The history and principles of optical computed tomography for scanning 3-D radiation dosimeters: 2008 update

On the Use of the Fricke-Pluronic F-127 Gel Dosimeter for Radiation Isocenter Testing of a Medical Linear Accelerator

This work presents a Fricke-XO-Pluronic F-127 2D radiochromic dosimeter with a flat-bed scanner for 2D reading and a dedicated data processing software package as a tool for performing coincidence testing of the radiation and mechanical isocenter of a medical accelerator. The optimal irradiation parameters were determined as follows: monitor units per beam and multi-leaf collimator gap, which are ≤750-≤2500 MU and 2-5 mm, respectively, for a cuboidal container with dimensions of 12 × 12 × 0.3 cm3. Despite the diffusion of Fe3+ ions occurring during irradiation, 2D reading can be performed at least 3 h after irradiation, without affecting the calculation performance of the coincidence test. The test was successfully performed for various irradiation settings. Overall, the Fricke-XO-Pluronic F-127 dosimeter has proven to be a potential tool for the coincidence testing of medical accelerators.

High-resolution three-dimensional dosimetry in clinically relevant volumes utilizing optically stimulated luminescence

BACKGROUND

The continued development of new radiotherapy techniques requires dosimetry systems that satisfy increasingly rigorous requirements, such as high sensitivity, wide dose range, and high spatial resolution. An emerging requirement is the ability to read out doses in three dimensions (3D) with high precision and spatial resolution. A few dosimetry systems with 3D capabilities are available, but their application in a clinical workflow is limited for various reasons, primarily originating from their chemical nature. The search for a 3D dosimetry system with potential for clinical implementation is thus ongoing.

PURPOSE

To demonstrate the capabilities of a novel optically-stimulated-luminescence (OSL)-based 3D dosimetry system capable of measuring radiation doses in clinically relevant volumes.

METHODS

A laser-based readout system was used to measure dose distributions delivered by both photons and protons, utilizing the OSL from a50 × 50 × 50 $50\times 50\times 50$  mm3 $^3$ YSO:Ce crystal. A homogeneous treatment plan consisting of two opposing photon fields was used to establish an inhomogeneity correction map of the crystal response and demonstrated the accuracy and precision of the system. The crystal was additionally irradiated with a photon treatment plan consisting of three overlapping10 × 10 $10\times 10$  mm2 $^2$ fields delivered from different angles, and a proton treatment plan consisting of four pencil beams with energies 90 MeV (× 2 $\times 2$ ), 115 MeV, and 140 MeV. The system abilities were quantified by comparing the 3D-resolved measurements to Monte Carlo simulations.

RESULTS

The dose map reproducibility of the system was found to be within 2% including both statistical and systematic errors. The measurements yielded integrated doses from a volume of50 × 50 × 40 $50\times 50\times 40$  mm3 $^3$ with voxel volumes of just0.28 × 0.28 × 0.50 $0.28\times 0.28\times 0.50$  mm3 $^3$ . An excellent agreement between the 3D-resolved measurements and the simulations was found for both photon- and proton-irradiation.

CONCLUSIONS

The capabilities of the devised system for measuring clinically relevant fields of photons and proton pencil beams within a clinically relevant volume were demonstrated. The system poses as a promising candidate for clinical applications, and enables future research in the field of OSL-based tissue-equivalent 3D dosimetry.

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.

3D isocentricity analysis for clinical linear accelerators

PURPOSE

To perform a three-dimensional (3D) concurrent isocentricity measurement of a clinical linear accelerator's (linac) using a single 3D dosimeter, PRESAGE.

METHODS

A 3D dosimeter, PRESAGE, set up on the treatment couch of a Varian TrueBeam LINAC using the setup lasers, was irradiated under gantry angles of 0 ∘ , 50 ∘ , 160 ∘ , and 270 ∘ with the couch fixed at 0 ∘ and subsequently, under couch angles of 10 ∘ , 330 ∘ , 300 ∘ , and 265 ∘ with the gantry fixed at 270 ∘ . The 1 cm 2 (at 100 cm SAD) square fields were delivered at 6 MV with 800 MU/field. After irradiation, the dosimeter was scanned using a single-beam optical scanner and images were reconstructed with submillimeter resolution using filtered back-projection. Postprocessing was used to extract views parallel to the star-shot planes from which beam trajectories and the smallest circles enclosing these were drawn and extracted. These circles and information from the view orthogonal to both star-shots were used to represent the rotational centers as spheroids. The linac isocenter was defined by the distribution of midpoints between any, randomly selected, points lying inside the center spheroids defined by the table and gantry rotations; isocenter location and size were defined by the average midpoint and the distribution's semi-axes. Collimator rotations were not included in this study.

