Optimization of a multipoint plastic scintillator dosimeter for high dose rate brachytherapy

Time-resolved clinical dose volume metrics, calculations and predictions based on source tracking measurements and uncertainties to aid treatment verification and error detection for HDR brachytherapy-a proof-of-principle study

Objective.High-dose-rate (HDR) brachytherapy lacks routinely available treatment verification methods. Real-time tracking of the radiation source during HDR brachytherapy can enhance treatment verification capabilities. Recent developments in source tracking allow for measurement of dwell times and source positions with high accuracy. However, more clinically relevant information, such as dose discrepancies, is still needed. To address this, a real-time dose calculation implementation was developed to provide more relevant information from source tracking data. A proof-of-principle of the developed tool was shown using source tracking data obtained from a 3D-printed anthropomorphic phantom.Approach.Software was developed to calculate dose-volume-histograms (DVH) and clinical dose metrics from experimental HDR prostate treatment source tracking data, measured in a realistic pelvic phantom. Uncertainty estimation was performed using repeat measurements to assess the inherent dose measuring uncertainty of thein vivodosimetry (IVD) system. Using a novel approach, the measurement uncertainty can be incorporated in the dose calculation, and used for evaluation of cumulative dose and clinical dose-volume metrics after every dwell position, enabling real-time treatment verification.Main results.The dose calculated from source tracking measurements aligned with the generated uncertainty bands, validating the approach. Simulated shifts of 3 mm in 5/17 needles in a single plan caused DVH deviations beyond the uncertainty bands, indicating errors occurred during treatment. Clinical dose-volume metrics could be monitored in a time-resolved approach, enabling early detection of treatment plan deviations and prediction of their impact on the final dose that will be delivered in real-time.Significance.Integrating dose calculation with source tracking enhances the clinical relevance of IVD methods. Phantom measurements show that the developed tool aids in tracking treatment progress, detecting errors in real-time and post-treatment evaluation. In addition, it could be used to define patient-specific action limits and error thresholds, while taking the uncertainty of the measurement system into consideration.

Widefield Diamond Quantum Sensing with Neuromorphic Vision Sensors

Despite increasing interest in developing ultrasensitive widefield diamond magnetometry for various applications, achieving high temporal resolution and sensitivity simultaneously remains a key challenge. This is largely due to the transfer and processing of massive amounts of data from the frame-based sensor to capture the widefield fluorescence intensity of spin defects in diamonds. In this study, a neuromorphic vision sensor to encode the changes of fluorescence intensity into spikes in the optically detected magnetic resonance (ODMR) measurements is adopted, closely resembling the operation of the human vision system, which leads to highly compressed data volume and reduced latency. It also results in a vast dynamic range, high temporal resolution, and exceptional signal-to-background ratio. After a thorough theoretical evaluation, the experiment with an off-the-shelf event camera demonstrated a 13× improvement in temporal resolution with comparable precision of detecting ODMR resonance frequencies compared with the state-of-the-art highly specialized frame-based approach. It is successfully deploy this technology in monitoring dynamically modulated laser heating of gold nanoparticles coated on a diamond surface, a recognizably difficult task using existing approaches. The current development provides new insights for high-precision and low-latency widefield quantum sensing, with possibilities for integration with emerging memory devices to realize more intelligent quantum sensors.

A scintillation dosimeter with real-time positional tracking information for in vivo dosimetry error detection in HDR brachytherapy

PURPOSE

To evaluate the performance of an electromagnetic (EM)-tracked scintillation dosimeter in detecting source positional errors of IVD in HDR brachytherapy treatment.

MATERIALS AND METHODS

Two different scintillator dosimeter prototypes were coupled to 5 degrees-of-freedom (DOF) EM sensors read by an Aurora V3 system. The scintillators used were a 0.3 × 0.4 × 0.4 mm3 ZnSe:O and a BCF-60 plastic scintillator of 0.5 mm diameter and 2.0 mm in length (Saint-Gobain Crystals). The sensors were placed at the dosimeter's tip at 20.0 mm from the scintillator. The EM sampling rate was 40/s while the scintillator signal was sampled at 100 000/s using two photomultiplier tubes from Hamamatsu (series H10722) connected to a data acquisition board. A high-pass filter and a low-pass filter were used to separate the light signal into two different channels. All measurements were performed with an afterloader unit (Flexitron-Elekta AB, Sweden) in full-scattered (TG43) conditions. EM tracking was further used to provide distance/angle-dependent energy correction for the ZnSe:O inorganic scintillator. For the error detection part, lateral shifts of 0.5 to 3 mm were induced by moving the source away from its planned position. Indexer length (longitudinal) errors between 0.5 to 10 mm were also introduced. The measured dose rate difference was converted to a shift distance, with and without using the positional information from the EM sensor.

