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Siavashpour Z, Kiarad R, Aghamiri MR, Babaloui S, Seiri M, Jaberi R. Feasibility of using micro silica bead TLDs for in-Vivo dosimetry of CT-based HDR prostate brachytherapy: An experimental and simulation study. Appl Radiat Isot 2024; 212:111429. [PMID: 38986180 DOI: 10.1016/j.apradiso.2024.111429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/20/2024] [Accepted: 07/06/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE Feasibility of silica-based dosimeters for IVD of HDR prostate brachytherapy. MATERIAL AND METHODS Plastic dosimeter holders and a water-fillable prostate phantom were built in-house. Interstitial prostate brachytherapy and Monte Carlo simulations were performed. The treatment planning, Monte-Carlo simulation, and dosimetry results were compared. RESULTS The relative differences between TLD-TPS, TLD-MCNP, and TPS-MCNP were 0.2-6.9 %, 0.5-6.5 %, and 0.6-6.3 %, respectively. CONCLUSION Micro-silica bead dosimeters can perform offline in situ quality assurance in HDR prostate brachytherapy.
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Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Kiarad
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran.
| | - Mahmoud Reza Aghamiri
- Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran
| | - Somayyeh Babaloui
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mahnaz Seiri
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran; Advanced Medical Technologies & Equipment Institute, Tehran University of Medical Science, Tehran, Iran
| | - Ramin Jaberi
- Radiation Oncology Research Center, Iran Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Physics, University of Surrey, Guildford, UK
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Garcia-Gil R, Casans S, Edith Navarro A, García-Sánchez AJ, Rovira-Escutia JJ, Garcia-Costa D, Sanchis-Sánchez E, Pérez-Calatayud I, Pérez-Calatayud J, Sanchis E. Embedded bleeding detector into a PMMA applicator for electron intraoperative radiotherapy. Phys Med 2022; 94:35-42. [PMID: 34995976 DOI: 10.1016/j.ejmp.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/29/2021] [Accepted: 12/29/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of this work is to present a ready to industrialize low-cost and easy-to-install bleeding detector for use in intraoperative electron radiation therapy (IOERT). The detector works in stand-alone mode and is embedded into a translucent polymethylmethacrylate (PMMA) applicator avoiding any contact with the patient, which represent a novelty compared to previous designs. The use of this detector will prevent dose misadministration during irradiation in the event of accumulation of fluids in the applicator. METHODS The detector is based on capacitive sensor and wireless power-supply electronics. Both sensor and electronics have been embedded in the applicator, so that any contact with the patient would be avoided. Since access to the tumor can be done through different trajectories, the detector has been calibrated for different tilting angles. RESULTS The result of the calibration provides us with a fit curve that allows the interpolation of the results at any angle. Comparison of estimated fluid height vs real height gives an error of 1 mm for tilting angles less than 10° and 2 mm for tilting angles greater than 15°. This accuracy is better than the one required by clinic. CONCLUSIONS The performance of the bleeding detector was evaluated in situ. No interference was observed between the detector and the beam. In addition, a user-friendly mobile application has been developed to help the surgical team making decisions before and during irradiation. The measurement provided by the mobile application was stable during the irradiation process.
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Affiliation(s)
| | - Silvia Casans
- Department of Electronic Engineering, University of Valencia, Spain
| | - A Edith Navarro
- Department of Electronic Engineering, University of Valencia, Spain
| | | | - Juan J Rovira-Escutia
- Centro Nacional de Dosimetría, Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | | | | | | | - José Pérez-Calatayud
- Department of Radiation Oncology, La Fe Hospital, Valencia, Spain; Department of Radiation Oncology, Clínica Benidorm, Alicante, Spain; IRIMED Joint Research Unit IIS La Fe - University of Valencia, Spain
| | - Enrique Sanchis
- Department of Electronic Engineering, University of Valencia, Spain; IRIMED Joint Research Unit IIS La Fe - University of Valencia, Spain.
