Plastic scintillation dosimeter with a conical mirror for measuring 3D dose distribution

PURPOSE

To test the measurement technique of the three-dimensional (3D) dose distribution measured image by capturing the scintillation light generated using a plastic scintillator and a scintillating screen.

METHODS

Our imaging system constituted a column shaped plastic scintillator covered by a Gd₂ O₂ S:Tb scintillating screen, a conical mirror and a cooled CCD camera. The scintillator was irradiated with 6 MV photon beams. Meanwhile, the irradiated plan was prepared for the static field plans, two-field plan (2F plan) and the conformal arc plan (CA plan). The 2F plan contained 16 mm² and 10 mm² fields irradiated from gantry angles of 0° and 25°, respectively. The gantry was rotated counterclockwise from 45° to 315° for the CA plan. The field size was then obtained as 10 mm² . A Monte Carlo simulation was performed in the experimental geometry to obtain the calculated 3D dose distribution as the reference data. Dose response was acquired by comparing between the reference and the measurement. The dose rate dependence was verified by irradiating the same MU value at different dose rates ranging from 100 to 600 MU/min. Deconvolution processing was applied to the measured images for the correction of light blurring. The measured 3D dose distribution was reconstructed from each measured image. Gamma analysis was performed to these 3D dose distributions. The gamma criteria were 3% for the dose difference, 2 mm for the distance-to-agreement and 10% for the threshold.

RESULTS

Dose response for the scintillation light was linear. The variation in the light intensity for the dose rate ranging from 100 to 600 MU/min was less than 0.5%, while our system presents dose rate independence. For the 3D dose measurement, blurring of light through deconvolution processing worked well. The 3D gamma passing rate (3D GPR) for the 10 × 10 mm² , 16 × 16 mm² , and 20 × 20 mm² fields were observed to be 99.3%, 98.8%, and 97.8%, respectively. Reproducibility of measurement was verified. The 3D GPR results for the 2F plan and the CA plan were 99.7% and 100%, respectively.

CONCLUSIONS

We developed a plastic scintillation dosimeter and demonstrated that our system concept can act as a suitable technique for measuring the 3D dose distribution from the gamma results. In the future, we will attempt to measure the 4D dose distribution for clinical volumetric modulated arc radiation therapy (VMAT)-SBRTplans.

Report of AAPM Task Group 155: Megavoltage photon beam dosimetry in small fields and non-equilibrium conditions

Small-field dosimetry used in advance treatment technologies poses challenges due to loss of lateral charged particle equilibrium (LCPE), occlusion of the primary photon source, and the limited choice of suitable radiation detectors. These challenges greatly influence dosimetric accuracy. Many high-profile radiation incidents have demonstrated a poor understanding of appropriate methodology for small-field dosimetry. These incidents are a cause for concern because the use of small fields in various specialized radiation treatment techniques continues to grow rapidly. Reference and relative dosimetry in small and composite fields are the subject of the International Atomic Energy Agency (IAEA) dosimetry code of practice that has been published as TRS-483 and an AAPM summary publication (IAEA TRS 483; Dosimetry of small static fields used in external beam radiotherapy: An IAEA/AAPM International Code of Practice for reference and relative dose determination, Technical Report Series No. 483; Palmans et al., Med Phys 45(11):e1123, 2018). The charge of AAPM task group 155 (TG-155) is to summarize current knowledge on small-field dosimetry and to provide recommendations of best practices for relative dose determination in small megavoltage photon beams. An overview of the issue of LCPE and the changes in photon beam perturbations with decreasing field size is provided. Recommendations are included on appropriate detector systems and measurement methodologies. Existing published data on dosimetric parameters in small photon fields (e.g., percentage depth dose, tissue phantom ratio/tissue maximum ratio, off-axis ratios, and field output factors) together with the necessary perturbation corrections for various detectors are reviewed. A discussion on errors and an uncertainty analysis in measurements is provided. The design of beam models in treatment planning systems to simulate small fields necessitates special attention on the influence of the primary beam source and collimating devices in the computation of energy fluence and dose. The general requirements for fluence and dose calculation engines suitable for modeling dose in small fields are reviewed. Implementations in commercial treatment planning systems vary widely, and the aims of this report are to provide insight for the medical physicist and guidance to developers of beams models for radiotherapy treatment planning systems.

A Modular System for Treating Moving Anatomical Targets With Scanned Ion Beams at Multiple Facilities: Pre-Clinical Testing for Quality and Safety of Beam Delivery

Background

Quality management and safety are integral to modern radiotherapy. New radiotherapy technologies require new consensus guidelines on quality and safety. Established analysis strategies, such as the failure modes and effects analysis (FMEA) and incident learning systems have been developed as tools to assess the safety of several types of radiation therapies. An extensive literature documents the widespread application of risk analysis methods to photon radiation therapy. Relatively little attention has been paid to performing risk analyses of nascent radiation therapy systems to treat moving tumors with scanned heavy ion beams. The purpose of this study was to apply a comprehensive safety analysis strategy to a motion-synchronized dose delivery system (M-DDS) for ion therapy.

