Sensitivity of linear CCD array based film scanners used for film dosimetry

Reading of gafchromic EBT-3 film using an overhead scanner

Gafchromic film, a commercially available radiochromic film, has been developed and widely used as an effective tool for radiation dose verification and quality assurance in radiotherapy. However, the orientation effect in scanning a film remains a concern for practical application in beam profile monitoring. To resolve this issue, the authors introduced a novel method using an overhead scanner (OHS) coupled with a tracing light board instead of a conventional flatbed scanner (FBS) to read Gafchromic EBT3 films. We investigated the orientation effect of the EBT3 film with a regular hexagonal shape after irradiation with 5 Gy x-rays (160 kV, 6.3 mA) and compared the digitized images acquired using a commercially available OHS (CZUR Aura) and a conventional FBS (EPSON GT-X980). As a result, RGB color intensities acquired from the OHS showed significantly lower orientation effect of the color intensities of RGB components than those from FBS. This finding indicates the high potential of the proposed method for achieving more precise two-dimensional dosimetry. Further studies are required to confirm the effectiveness of this method under different irradiation conditions over a wider dose range.

Comparison of skin dose in IMRT and VMAT with TrueBeam and Halcyon linear accelerator for whole breast irradiation

With the increasing use of flattening filter free (FFF) beams, it is important to evaluate the impact on the skin dose and target coverage of breast cancer treatments. This study aimed to compare skin doses of treatments using FFF and flattening filter (FF) beams for breast cancer. The study established treatment plans for left breast of an anthropomorphic phantom using Halcyon's 6-MV FFF beam and TrueBeam's 6-MV FF beam. Volumetric modulated arc therapy (VMAT) with varying numbers of arcs and intensity modulated radiation therapy (IMRT) were employed, and skin doses were measured at five points using Gafchromic EBT3 film. Each measurement was repeated three times, and averaged to reduce uncertainty. All plans were compared in terms of plan quality to ensure homogeneous target coverage. The study found that when using VMAT with two, four, and six arcs, in-field doses were 19%, 15%, and 6% higher, respectively, when using Halcyon compared to TrueBeam. Additionally, when using two arcs for VMAT, in-field doses were 10% and 15% higher compared to four and six arcs when using Halcyon. Finally, in-field dose from Halcyon using IMRT was about 1% higher than when using TrueBeam. Our research confirmed that when treating breast cancer with FFF beams, skin dose is higher than with traditional FF beams. Moreover, number of arcs used in VMAT treatment with FFF beams affects skin dose to the patient. To maintain a skin dose similar to that of FF beams when using Halcyon, it may be worth considering increasing the number of arcs.

2D mapping of radiation dose and clonogenic survival for accurate assessment ofin vitroX-ray GRID irradiation effects

Spatially fractionated radiation therapy (SFRT or GRID) is an approach to deliver high local radiation doses in an 'on-off' pattern. To better appraise the radiobiological effects from GRID, a framework to link local radiation dose to clonogenic survival needs to be developed. A549 lung cancer cells were irradiated in T25 cm²flasks using 220 kV x-rays with an open field or through a tungsten GRID collimator with periodical 5 mm openings and 10 mm blockings. Delivered nominal doses were 2, 5, and 10 Gy. A novel approach for image segmentation was used to locate the centroid of surviving colonies in scanned images of the cell flasks. Gafchromic^TMfilm dosimetry (GFD) and FLUKA Monte Carlo (MC) simulations were employed to map the dose at each surviving colony centroid. Fitting the linear-quadratic (LQ) function to clonogenic survival data for open field irradiation, the expected survival level at a given dose level was calculated. The expected survival levels were then mapped together with the observed levels in the GRID-irradiated flasks. GFD and FLUKA MC gave similar dose distributions, with a mean peak-to-valley dose ratio of about 5. LQ-parameters for open field irradiation gaveα=0.24±0.02Gy^-1andβ=0.019±0.002Gy^-2. The mean relative percentage deviation between observed and predicted survival in the (peak; valley) dose regions was (4.6; 3.1) %, (26.6; -1.0) %, and (129.8; -2.3) % for 2, 5 and 10 Gy, respectively. In conclusion, a framework for mapping of surviving colonies following GRID irradiation together with predicted survival levels from homogeneous irradiation was presented. For the given cell line, our findings indicate that GRID irradiation causes reduced survival in the peak regions compared to an open field configuration.

Dose-response linearization in radiochromic film dosimetry based on multichannel normalized pixel value with an integrated spectral correction for scanner response variations

PURPOSE

To introduce a model that reproducibly linearizes the response from radiochromic film (RCF) dosimetry systems at extended dose range. To introduce a correction method, generated from the same scanned images, which corrects for scanner temporal response variation and scanner bed inhomogeneity.