RESULTS

Relative to the setup center defined by lasers, the table and gantry rotation center coordinates (lat., long., vert.) were measured in units of millimeters, to be (-0.24, 0.18, -0.52) and (0.10, 0.53, -0.52), respectively. Displacements from the setup center were 0.60 and 0.75 mm for the table and gantry centers, while the distance between them measured 0.49 mm. The linac's radiation isocenter was calculated to be at (-0.07, -0.17, 0.51) relative to the setup lasers and its size was found to be most easily described by a spheroid prolate in vertical direction with semi-axis lengths of 0.13 and 0.23 mm for the lateral-longitudinal and vertical directions, respectively.

CONCLUSIONS

This study demonstrates how to measure the location and sizes of rotational centers in 3D with one setup. The proposed method provides a more comprehensive view on the isocentricity of LINAC than the conventional two-dimensional film measurements. Additionally, a new definition of isocenter and its size was proposed.

Clinical radiotherapy application of N-vinylpyrrolidone-containing 3D polymer gel dosimeters with remote external MR-reading

PURPOSE

Advanced 3D dosimetry is required for verifications of complex dose distributions in modern radiotherapy. Two 3D polymer gel dosimeters, coupled with magnetic resonance (MR) imaging (3 T MRI) readout and data processing with polyGeVero® software, were tested for the verification of calculated 3D dose distributions by a treatment planning system (TPS) and ArcCHECK®-3DVH®, related to eradication of a lung tumour.

METHODS

N-vinylpyrrolidone-containing 3D polymer gel dosimeters were used: VIC (containing ascorbic acid and copper sulfate pentahydrate) and VIC-T (containing tetrakis(hydroxymethyl)phosphonium chloride). Three remote centers were involved in the dosimeters preparation and irradiation (Poland), and MRI (Austria). Cross beam calibration of the dosimeters and verification of a 3D dose distribution calculated with an Eclipse External Beam TPS and ArcCHECK®-3DVH® were performed. The 3D-to-3D comparisons of the VIC and VIC-T with TPS and ArcCHECK®-3DVH® along with ArcCHECK®-3DVH® versus TPS dose matrixes were performed with the aid of the polyGeVero® by analyzing dose profiles, isodoses lines, gamma index, gamma angle, dose difference, and related histograms.

RESULTS

The measured MR-relaxation rate (R₂ = 1/T₂) for the dosimeters relates to the dose, as follows: R₂ = 0.0928 ± 0.0008 [Gy^-1 s^-1] × D [Gy] + 2.985 ± 0.012 [s^-1] (VIC) and 0.1839 ± 0.0044 [Gy^-1 s^-1] × D [Gy] + 2.519 ± 0.053 [s^-1] (VIC-T). The 3D-to-3D comparisons revealed a good agreement between the measured and calculated 3D dose distributions.

CONCLUSIONS

VIC and VIC-T with 3T MRI readout and polyGeVero® showed potential for verifications of calculated irradiation plans. The results obtained suggest the implementation of the irradiation plan for eradication of the lung tumour.

