Optimizing the sensitivity and radiological properties of the PRESAGE® dosimeter using metal compounds

A Review of PRESAGE Radiochromic Polymer and the Compositions for Application in Radiotherapy Dosimetry

Recent advances in radiotherapy technology and techniques have allowed a highly conformal radiation to be delivered to the tumour target inside the body for cancer treatment. A three-dimensional (3D) dosimetry system is required to verify the accuracy of the complex treatment delivery. A 3D dosimeter based on the radiochromic response of a polymer towards ionising radiation has been introduced as the PRESAGE dosimeter. The polyurethane dosimeter matrix is combined with a leuco-dye and a free radical initiator, whose colour changes in proportion to the radiation dose. In the previous decade, PRESAGE gained improvement and enhancement as a 3D dosimeter. Notably, PRESAGE overcomes the limitations of its predecessors, the Fricke gel and the polymer gel dosimeters, which are challenging to fabricate and read out, sensitive to oxygen, and sensitive to diffusion. This article aims to review the characteristics of the radiochromic dosimeter and its clinical applications. The formulation of PRESAGE shows a delicate balance between the number of radical initiators, metal compounds, and catalysts to achieve stability, optimal sensitivity, and water equivalency. The applications of PRESAGE in advanced radiotherapy treatment verifications are also discussed.

Nanoparticle dose enhancement of synchrotron radiation in PRESAGE dosimeters

The physical absorbed dose enhancement by the inclusion of gold and bismuth nanoparticles fabricated into water-equivalent PRESAGE dosimeters was investigated. Nanoparticle-loaded water-equivalent PRESAGE dosimeters were irradiated with superficial, synchrotron and megavoltage X-ray beams. The change in optical density of the dosimeters was measured using UV-Vis spectrophotometry pre- and post-irradiation using a wavelength of 630 nm. Dose enhancement was measured for 5 nm and 50 nm monodispersed gold nanoparticles, 5-50 nm polydispersed bismuth nanoparticles, and 80 nm monodispersed bismuth nanoparticles at concentrations from 0.25 mM to 2 mM. The dose enhancement was highest for the 95.3 keV mean energy synchrotron beam (16-32%) followed by the 150 kVp superficial beam (12-21%) then the 6 MV beam (2-5%). The bismuth nanoparticle-loaded dosimeters produced a larger dose enhancement than the gold nanoparticle-loaded dosimeters in the synchrotron beam for the same concentration. For the superficial and megavoltage beams the dose enhancement was similar for both species of nanoparticles. The dose enhancement increased with nanoparticle concentration in the dosimeters; however, there was no observed nanoparticle size dependence on the dose enhancement.

Investigation of magnetic field effects on the dose-response of 3D dosimeters for magnetic resonance - image guided radiation therapy applications

BACKGROUND AND PURPOSE

The strong magnetic field of integrated magnetic resonance imaging (MRI) and radiation treatment systems influences secondary electrons resulting in changes in dose deposition in three dimensions. To fill the need for volumetric dose quality assurance, we investigated the effects of strong magnetic fields on 3D dosimeters for MR-image-guided radiation therapy (MR-IGRT) applications.

MATERIAL AND METHODS

There are currently three main categories of 3D dosimeters, and the following were used in this study: radiochromic plastic (PRESAGE®), radiochromic gel (FOX), and polymer gel (BANG™). For the purposes of batch consistency, an electromagnet was used for same-day irradiations with and without a strong magnetic field (B₀, 1.5T for PRESAGE® and FOX and 1.0T for BANG™).

RESULTS

For PRESAGE®, the percent difference in optical signal with and without B₀ was 1.5% at the spectral peak of 632nm. For FOX, the optical signal percent difference was 1.6% at 440nm and 0.5% at 585nm. For BANG™, the percent difference in R₂ MR signal was 0.7%.

CONCLUSIONS

The percent differences in responses with and without strong magnetic fields were minimal for all three 3D dosimeter systems. These 3D dosimeters therefore can be applied to MR-IGRT without requiring a correction factor.