METHODS

Six calibration curves were established for different lot numbers of EBT3 GAFCHROMIC™ film model based on four EPSON scanners [10000XL (2 units), 11000XL, 12000XL] at three different centers. These films were calibrated in terms of absorbed dose to water based on TG51 protocol or TRS398 with dose ranges up to 40 Gy. The film response was defined in terms of a proposed normalized pixel value ( n P V RGB ) as a summation of first-order equations based on information from red, green, and blue channels. The fitting parameters of these equations are chosen in a way that makes the film response equal to dose at the time of calibration. An integrated set of correction factors (one per color channel) was also introduced. These factors account for the spatial and temporal changes in scanning states during calibration and measurements. The combination of n P V RGB and this "fingerprint" correction formed the basis of this new protocol and it was tested against net optical density ( n e t O D X = R , G , B ) single-channel dosimetry in terms of accuracy, precision, scanner response variability, scanner bed inhomogeneity, noise, and long-term stability.

RESULTS

Incorporating multichannel features (RGB) into the normalized pixel value produced linear response to absorbed dose (slope of 1) in all six RCF dosimetry systems considered in this study. The "fingerprint" correction factors of each of these six systems displayed unique patterns at the time of calibration. The application of n P V RGB to all of these six systems could achieve a level of accuracy of ± 2.0% in the dose range of interest within modeled uncertainty level of 2.0%-3.0% depending on the dose level. Consistent positioning of control and measurement film pieces and integrating the multichannel correction into the response function formalism mitigated possible scanner response variations of as much as ± 10% at lower doses and scanner bed inhomogeneity of ± 8% to the established level of uncertainty at the time of calibration. The system was also able to maintain the same level of accuracy after 3 and 6 months post calibration.

CONCLUSIONS

Combining response linearity with the integrated correction for scanner response variation lead to a sustainable and practical RCF dosimetry system that mitigated systematic response shifts and it has the potential to reduce errors in reporting relative information from the film response.

Precise film dosimetry for stereotactic radiosurgery and stereotactic body radiotherapy quality assurance using Gafchromic™ EBT3 films

Purpose

The purpose of this study is to evaluate the dosimetric uncertainty associated with Gafchromic™ (EBT3) films and establish a practical and efficient film dosimetry protocol for Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT).

Method and materials

EBT3 films were irradiated at each of seven different dose levels between 1 and 15 Gy with open fields and standard deviations of dose maps were calculated at each color channel for evaluation. A scanner non-uniform response correction map was built by registering and comparing film doses to the reference ion chamber array-based dose map delivered with the same doses. To determine the temporal dependence of EBT3 films, the average correction factors of different dose levels as a function of time were evaluated up to 4 days after irradiation.

An integrated film dosimetry protocol was developed for dose calibration, calibration curve fitting, dose mapping, and profile/gamma analysis. Patient specific quality assurance (PSQA) was performed for 83 SRS/SBRT treatment plans, and analysis of the measurements and calculations are presented here.

Results

The scanner response varied within 1 % for the field sizes less than 5 × 5 cm², and up to 5 % for the field sizes of 10 × 10 cm² for all color channels. The scanner correction method was able to remove visually evident, irregular detector responses for larger field sizes. The dose response of the film changed rapidly (~10 %) in the first two hours and became smooth plateaued afterwards, ~3 % change between 2 and 24 h. The uncertainties were approximately 1.5, 1.7 and 4.8 % over the dose range of 3~15 Gy for the red, green and blue channels. The green channel showed very high sensitivity and low uncertainty in the dose range between 10 and 15 Gy, which is suitable for SRS/SBRT commissioning and PSQA. The difference between the calculated dose and measured dose of ion chamber measurement at isocenter was −0.64 ± 2.02 for all plans, corresponding to a 95 % confidence interval of (−1.09, −0.26). The percentage of points passing the 3 %/1 mm gamma criteria in absolute dose, averaged over all tests was 95.0 ± 4.2.

Conclusion

We have developed the EBT3 films based dosimetry protocol to obtain absolute dose values. The overall uncertainty has been established to be 1.5 % for SRS and SBRT PSQA.

