Nanoclay gel-based radio-fluorogenic gel dosimeters using various fluorescence probes

Validation of complex radiotherapy techniques using polymer gel dosimetry

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.

Development of a silicone-based radio-fluorogenic dosimeter using dihydrorhodamine 6G

A silicon-based three-dimensional dosimeter can be formed in a free shape without a container and deformed because of its flexibility. Several studies have focused on enhancing its radiological characteristics and assessing its applicability as a quality assurance tool for image-guided and adaptive radiation therapy, considering motion and deformation. Here, we applied a fluorescence probe (dihydrorhodamine 6G, DHR6G) to a silicon elastomer as a new radiosensitive compound that converts nonfluorescent into fluorescent dyes using irradiation, and its fluorescence intensity increases linearly with the absorbed dose. In this study, we demonstrated a cost-effective synthesis method and optimized the composition conditions. The results showed that the DHR6G-SE prepared from 2.2 × 10-3 wt% DHR6G, 0.024 wt% pyridine, and a silicone elastomer (SE) (SILPOT TM 184, base/curing agent = 10/1) exhibited a linear increase in fluorescence with radiation exposure within a dose range of 0-8 Gy and a highly stable sensitivity for as long as 64 h. To demonstrate its container-less characteristics, the possibility of dosimetry for low-energy X-rays using DHR6G-SE was investigated.

Enhanced X-ray Dose Response of Radio-fluorescent Hydrogels Enabled by Persulfate Salts

Coumarin 3-carboxylic acid (CCA)-loaded radio-fluorescent hydrogels have attracted interest for ionizing radiation dosimeters, but their sensitivity needs to be improved. In this study, we added ammonium persulfate (APS) to a polyacrylamide (PAAm)-CCA hydrogel. The introduction of APS improved the hydrogel dose sensitivity to 336.02 Gy- 1, which is 1.8 times that of the counterpart without APS. Our hydrogel can measure the X-ray dose in a range of 0 - 15 Gy with a lower limit of detection (LOD) of 0.1 Gy. Additionally, the hydrogel can sense X-ray doses within a wide range of the dose rate and temperature, and the dose‒response can be well retained 7 days postirradiation. Therefore, we think this study provides a simple and robust method to improve the sensitivity of CCA hydrogel dosimeters, presenting great potential in clinical radiotherapy.

Review of nanomaterial advances for ionizing radiation dosimetry

There are a wide range of applications with ionizing radiation and a common theme throughout these is that accurate dosimetry is usually required, although many newer demands are provided by improved features in higher range, multi-spectral and particle type detected. Today, the array of dosimeters includes both offline and online tools, such as gel dosimeters, thermoluminescence (TL), scintillators, optically stimulated luminescence (OSL), radiochromic polymeric films, gels, ionization chambers, colorimetry, and electron spin resonance (ESR) measurement systems. Several future nanocomposite features and interpretation of their substantial behaviors are discussed that can lead to improvements in specific features, such as (1) lower sensitivity range, (2) less saturation at high range, (3) overall increased dynamic range, (4) superior linearity, (5) linear energy transfer and energy independence, (6) lower cost, (7) higher ease of use, and (8) improved tissue equivalence. Nanophase versions of TL and ESR dosimeters and scintillators each have potential for higher range of linearity, sometimes due to superior charge transfer to the trapping center. Both OSL and ESR detection of nanomaterials can have increased dose sensitivity because of their higher readout sensitivity with nanoscale sensing. New nanocrystalline scintillators, such as perovskite, have fundamentally important advantages in sensitivity and purposeful design for key new applications. Nanoparticle plasmon coupled sensors doped within a lower Zeff material have been an effective way to achieve enhanced sensitivity of many dosimetry systems while still achieving tissue equivalency. These nanomaterial processing techniques and unique combinations of them are key steps that lead to the advanced features. Each must be realized through industrial production and quality control with packaging into dosimetry systems that maximize stability and reproducibility. Ultimately, recommendations for future work in this field of radiation dosimetry were summarized throughout the review.

Radio-fluorogenic nanoclay gel dosimeters with reduced linear energy transfer dependence for carbon-ion beam radiotherapy

PURPOSE

The precise assessment of the dose distribution of high linear energy transfer (LET) radiation remains a challenge, because the signal of most dosimeters will be saturated due to the high ionization density. Such measurements are particularly important for heavy-ion beam cancer therapy. On this basis, the present work examined the high LET effect associated with three-dimensional gel dosimetry based on radiation-induced chemical reactions. The purpose of this study was to create an ion beam radio-fluorogenic gel dosimeter with a reduced effect of LET.

