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Wahabi JM, Wong JHD, Mahdiraji GA, Ung NM. Feasibility of determining external beam radiotherapy dose using LuSy dosimeter. J Appl Clin Med Phys 2024:e14387. [PMID: 38778567 DOI: 10.1002/acm2.14387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Radiation dose measurement is an essential part of radiotherapy to verify the correct delivery of doses to patients and ensure patient safety. Recent advancements in radiotherapy technology have highlighted the need for fast and precise dosimeters. Technologies like FLASH radiotherapy and magnetic-resonance linear accelerators (MR-LINAC) demand dosimeters that can meet their unique requirements. One promising solution is the plastic scintillator-based dosimeter with high spatial resolution and real-time dose output. This study explores the feasibility of using the LuSy dosimeter, an in-house developed plastic scintillator dosimeter for dose verification across various radiotherapy techniques, including conformal radiotherapy (CRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT), and stereotactic radiosurgery (SRS). MATERIALS AND METHODS A new dosimetry system, comprising a new plastic scintillator as the sensing material, was developed and characterized for radiotherapy beams. Treatment plans were created for conformal radiotherapy, IMRT, VMAT, and SRS and delivered to a phantom. LuSy dosimeter was used to measure the delivered dose for each plan on the surface of the phantom and inside the target volumes. Then, LuSy measurements were compared against an ionization chamber, MOSFET dosimeter, radiochromic films, and dose calculated using the treatment planning system (TPS). RESULTS For CRT, surface dose measurement by LuSy dosimeter showed a deviation of -5.5% and -5.4% for breast and abdomen treatment from the TPS, respectively. When measuring inside the target volume for IMRT, VMAT, and SRS, the LuSy dosimeter produced a mean deviation of -3.0% from the TPS. Surface dose measurement resulted in higher TPS discrepancies where the deviations for IMRT, VMAT, and SRS were -2.0%, -19.5%, and 16.1%, respectively. CONCLUSION The LuSy dosimeter was feasible for measuring radiotherapy doses for various treatment techniques. Treatment delivery verification enables early error detection, allowing for safe treatment delivery for radiotherapy patients.
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Affiliation(s)
- Janatul Madinah Wahabi
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Radiotherapy and Oncology Department, National Cancer Institute, Putrajaya, Malaysia
| | - Jeannie Hsiu Ding Wong
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Universiti Malaya Research Imaging Centre (UMRIC), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Ngie Min Ung
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Esteves J, Pivot O, Ribouton J, Jalade P, Zouaoui A, Desbat L, Rit S, Blanc F, Haefeli G, Hopchev P, Galvan JM, Lu GN, Pittet P. A novel QA phantom based on scintillating fiber ribbons with implementation of 2D dose tomography for small-field radiotherapy. Med Phys 2023; 50:619-632. [PMID: 35933612 PMCID: PMC10087208 DOI: 10.1002/mp.15902] [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: 03/08/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To develop a novel instrument for real-time quality assurance (QA) procedures in radiotherapy. The system implements a scintillation-based phantom and associated signal acquisition and processing modules and aims to monitor two-dimensional (2D) dose distributions of small fields. MATERIALS AND METHODS For the proposed phantom, we have designed and realized a prototype implementing six high-resolution tissue-equivalent scintillating fiber ribbons stacked with in-plane 30° rotated orientations from each other. Each ribbon output is coupled to a silicon photodiode linear array (with an element pitch of 400 μm) to detect scintillating signal, which represents the projected irradiation profile perpendicular to the ribbon's orientation. For the system providing six acquired projected dose profiles at different orientations, we have developed a two-step signal processing method to perform 2D dose reconstruction. The first step is to determine irradiation field geometry parameters using a tomographic geometry approach, and the second one is to perform specific penumbra estimation. The QA system prototype has been tested on a Novalis TrueBeam STX with a 6-MV photon beam for small elliptic fields defined by 5- and 10-mm cone collimators and for 10 × 10- and 20 × 10-mm2 rectangular fields defined by the micro-multileaf collimator. Gamma index analysis using EBT3 films as reference has been carried out with tight 2%-dose-difference (DD)/700-μm-distance-to-agreement (DTA) as well as 1%-DD/1-mm-DTA criteria for evaluating the system performances. The testing also includes an evaluation of the proposed two-step field reconstruction method in comparison with two conventional methods: filtered back projection (FBP) and simultaneous iterative reconstruction technique (SIRT). RESULTS The reconstructed 2D dose distributions have gamma index pass rates higher than 95% for all the tested configurations as compared with EBT3 film measurements with both 2%-DD/700-μm-DTA and 1%-DD/1-mm criteria. 