Evaluation of the uncertainty in an EBT3 film dosimetry system utilizing net optical density

Radiochromic film has become an important tool to verify dose distributions for intensity-modulated radiotherapy (IMRT) and quality assurance (QA) procedures. A new radiochromic film model, EBT3, has recently become available, whose composition and thickness of the sensitive layer are the same as those of previous EBT2 films. However, a matte polyester layer was added to EBT3 to prevent the formation of Newton's rings. Furthermore, the symmetrical design of EBT3 allows the user to eliminate side-orientation dependence. This film and the flatbed scanner, Epson Perfection V750, form a dosimetry system whose intrinsic characteristics were studied in this work. In addition, uncertainties associated with these intrinsic characteristics and the total uncertainty of the dosimetry system were determined. The analysis of the response of the radiochromic film (net optical density) and the fitting of the experimental data to a potential function yielded an uncertainty of 2.6%, 4.3%, and 4.1% for the red, green, and blue channels, respectively. In this work, the dosimetry system presents an uncertainty in resolving the dose of 1.8% for doses greater than 0.8 Gy and less than 6 Gy for red channel. The films irradiated between 0 and 120 Gy show differences in the response when scanned in portrait or landscape mode; less uncertainty was found when using the portrait mode. The response of the film depended on the position on the bed of the scanner, contributing an uncertainty of 2% for the red, 3% for the green, and 4.5% for the blue when placing the film around the center of the bed of scanner. Furthermore, the uniformity and reproducibility radiochromic film and reproducibility of the response of the scanner contribute less than 1% to the overall uncertainty in dose. Finally, the total dose uncertainty was 3.2%, 4.9%, and 5.2% for red, green, and blue channels, respectively. The above uncertainty values were obtained by mini-mizing the contribution to the total dose uncertainty of the film orientation and film homogeneity.

How flatbed scanners upset accurate film dosimetry

Film is an excellent dosimeter for verification of dose distributions due to its high spatial resolution. Irradiated film can be digitized with low-cost, transmission, flatbed scanners. However, a disadvantage is their lateral scan effect (LSE): a scanner readout change over its lateral scan axis. Although anisotropic light scattering was presented as the origin of the LSE, this paper presents an alternative cause. Hereto, LSE for two flatbed scanners (Epson 1680 Expression Pro and Epson 10000XL), and Gafchromic film (EBT, EBT2, EBT3) was investigated, focused on three effects: cross talk, optical path length and polarization. Cross talk was examined using triangular sheets of various optical densities. The optical path length effect was studied using absorptive and reflective neutral density filters with well-defined optical characteristics (OD range 0.2-2.0). Linear polarizer sheets were used to investigate light polarization on the CCD signal in absence and presence of (un)irradiated Gafchromic film. Film dose values ranged between 0.2 to 9 Gy, i.e. an optical density range between 0.25 to 1.1. Measurements were performed in the scanner's transmission mode, with red-green-blue channels. LSE was found to depend on scanner construction and film type. Its magnitude depends on dose: for 9 Gy increasing up to 14% at maximum lateral position. Cross talk was only significant in high contrast regions, up to 2% for very small fields. The optical path length effect introduced by film on the scanner causes 3% for pixels in the extreme lateral position. Light polarization due to film and the scanner's optical mirror system is the main contributor, different in magnitude for the red, green and blue channel. We concluded that any Gafchromic EBT type film scanned with a flatbed scanner will face these optical effects. Accurate dosimetry requires correction of LSE, therefore, determination of the LSE per color channel and dose delivered to the film.

Comparative evaluation of modern dosimetry techniques near low- and high-density heterogeneities

The purpose of this study is to compare performance of several dosimetric methods in heterogeneous phantoms irradiated by 6 and 18 MV beams. Monte Carlo (MC) calculations were used, along with two versions of Acuros XB, anisotropic analytical algorithm (AAA), EBT2 film, and MOSkin dosimeters. Percent depth doses (PDD) were calculated and measured in three heterogeneous phantoms. The first two phantoms were a 30×30×30 cm3 solid‐water slab that had an air‐gap of 20×2.5×2.35 cm3. The third phantom consisted of 30×30×5 cm3 solid water slabs, two 30×30×5 cm3 slabs of lung, and one 30×30×1 cm3 solid water slab. Acuros XB, AAA, and MC calculations were within 1% in the regions with particle equilibrium. At media interfaces and buildup regions, differences between Acuros XB and MC were in the range of +4.4% to −12.8%. MOSkin and EBT2 measurements agreed to MC calculations within ∼2.5%, except for the first centimeter of buildup where differences of 4.5% were observed. AAA did not predict the backscatter dose from the high‐density heterogeneity. For the third, multilayer lung phantom, 6 MV beam PDDs calculated by all TPS algorithms were within 2% of MC. 18 MV PDDs calculated by two versions of Acuros XB and AAA differed from MC by up to 2.8%, 3.2%, and 6.8%, respectively. MOSkin and EBT2 each differed from MC by up to 2.9% and 2.5% for the 6 MV, and by −3.1% and ∼2% for the 18 MV beams. All dosimetric techniques, except AAA, agreed within 3% in the regions with particle equilibrium. Differences between the dosimetric techniques were larger for the 18 MV than the 6 MV beam. MOSkin and EBT2 measurements were in a better agreement with MC than Acuros XB calculations at the interfaces, and they were in a better agreement to each other than to MC. The latter is due to their thinner detection layers compared to MC voxel sizes.