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Sanchis E, Casans S, García-Gil R, Martos J, Sanchis-Sánchez E, Pérez-Calatayud I, José Pérez-Calatayud M, Pérez-Calatayud J. Improving bleeding detector features for electron intraoperative radiotherapy. Phys Med 2019; 65:150-156. [PMID: 31473502 DOI: 10.1016/j.ejmp.2019.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2019] [Accepted: 08/23/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The aim of this work is to improve the potential bleeding detection during intraoperative radiotherapy with linac polymethyl methacrylate applicators (PMMA), based on one previously developed. The improvements carried out have been focused on: i) minimizing the impact of the detector on the visual through the plastic applicators and ii) avoiding the asymmetry in the detection capability when the applicator is tilted. METHODS Simulations have been made to select the geometry that provides a reduced visual impact on the applicator as well as allowing an independent response with the tilting angle of the applicator. A low-noise circuit for signal conditioning has been developed. Measurements have been made on three setups: 10 cm, 7 cm and 4 cm applicator diameters, 0° and 45° tilted. RESULTS The detector has a visibility through the applicator greater than 50%. Due to the geometry, optimal detection is ensured regardless of its orientation when the applicator is tilted. It is possible to detect the presence of fluid well below the typical perturbing fluid depth established by the clinic (1-1.5 cm). CONCLUSIONS The detector can distinguish the presence of around 0.5 cm of fluid depth while showing a high visual field through the PMMA applicators and providing a measure that does not depend on the detector orientation when the applicator is tilted. The prototype is ready for its industrialization by embedding it into the applicator for clinical use. The detector would have a significant impact on both the quality assurance and the outcome of the treatment.
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Affiliation(s)
- Enrique Sanchis
- Department of Electronic Engineering, University of Valencia, E-46100, Spain; IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain.
| | - Silvia Casans
- Department of Electronic Engineering, University of Valencia, E-46100, Spain
| | - Rafael García-Gil
- Department of Electronic Engineering, University of Valencia, E-46100, Spain
| | - Julio Martos
- Department of Electronic Engineering, University of Valencia, E-46100, Spain
| | - Enrique Sanchis-Sánchez
- Department of Physical Therapy, University of Valencia, E-46010, Spain; IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain
| | | | | | - José Pérez-Calatayud
- Department of Radiation Oncology, La Fe Polytechnic and University Hospital, Valencia E-46026, Spain; IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain
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Abstract
Literature was reviewed to assess the physical aspects governing the present and emerging technologies used in intraoperative radiation therapy (IORT). Three major technologies were identified: treatment with electrons, treatment with external generators of kV X-rays and electronic brachytherapy. Although also used in IORT, literature on brachytherapy with radioactive sources is not systematically reviewed since an extensive own body of specialized literature and reviews exists in this field. A comparison with radioactive sources is made in the use of balloon catheters for partial breast irradiation where these are applied in almost an identical applicator technique as used with kV X-ray sources. The physical constraints of adaption of the dose distribution to the extended target in breast IORT are compared. Concerning further physical issues, the literature on radiation protection, commissioning, calibration, quality assurance (QA) and in-vivo dosimetry of the three technologies was reviewed. Several issues were found in the calibration and the use of dosimetry detectors and phantoms for low energy X-rays which require further investigation. The uncertainties in the different steps of dose determination were estimated, leading to an estimated total uncertainty of around 10-15% for IORT procedures. The dose inhomogeneity caused by the prescription of electrons at 90% and by the steep dose gradient of kV X-rays causes additional deviations from prescription dose which must be considered in the assessment of dose response in IORT.
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Affiliation(s)
- Frank W Hensley
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
- , Present address: Birkenweg 35, 69221, Dossenheim, Germany.
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López-Tarjuelo J, Bouché-Babiloni A, Morillo-Macías V, Santos-Serra A, Ferrer-Albiach C. Practical issues regarding angular and energy response in in vivo intraoperative electron radiotherapy dosimetry. Rep Pract Oncol Radiother 2016; 22:55-67. [PMID: 27790075 DOI: 10.1016/j.rpor.2016.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 11/16/2015] [Accepted: 09/15/2016] [Indexed: 10/20/2022] Open
Abstract
AIM To estimate angular response deviation of MOSFETs in the realm of intraoperative electron radiotherapy (IOERT), review their energy dependence, and propose unambiguous names for detector rotations. BACKGROUND MOSFETs have been used in IOERT. Movement of the detector, namely rotations, can spoil results. MATERIALS AND METHODS We propose yaw, pitch, and roll to name the three possible rotations in space, as these unequivocally name aircraft rotations. Reinforced mobile MOSFETs (model TN-502RDM-H) and an Elekta Precise linear accelerator were used. Two detectors were placed in air for the angular response study and the whole set of five detectors was calibrated as usual to evaluate energy dependence. RESULTS The maximum readout was obtained with a roll of 90° and 4 MeV. With regard to pitch movement, a substantial drop in readout was achieved at 90°. Significant overresponse was measured at 315° with 4 MeV and at 45° with 15 MeV. Energy response is not different for the following groups of energies: 4, 6, and 9 MeV; and 12 MeV, 15 MeV, and 18 MeV. CONCLUSIONS Our proposal to name MOSFET rotations solves the problem of defining sensor orientations. Angular response could explain lower than expected results when the tip of the detector is lifted due to inadvertent movements. MOSFETs energy response is independent of several energies and differs by a maximum of 3.4% when dependent. This can limit dosimetry errors and makes it possible to calibrate the detectors only once for each group of energies, which saves time and optimizes lifespan of MOSFETs.