RESULTS

The inorganic scintillator had both a signal-to-noise-ratio (SNR) and signal-to-background-ratio (SBR) close to 70 times higher than those of the plastic scintillator. The mean absolute difference from the dose measurement to the dose calculated with TG-43U1 was 1.5% ±0.7%. The mean absolute error for BCF-60 detector was 1.7%± 1.2 % $\pm 1.2\%$ when compared to TG-43 calculations formalism. With the inorganic scintillator and EM tracking, a maximum area under the curve (AUC) gain of 24.0% was obtained for a 0.5-mm lateral shift when using the EMT data with the ZnSe:O. Lower AUC gains were obtained for a 3-mm lateral shifts with both scintillators. For the plastic scintillator, the highest gain from using EM tracking information occurred for a 0.5-mm lateral shift at 20 mm from the source. The maximal gain (17.4%) for longitudinal errors was found at the smallest shifts (0.5 mm).

CONCLUSIONS

This work demonstrates that integrating EM tracking to in vivo scintillation dosimeters enables the detection of smaller shifts, by decreasing the dosimeter positioning uncertainty. It also serves to perform position-dependent energy correction for the inorganic scintillator,providing better SNR and SBR, allowing detection of errors at greater distances from the source.

Six-probe scintillator dosimeter for treatment verification in HDR-brachytherapy

BACKGROUND

In vivo dosimetry (IVD) is gaining interest for treatment delivery verification in HDR-brachytherapy. Time resolved methods, including source tracking, have the ability both to detect treatment errors in real time and to minimize experimental uncertainties. Multiprobe IVD architectures holds promise for simultaneous dose determinations at the targeted tumor and surrounding healthy tissues while enhancing measurement accuracy. However, most of the multiprobe dosimeters developed so far either suffer from compactness issues or rely on complex data post-treatment.

PURPOSE

We introduce a novel concept of a compact multiprobe scintillator detector and demonstrate its applicability in HDR-brachytherapy. Our fabricated seven-fiber probing system is sufficiently narrow to be inserted in a brachytherapy needle or in a catheter.

METHODS

Our multiprobe detection system results from the parallel implementation of six miniaturized inorganic Gd2 O2 S:Tb scintillator detectors at the end of a bundle of seven fibers, one fiber is kept bare to assess the stem effect. The resulting system, which is narrower than 320 microns, is tested with a MicroSelectron 9.14 Ci Ir-192 HDR afterloader, in a water phantom. The detection signals from all six probes are simultaneously read with a sCMOS camera (at a rate of 0.06 s). The camera is coupled to a chromatic filter to cancel Cerenkov signal induced within the fibers upon exposure. By implementing an aperiodic array of six scintillating cells along the bundle axis, we first determine the range of inter-probe spacings leading to optimal source tracking accuracy (first tracking method). Then, three different source tracking algorithms involving all the scintillating probes are tested and compared. In each of these four methods, dwell positions are assessed from dose measurements and compared to the treatment plan. Dwell time is also determined and compared to the treatment plan.

RESULTS

The optimum inter-probe spacing for an accurate source tracking ranges from 15 to 35 mm. The optimum detection algorithm consists of adding the readout signals from all detector probes. In that case, the error to the planned dwell positions is of 0.01 ± 0.14 mm and 0.02 ± 0.29 mm at spacings between the source and detector axes of 5.5 and 40 mm, respectively. Using this approach, the average deviations to the expected dwell time are of- 0.006 ± 0.009 $-0.006\,\pm \,0.009$ s and- 0.008 ± 0.058 $-0.008\, \pm 0.058$ s, at spacings between source and probe axes of 5.5 and 20 mm, respectively.

CONCLUSIONS

Our six-probe Gd2 O2 S:Tb dosimeter coupled to a sCMOS camera can perform time-resolved treatment verification in HDR brachytherapy. This detection system of high spatial and temporal resolutions (0.25 mm and 0.06 s, respectively) provides a precise information on the treatment delivery via a dwell time and position verification of unmatched accuracy.

Treatment verification in high dose rate brachytherapy using a realistic 3D printed head phantom and an imaging panel

PURPOSE

Even though High Dose Rate (HDR) brachytherapy has good treatment outcomes in different treatment sites, treatment verification is far from widely implemented because of a lack of easily available solutions. Previously it has been shown that an imaging panel (IP) near the patient can be used to determine treatment parameters such as the dwell time and source positions in a single material pelvic phantom. In this study we will use a heterogeneous head phantom to test this IP approach, and simulate common treatment errors to assess the sensitivity and specificity of the error-detecting capabilities of the IP.