METHODS

Nanoclay radio-fluorogenic gel (NC-RFG) dosimeters were prepared, typically containing 100 μM dihydrorhodamine 123 (DHR123) and 2.0 wt% nanoclay together with catalytic additives promoting Fenton or Fenton-like reactions. The radiological properties of NC-RFG dosimeters having different compositions in response to a carbon-ion beam were investigated using a fluorescence gel scanner.

RESULTS

An NC-RFG dosimeter capable of generating a fluorescence intensity distribution reflecting the carbon-ion beam dose profile was obtained. It was clarified that the reduction of the unfavorable LET dependence results from an acceleration of the reactions between DHR123 and H₂ O₂ , which is a molecular radiolysis product. The effects of varying the preparation conditions on the radiological properties of these gels were also examined. The optimum H₂ O₂ catalyst was determined to include 1 mM Fe³⁺ ions, and the addition of 100 mM pyridine was also found to increase the sensitivity.

CONCLUSIONS

This technique allows the first-ever evaluation of the depth-dose profile of a carbon-ion beam at typical therapeutic levels of several Gy without LET effect.

Gold-Nanoparticle-Enhanced Radio-Fluorogenic Hydrogel Sensor for Low Radiation Doses in Clinical Radiotherapy

Radio-fluorogenic hydrogel dosimeters are urgently needed in radiotherapy for 3D dose verification. However, few hydrogel sensors have been reported at low absorbed doses under 2 Gy which meets the requirements of clinical practice. Here, we report a new type of gold-nanoparticle-enhanced radio-fluorogenic agarose hydrogel with coumarin as the dose-responsive material. An optimal composition of 3 wt% of agarose, 0.1 mM of gold nanoparticles, and 0.5 mM coumarin was selected. The addition of gold nanoparticles enhanced the hydroxyl radicals generated from the radiolysis of water, which can react with coumarin and generate fluorescent 7-hydroxy-coumarin and, eventually, achieve low-dose verification of 0-2.4 Gy with a high linear correlation coefficient. These findings provide an effective method for 3D dose verification, and will inspire the development of other radio-fluorogenic sensing hydrogels as well.

Radiation Dosimetry by Use of Radiosensitive Hydrogels and Polymers: Mechanisms, State-of-the-Art and Perspective from 3D to 4D

Gel dosimetry was developed in the 1990s in response to a growing need for methods to validate the radiation dose distribution delivered to cancer patients receiving high-precision radiotherapy. Three different classes of gel dosimeters were developed and extensively studied. The first class of gel dosimeters is the Fricke gel dosimeters, which consist of a hydrogel with dissolved ferrous ions that oxidize upon exposure to ionizing radiation. The oxidation results in a change in the nuclear magnetic resonance (NMR) relaxation, which makes it possible to read out Fricke gel dosimeters by use of quantitative magnetic resonance imaging (MRI). The radiation-induced oxidation in Fricke gel dosimeters can also be visualized by adding an indicator such as xylenol orange. The second class of gel dosimeters is the radiochromic gel dosimeters, which also exhibit a color change upon irradiation but do not use a metal ion. These radiochromic gel dosimeters do not demonstrate a significant radiation-induced change in NMR properties. The third class is the polymer gel dosimeters, which contain vinyl monomers that polymerize upon irradiation. Polymer gel dosimeters are predominantly read out by quantitative MRI or X-ray CT. The accuracy of the dosimeters depends on both the physico-chemical properties of the gel dosimeters and on the readout technique. Many different gel formulations have been proposed and discussed in the scientific literature in the last three decades, and scanning methods have been optimized to achieve an acceptable accuracy for clinical dosimetry. More recently, with the introduction of the MR-Linac, which combines an MRI-scanner and a clinical linear accelerator in one, it was shown possible to acquire dose maps during radiation, but new challenges arise.

Nanomaterials Based on Functional Polymers for Sensitizing Cancer Radiotherapy

Despite being the mainstay treatment for many types of cancer in clinic, radiotherapy is undertaking great challenges in overcoming a series of limitations. Radiosensitizers are promising agents capable of depositing irradiation energy and generating free radicals to enhance the radiosensitivity of tumor cells. Combining radiosensitizers with functional polymer-based nanomaterials holds great potential to improve biodistribution, circulation time, and stability in vivo. The derived polymeric nano-radiosensitizers can significantly improve the efficiency of tumor targeting and radiotherapy, and reduce the side effect to healthy tissues. In this review, we provide an overview of functional polymer-based nanomaterials for radiosensitization in recent years. Particular emphases are given to the action mechanisms, drug loading methods, targeting efficiencies, the impact on therapeutic effects and biocompatibility of various radiosensitizing polymers, which are classified as polymeric micelles, dendrimers, polymeric nanospheres, nanoscale coordination polymers, polymersomes, and nanogels. The challenges and outlooks of polymeric nano-radiosensitizers are also discussed. This article is protected by copyright. All rights reserved.

