning electron microscope images showed that desiccated film was similar in topographical structure to the commercial EBT‐3 form. It maintained a non‐linear ∆OD with dose but resulted in ∼1/3 signal compared to the commercial film. Evaluation of post‐exposure response showed significantly lower percent increase in ∆OD for desiccated film initially, with no statistically significant difference at 1 h after the end of irradiation. Combining both films and simultaneously measuring their absorbance illustrated that the two absorbance peaks were identifiable and resolvable to allow for an independent determination of dose from each.

Conclusions

Water is implicated in the crystal structure of the EBT‐3 radiochromic film, with its removal through desiccation affecting both dosimetric and spectroscopic characteristics of the material. The two forms of radiochromic material (with and without water) are spectrally resolvable allowing for independent dose determination from each, opening up possibilities for dose measurements at different locations along a single fiber.

Gafchromic™ EBT3 Film Measurements of Dose Enhancement Effects by Metallic Nanoparticles for 192Ir Brachytherapy, Proton, Photon and Electron Radiotherapy

Interest in combining metallic nanoparticles, such as iron (SPIONs), gold (AuNPs) and bismuth oxide (BiONPs), with radiotherapy has increased due to the promising therapeutic advantages. While the underlying physical mechanisms of NP-enhanced radiotherapy have been extensively explored, only a few research works were motivated to quantify its contribution in an experimental dosimetry setting. This work aims to explore the feasibility of radiochromic films to measure the physical dose enhancement (DE) caused by the release of secondary electrons and photons during NP–radiotherapy interactions. A 10 mM each of SPIONs, AuNPs or BiONPs was loaded into zipper bags packed with GAFCHROMIC™ EBT3 films. The samples were exposed to a single radiation dose of 4.0 Gy with clinically relevant beams. Scanning was conducted using a flatbed scanner in red-component analysis for optimum sensitivity. Experimental dose enhancement factors (DEFExperimental) were then calculated using the ratio of absorbed doses (with/without NPs) converted from the films’ calibration curves. DEFExperimental for all NPs showed no significant physical DE beyond the uncertainty limits (p > 0.05). These results suggest that SPIONs, AuNPs and BiONPs might potentially enhance the dose in these clinical beams. However, changes in NPs concentration, as well as dosimeter sensitivity, are important to produce observable impact.

Dose calculation validation of a convolution algorithm in a solid water phantom

PURPOSE

The dose calculated using a convolution algorithm should be validated in a simple homogeneous water-equivalent phantom before clinical use. The dose calculation accuracy within a solid water phantom was investigated.

METHODS

The specific Gamma knife design requires a dose rate calibration within a spherical solid water phantom. The TMR10 algorithm, which approximates the phantom material as liquid water, correctly computes the absolute dose in water. The convolution algorithm, which considers electron density miscalculates the dose in water as the phantom Hounsfield units were converted into higher electron density when the original CT calibration curve was used. To address this issue, the electron density of liquid water was affected by modifying the CT calibration curve. The absolute dose calculated using the convolution algorithm was compared with that computed by the TMR10. The measured depth dose profiles were also compared to those computed by the convolution and TMR10 algorithms. A patient treatment was recalculated in the solid-water phantom and the delivery quality assurance was checked.

RESULTS

The convolution algorithm and the TMR10 calculate an absolute dose within 1% when using the modified CT calibration curve. The dose depth profile calculated using the convolution algorithms was superimposed on the TMR10 and measured dose profiles when the modified CT calibration curve was applied. The Gamma index was better than 93%.

CONCLUSIONS

Dose calculation algorithms, which consider electron density, require a CT calibration curve adapted to the phantom material to correctly compute the dose in water.

Treatment planning system and beam data validation for the ZAP-X: A novel self-shielded stereotactic radiosurgery system

PURPOSE

To evaluate the treatment planning system (TPS) performance of the ZAP-X stereotactic radiosurgery (SRS) system through nondosimetric, dosimetric, and end-to-end (E2E) tests.