METHODS AND MATERIALS

A heterogeneous head-phantom consisting of soft tissue and bone equivalent materials was 3D-printed to simulate a base of tongue treatment. An High Dose Rate treatment plan with 3 different catheters was used to simulate a treatment delivery, using dwell times ranging from 0.3 s to 4 s and inter-dwell distances of 2 mm. The IP was used to measure dwell times, positions and detect simulated errors. Measured dwell times and positions were used to calculate the delivered dose.

RESULTS

Dwell times could be determined within 0.1 s. Source positions were measured with submillimeter accuracy in the plane of the IP, and average distance accuracy of 1.7 mm in three dimensions. All simulated treatment errors (catheter swap, catheter shift, afterloader errors) were detected. Dose calculations show slightly different distributions with the measured dwell positions and dwell times (gamma pass rate for 1 mm/1% of 96.5%).

CONCLUSIONS

Using an IP, it was possible to verify the treatment in a realistic heterogeneous phantom and detect certain treatment errors.

Characterization of a miniaturized scintillator detector for time-resolved treatment monitoring in HDR-brachytherapy

Purpose.HDR brachytherapy combines steep dose gradients in space and time, thereby requiring detectors of high spatial and temporal resolution to perform accurate treatment monitoring. We demonstrate a miniaturized fiber-integrated scintillator detector (MSD) of unmatched compactness which fulfills these conditions.Methods.The MSD consists of a 0.28 mm large and 0.43 mm long detection cell (Gd₂O₂S:Tb) coupled to a 110 micron outer diameter silica optical fiber. The fiber probe is tested in a phantom using a MicroSelectron 9.1 Ci Ir-192 HDR afterloader. The detection signal is acquired at a rate of 0.08 s with a standard sCMOS camera coupled to a chromatic filter (to cancel spurious Cerenkov signal). The dwell position and time monitoring are analyzed over prostate treatment sequences with dwell times spanning from 0.1 to 11 s. The dose rate at the probe position is both evaluated from a direct measurement and by reconstruction from the measured dwell position using the AAPM TG-43 formalism.Results.A total number of 1384 dwell positions are analyzed. In average, the measured dwell positions differ by 0.023 ± 0.077 mm from planned values over a 6-54 mm source-probe distance range. The standard deviation of the measured dwell positions is below 0.8 mm. 94% of the 966 dwell positions occurring at a source-probe inter-catheter spacing below 20 mm are successfully identified, with a 100% detection rate for dwell times exceeding 0.5 s. The average deviation to the planned dwell times is of 0.005 ± 0.060 s. The instant dose retrieval from dwell position monitoring leads to a relative mismatch to planned values of 0.14% ± 0.7%.Conclusion.A miniaturized Gd2O₂S:Tb detector coupled to a standard sCMOS camera can be used for time-resolved treatment monitoring in HDR Brachytherapy.

On the use of polychromatic cameras for high spatial resolution spectral dose measurements

Objective. Despite the demonstrated benefits of hyperspectral formalism for stem effect corrections in the context of fiber dose measurements, this approach has not been yet translated into volumetric measurements where cameras are typically used for their distinguishing spatial resolution. This work investigates demosaicing algorithms for polychromatic cameras based spectral imaging. Approach. The scintillation and Cherenkov signals produced in a radioluminescent phantom are imaged by a polychromatic camera and isolated using the spectral formalism. To do so, five demosaicing algorithms are investigated from calibration to measurements: a clustering method and four interpolation algorithms. The resulting accuracy of scintillation and Cherenkov images is evaluated with measurements of the differences (mean ± standard deviation) between the obtained and expected signals from profiles drawn across a scintillation spot. Signal-to-noise ratio and signal-to-background ratio are further measured and compared in the resulting scintillation images. Finally, the resulting differences on the scintillation signal from a 0.2 × 0.2 cm2 region-of-interest (ROI) were reported. Main results. Clustering, OpenCV, bilinear, Malvar and Menon demosaicing algorithms respectively yielded differences of 3 ± 5%, 1 ± 3%, 1 ± 3%, 1 ± 2% and 2 ± 4% in the resulting scintillation images. For the Cherenkov images, all algorithms provided differences below 1%. All methods enabled measurements over the detectability (SBR > 2) and sensitivity (SNR > 5) thresholds with the bilinear algorithm providing the best SNR value. Clustering, OpenCV, bilinear, Malvar and Menon demosaicing algorithms respectively provided differences on the ROI analysis of 7 ± 5%, 3 ± 2%, 3 ± 2%, 4 ± 2%, 7 ± 3%. Significance. Radioluminescent signals can accurately be isolated using a single polychromatic camera. Moreover, demosaicing using a bilinear kernel provided the best results and enabled Cherenkov signal subtraction while preserving the full spatial resolution of the camera.