2D global gamma analysis shows that the two-step and FBP radiation field reconstruction methods systematically outperform the SIRT approach. Moreover, higher gamma index success rates are obtained with the two-step method than with FBP in the case of the fields defined with the stereotactic cones. CONCLUSIONS The proposed small-field QA system makes a use of six water-equivalent scintillating detectors (fiber ribbons) to acquire dose distribution. The developed two-step signal processing method performs tomographic 2D dose reconstruction. A system prototype has been built and tested using hospital facilities with small rectangular and elliptic fields. Testing results show 2D reconstructed dose distributions with high accuracy and resolution. Such a system could potentially be an alternative approach to film dosimetry for small-field QA, which is still widely used as reference in clinical practice.
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Affiliation(s)
- Josué Esteves
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, INSA Lyon, Ecole Centrale de Lyon, CPE Lyon, INL, UMR5270, Villeurbanne, France
| | - Odran Pivot
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Julien Ribouton
- Service de Radiophysique et Radiovigilance, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Patrice Jalade
- Service de Radiophysique et Radiovigilance, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Abdelaali Zouaoui
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, INSA Lyon, Ecole Centrale de Lyon, CPE Lyon, INL, UMR5270, Villeurbanne, France
| | - Laurent Desbat
- Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | - Simon Rit
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, CREATIS, Lyon, France
| | | | | | | | - Jean-Marc Galvan
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, INSA Lyon, Ecole Centrale de Lyon, CPE Lyon, INL, UMR5270, Villeurbanne, France
| | - Guo-Neng Lu
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, INSA Lyon, Ecole Centrale de Lyon, CPE Lyon, INL, UMR5270, Villeurbanne, France
| | - Patrick Pittet
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, INSA Lyon, Ecole Centrale de Lyon, CPE Lyon, INL, UMR5270, Villeurbanne, France
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Das IJ, Francescon P, Moran JM, Ahnesjö A, Aspradakis MM, Cheng CW, Ding GX, Fenwick JD, Saiful Huq M, Oldham M, Reft CS, Sauer OA. Report of AAPM Task Group 155: Megavoltage photon beam dosimetry in small fields and non-equilibrium conditions. Med Phys 2021; 48:e886-e921. [PMID: 34101836 DOI: 10.1002/mp.15030] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/06/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022] Open
Abstract
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.
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Affiliation(s)
- Indra J Das
- Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paolo Francescon
- Department of Radiation Oncology, Ospedale Di Vicenza, Vicenza, Italy
| | - Jean M Moran
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Anders Ahnesjö
- Medical Radiation Sciences, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Maria M Aspradakis
- Institute of Radiation Oncology, Cantonal Hospital of Graubünden, Chur, Switzerland
| | - Chee-Wai Cheng
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - George X Ding
- Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - John D Fenwick
- Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - M Saiful Huq
- Department of Radiation Oncology, University of Pittsburgh, School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Mark Oldham
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Chester S Reft
- Department of Radiation Oncology, University of Chicago, Chicago, IL, USA
| | - Otto A Sauer
- Department of Radiation Oncology, Klinik fur Strahlentherapie, University of Würzburg, Würzburg, Germany
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