Evaluation of hybrid SART + OS + TV iterative reconstruction algorithm for optical-CT gel dosimeter imaging

Optical computed tomography (optical-CT) is a high-resolution, fast, and easily accessible readout modality for gel dosimeters. This paper evaluates a hybrid iterative image reconstruction algorithm for optical-CT gel dosimeter imaging, namely, the simultaneous algebraic reconstruction technique (SART) integrated with ordered subsets (OS) iteration and total variation (TV) minimization regularization. The mathematical theory and implementation workflow of the algorithm are detailed. Experiments on two different optical-CT scanners were performed for cross-platform validation. For algorithm evaluation, the iterative convergence is first shown, and peak-to-noise-ratio (PNR) and contrast-to-noise ratio (CNR) results are given with the cone-beam filtered backprojection (FDK) algorithm and the FDK results followed by median filtering (mFDK) as reference. The effect on spatial gradients and reconstruction artefacts is also investigated. The PNR curve illustrates that the results of SART  +  OS  +  TV finally converges to that of FDK but with less noise, which implies that the dose-OD calibration method for FDK is also applicable to the proposed algorithm. The CNR in selected regions-of-interest (ROIs) of SART  +  OS  +  TV results is almost double that of FDK and 50% higher than that of mFDK. The artefacts in SART  +  OS  +  TV results are still visible, but have been much suppressed with little spatial gradient loss. Based on the assessment, we can conclude that this hybrid SART  +  OS  +  TV algorithm outperforms both FDK and mFDK in denoising, preserving spatial dose gradients and reducing artefacts, and its effectiveness and efficiency are platform independent.

Investigations into the feasibility of optical-CT 3D dosimetry with minimal use of refractively matched fluids

PURPOSE

In optical-CT, the use of a refractively matched polyurethane solid-tank in place of a fluid bath has the potential to greatly increase practical convenience, reduce cost, and possibly improve the efficacy of flood corrections. This work investigates the feasibility of solid-tank optical-CT imaging for 3D dosimetry through computer simulation.

METHODS

A matlab ray-tracing simulation platform, ScanSim, was used to model a parallel-source telecentric optical-CT imaging system through a polyurethane solid-tank containing a central cylindrical hollow into which PRESAGE radiochromic dosimeters can be placed. A small amount of fluid fills the 1-5 mm gap between the dosimeter and the walls of the tank. The use of the solid-tank reduces the required amount of fluid by approximately 97%. To characterize the efficacy of solid-tank, optical-CT scanning simulations investigated sensitivity to refractive index (RI) mismatches between dosimeter, solid-tank, and fluid, for a variety of dosimeter (RI = 1.5-1.47) and fluid (RI = 1.55-1.0) combinations. Efficacy was evaluated through the usable radius (ru) metric, defined as the fraction of the radius of the dosimeter where measured dose is predicted to be within 2% of the ground truth entered into the simulation. Additional simulations examined the effect of increasing gap size (1-5 mm) between the dosimeter and solid-tank well. The effects of changing the lens tolerance (0.5°-5.0°) were also investigated.

RESULTS

As the RI mismatch between the dosimeter and solid-tank increased from 0 to 0.02, the usable radius decreased from 97.6% to 50.2%. The optimal fluid RI decreased nonlinearly from 1.5 to 1.34 as the mismatch increased and was up to 9% lower than the tank. Media mismatches between the dosimeter and solid-tank also exacerbate the effects of changing the gap size, with no easily quantifiable relationship with usable radius. Generally, the optimal fluid RI value increases as gap size increases and is closely matched to the dosimeter at large gap sizes (> 3 mm). Increasing the telecentric lens tolerance increases the usable radius for all refractive media combinations and improves the maximum usable radius of mismatched media to that of perfectly matched media for tolerances > 5.0°. The maximum usable radius can be improved up to a factor of 2 when lens tolerances are small (< 1.0°).

CONCLUSIONS

Dry solid-tank optical-CT imaging in a telecentric system is feasible if the dosimeter RI is a close match with the solid-tank (< 0.01 difference), providing accurate dose measurements within ± 2% of true dose to over 80% of the dosimeter volume. In order to achieve accurate measurements over 96% of the dosimeter volume (representing out to 2 mm from the dosimeter edge), the dosimeter-tank RI mismatch must be less than 0.005. Optimal results occur when the RI of the dosimeter and tank is the same, in which case the fluid will have the same RI. If mismatches between the tank and dosimeter RI occur, the RI of the matching fluid needs to be fine tuned to achieve the highest usable radius.

Incorporating multislice imaging into x-ray CT polymer gel dosimetry

PURPOSE

To evaluate multislice computed tomography (CT) scanning for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD) and to establish a baseline assessment of image noise and uniformity in an unirradiated gel dosimeter.