Detection of therapeutic radiation in three-dimensions

For over the last twenty years there has been a multitude of sophisticated three-dimensional radiation delivery procedures developed which requires a corresponding verification of the impact on patients. This article reviews the state of the art in the development of chemical detectors used to characterize the three-dimensional shape of therapeutic radiation. These detectors are composed of polyurethane, radical initiator and a leuco dye, which is radiolytically oxidized to a dye absorbing at 630 nm.

Water equivalence evaluation of PRESAGE(®) formulations for megavoltage electron beams: a Monte Carlo study

To investigate the radiological water equivalency of three different formulations of the radiochromic, polyurethane based dosimeter PRESAGE(®) for three dimensional (3D) dosimetry of electron beams. The EGSnrc/BEAMnrc Monte Carlo package was used to model 6-20 MeV electron beams and calculate the corresponding doses delivered in the three different PRESAGE(®) formulations and water. The depth of 50 % dose and practical range of electron beams were determined from the depth dose calculations and scaling factors were calculated for these electron beams. In the buildup region, a 1.0 % difference in dose was found for all PRESAGE(®) formulations relative to water for 6 and 9 MeV electron beams while the difference was negligible for the higher energy electron beams. Beyond the buildup region (at a depth range of 22-26 mm for the 6 MeV beam and 38 mm for the 9 MeV beam), the discrepancy from water was found to be 5.0 % for the PRESAGE(®) formulations with lower halogen content than the original formulation, which was found to have a discrepancy of up to 14 % relative to water. For a 16 MeV electron beam, the dose discrepancy from water increases and reaches about 7.0 % at 70 mm depth for the lower halogen content PRESAGE(®) formulations and 20 % at 66 mm depth for the original formulation. For the 20 MeV electron beam, the discrepancy drops to 6.0 % at 90 mm depth for the lower halogen content formulations and 18 % at 85 mm depth for the original formulation. For the lower halogen content PRESAGE(®), the depth of 50 % dose and practical range of electrons differ from water by up to 3.0 %, while the range of differences from water is between 6.5 and 8.0 % for the original PRESAGE(®) formulation. The water equivalent depth scaling factor required for the original formulation of PRESAGE(®) was determined to be 1.07-1.08, which is larger than that determined for the lower halogen content formulations (1.03) over the entire beam energy range of electrons. All three of the PRESAGE(®) formulations studied require a depth scaling factor to convert depth in PRESAGE(®) to water equivalent depth for megavoltage electron beam dosimetry. Compared to the original PRESAGE(®) formulation, the lower halogen content formulations require a significantly smaller scaling factor and are thus recommended over the original PRESAGE(®) formulation for electron beam dosimetry.

Customising PRESAGE® for diverse applications

PRESAGE® is a solid radiochromic dosimeter consisting of a polyurethane matrix, a triarylmethane leuco dye, and a trihalomethane initiator. Varying the composition and/or relative amounts of these constituents can affect the dose sensitivity, post-irradiation stability, and physical properties of the dosimeter. This allows customisation of PRESAGE® to meet application-specific requirements, such as low sensitivity for high dose applications, stability for remote dosimetry, optical clearing for reusability, and tissue-like elasticity for deformable dosimetry. This study evaluates five hard, non-deformable PRESAGE® formulations and six deformable PRESAGE® formulations and characterizes them for dose sensitivity and stability. Results demonstrated sensitivities in the range of 0.0029 - 0.0467 ΔOD/(Gy·cm) for hard formulations and 0.0003 - 0.0056 ΔOD/(Gy·cm) for deformable formulations. Exceptional stability was seen in both standard and low sensitivity non-deformable formulations, with promising applications for remote dosimetry. Deformable formulations exhibited potential for reusability with strong post-irradiation optical clearing. Tensile compression testing of the deformable formulations showed elastic response consistent with soft tissues, with further testing required for direct comparison. These results demonstrate that PRESAGE® dosimeters have the flexibility to be adapted for a wide spectrum of clinical applications.