METHODS

A comprehensive set of TPS commissioning and validation tests was developed using published guidelines. Nondosimetric validation tests included information transfer, computed tomography-magnetic resonance (CT-MR) image registration, structure/contouring, geometry, dose tools, and CT density. Dosimetric validation included comparisons between TPS and water tank/Solid Water measurements for various geometries and beam arrangements and end-to-end (E2E) tests. Patient-specific quality assurance was performed with an ion chamber in the Lucy phantom and with Gafchromic EBT3 film in the CyberKnife head phantom. RadCalc was used for independent verification of monitor units. Additional E2E tests were performed using the RPC Gamma Knife thermoluminescent dosimeter (TLD) phantom, MD Anderson SRS head phantom, and PseudoPatient gel phantom for independent absolute dose verification.

RESULTS

CT-MR image registrations with known translational and rotational offsets were within tolerance (<0.5 × maximum voxel dimension). Slice thickness and distance accuracy were within 0.1 mm, and volume accuracy was within 0 to 0.11 cm³ . Treatment planning system volume measurement uncertainty was within 0.1 to 0.4 cm³ . Ion chamber point-dose measurements for a single beam in a water phantom agreed to TPS-calculated values within ±4% for collimator diameters 10 to 25 mm, and ±6% for 7.5 mm, for all measured depths (7, 50, 100, 150, and 200 mm). In homogeneous Solid Water, point-dose measurements agreed to within ±4% for cones sizes 7.5 to 25 mm. With 1-cm high/low density inserts, measurements were within ±4.2% for cone sizes 10 to 25 mm. Film-based E2E using 4/5-mm cones resulted in a gamma passing rate (%GP) of 99.8% (2%/1.5 mm). Point-dose measurements in a Lucy phantom with an ion chamber using 36 beams distributed along three noncoplanar arcs agreed to within ±4% for cone sizes 10 to 25 mm. The RPC Gamma Knife TLD phantom yielded passing results with a measured-to-expected TLD dose ratio of 1.02. The MD Anderson SRS head phantom yielded passing results, with 4% TLD agreement and %GP of 95%/93% (5%/3 mm) for coronal/sagittal film planes. The RTsafe gel phantom gave %GP of >95% (5%/2 mm) for all four targets. For our first 58 patients, film-based patient-specific quality assurance has resulted in an average %GP of 98.7% (range, 94-100%) at 2%/2 mm.

CONCLUSIONS

Core ZAP-X features were found to be functional. On the basis of our results, point-dose and planar measurements were in agreement with TPS calculations using multiple phantoms and setup geometries, validating the ZAP-X TPS beam model for clinical use.

Calibration of radiochromic EBT3 film using laser-accelerated protons

We present a proof of principle for onsite calibration of a radiochromic film (EBT3) using CR-39 as an absolute proton-counting detector and laser-accelerated protons as a calibration source. A special detector assembly composed of aluminum range filters, an EBT3 film, and a CR-39 detector is used to expose the EBT3 film with protons in an energy range of 3.65 MeV-5.85 MeV. In our design, the proton beam is divided into small beamlets and their projection images are taken on the EBT3 film and the CR-39 detector by maintaining a certain distance between the two detectors. Owing to the geometrical factor of the configuration and scattering inside the EBT3, the areal number density of protons was kept below the saturation level of the CR-39 detector. We also present a method to relate the number of protons detected on the CR-39 in a narrow energy range to protons with a broad energy spectrum that contribute to the dose deposited in the EBT3 film. The energy spectrum of protons emitted along the target normal direction is simultaneously measured using another CR-39 detector installed in a Thomson parabola spectrometer. The calibration curves for the EBT3 film were obtained in the optical density range of 0.01-0.25 for low dose values of 0.1 Gy-3.0 Gy. Our results are in good agreement with the calibrations of the EBT3 film that are traditionally carried out using conventional accelerators. The method presented here can be further extended for onsite calibration of radiochromic films of other types and for a higher range of dose values.

Reconstruction of dose distributions for fine carbon-ion beams using iterative approximation toward carbon-knife