Methods

We applied a risk analysis method to new treatment planning and treatment delivery processes with scanned heavy ion beams. The processes utilize a prototype, modular dose delivery system, currently undergoing preclinical testing, that provides new capabilities for treating moving anatomy. Each step in the treatment process was listed in a process map, potential errors for each step were identified and scored using the risk probability number in an FMEA, and the possible causes of each error were described in a fault tree analysis. Solutions were identified to mitigate the risk of these errors, including permanent corrective actions, periodic quality assurance (QA) tests, and patient specific QA (PSQA) tests. Each solution was tested experimentally.

Results

The analysis revealed 58 potential errors that could compromise beam delivery quality or safety. Each of the 14 binary (pass-or-fail) tests passed. Each of the nine QA and four PSQA tests were within anticipated clinical specifications. The modular M-DDS was modified accordingly, and was found to function at two centers.

Conclusion

We have applied a comprehensive risk analysis strategy to the M-DDS and shown that it is a clinically viable motion mitigation strategy. The described strategy can be utilized at any ion therapy center that operates with the modular M-DDS. The approach can also be adapted for use at other facilities and can be combined with existing safety analysis systems.

Temperature dependence and temporal stability of stacked radiochromic sheets for three-dimensional dose verification

PURPOSE

Recently a novel radiochromic sheet dosimeter, termed as PRESAGE sheets, consisting of leuco crystal violet dye and radical initiator had been developed and characterized. This study examines the dosimeter's temporal stability and storage temperature dependence postirradiation, and its applicability for dose verification in three dimensions (3D) as a stack dosimeter.

METHODS

PRESAGE sheets were irradiated using 6 MV photons at a dose range of 0-20 Gy with the change in optical density measured using a flatbed scanner. Following their irradiation, PRESAGE sheets were stored in different temperature environments (-18 °C, 4 °C, and 22 °C) and scanned at different time points, ranging from 1 to 168 h postirradiation, to track changes in measured signal and linearity of dose response. Multiple PRESAGE sheets were bound together to create a 12 × 13 × 8.7 cm³ film stack, with EBT3 film inserted between the sheets in the central region of the stack, that was treated using a clinical VMAT plan. Based on the results from the time and storage temperature study, two-dimensional (2D) relative dose distribution measurements in PRESAGE were acquired promptly following irradiation at selected planes in the coronal, sagittal, and axial orientation of the film stack and compared to the treatment planning system calculations in their respective axes. Dose distribution measurements on the coronal axis of the stack dosimeter were also independently verified using EBT3 film.

RESULTS

The dose response was observed to be linear (R² > 0.995) with sheets stored in colder temperatures retaining their signal and dose response sensitivity for extended periods postirradiation. Sheets stored in 22 °C environment should be measured within an hour postirradiation. Sheets stored in a 4 °C and -18 °C environment can be scanned up to 20- and 72 h postirradiation, respectively, while preserving the integrity of their dose response sensitivity and linearity of dose response within a mean absolute percent error of 2.0%. For instance, at 20 h postirradiation the dose response sensitivity for sheets stored in a -18 °C, 4 °C, and 22 °C temperature environment was measured to be 97%, 91%, and 77% of their original values measured within an hour postirradiation, respectively. The 2D gamma pass rate for central slices exceed 95% for PRESAGE film stack compared with treatment planning system on selected planes in the axial, coronal, and sagittal orientation and EBT3 film in the coronal orientation using a 2D gamma index of 2%/2mm. The gamma pass rate in comparing the calculated dose distribution with the measured dose distribution from PRESAGE-LCV was observed to decrease in sheets scanned at later elapsed times postirradiation. In one example, the gamma pass rate for 2%/2mm criteria in the coronal plane was observed to decrease from 97.7% pass rate when scanned within an hour postirradiation to 92.1% pass rate when scanned at 20 h postirradiation under room temperature conditions.

CONCLUSIONS

This is the first study to demonstrate that the temporal stability of PRESAGE sheets can be enhanced through its storage in colder temperature environments postirradiation and that sheets as a film stack dosimeter hold promise for precise relative dose distribution measurements in 3D where advanced optical CT is unavailable.

PSEUDO-3D IMRT VERIFICATION WITH EBT3 RADIOCHROMIC FILM

This work proposes a new method for pseudo-3D verification of intensity-modulated radiation therapy (IMRT) dose distributions. Unlike commercial solutions, it uses measured doses only for gamma evaluation. Its resolution is far better than with electronic detectors within the measured plane and comparable in other directions. It is readily available at clinics because it uses existing resources-a slab phantom and EBT3 films. The method was tested on six IMRT clinical cases. An in-house code for 2D and pseudo-3D gamma analysis was written in MATLAB and compared to OmniPro I'mRT.