Structured Scintillators for Efficient Radiation Detection

Scintillators, which can convert high-energy ionizing radiation into visible light, have been serving as the core component in radiation detectors for more than a century of history. To address the increasing application demands along with the concern on nuclear security, various strategies have been proposed to develop a next-generation scintillator with a high performance in past decades, among which the novel approach via structure control has received great interest recently due to its high feasibility and efficiency. Herein, the concept of "structure engineering" is proposed for the exploration of this type of scintillators. Via internal or external structure design with size ranging from micro size to macro size, this promising strategy cannot only improve scintillator performance, typically radiation stopping power and light yield, but also extend its functionality for specific applications such as radiation imaging and therapy, opening up a new range of material candidates. The research and development of various types of structured scintillators are reviewed. The current state-of-the-art progresses on structure design, fabrication techniques, and the corresponding applications are discussed. Furthermore, an outlook focusing on the current challenges and future development is proposed.

On the use of machine learning methods for mPSD calibration in HDR brachytherapy

We sought to evaluate the feasibility of using machine learning (ML) algorithms for multipoint plastic scintillator detector (mPSD) calibration in high-dose-rate (HDR) brachytherapy. Dose measurements were conducted under HDR brachytherapy conditions. The dosimetry system consisted of an optimized 1-mm-core mPSD and a compact assembly of photomultiplier tubes coupled with dichroic mirrors and filters. An ¹⁹²Ir source was remotely controlled and sent to various positions in a homemade PMMA holder, ensuring 0.1-mm positional accuracy. Dose measurements covering a range of 0.5 to 12 cm of source displacement were carried out according to TG-43 U1 recommendations. Individual scintillator doses were decoupled using a linear regression model, a random forest estimator, and artificial neural network algorithms. The dose predicted by the TG-43U1 formalism was used as the reference for system calibration and ML algorithm training. The performance of the different algorithms was evaluated using different sample sizes and distances to the source for the mPSD system calibration. We found that the calibration conditions influenced the accuracy in predicting the measured dose. The decoupling methods' deviations from the expected TG-43 U1 dose generally remained below 20%. However, the dose prediction with the three algorithms was accurate to within 7% relative to the dose predicted by the TG-43 U1 formalism when measurements were performed in the same range of distances used for calibration. In such cases, the predictions with random forest exhibited minimal deviations (<2%). However, the performance random forest was compromised when the predictions were done beyond the range of distances used for calibration. Because the linear regression algorithm can extrapolate the data, the dose prediction by the linear regression was less influenced by the calibration conditions than random forest. The linear regression algorithm's behavior along the distances to the source was smoother than those for the random forest and neural network algorithms, but the observed deviations were more significant than those for the neural network and random forest algorithms. The number of available measurements for training purposes influenced the random forest and neural network models the most. Their accuracy tended to converge toward deviation values close to 1% from a number of dwell positions greater than 100. In performing HDR brachytherapy dose measurements with an optimized mPSD system, ML algorithms are good alternatives for precise dose reporting and treatment assessment during this kind of cancer treatment.

A high-Z inorganic scintillator-based detector for time-resolved in vivo dosimetry during brachytherapy

PURPOSE

High-dose rate (HDR) and pulsed-dose rate (PDR) brachytherapy would benefit from an independent treatment verification system to monitor treatment delivery and to detect errors in real time. This paper characterizes and provides an uncertainty budget for a detector based on a fiber-coupled high-Z inorganic scintillator capable of performing time-resolved in vivo dosimetry during HDR and PDR brachytherapy.

METHOD

The detector was composed of a detector probe and an optical reader. The detector probe consisted of either a 0.5 × 0.4 × 0.4 mm³ (HDR) or a 1.0 × 0.4 × 0.4 mm³ (PDR) cuboid ZnSe:O crystal glued onto an optical-fiber cable. The outer diameter of the detector probes was 1 mm, and fit inside standard brachytherapy catheters. The signal from the detector probe was read out at 20 Hz by a photodiode and a data acquisition device inside the optical reader. In order to construct an uncertainty budget for the detector, six characteristics were determined: (1) temperature dependence of the detector probe, (2) energy dependence as a function of the probe-to-source position in 2D (determined with 2 mm resolution using a robotic arm), (3) the signal-to-noise ratio (SNR), (4) short-term stability over 8 h, and (5) long-term stability of three optical readers and four probes used for in vivo monitoring in HDR and PDR treatments over 21 months (196 treatments and 189 detector calibrations, and (6) dose-rate dependence.

