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Karger CP, Elter A, Dorsch S, Mann P, Pappas E, Oldham M. Validation of complex radiotherapy techniques using polymer gel dosimetry. Phys Med Biol 2024; 69:06TR01. [PMID: 38330494 DOI: 10.1088/1361-6560/ad278f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/08/2024] [Indexed: 02/10/2024]
Abstract
Modern radiotherapy delivers highly conformal dose distributions to irregularly shaped target volumes while sparing the surrounding normal tissue. Due to the complex planning and delivery techniques, dose verification and validation of the whole treatment workflow by end-to-end tests became much more important and polymer gel dosimeters are one of the few possibilities to capture the delivered dose distribution in 3D. The basic principles and formulations of gel dosimetry and its evaluation methods are described and the available studies validating device-specific geometrical parameters as well as the dose delivery by advanced radiotherapy techniques, such as 3D-CRT/IMRT and stereotactic radiosurgery treatments, the treatment of moving targets, online-adaptive magnetic resonance-guided radiotherapy as well as proton and ion beam treatments, are reviewed. The present status and limitations as well as future challenges of polymer gel dosimetry for the validation of complex radiotherapy techniques are discussed.
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Affiliation(s)
- Christian P Karger
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Alina Elter
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Stefan Dorsch
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Philipp Mann
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Evangelos Pappas
- Radiology & Radiotherapy Sector, Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Mark Oldham
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States of America
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Park H, Paganetti H, Schuemann J, Jia X, Min CH. Monte Carlo methods for device simulations in radiation therapy. Phys Med Biol 2021; 66:10.1088/1361-6560/ac1d1f. [PMID: 34384063 PMCID: PMC8996747 DOI: 10.1088/1361-6560/ac1d1f] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/12/2021] [Indexed: 11/12/2022]
Abstract
Monte Carlo (MC) simulations play an important role in radiotherapy, especially as a method to evaluate physical properties that are either impossible or difficult to measure. For example, MC simulations (MCSs) are used to aid in the design of radiotherapy devices or to understand their properties. The aim of this article is to review the MC method for device simulations in radiation therapy. After a brief history of the MC method and popular codes in medical physics, we review applications of the MC method to model treatment heads for neutral and charged particle radiation therapy as well as specific in-room devices for imaging and therapy purposes. We conclude by discussing the impact that MCSs had in this field and the role of MC in future device design.
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Affiliation(s)
- Hyojun Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, Republic of Korea
| | - Harald Paganetti
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Jan Schuemann
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Xun Jia
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75235, United States of America
| | - Chul Hee Min
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, Republic of Korea
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Farhood B, Geraily G, Abtahi SMM. A systematic review of clinical applications of polymer gel dosimeters in radiotherapy. Appl Radiat Isot 2019; 143:47-59. [PMID: 30390500 DOI: 10.1016/j.apradiso.2018.08.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 12/15/2022]
Abstract
Radiotherapy has rapidly improved because of the use of new equipment and techniques. Hence, the appeal for a feasible and accurate three-dimensional (3D) dosimetry system has increased. In this regard, gel dosimetry systems are accurate 3D dosimeters with high resolution. This systematic review evaluates the clinical applications of polymer gel dosimeters in radiotherapy. To find the clinical applications of polymer gel dosimeters in radiotherapy, a full systematic literature search was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in electronic databases up to January 31, 2017, with use of search-related terms in the titles and abstracts of articles. A total of 765 articles were screened in accordance with our inclusion and exclusion criteria. Eventually, 53 articles were included in the study. The findings show that most clinical applications of polymer gel dosimeters relate to external radiotherapy. Most of the gel dosimeters studied have acceptable dose accuracy as a 3D dosimeter with high resolution. It is difficult to judge which is the best polymer gel dosimeter to use in a clinical setting, because each gel dosimeter has advantages and limitations. For example, methacrylic acid-based gel dosimeters have high dose sensitivity and low toxicity, while their dose response is beam energy dependent; in contrast, N-isopropylacrylamide gel dosimeters have low dose resolution, but their sensitivity is lower and they are relatively toxic.
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Affiliation(s)
- Bagher Farhood
- Department of Medical Physics and Radiology, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, 8115187159 Kashan, Iran
| | - Ghazale Geraily
- Medical Physics and Medical Engineering Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Najafi M, Shirazi A, Geraily G, Esfahani M, Teimouri J. Evaluation of dose profiles using Gafchromic EBT3 films in Leksell Gamma Knife 4C around inhomogeneities in the treatment of pituitary adenoma in anthropomorphic heterogeneous head phantom. Radiat Phys Chem Oxf Engl 1993 2018. [DOI: 10.1016/j.radphyschem.2018.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Niebanck M, Juang T, Newton J, Adamovics J, Wang Z, Oldham M. Investigating the reproducibility of a complex multifocal radiosurgery treatment. JOURNAL OF PHYSICS. CONFERENCE SERIES 2013; 444:012072. [PMID: 27081397 PMCID: PMC4828920 DOI: 10.1088/1742-6596/444/1/012072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Stereotactic radiosurgery has become a widely used technique to treat solid tumors and secondary metastases of the brain. Multiple targets can be simultaneously treated with a single isocenter in order to reduce the set-up time to improve patient comfort and workflow. In this study, a 5-arc multifocal RapidArc treatment was delivered to multiple PRESAGE® dosimeters in order to explore the repeatability of the treatment. The three delivery measurements agreed well with each other, with less than 3% standard deviation of dose in the target. The deliveries also agreed well with the treatment plan, with gamma passing rates greater than 90% (5% dose-difference, and 2 mm distance-to-agreement criteria). The optical-CT PRESAGE® system provided a reproducible measurement for treatment verification, provided measurements were made immediately following treatment.