For the practical application of carbon-knife with fine carbon-ion beams, the quantification of the dose distribution is essential and requires a high spatial resolution. We propose a novel method to quantify dose distributions with a spatial resolution smaller than the dosimeter size. The proposed method innovates the iterative reconstruction technique. Using a diode dosimeter with a sensitive area of 1 mm², two-dimensional dose-area-product (DAP) distributions were measured at a 0.1 mm step at the surface and near the Bragg peak depths for fine carbon-ion beams of ∼1 mm size at the full width at half maximum (FWHM). Then, the dose distributions were reconstructed with a spatial resolution of 0.1 × 0.1 mm² from the measured DAP distributions. However, an unnaturally high noise was observed in the reconstructed dose distributions, which were considered to originate from the measurement reproducibility errors of the DAP distributions estimated to be 2.5%-3%. Therefore, a low-pass filtering process was implemented to reduce the errors on the reconstructed dose distributions. The optimum cut-off frequencies of the low-pass filter were estimated depending on the amplitude of the induced noise. Using the filtering process with the obtained optimum cut-off frequency, the dose distribution was quantified with an average error of approximately 3% or less with respect to the peak value, when the actual measurement had an error of 3%. In the reconstructed dose rate distributions, a steep penumbra P_80-20 ∼ 0.2 mm was observed at the surface, and a dose rate at the center axis of ∼90 Gy s^-1 and a beam size of ∼1.1 mm at FWHM near the Bragg peak were obtained. The proposed method is expected to be useful for the measurement-based determination of microbeam models for commissioning and dose distribution calculations toward carbon-knife applications.

Characterization of natural rubber as a bolus material for electron beam radiotherapy

Background

Bolus is an accessory that is directly placed on the surface region to shift the radiation dose up to the skin during high energy photon and electron beam irradiations. The aim of this study was to mold the bolus using natural rubber material and assess both the physical and dosimetric characteristics.

Materials and methods

A natural rubber with additional plasticizer material was fabricated as a bolus sheet. The physical properties of natural rubber bolus sheets have been investigated using computed tomography (CT) images. Gafchromic EBT3 films were used to acquire the dose at depth of 0, 2, 3, and 3.5 cm for the 9-MeV therapeutic electron beam. A comparison of our natural rubber bolus sheets to the commercial bolus sheets was studied.

Results

The in-house natural rubber bolus sheets with the thickness of 0.32 and 0.52 cm were successfully made. Relative electron density of the two sheets was consistent with each other. However, similar to the commercial boluses, the natural rubber boluses were not provided with the same CT number over the whole sheet. Different bolus material gave different dose at the surface. Both material and thickness of the bolus showed a stronger impact on the dose beyond the depth of maximum dose.

Conclusion

Because of the density, simple fabrication, and vast availability, natural rubber material has an effective potential to be used as a bolus sheet in radiotherapy.

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.

Evaluation of a pixelated large format CMOS sensor for x-ray microbeam radiotherapy

PURPOSE

Current techniques and procedures for dosimetry in microbeams typically rely on radiochromic film or small volume ionization chambers for validation and quality assurance in 2D and 1D, respectively. Whilst well characterized for clinical and preclinical radiotherapy, these methods are noninstantaneous and do not provide real time profile information. The objective of this work is to determine the suitability of the newly developed vM1212 detector, a pixelated CMOS (complementary metal-oxide-semiconductor) imaging sensor, for in situ and in vivo verification of x-ray microbeams.

METHODS

Experiments were carried out on the vM1212 detector using a 220 kVp small animal radiation research platform (SARRP) at the Helmholtz Centre Munich. A 3 x 3 cm² square piece of EBT3 film was placed on top of a marked nonfibrous card overlaying the sensitive silicon of the sensor. One centimeter of water equivalent bolus material was placed on top of the film for build-up. The response of the detector was compared to an Epson Expression 10000XL flatbed scanner using FilmQA Pro with triple channel dosimetry. This was also compared to a separate exposure using 450 µm of silicon as a surrogate for the detector and a Zeiss Axio Imager 2 microscope using an optical microscopy method of dosimetry. Microbeam collimator slits with range of nominal widths of 25, 50, 75, and 100 µm were used to compare beam profiles and determine sensitivity of the detector and both film measurements to different microbeams.

RESULTS

The detector was able to measure peak and valley profiles in real-time, a significant reduction from the 24 hr self-development required by the EBT3 film. Observed full width at half maximum (FWHM) values were larger than the nominal slit widths, ranging from 130 to 190 µm due to divergence. Agreement between the methods was found for peak-to-valley dose ratio (PVDR), peak to peak separation and FWHM, but a difference in relative intensity of the microbeams was observed between the detectors.

CONCLUSIONS

The investigation demonstrated that pixelated CMOS sensors could be applied to microbeam radiotherapy for real-time dosimetry in the future, however the relatively large pixel pitch of the vM1212 detector limit the immediate application of the results.

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.