Recent Advances in Hydrogel-Based Sensors Responding to Ionizing Radiation

Ionizing radiation and its applications are widely spread throughout life. Similar to many other things, both the positive and negative aspects of ionizing radiation should always be kept in mind. For example, a proper radiation dose can be delivered to tumor tissue to kill malignant cells in radiotherapy. On the other hand, exceeding this dose can damage the normal tissues of a human organism. Therefore, the application of sensors for measuring ionizing radiation doses is of utmost importance in many fields, especially in cancer therapy. Traditional dosimeters, such as ionization chambers, silicon diodes and thermoluminescence dosimeters, are widely used. However, they have limitations in certain aspects. Hydrogel-based sensors (or dosimeters) for measuring ionizing radiation doses attract extensive attention for decades due to their equivalence to living tissue and biocompatibility. In this review, we catalog hydrogel-based dosimeters such as polymer, Fricke, radio-chromic, radio-fluorescence and NPs-embedded dosimeters. Most of them demonstrate desirable linear response and sensitivity regardless of energy and dose rate of ionizing radiation. We aim to review these dosimeters and their potential applications in radiotherapy as well as to stimulate a joint work of the experts from different fields such as materials science, chemistry, cancer therapy, radiobiology and nuclear science.

Dose Rate Effects in Fluorescence Chemical Dosimeters Exposed to Picosecond Electron Pulses: An Accurate Measurement of Low Doses at High Dose Rates

The development of ultra-intense electron pulse for applications needs to be accompanied by the implementation of a practical dosimetry system. In this study four different systems were investigated as dosimeters for low doses with a very high-dose-rate source. First, the effects of ultra-short pulses were investigated for the yields of the Fricke dosimeter based on acidic solutions of ferrous sulfate; it was established that the yields were not significantly affected by the high dose rates, so the Fricke dosimeter system was used as a reference. Then, aqueous solutions of three compounds as fluorescence chemical dosimeters were utilized, each operated at a different solution pH: terephthalic acid - basic, trimesic acid - acidic, and coumarin-3-carboxylic acid (C3CA) - neutral. Fluorescence chemical dosimeters offer an attractive alternative to chemical dosimeters based on optical absorption for measuring biologically relevant low doses because of their higher sensitivity. The effects of very intense dose rate (TGy/ s) from pulses of fast electrons generated by a picosecond linear accelerator on the chemical yields of fluorescence chemical dosimeters were investigated at low peak doses (<20 Gy) and compared with yields determined under low-dose-rate irradiation from a 60 Co gamma-ray source (mGy/s). For the terephthalate and the trimesic acid dosimeters changes in the yields were not detected within the estimated (∼10%) precision of the experiments, but, due to the complexity of the mechanism of the hydroxyl radical initiated reactions in solutions of the relevant aromatic compounds, significant reductions of the chemical yield (-60%) were observed when the C3CA dosimeter was irradiated with the ultra-short pulses.

Whole Three-Dimensional Dosimetry of Carbon Ion Beams with an MRI-Based Nanocomposite Fricke Gel Dosimeter Using Rapid T1 Mapping Method

MRI-based gel dosimeters are attractive systems for the evaluation of complex dose distributions in radiotherapy. In particular, the nanocomposite Fricke gel dosimeter is one among a few dosimeters capable of accurately evaluating the dose distribution of heavy ion beams. In contrast, reduction of the scanning time is a challenging issue for the acquisition of three-dimensional volume data. In this study, we investigated a three-dimensional dose distribution measurement method for heavy ion beams using variable flip angle (VFA), which is expected to significantly reduce the MRI scanning time. Our findings clarified that the whole three-dimensional dose distribution could be evaluated within the conventional imaging time (20 min) and quality of one cross-section.