RESULTS

The total uncertainty of the detector at a 20 mm probe-to-source distance was < 5.1% and < 5.8% for the HDR and PDR versions, respectively. Regarding the above characteristics, (1) the sensitivity of the detector decreased by an average of 1.4%/°C for detector probe temperatures varying from 22 to 37°C; (2) the energy dependence of the detector was nonlinear and depended on both probe-to-source distance and the angle between the probe and the brachytherapy source; (3) the median SNRs were 187 and 34 at a 20 mm probe-to-source distance for the HDR and PDR versions, respectively (corresponding median source activities of 4.8 and 0.56 Ci, respectively); (4) the detector response varied by 0.6% in 11 identical irradiations over 8 h; (5) the sensitivity of the four detector probes decreased systematically by 0-1.2%/100 Gy of dose delivered to the probes, and random fluctuations of 4.8% in the sensitivity were observed for the three probes used in PDR and 1.9% for the probe used in HDR; and (6) the detector response was linear with dose rate.

CONCLUSION

ZnSe:O detectors can be used effectively for in vivo dosimetry and with high accuracy for HDR and PDR brachytherapy applications.

Comparative optic and dosimetric characterization of the HYPERSCINT scintillation dosimetry research platform for multipoint applications

This study introduces the HYPERSCINT research platform (HYPERSCINT-RP100, Medscint Inc., Quebec, Canada), the first commercially available scintillation dosimetry platform capable of multi-point dosimetry through the hyperspectral approach. Optic and dosimetric performances of the system were investigated through comparison with another commercially available solution, the Ocean Optics QE65Pro spectrometer. The optical characterization was accomplished by measuring the linearity of the signal as a function of integration time, photon detection efficiency and spectral resolution for both systems under the same conditions. Dosimetric performances were then evaluated with a 3-point plastic scintillator detector (mPSD) in terms of signal to noise ratio (SNR) and signal to background ratio (SBR) associated with each scintillator. The latter were subsequently compared with those found in the literature for the Exradin W1, a single-point plastic scintillator detector. Finally, various beam measurements were realized with the HYPERSCINT platform to evaluate its ability to perform clinical photon beam dosimetry. Both systems were found to be comparable in terms of linearity of the signal as a function of the intensity. Although the QE65Pro possesses a higher spectral resolution, the detection efficiency of the HYPERSCINT is up to 1000 time greater. Dosimetric measurements shows that the latter also offers a better SNR and SBR, surpassing even the SNR of the Exradin W1 single-point PSD. While doses ranging from 1 to 600 cGy were accurately measured within 2.1% of the predicted dose using the HYPERSCINT platform coupled to the mPSD, the Ocean optics spectrometer shows discrepancies up to 86% under 50cGy. Similarly, depth dose, full width at half maximum region of the beam profile and output factors were all accurately measured within 2.3% of the predicted dose using the HYPERSCINT platform and exhibit an average difference of 0.5%, 1.6% and 0.6%, respectively.

3D source tracking and error detection in HDR using two independent scintillator dosimetry systems

PURPOSE

The aim of this study is to perform three-dimensional (3D) source position reconstruction by combining in vivo dosimetry measurements from two independent detector systems.

METHODS

Time-resolved dosimetry was performed in a water phantom during HDR brachytherapy irradiation with 192 Ir source using two detector systems. The first was based on three plastic scintillator detectors and the second on a single inorganic crystal (CsI:Tl). Brachytherapy treatments were simulated in water under TG-43U1 conditions, including a HDR prostate plan. Treatment needles were placed in distances covering a range of source movement of 120 mm around the detectors. The distance from each dwell position to each scintillator was determined based on the measured dose rates. The three distances given by the mPSD were recalculated to a position along the catheter (z) and a distance radially away from the mPSD (xy) for each dwell position (a circumference around the mPSD). The source x, y, and z coordinates were derived from the intersection of the mPSD's circumference with the sphere around the ISD based on the distance to this detector. We evaluated the accuracy of the source position reconstruction as a function of the distance to the source, the most likely location for detector positioning within a prostate volume, as well as the capacity to detect positioning errors.

RESULTS

Approximately 4000 source dwell positions were tracked for eight different HDR plans. An intersection of the mPSD torus and the ISD sphere was observed in 77.2% of the dwell positions, assuming no uncertainty in the dose rate determined distance. This increased to 100% if 1σ search regions were added. However, only 73(96)% of the expected dwell positions were found within the intersection band for 1(2) σ uncertainties. The agreement between the source's reconstructed and expected positions was within 3 mm for a range of distances to the source up to 50 mm. The experiments on a HDR prostate plan, showed that by having at least one of the detectors located in the middle of the prostate volume, reduces the measurement deviations considerably compared to scenarios where the detectors were located outside of the prostate volume. The analysis showed a detection probability that, in most cases, is far from the random detection threshold. Errors of 1(2) mm can be detected in ranges of 5-25 (25-50) mm from the source, with a true detection probability rate higher than 80%, while the false probability rate is kept below 20%.