PACS numbers: 87.55.K‐, 87.55.kd, 87.55.km, 87.53.Bn, 87.55.k

Proposed linear energy transfer areal detector for protons using radiochromic film

Radiation therapy depends on predictably and reliably delivering dose to tumors and sparing normal tissues. Protons with kinetic energy of a few hundred MeV can selectively deposit dose to deep seated tumors without an exit dose, unlike x-rays. The better dose distribution is attributed to a phenomenon known as the Bragg peak. The Bragg peak is due to relatively high energy deposition within a given distance or high Linear Energy Transfer (LET). In addition, biological response to radiation depends on the dose, dose rate, and localized energy deposition patterns or LET. At present, the LET can only be measured at a given fixed point and the LET spatial distribution can only be inferred from calculations. The goal of this study is to develop and test a method to measure LET over extended areas. Traditionally, radiochromic films are used to measure dose distribution but not for LET distribution. We report the first use of these films for measuring the spatial distribution of the LET deposited by protons. The radiochromic film sensitivity diminishes for large LET. A mathematical model correlating the film sensitivity and LET is presented to justify relating LET and radiochromic film relative sensitivity. Protons were directed parallel to radiochromic film sandwiched between solid water slabs. This study proposes the scaled-normalized difference (SND) between the Treatment Planning system (TPS) and measured dose as the metric describing the LET. The SND is correlated with a Monte Carlo (MC) calculation of the LET spatial distribution for a large range of SNDs. A polynomial fit between the SND and MC LET is generated for protons having a single range of 20 cm with narrow Bragg peak. Coefficients from these fitted polynomial fits were applied to measured proton dose distributions with a variety of ranges. An identical procedure was applied to the protons deposited from Spread Out Bragg Peak and modulated by 5 cm. Gamma analysis is a method for comparing the calculated LET with the LET measured using radiochromic film at the pixel level over extended areas. Failure rates using gamma analysis are calculated for areas in the dose distribution using parameters of 25% of MC LET and 3 mm. The processed dose distributions find 5%-10% failure rates for the narrow 12.5 and 15 cm proton ranges and 10%-15% for proton ranges of 15, 17.5, and 20 cm and modulated by 5 cm. It is found through gamma analysis that the measured proton energy deposition in radiochromic film and TPS can be used to determine LET. This modified film dosimetry provides an experimental areal LET measurement that can verify MC calculations, support LET point measurements, possibly enhance biologically based proton treatment planning, and determine the polymerization process within the radiochromic film.

A method for multichannel dosimetry with EBT3 radiochromic films

PURPOSE

An improved method for multichannel dosimetry is presented. This method explicitly takes into account the information provided by the unexposed image of the film.

METHODS

The method calculates the dose by applying a couple of perturbations to the scanned dose, one dependent and the other independent on the color channel. The method has been compared with previous multichannel and two single channel methods (red and green) against measurements using two different tests: first, five percentage depth dose profiles covering a wide range of doses; second, the dose map perpendicular to the beam axis for a 15 × 15 cm(2) square field. Finally, the results of 30 IMRT quality assurances tests are presented. All tests have been evaluated using the gamma analysis.

RESULTS

The coefficient of variation was found to be similar for all methods in a wide range of doses. The results of the proposed method are more in agreement with the experimental measurements and with the treatment planning system. Furthermore, the differences in the mean gamma pass rates are statistically significant.

CONCLUSIONS

The improved multichannel dosimetric method is able to remove many of the common disturbances usually present in radiochromic films and improves the gamma analysis results compared with the other three methods.

On multichannel film dosimetry with channel-independent perturbations

PURPOSE

Different multichannel methods for film dosimetry have been proposed in the literature. Two of them are the weighted mean method and the method put forth by Micke et al. ["Multichannel film dosimetry with nonuniformity correction," Med. Phys. 38, 2523-2534 (2011)] and Mayer et al. ["Enhanced dosimetry procedures and assessment for EBT2 radiochromic film," Med. Phys. 39, 2147-2155 (2012)]. The purpose of this work was to compare their results and to develop a generalized channel-independent perturbations framework in which both methods enter as special cases.