METHODS

A 16-slice CT scanner was used to acquire images through a 1 L cylinder filled with water. Additional images were collected using a single slice machine. The variability in CT number (NCT) associated with the anode heel effect was evaluated and used to define a new slice-by-slice background subtraction artifact removal technique for CT PGD. Image quality was assessed for the multislice system by evaluating image noise and uniformity. The agreement in NCT for slices acquired simultaneously using the multislice detector array was also examined. Further study was performed to assess the effects of increasing x-ray tube load on the constancy of measured NCT and overall scan time. In all cases, results were compared to the single slice machine. Finally, images were collected throughout the volume of an unirradiated gel dosimeter to quantify image noise and uniformity before radiation is delivered.

RESULTS

Slice-by-slice background subtraction effectively removes the variability in NCT observed across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image noise was higher for the multislice system compared to the single slice scanner, but overall image quality was comparable between the two systems. Further study showed NCT was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thicknesses examined. In addition, the multislice system was found to eliminate variations in NCT due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Images acquired through an unirradiated, active gel revealed NCT varies between the top and bottom of the 1 L cylinder as well as across the diameter of the cylinder by up to 7 HU.

CONCLUSIONS

Multislice CT imaging has been evaluated for CT PGD and found to be the superior technique compared to single slice imaging in terms of the time required to complete a scan and the tube load characteristics associated with each scanning method. The implementation of multislice scanning is straightforward and expected to facilitate routine gel dosimetry measurements for complex dose distributions in modern RT centers.

Eliminating the need for refractive index matching in optical CT scanners for radiotherapy dosimetry: I. Concept and simulations

Optical computed tomography has now become a well-established method for making empirical measurements of 3D dose distributions in radiotherapy treatment verification. The requirement for effective refractive index matching as part of the scanning process has long been an inconvenience for users, limiting the speed of sample throughput. We propose a new method for reconstructing data that takes explicit account of the refracted path of the light rays and demonstrate theoretically the conditions under which there are sufficient data to create a good reconstruction. Examples of the performance of the algorithm are given. For smoothly varying data, reconstructed images of very high quality are obtained, with RMS deviation of under 1% from the original, provided that the irradiated region lies entirely within a critical radius. For the dosimeter material PRESAGE, this critical value is approximately 0.65 of the sample radius. Regions outside this are not reconstructed successfully, but we argue that there are many cases where this disadvantage is outweighed by the benefits of the technique.

An investigation of the potential of optical computed tomography for imaging of synchrotron-generated x-rays at high spatial resolution

X-ray microbeam radiation therapy (MRT) is a novel form of treatment, currently in its preclinical stage, which uses microplanar x-ray beams from a synchrotron radiation source. It is important to perform accurate dosimetry on these microbeams, but, to date, there has been no accurate enough method available for making 3D dose measurements with isotropic, high spatial resolution to verify the results of Monte Carlo dose simulations. Here, we investigate the potential of optical computed tomography for satisfying these requirements. The construction of a simple optical CT microscopy (optical projection tomography) system from standard commercially available hardware is described. The measurement of optical densities in projection data is shown to be highly linear (r2=0.999). The depth-of-field (DOF) of the imaging system is calculated based on the previous literature and measured experimentally using a commercial DOF target. It is shown that high quality images can be acquired despite the evident lack of telecentricity and despite DOF of the system being much lower than the sample diameter. Possible reasons for this are discussed. Results are presented for a complex irradiation of a 22 mm diameter cylinder of the radiochromic polymer PRESAGE, demonstrating the exquisite 'dose-painting' abilities available in the MRT hutch of beamline ID-17 at the European Synchrotron Radiation Facility. Dose distributions in this initial experiment are equally well resolved on both an optical CT scan and a corresponding transmission image of radiochromic film, down to a line width of 83 microm (6 lp mm(-1)) with an MTF value of 0.40. A group of 33 microm wide lines was poorly resolved on both the optical CT and film images, and this is attributed to an incorrect exposure time calculation, leading to under-delivery of dose. Image artefacts in the optical CT scan are discussed. PRESAGE irradiated using the microbeam facility is proposed as a suitable material for producing phantom samples for quantitative characterization of optical CT microscopy systems.