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Affiliation(s)
- Juan López-Tarjuelo
- Servicio de Radiofísica y Protección Radiológica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, 19, Castellón de la Plana 12002, Spain
| | - Ana Bouché-Babiloni
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, 19, Castellón de la Plana 12002, Spain
| | - Virginia Morillo-Macías
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, 19, Castellón de la Plana 12002, Spain
| | - Agustín Santos-Serra
- Servicio de Radiofísica y Protección Radiológica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, 19, Castellón de la Plana 12002, Spain
| | - Carlos Ferrer-Albiach
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, 19, Castellón de la Plana 12002, Spain
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López-Tarjuelo J, Morillo-Macías V, Bouché-Babiloni A, Boldó-Roda E, Lozoya-Albacar R, Ferrer-Albiach C. Implementation of an intraoperative electron radiotherapy in vivo dosimetry program. Radiat Oncol 2016; 11:41. [PMID: 26980076 PMCID: PMC4793509 DOI: 10.1186/s13014-016-0621-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 03/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraoperative electron radiotherapy (IOERT) is a highly selective radiotherapy technique which aims to treat restricted anatomic volumes during oncological surgery and is now the subject of intense re-evaluation. In vivo dosimetry has been recommended for IOERT and has been identified as a risk-reduction intervention in the context of an IOERT risk analysis. Despite reports of fruitful experiences, information about in vivo dosimetry in intraoperative radiotherapy is somewhat scarce. Therefore, the aim of this paper is to report our experience in developing a program of in vivo dosimetry for IOERT, from both multidisciplinary and practical approaches, in a consistent patient series. We also report several current weaknesses. METHODS Reinforced TN-502RDM-H mobile metal oxide semiconductor field effect transistors (MOSFETs) and Gafchromic MD-55-2 films were used as a redundant in vivo treatment verification system with an Elekta Precise fixed linear accelerator for calibrations and treatments. In vivo dosimetry was performed in 45 patients in cases involving primary tumors or relapses. The most frequent primary tumors were breast (37 %) and colorectal (29 %), and local recurrences among relapses was 83 %. We made 50 attempts to measure with MOSFETs and 48 attempts to measure with films in the treatment zones. The surgical team placed both detectors with supervision from the radiation oncologist and following their instructions. RESULTS The program was considered an overall success by the different professionals involved. The absorbed doses measured with MOSFETs and films were 93.8 ± 6.7 % and 97.9 ± 9.0 % (mean ± SD) respectively using a scale in which 90 % is the prescribed dose and 100 % is the maximum absorbed dose delivered by the beam. However, in 10 % of cases we experienced dosimetric problems due to detector misalignment, a situation which might be avoided with additional checks. The useful MOSFET lifetime length and the film sterilization procedure should also be controlled. CONCLUSIONS It is feasible to establish an in vivo dosimetry program for a wide set of locations treated with IOERT using a multidisciplinary approach according to the skills of the professionals present and the detectors used; oncological surgeons' commitment is key to success in this context. Films are more unstable and show higher uncertainty than MOSFETs but are cheaper and are useful and convenient if real-time treatment monitoring is not necessary.
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Affiliation(s)
- Juan López-Tarjuelo
- Servicio de Radiofísica y Protección Radiológica, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará, nº 19, Castellón de la Plana, 12004, Castellón, Spain.
| | - Virginia Morillo-Macías
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
- Unitat predepartamental de Medicina, Facultat de Ciències de la Salut, Universitat Jaume I, Avda. Vicent Sos Baynat, s/n, Castellón de la Plana, 12071, Castellón, Spain
| | - Ana Bouché-Babiloni
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - Enrique Boldó-Roda
- Unidad de Cirugía Oncológica, Servicio de Cirugía, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - Rafael Lozoya-Albacar
- Unidad de Cirugía Oncológica, Servicio de Cirugía, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - Carlos Ferrer-Albiach
- Servicio de Oncología Radioterápica, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
- Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, C/ Grecia 31, Castellón de la Plana, 12006, Castellón, Spain
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