CONCLUSIONS

By combining two detector responses, we enabled the determination of the absolute source coordinates. The combination of the mPSD and the ISD in vivo dosimetry constitutes a promising alternative for real-time 3D source tracking in HDR brachytherapy.

Accuracy of an in vivo dosimetry-based source tracking method for afterloading brachytherapy - A phantom study

PURPOSE

To report on the accuracy of an in vivo dosimetry (IVD)-based source tracking (ST) method for high dose rate (HDR) prostate brachytherapy (BT).

METHODS

The ST was performed on a needle-by-needle basis. A least square fit of the expected to the measured dose rate was performed using the active dwell positions in the given needle. Two fitting parameters were used to determine the position of each needle relative to the IVD detector: radial (away or toward the detector) and longitudinal (along the axis of the treatment needle). The accuracy of the ST was assessed in a phantom where the geometries of five HDR prostate BT treatments previously treated at our clinic were reproduced. For each of the five treatment geometries, one irradiation was performed with the detector placed in the middle of the implant. Furthermore, four additional irradiations were performed for one of the geometries where the detector was retracted caudally in four steps of 10-15 mm and up to 12 mm inferior of the most inferior active dwell position, which represented the prostate apex. The time resolved dose measurements were retrieved at a rate of 20 Hz using a detector based on an Al₂ O₃ :C radioluminescence crystal, which was placed inside a standard BT needle. Individual calibrations of the detector were performed prior to each of the nine irradiations.

RESULTS

Source tracking could be applied in all needles across all nine irradiations. For irradiations with the detector located in the middle region of the implant (a total of 89 needles), the mean ± standard deviation (SD, k = 1) accuracy was -0.01 mm ± 0.38 mm and 0.30 mm ± 0.38 mm in the radial and longitudinal directions, respectively. Caudal retraction of the detector did not lead to reduced accuracy as long as the detector was located superior to the most inferior active dwell positions in all needles. However, reduced accuracy was observed for detector positions inferior to the most inferior active dwell positions which corresponded to detector positions in and inferior to the prostate apex region. Detector positions in the prostate apex and 12 mm inferior to the prostate resulted in mean ± SD (k = 1) ST accuracy of 0.7 mm ± 1 mm and 2.8 mm ± 1.6 mm, respectively, in radial direction, and -1.7 mm ± 1 mm and -2.1 mm ± 1.1 mm, respectively, in longitudinal direction. The largest deviations for the configurations with those detector positions were 2.6 and 5.4 mm, respectively, in the radial direction and -3.5 and -3.8 mm, respectively, in the longitudinal direction.

CONCLUSION

This phantom study demonstrates that ST based on IVD during prostate BT is adequately accurate for clinical use. The ST yields submillimeter accuracy on needle positions as long as the IVD detector is positioned superior to at least one active dwell position in all needles. Locations of the detector inferior to the prostate apex result in decreased ST accuracy while detector locations in the apex region and above are advantageous for clinical applications.

High resolution small-scale inorganic scintillator detector: HDR brachytherapy application

PURPOSE

Brachytherapy (BT) deals with high gradient internal dose irradiation made up of a complex system where the source is placed nearby the tumor to destroy cancerous cells. A primary concern of clinical safety in BT is quality assurance to ensure the best matches between the delivered and prescribed doses targeting small volume tumors and sparing surrounding healthy tissues. Hence, the purpose of this study is to evaluate the performance of a point size inorganic scintillator detector (ISD) in terms of high dose rate brachytherapy (HDR-BT) treatment.

METHODS

A prototype of the dose verification system has been developed based on scintillating dosimetry to measure a high dose rate while using an ¹⁹² Ir BT source. The associated dose rate is measured in photons/s employing a highly sensitive photon counter (design data: 20 photons/s). Dose measurement was performed as a function of source-to-detector distance according to TG43U1 recommendations. Overall measurements were carried out inside water phantoms keeping the ISD along the BT needle; a minimum of 0.1 cm distance was maintained between each measurement point. The planned dwell times were measured accurately from the difference of two adjacent times of transit. The ISD system performances were also evaluated in terms of dose linearity, energy dependency, scintillation stability, signal-to-noise ratio (SNR), and signal-to-background ratio (SBR). Finally, a comparison was presented between the ISD measurements and results obtained from TG43 reference dataset.