METHODS

Four models of channel-independent perturbations were compared: weighted mean, Micke-Mayer method, uniform distribution, and truncated normal distribution. A closed-form formula to calculate film doses and the associated type B uncertainty for all four models was deduced. To evaluate the models, film dose distributions were compared with planned and measured dose distributions. At the same time, several elements of the dosimetry process were compared: film type EBT2 versus EBT3, different waiting-time windows, reflection mode versus transmission mode scanning, and planned versus measured dose distribution for film calibration and for γ-index analysis. The methods and the models described in this study are publicly accessible through IRISEU. Alpha 1.1 (http://www.iriseu.com). IRISEU. is a cloud computing web application for calibration and dosimetry of radiochromic films.

RESULTS

The truncated normal distribution model provided the best agreement between film and reference doses, both for calibration and γ-index verification, and proved itself superior to both the weighted mean model, which neglects correlations between the channels, and the Micke-Mayer model, whose accuracy depends on the properties of the sensitometric curves. With respect to the selection of dosimetry protocol, no significant differences were found between transmission and reflection mode scanning, between 75 ± 5 min and 20 ± 1 h waiting-time windows or between employing EBT2 or EBT3 films. Significantly better results were obtained when a measured dose distribution was used instead of a planned one as reference for the calibration, and when a planned dose distribution was used instead of a measured one as evaluation for the γ-analysis.

CONCLUSIONS

The truncated normal distribution model of channel-independent perturbations was found superior to the other three models under comparison and the authors propose its use for multichannel dosimetry.

Dosimetry of biological irradiations using radiochromic films

Delivering accurate radiation dose to blood specimens during biological irradiations is essential in quantifying damage of ionizing radiation. To estimate dose to blood samples as accurately as possible, pieces of EBT2 model GAFCHROMIC™ film were placed within an approximately 10 mm finely ground rice layer that was used to simulate test specimens inside 40 mL plastic flasks. Irradiations of flasks were carried out using an X-RAD 320 irradiator with a beam quality of 320 kVp and a measured half value layer of 1.12 mm Cu, in air and in a full scattering setup which consisted of either rice or Solid Water™ (SW) surrounding flasks, filled to the same level at top of the flasks, together with a 5 cm thick SW slab beneath them. Outputs, per cent depth doses and beam profiles at different depths were measured and compared between setups. For the same setting, the dose delivered to the middle flask under the full scattering setup is 22% larger than with the in-air setup at the depth of the specimen and 9.2% more homogeneous across the specimen thickness of 10 mm (2.3% variation in comparison to the surface). Rice showed a fairly similar performance to SW within 1% at the same depth of 10 mm. Experimental setup based on full scattering conditions was shown to provide faster, more homogenous and fairly uniform dose delivery to biological specimens in comparison to conventionally used in-air setups.

High throughput film dosimetry in homogeneous and heterogeneous media for a small animal irradiator

PURPOSE

We have established a high-throughput Gafchromic film dosimetry protocol for narrow kilovoltage beams in homogeneous and heterogeneous media for small-animal radiotherapy applications. The kV beam characterization is based on extensive Gafchromic film dosimetry data acquired in homogeneous and heterogeneous media. An empirical model is used for parameterization of depth and off-axis dependence of measured data.

METHODS

We have modified previously published methods of film dosimetry to suit the specific tasks of the study. Unlike film protocols used in previous studies, our protocol employs simultaneous multi-channel scanning and analysis of up to nine Gafchromic films per scan. A scanner and background correction were implemented to improve accuracy of the measurements. Measurements were taken in homogeneous and inhomogeneous phantoms at 220 kVp and a field size of 5 × 5 mm(2). The results were compared against Monte Carlo simulations.

RESULTS

Dose differences caused by variations in background signal were effectively removed by the corrections applied. Measurements in homogeneous phantoms were used to empirically characterize beam data in homogeneous and heterogeneous media. Film measurements in inhomogeneous phantoms and their empirical parameterization differed by about 2%-3%. The model differed from MC by about 1% (water, lung) to 7% (bone). Good agreement was found for measured and modelled off-axis ratios.

CONCLUSIONS

EBT2 films are a valuable tool for characterization of narrow kV beams, though care must be taken to eliminate disturbances caused by varying background signals. The usefulness of the empirical beam model in interpretation and parameterization of film data was demonstrated.

