Clinical quality assurance for 106Ru ophthalmic applicators

Dosimetric Investigation of Six Ru-106 Eye Plaques by EBT3 Radiochromic Films and Monte Carlo Simulation

Background

Ophthalmic brachytherapy using radioactive plaques is an effective technique for the treatment of uveal melanoma. Ru-106 eye plaques are considered as interesting issue due to their steep gradient dose. The pre-planning evaluation of dosimetric parameters is essential for the treatment planning system.

Objective

The current study aims at providing dose distributions of six Ru-106 eye plaques (CCA, CCB, CGD, CIB, COB and COD) using radiochromic EBT3 film, Geant4 Monte Carlo toolkit and the treatment planning software (Plaque Simulator).

Material and Methods

In this experimental study, an in-house phantom was employed for depth dose measurements with EBT3 films. Also, Geant4.10.5 scoring mesh was implemented to obtain the 2D dose distribution of the plaques. The results were compared with Plaque Simulator software and the manufacturer's (BEBIG) data. The gamma index criterion (3%/3 mm) was used to evaluate dose distributions obtained by the film measurements and Geant4 simulation.

Results

A good agreement was achieved between simulation and experimental results. Gamma index passing rate was 94.2%, 89.3%, 88.2%, 82.2%, 92.2% and 90.1% for CCA, CCB, CGD, CIB, COB and COD plaques, respectively. Absolute dose rate (mGy/min) obtained by EBT3 film at the depth of 2 mm was 79.4 mGy/min, 81.0 mGy/min, 78.6 mGy/min, 62.2 mGy/min, 75.2 mGy/min and 81.2 mGy/min for CCA, CCB, CGD, CIB, COB and COD plaques, respectively.

Conclusion

The measured dose distributions and lateral dose profiles may be utilized in the treatment planning system to cover clinical volumes such as the clinical target volume and the gross tumor volume.

AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221

The American Association of Physicists in Medicine (AAPM) formed Task Group 221 (TG-221) to discuss a generalized commissioning process, quality management considerations, and clinical physics practice standards for ocular plaque brachytherapy. The purpose of this report is also, in part, to aid the clinician to implement recommendations of the AAPM TG-129 report, which placed emphasis on dosimetric considerations for ocular brachytherapy applicators used in the Collaborative Ocular Melanoma Study (COMS). This report is intended to assist medical physicists in establishing a new ocular brachytherapy program and, for existing programs, in reviewing and updating clinical practices. The report scope includes photon- and beta-emitting sources and source:applicator combinations. Dosimetric studies for photon and beta sources are reviewed to summarize the salient issues and provide references for additional study. The components of an ocular plaque brachytherapy quality management program are discussed, including radiation safety considerations, source calibration methodology, applicator commissioning, imaging quality assurance tests for treatment planning, treatment planning strategies, and treatment planning system commissioning. Finally, specific guidelines for commissioning an ocular plaque brachytherapy program, clinical physics practice standards in ocular plaque brachytherapy, and other areas reflecting the need for specialized treatment planning systems, measurement phantoms, and detectors (among other topics) to support the clinical practice of ocular brachytherapy are presented. Expected future advances and developments for ocular brachytherapy are discussed.

Absorbed dose distributions from ophthalmic 106 Ru/106 Rh plaques measured in water with radiochromic film

PURPOSE

Brachytherapy with ¹⁰⁶ Ru/¹⁰⁶ Rh plaques offers good outcomes for small-to-medium choroidal melanomas and retinoblastomas. The dose measurement of the plaques is challenging, due to the small range of the emitted beta particles and steep dose gradients involved. The scarce publications on film dosimetry of ¹⁰⁶ Ru/¹⁰⁶ Rh plaques used solid phantoms. This work aims to develop a practical method for measuring the absorbed dose distribution in water produced by ¹⁰⁶ Ru/¹⁰⁶ Rh plaques using EBT3 radiochromic film.

METHODS

Experimental setups were developed to determine the dose distribution at a plane perpendicular to the symmetry axis of the plaque and at a plane containing the symmetry axis. One CCA and two CCX plaques were studied. The dose maps were obtained with the FilmQA Pro 2015 software, using the triple-channel dosimetry method. The measured dose distributions were compared to published Monte Carlo simulation and experimental data.

RESULTS

A good agreement was found between measurements and simulations, improving upon published data. Measured reference dose rates agreed within the experimental uncertainty with data obtained by the manufacturer using a scintillation detector, with typical differences below 5%. The attained experimental uncertainty was 4.1% (k = 1) for the perpendicular setup, and 7.9% (k = 1) for the parallel setup. These values are similar or smaller than those obtained by the manufacturer and other authors, without the need of solid phantoms that are not available to most users.

CONCLUSIONS

The proposed method may be useful to the users to perform quality assurance preclinical tests of ¹⁰⁶ Ru/¹⁰⁶ Rh plaques.