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Affiliation(s)
- M Niebanck
- Duke University Medical Center, Durham, NC, USA
| | - T Juang
- Duke University Medical Center, Durham, NC, USA
| | - J Newton
- Duke University Medical Center, Durham, NC, USA
| | | | - Z Wang
- Duke University Medical Center, Durham, NC, USA
| | - M Oldham
- Duke University Medical Center, Durham, NC, USA
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Kairn T, Taylor ML, Crowe SB, Dunn L, Franich RD, Kenny J, Knight RT, Trapp JV. Monte Carlo verification of gel dosimetry measurements for stereotactic radiotherapy. Phys Med Biol 2012; 57:3359-69. [DOI: 10.1088/0031-9155/57/11/3359] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Du N, Liao L, Xiao Y, Xiao X, Zhao Z, Lin Y, Nie C. Developing a wireless sensing method for the measurement of gamma radiation dose based on the polymerization of acrylamide. RADIAT MEAS 2012. [DOI: 10.1016/j.radmeas.2012.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Taylor ML, Kron T, Franich RD. A contemporary review of stereotactic radiotherapy: inherent dosimetric complexities and the potential for detriment. Acta Oncol 2011; 50:483-508. [PMID: 21288161 DOI: 10.3109/0284186x.2010.551665] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The advantages of highly localised, conformal treatments achievable with stereotactic radiotherapy (SRT) are increasingly being extended to extracranial sites as stereotactic body radiotherapy with advancements in imaging and beam collimation. One of the challenges in stereotactic treatment lies in the significant complexities associated with small field dosimetry and dose calculation. This review provides a comprehensive overview of the complexities associated with stereotactic radiotherapy and the potential for detriment. METHODS This study is based on a comprehensive review of literature accessible via PubMed and other sources, covering stereotactic radiotherapy, small-field dosimetry and dose calculation. FINDINGS Several key issues were identified in the literature. They pertain to dose prescription, dose measurement and dose calculation within and beyond the treatment field. Field-edge regions and penumbrae occupy a significant portion of the total field size. Spectral and dosimetric characteristics are difficult to determine and are compounded by effects of tissue inhomogeneity. Measurement of small-fields is made difficult by detector volume averaging and energy response. Available dosimeters are compared, and emphasis is given to gel dosimetry which offers the greatest potential for three-dimensional small-field dosimetry. The limitations of treatment planning system algorithms as applied to small-fields (particularly in the presence of heterogeneities) is explained, and a review of Monte Carlo dose calculation is provided, including simplified treatment planning implementations. Not incorporated into treatment planning, there is evidence that far from the primary field, doses to patients (and corresponding risks of radiocarcinogenesis) from leakage/scatter in SRT are similar to large fields. CONCLUSIONS Improved knowledge of dosimetric issues is essential to the accurate measurement and calculation of dose as well as the interpretation and assessment of planned and delivered treatments. This review highlights such issues and the potential benefit that may be gained from Monte Carlo dose calculation and verification via three-dimensional dosimetric methods (such as gel dosimetry) being introduced into routine clinical practice.
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Affiliation(s)
- Michael L Taylor
- School of Applied Sciences, RMIT University, Melbourne, Victoria, Australia.
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Watanabe Y, Kubo H. A variable echo-number method for estimating R2 in MRI-based polymer gel dosimetry. Med Phys 2011; 38:975-82. [PMID: 21452734 DOI: 10.1118/1.3544659] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Spin-spin relaxation rate R2 is commonly used to quantify absorbed dose for magnetic resonance imaging (MRI)-based polymer gel dosimetry. R2 is estimated by applying a parameter fitting algorithm to a train of spin-echo signals. However, a careless application of a large number of echoes can result in anomalous R2 values because the echo signal intensity decreases to the background signal offset level for a long echo time. In this article, the authors proposed and evaluated a variable echo-number (VAREC) method to remedy the problem. METHODS The VAREC algorithm uses only echo signals, whose intensities are greater than a preset threshold. Here, the threshold is defined as the standard deviation of Gaussian noise times a multiplier alpha. The authors implemented three R2 estimation methods in an in-house program: The nonlinear least-squares algorithm (NLLS), the VAREC method, and the maximum likelihood estimator with the Rician signal intensity distribution (MLE_R). Those methods were used to estimate the R2 values of test phantoms with known R2 values and BANG3-type polymer gels, which were irradiated to 12 different doses ranging from 0 to 50 Gy. The R2 values were measured by using a 32-echo CPMG pulse sequence on 3 T MRI scanners. The R2 values of the VAREC method were compared with those of NLLS and MLE_R. RESULTS The R2 values of the NLLS method incorrectly decreased to the zero-dose level for doses greater than 10 Gy. The R2 values of the VAREC method with alpha=2 agreed with those of MLE_R within the measurement uncertainty. The uncertainties of the R2 values were the smallest for alpha=2 or 3 among various alpha values. CONCLUSIONS The VAREC algorithm is simple, fast, and robust for the R2 estimation. The authors recommend this method with alpha=2 or 3 for R2 estimation using multispin echo MRI protocols.
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Affiliation(s)
- Yoichi Watanabe
- Department of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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