Reference dosimetry using radiochromic film

The objectives of this study are to identify and quantify factors that influence radiochromic film dose response and to determine whether such films are suitable for reference dosimetry. The influence of several parameters that may introduce systematic dose errors when performing reference dose measurements were investigated. The effect of the film storage temperature was determined by comparing the performance of three lots of GAFCHROMIC EBT2 films stored at either 4ºC or room temperature. The effect of high (> 80%) or low (< 20%) relative humidity was also determined. Doses measured in optimal conditions with EBT and EBT2 films were then compared with an A12 ionization chamber measurement. Intensity-modulated radiation therapy quality controls using EBT2 films were also performed in reference dose. The results obtained using reference dose measurements were compared with those obtained using relative dose measurements. Storing the film at 4ºC improves the stability of the film over time, but does not eliminate the noncatalytic film development, seen as a rise in optical density over time in the absence of radiation. Relative humidity variations ranging from 80% to 20% have a strong impact on the optical density and could introduce dose errors of up to 15% if the humidity were not controlled during the film storage period. During the scanning procedure, the film temperature influences the optical density that is measured. When controlling for these three parameters, the dose differences between EBT or EBT2 and the A12 chamber are found to be within ± 4% (2σ level) over a dose range of 20-350 cGy. Our results also demonstrate the limitation of the Anisotropic Analytical Algorithm for dose calculation of highly modulated treatment plans.

A comparison between radiochromic EBT2 film model and its predecessor EBT film model

The manufacturer has introduced the new EBT2 film model so as to improve its predecessor, the EBT radiochromic film model. According to the manufacturer, some of its main advantages include a higher tolerance to light exposure and it can correct non-uniformity of the active layer thickness using a marker dye. However, the equivalence in uniformity between both models was questioned by some authors, and the asymmetrical configuration of layers of the EBT2 film model produces a new dependence on the film side being scanned (front and back orientation). In this study, the EBT2 radiochromic film model was compared with the EBT model and the new marker dye feature was assessed. We also compared this correction method with a pre-irradiated pixel value correction method. An Epson Expression 10000XL scanner in transmission mode was used to scan the films and the red channel response was analyzed. We confirmed the lower-measured signal dependence on the visible light exposure of the EBT2 film model. Differences in pixel values remained below 0.5% for a minimum of 15 days. In regard to the uniformity, similar results for EBT2 and EBT film models were obtained; in both cases inhomogeneity was found to be less than 1%, in relative pixel value from the mean. However, we found that the signal-to-noise ratio was reduced for low doses by 37% for old EBT2 batch and by 21% for new EBT2 batch compared to signal-to-noise ratio for EBT. The EBT2 film model's pixel value difference for the front and back orientation reached up to 1.0% in the red channel. Our results did not show a clear advantage between to use a pre-irradiated pixel value correction and to use the manufacturer's correction.

Commissioning a small-field biological irradiator using point, 2D, and 3D dosimetry techniques

PURPOSE

To commission a small-field biological irradiator, the XRad225Cx from Precision x-Ray, Inc., for research use. The system produces a 225 kVp x-ray beam and is equipped with collimating cones that produce both square and circular radiation fields ranging in size from 1 to 40 mm. This work incorporates point, 2D, and 3D measurements to determine output factors (OF), percent-depth-dose (PDD) and dose profiles at multiple depths.

METHODS

Three independent dosimetry systems were used: ion-chambers (a farmer chamber and a micro-ionisation chamber), 2D EBT2 radiochromic film, and a novel 3D dosimetry system (DLOS∕PRESAGE®). Reference point dose rates and output factors were determined from in-air ionization chamber measurements for fields down to ∼13 mm using the formalism of TG61. PDD, profiles, and output factors at three separate depths (0, 0.5, and 2 cm), were determined for all field sizes from EBT2 film measurements in solid water. Several film PDD curves required a scaling correction, reflecting the challenge of accurate film alignment in very small fields. PDDs, profiles, and output factors were also determined with the 3D DLOS∕PRESAGE® system which generated isotropic 0.2 mm data, in scan times of 20 min.

RESULTS

Surface output factors determined by ion-chamber were observed to gradually drop by ∼9% when the field size was reduced from 40 to 13 mm. More dramatic drops were observed for the smallest fields as determined by EBT∼18% and ∼42% for the 2.5 mm and 1 mm fields, respectively. PRESAGE® and film output factors agreed well for fields <20 mm (where 3D data were available) with mean deviation of 2.2% (range 1%-4%). PDD values at 2 cm depth varied from ∼72% for the 40 mm field, down to ∼55% for the 1 mm field. EBT and PRESAGE® PDDs agreed within ∼3% in the typical therapy region (1-4 cm). At deeper depths the EBT curves were slightly steeper (2.5% at 5 cm). These results indicate good overall consistency between ion-chamber, EBT2 and PRESAGE® measured OFs, PDDs, and profiles.

CONCLUSIONS

The combination of independent 2D and 3D measurements was found to be valuable to ensure accurate and comprehensive commissioning. Film measurements were time consuming and challenging due to the difficulty of film alignment in small fields. PRESAGE® 3D measurements were comprehensive and efficient, because alignment errors are negligible, and all parameters for multiple fields could be obtained from a single dosimeter and scan. However, achieving accurate superficial data (within 4 mm) is not yet feasible due to optical surface artifacts.