RESULTS

The detection efficiency of the ISD was verified by measuring the planned dwell times at different dwell positions. Measurements demonstrated that the ISD has a perfectly linear behavior with dose rate (R²  = 1) and shows high SNR (>35) and SBR (>36) values even at the lowest dose rate investigated at around 10 cm from the source. Standard deviation (1σ) remains within 0.03% of signal magnitude, and less than 0.01% STEM signal was monitored at 0.1 cm source-to-detector distance. Stability of 0.54% is achieved, and afterglow stays less than 1% of the total signal in all the irradiations. Excellent symmetrical behavior of the dose rate regarding source position was observed at different radiation planes. Finally, a comparison with TG-43 reference dataset shows that corrected measurements agreed with simulation data within 1.2% and 1.3%, and valid for the source-to-detector distance greater than 0.25 cm.

CONCLUSION

The proposed ISD in this study anticipated that the system could be promoted to validate with further clinical investigations. It allows an appropriate dose verification with dwell time estimation during source tracking and suitable dose measurement with a high spatial resolution both nearby (high dose gradient) and far (low dose gradient) from the source position.

Automated multi-parameter high-dose-rate brachytherapy quality assurance via radioluminescence imaging

The purpose of this study is to leverage radioluminescence imaging for the development of an automated high-dose-rate (HDR) brachytherapy quality assurance (QA) system that enables simultaneous measurements of dwell position, dwell time, wire velocity, and relative source strength in a single test. The system consists of a radioluminescence phosphor sheet (a mixture of Gd2O2S:Tb and PDMS) positioned atop a HDR needle applicator, a complementary metal-oxide-semiconductor digital camera used to capture the emitted radioluminescence signals from the scintillator sheet, and an in-house graphical user interface for signal processing. The signal processing was used to extract source intensity, location, and elapsed time, yielding the final measurements on dwell position, dwell time, and wire velocity. The source strength relative to the well chamber calibration (in unit of Air-Kerma strength, Sk ) is measured by establishing a calibration curve that correlates Sk with the detector response. Validation experiments are performed using three customized treatment plans. With these plans, the dwell position and dwell time are verified for a range of 110.0 cm-117.5 cm and 2 s-16 s, respectively, and the linear correlation with Sk is demonstrated for the source strength varying between 28 348 U (cGy cm2 h-1) and 41 906 U. The wire velocity, i.e. the speed of the radioactive source averaged over the distance in between dwell positions, is calculated for various distances ranging from 5 mm to 50 mm. Results show that the mean deviations of the measured dwell position and dwell time are 0.1 mm (range from 0 to 0.2 mm) and 32.5 ms (range from 0 to 60.0 ms) with respect to the planned values, respectively, and the system response is highly linear with Sk ( R2 = 0.998). Moreover, the measured wire velocities are comparable to previously reported values. Benefitting from the compact hardware design and image processing algorithms, the system provides a practical, reliable, and comprehensive solution for HDR QA.

Characterization of a Low-Cost Plastic Fiber Array Detector for Proton Beam Dosimetry

The Pencil Beam Scanning (PBS) technique in proton therapy uses fast magnets to scan the tumor volume rapidly. Changing the proton energy allows changing to layers in the third dimension, hence scanning the same volume several times. The PBS approach permits adapting the speed and/or current to modulate the delivered dose. We built a simple prototype that measures the dose distribution in a single step. The active detection material consists of a single layer of scintillating fibers (i.e., 1D) with an active length of 100 mm, a width of 18.25 mm, and an insignificant space (20 μm) between them. A commercial CMOS-based camera detects the scintillation light. Short exposure times allow running the camera at high frame rates, thus, monitoring the beam motion. A simple image processing method extracts the dose information from each fiber of the array. The prototype would allow scaling the concept to multiple layers read out by the same camera, such that the costs do not scale with the dimensions of the fiber array. Presented here are the characteristics of the prototype, studied under two modalities: spatial resolution, linearity, and energy dependence, characterized at the Center for Proton Therapy (Paul Scherrer Institute); the dose rate response, measured at an electron accelerator (Swiss Federal Institute of Metrology).

Advances on inorganic scintillator-based optic fiber dosimeters

This article presents a new perspective on the development of inorganic scintillator-based fiber dosimeters (IOSFDs) for medical radiotherapy dosimetry (RTD) focusing on real-time in vivo dosimetry. The scintillator-based optical fiber dosimeters (SFD) are compact, free of electromagnetic interference, radiation-resistant, and robust. They have shown great potential for real-time in vivo RTD. Compared with organic scintillators (OSs), inorganic scintillators (IOSs) have larger X-ray absorption and higher light output. Variable IOSs with maximum emission peaks in the red part of the spectrum offer convenient stem effect removal. This article outlines the main advantages and disadvantages of utilizing IOSs for SFD fabrication. IOSFDs with different configurations are presented, and their use for dosimetry in X-ray RT, brachytherapy (BT), proton therapy (PT), and boron neutron capture therapy (BNCT) is reviewed. Challenges including the percentage depth dose (PDD) deviation from the standard ion chamber (IC) measurement, the angular dependence, and the Cherenkov effect are discussed in detail; methods to overcome these problems are also presented.