Verification of dose distribution in high-dose-rate brachytherapy using a nanoclay-based radio-fluorogenic gel dosimeter

Dose distributions have become more complex with the introduction of image-guided brachytherapy in high-dose-rate (HDR) brachytherapy treatments. Therefore, to correctly execute HDR, conducting a quality assurance programme for the remote after-loading system and verifying the dose distribution in the patient treatment plan are necessary. The characteristics of the dose distribution of HDR brachytherapy are that the dose is high near the source and rapidly drops when the distance from the source increases. Therefore, a measurement tool corresponding to the characteristic is required. In this study, using an Iridium-192 (Ir-192) source, we evaluated the basic characteristics of a nanoclay-based radio-fluorogenic gel (NC-RFG) dosimeter that is a fluorescent gel dosimeter using dihydrorhodamine 123 hydrochloride as a fluorescent probe. The two-dimensional dose distribution measurements were performed at multiple source positions to simulate a clinical plan. Fluorescence images of the irradiated NC-RFG were obtained at a high resolution (0.04 mm pixel^-1) using a gel scanner with excitation at 465 nm. Good linearity was confirmed up to a dose range of 100 Gy without dose rate dependence. The dose distribution measurement at the five-point source position showed good agreement with the treatment planning system calculation. The pass ratio by gamma analysis was 92.1% with a 2%/1 mm criterion. The NC-RFG dosimeter demonstrates to have the potential of being a useful tool for quality assurance of the dose distribution delivered by HDR brachytherapy. Moreover, compared with conventional gel dosimeters such as polymer gel and Fricke gel dosimeters it solves the problems of diffusion, dose rate dependence and inhibition of oxygen-induced reactions. Furthermore, it facilitates dose data to be read in a short time after irradiation, which is useful for clinical use.

Sensitivity enhancement of DHR123 radio-fluorogenic nanoclay gel dosimeter by incorporating surfactants and halogenides

Dosimetry of spatial dose distribution of ionizing radiation in tissue equivalent materials is particularly important for cancer radiotherapy. Here, we describe a radio-fluorogenic gel-based dosimeter that has achieved 16 times higher sensitivity by incorporating surfactants and halogenides. The gel dosimeters were prepared from dihydrorhodamine 123 (DHR123) and small amounts of nano-sized clay and a radiosensitizer. By comprehensively changing the type of additives for the sensitizer (three surfactants: Triton X-100, sodium dodecyl sulfate (SDS) and cetyltrimethylammonium bromide, and three halogenides: trichloroacetic acid, tribromoacetic acid and 2,2,2-trichloroethanol), the increase in sensitivity can be explained by an increase in relative fluorescence quantum yield and an increase in radiation chemical yield. These highly sensitive gel dosimeters also show dose rate independent sensitivity under irradiation at 0.64 and 0.77 Gy min⁻¹ using a 6 MV X-ray therapeutic beam from the medical linac.

Dosimetry of spatial dose distribution of ionizing radiation in tissue equivalent materials using high sensitive radio-fluorogenic gel dosimeter using DHR123 with sensitizer. (Radiation therapy planning image courtesy of Varian Medical Systems, Inc. All rights reserved.)

FluoroTome 1: An Apparatus for Tomographic Imaging of Radio-Fluorogenic (RFG) Gels

Radio-fluorogenic (RFG) gels become permanently fluorescent when exposed to high-energy radiation with the intensity of the emission proportional to the local dose of radiation absorbed. An apparatus is described, FluoroTome 1, that is capable of taking a series of tomographic images (thin slices) of the fluorescence of such an irradiated RFG gel on-site and within minutes of radiation exposure. These images can then be compiled to construct a 3D movie of the dose distribution within the gel. The historical development via a laboratory-bench prototype to a readily transportable, user-friendly apparatus is described. Instrumental details and performance tests are presented.

Radio-Fluorogenic Gel Dosimetry with Coumarin

Gel dosimeters are attractive detectors for radiation therapy, with properties similar to biological tissue and the potential to visualize volumetric dose distributions. Radio-fluorogenesis is the yield of fluorescent chemical products in response to energy deposition from ionizing radiation. This report shares the development of a novel radio-fluorogenic gel (RFG) dosimeter, gelatin infused with coumarin-3-carboxlyic acid (C3CA), for the quantification of imparted energy. Aqueous solutions exposed to ionizing radiation result in the production of hydroxyl free radicals through water radiolysis. Interactions between hydroxyl free radicals and coumarin-3-carboxylic acid produce a fluorescent product. 7-hydroxy-coumarin-3-carboxylic acid has a blue (445 nm) emission following ultra-violet (UV) to near UV (365–405 nm) excitation. Effects of C3CA concentration and pH buffers were investigated. The response of the RFG was explored with respect to strength, type, and exposure rate of high-energy radiation. Results show a linear dose response relationship independent of energy and type, with a dose-rate dependency. This report demonstrates increased photo-yield with high pH and the utility of gelatin-RFG for phantom studies of radiation dosimetry.