Radiochromic film dosimetry of HDR (192)Ir source radiation fields

PURPOSE

A radiochromic film based dosimetry system for high dose rate (HDR) Iridium-192 brachytherapy source was described. A comparison between calibration curves established in water and Solid Water™ was provided.

METHODS

Pieces of EBT-2 model GAFCHROMIC™ film were irradiated in both water and Solid Water™ with HDR (192)Ir brachytherapy source in a dose range from 0 to 50 Gy. Responses of EBT-2 GAFCHROMIC™ film were compared for irradiations in water and Solid Water™ by scaling the dose between media through Monte Carlo calculated conversion factor for both setups. To decrease uncertainty in dose delivery due to positioning of the film piece with respect to the radiation source, traceable calibration irradiations were performed in a parallel-opposed beam setup.

RESULTS

The EBT-2 GAFCHROMIC™ film based dosimetry system described in this work can provide an overall one-sigma dose uncertainty of 4.12% for doses above 1 Gy. The ratio of dose delivered to the sensitive layer of the film in water to the dose delivered to the sensitive layer of the film in Solid Water™ was calculated using Monte Carlo simulations to be 0.9941 ± 0.0007.

CONCLUSIONS

A radiochromic film based dosimetry system using only the green color channel of a flatbed document scanner showed superior precision if used alone in a dose range that extends up to 50 Gy, which greatly decreases the complexity of work. In addition, Solid Water™ material was shown to be a viable alternative to water in performing radiochromic film based dosimetry with HDR (192)Ir brachytherapy sources.

A simple 96 well microfluidic chip combined with visual and densitometry detection for resource-poor point of care testing

There is a well-recognized need for low cost biodetection technologies for resource-poor settings with minimal medical infrastructure. Lab-on-a-chip (LOC) technology has the ability to perform biological assays in such settings. The aim of this work is to develop a low cost, high-throughput detection system for the analysis of 96 samples simultaneously outside the laboratory setting. To achieve this aim, several biosensing elements were combined: a syringe operated ELISA lab-on-a-chip (ELISA-LOC) which integrates fluid delivery system into a miniature 96-well plate; a simplified non-enzymatic reporter and detection approach using a gold nanoparticle-antibody conjugate as a secondary antibody and silver enhancement of the visual signal; and Carbon nanotubes (CNT) to increase primary antibody immobilization and improve assay sensitivity. Combined, these elements obviate the need for an ELISA washer, electrical power for operation and a sophisticated detector. We demonstrate the use of the device for detection of Staphylococcal enterotoxin B, a major foodborne toxin using three modes of detection, visual detection, CCD camera and document scanner. With visual detection or using a document scanner to measure the signal, the limit of detection (LOD) was 0.5ng/ml. In addition to visual detection, for precise quantitation of signal using densitometry and a CCD camera, the LOD was 0.1ng/ml for the CCD analysis and 0.5 ng/ml for the document scanner. The observed sensitivity is in the same range as laboratory-based ELISA testing. The point of care device can analyze 96 samples simultaneously, permitting high throughput diagnostics in the field and in resource poor areas without ready access to laboratory facilities or electricity.

Energy dependence of radiochromic dosimetry films for use in radiotherapy verification

AIM

The purpose of the study was to examine the energy dependence of Gafchromic EBT radiochromic dosimetry films, in order to assess their potential use in intensity-modulated radiotherapy (IMRT) verifications.

MATERIALS AND METHODS

The film samples were irradiated with doses from 0.1 to 12 Gy using photon beams from the energy range 1.25 MeV to 25 MV and the film response was measured using a flat-bed scanner. The samples were scanned and the film responses for different beam energies were compared.

RESULTS

A high uncertainty in readout of the film response was observed for samples irradiated with doses lower than 1 Gy. The relative difference exceeds 20% for doses lower than 1 Gy while for doses over 1 Gy the measured film response differs by less than 5% for the whole examined energy range. The achieved uncertainty of the experimental procedure does not reveal any energy dependence of Gafchromic EBT film response in the investigated energy range.

CONCLUSIONS

Gafchromic EBT film does not show any energy dependence in the conditions typical for IMRT but the doses measured for pre-treatment plan verifications should exceed 1 Gy.

An easy method to account for light scattering dose dependence in radiochromic films

PURPOSE

To date no detector can offer the unbeatable characteristics of film dosimetry in terms of spatial resolution and this is why it has been chosen by many institutions for treatment verification and, in that respect, radiochromic films are becoming increasingly popular due to their advantageous properties. It is the aim of this work to suggest an easy method to overcome one of the drawbacks in radiochromic film dosimetry associated with the scanning device, namely, the nonuniform dose dependent response, mainly due to the light scattering effect.