Monte Carlo dosimetric characterization of a new high dose rate 169 Yb brachytherapy source and independent verification using a multipoint plastic scintillator detector

PURPOSE

A prototype 169 Yb source was developed in combination with a dynamic rotating platinum shield system (AIM-Brachy) to deliver intensity modulated brachytherapy (IMBT). The purpose of this study was to evaluate the dosimetric characteristics of the bare/shielded 169 Yb source using Monte Carlo (MC) simulations and perform an independent dose verification using a dosimetry platform based on a multipoint plastic scintillator detector (mPSD).

METHODS

The TG-43U1 dosimetric parameters were calculated for the source model using RapidBrachyMCTPS. Real-time dose rate measurements were performed in a water tank for both the bare/shielded source using a custom remote afterloader. For each dwell position, the dose rate was independently measured by the three scintillators (BCF-10, BCF-12, and BCF-60). For the bare source, dose rate was measured at distances up to 3 cm away from the source over a range of 7 cm along the catheter. For the shielded source, measurements were performed with the mPSD placed at 1 cm from the source at four different azimuthal angles ( 0 ∘ , 9 0 ∘ , 18 0 ∘ , and 27 0 ∘ ).

RESULTS

The dosimetric parameters were tabulated for the source model. For the bare source, differences between measured and calculated along-away dose rates were generally below 5-10%. Along the transverse axis, deviations were, on average (range), 3.3% (0.6-6.2%) for BCF-10, 1.7% (0.9-2.9%) for BCF-12, and 2.2% (0.3-4.4%) for BCF-60. The maximum dose rate reduction due to shielding at a radial distance of 1 cm was 88.8 ± 1.2%, compared to 83.5 ± 0.5% as calculated by MC.

CONCLUSIONS

The dose distribution for the bare/shielded 169 Yb source was independently verified using mPSD with good agreement in regions close to the source. The 169 Yb source coupled with the partial-shielding system is an effective technique to deliver IMBT.

High spatial resolution inorganic scintillator detector for high-energy X-ray beam at small field irradiation

Purpose

Small field dosimetry for radiotherapy is one of the major challenges due to the size of most dosimeters, for example, sufficient spatial resolution, accurate dose distribution and energy dependency of the detector. In this context, the purpose of this research is to develop a small size scintillating detector targeting small field dosimetry and compare its performance with other commercial detectors.

Method

An inorganic scintillator detector (ISD) of about 200 µm outer diameter was developed and tested through different small field dosimetric characterizations under high‐energy photons (6 and 15 MV) delivered by an Elekta Linear Accelerator (LINAC). Percentage depth dose (PDD) and beam profile measurements were compared using dosimeters from PTW namely, microdiamond and PinPoint three‐dimensional (PP3D) detector. A background fiber method has been considered to quantitate and eliminate the minimal Cerenkov effect from the total optical signal magnitude. Measurements were performed inside a water phantom under IAEA Technical Reports Series recommendations (IAEA TRS 381 and TRS 483).

Results

Small fields ranging from 3 × 3 cm², down to 0.5 × 0.5 cm² were sequentially measured using the ISD and commercial dosimeters, and a good agreement was obtained among all measurements. The result also shows that, scintillating detector has good repeatability and reproducibility of the output signal with maximum deviation of 0.26% and 0.5% respectively. The Full Width Half Maximum (FWHM) was measured 0.55 cm for the smallest available square size field of 0.5 × 0.5 cm², where the discrepancy of 0.05 cm is due to the scattering effects inside the water and convolution effect between field and detector geometries. Percentage depth dose factor dependence variation with water depth exhibits nearly the same behavior for all tested detectors. The ISD allows to perform dose measurements at a very high accuracy from low (50 cGy/min) to high dose rates (800 cGy/min) and was found to be independent of dose rate variation. The detection system also showed an excellent linearity with dose; hence, calibration was easily achieved.

Conclusions

The developed detector can be used to accurately measure the delivered dose at small fields during the treatment of small volume tumors. The author's measurement shows that despite using a nonwater‐equivalent detector, the detector can be a powerful candidate for beam characterization and quality assurance in, for example, radiosurgery, Intensity‐Modulated Radiotherapy (IMRT), and brachytherapy. Our detector can provide real‐time dose measurement and good spatial resolution with immediate readout, simplicity, flexibility, and robustness.