METHODS

The suggested procedure consists of building four correction matrices by sequentially scanning one, two, three, and four unexposed blank films. The color level of these four matrices is compatible with four points in the calibration curve dose range. Therefore, the dose dependent correction to the scanned irradiated film will be obtained by interpolating between the four correction matrices.

RESULTS

The validity of the suggested method is checked against an ion chamber 2D array. The use of the proposed flattening correction improves considerably the dose agreement when compared with the cases in which no correction is applied.

CONCLUSIONS

The method showed to be fast and easy and practically overcomes the dependence on the dose of light scattering of flatbed scanners.

IMRT quality assurance using a second treatment planning system

We used a second treatment planning system (TPS) for independent verification of the dose calculated by our primary TPS in the context of patient-specific quality assurance (QA) for intensity-modulated radiation therapy (IMRT). QA plans for 24 patients treated with inverse planned dynamic IMRT were generated using the Nomos Corvus TPS. The plans were calculated on a computed tomography scan of our QA phantom that consists of three Solid Water slabs sandwiching radiochromic films, and an ion chamber that is inserted into the center slab of the phantom. For the independent verification, the dose was recalculated using the Varian Eclipse TPS using the multileaf collimator files and beam geometry from the original plan. The data was then compared in terms of absolute dose to the ion chamber volume as well as relative dose on isodoses calculated at the film plane. The calculation results were also compared with measurements performed for each case. When comparing ion chamber doses, the mean ratio was 0.999 (SD 0.010) for Eclipse vs. Corvus, 0.988 (SD 0.020) for the ionization chamber measurements vs. Corvus, and 0.989 (SD 0.017) for the ionization chamber measurements vs. Eclipse. For 2D doses with gamma histogram, the mean value of the percentage of pixels passing the criteria of 3%, 3 mm was 94.4 (SD 5.3) for Eclipse vs. Corvus, 85.1 (SD 10.6) for Corvus vs. film, and 93.7 (SD 4.1) for Eclipse vs. film; and for the criteria of 5%, 3 mm, 98.7 (SD 1.5) for Eclipse vs. Corvus, 93.0 (SD 7.8) for Corvus vs. film, and 98.0 (SD 1.9) for Eclipse vs. film. We feel that the use of the Eclipse TPS as an independent, accurate, robust, and time-efficient method for patient-specific IMRT QA is feasible in clinic.

Optimizing the dynamic range extension of a radiochromic film dosimetry system

The authors present a radiochromic film dosimetry protocol for a multicolor channel radiochromic film dosimetry system consisting of the external beam therapy (EBT) model GAFCHROMIC film and the Epson Expression 1680 flat-bed document scanner. Instead of extracting only the red color channel, the authors are using all three color channels in the absorption spectrum of the EBT film to extend the dynamic dose range of the radiochromic film dosimetry system. By optimizing the dose range for each color channel, they obtained a system that has both precision and accuracy below 1.5%, and the optimized ranges are 0-4 Gy for the red channel, 4-50 Gy for the green channel, and above 50 Gy for the blue channel.

Simulation of intrafraction motion and overall geometrical accuracy of a frameless intracranial radiosurgery process

We conducted a comprehensive evaluation of the clinical accuracy of an image-guided frameless intracranial radiosurgery system. All links in the process chain were tested. Using healthy volunteers, we evaluated a novel method to prospectively quantify the range of target motion for optimal determination of the planning target volume (PTV) margin. The overall system isocentric accuracy was tested using a rigid anthropomorphic phantom containing a hidden target. Intrafraction motion was simulated in 5 healthy volunteers. Reinforced head-and-shoulders thermoplastic masks were used for immobilization. The subjects were placed in a treatment position for 15 minutes (the maximum expected time between repeated isocenter localizations) and the six-degrees-of-freedom target displacements were recorded with high frequency by tracking infrared markers. The markers were placed on a customized piece of thermoplastic secured to the head independently of the immobilization mask. Additional data were collected with the subjects holding their breath, talking, and deliberately moving. As compared with fiducial matching, the automatic registration algorithm did not introduce clinically significant errors (<0.3 mm difference). The hidden target test confirmed overall system isocentric accuracy of < or =1 mm (total three-dimensional displacement). The subjects exhibited various patterns and ranges of head motion during the mock treatment. The total displacement vector encompassing 95% of the positional points varied from 0.4 mm to 2.9 mm. Pre-planning motion simulation with optical tracking was tested on volunteers and appears promising for determination of patient-specific PTV margins. Further patient study is necessary and is planned. In the meantime, system accuracy is sufficient for confident clinical use with 3 mm PTV margins.