Magnetic resonance imaging of radiation dose distributions using a polymer-gel dosimeter

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.

Chemical Overview of Gel Dosimetry Systems: A Comprehensive Review

Advances in radiotherapy technology during the last 25 years have significantly improved both dose conformation to tumors and the preservation of healthy tissues, achieving almost real-time feedback by means of high-precision treatments and theranostics. Owing to this, developing high-performance systems capable of coping with the challenging requirements of modern ionizing radiation is a key issue to overcome the limitations of traditional dosimeters. In this regard, a deep understanding of the physicochemical basis of gel dosimetry, as one of the most promising tools for the evaluation of 3D high-spatial-resolution dose distributions, represents the starting point for developing new and innovative systems. This review aims to contribute thorough descriptions of the chemical processes and interactions that condition gel dosimetry outputs, often phenomenologically addressed, and particularly formulations reported since 2017.

Investigating the Sensitivity of New Formulation MAGAT and NIPAM Polymer Gels in the Radiation Therapy Dosimetry

BACKGROUND

Normoxic polymer gels have been used as a three dimensional (3D) dosimeter in radiation therapy, recently. The sensitivity of these gels is important in dosimetry and their improvement can be also useful.

OBJECTIVE

In this study, different modalities of gel reading were used and the structure of gel changed due to the best improvement of sensitivity. The sensitivities of the new formulation of Methacrylic acid gel (MAGAT) and N-isopropyl acrylamide (NIPAM) polymer gel dosimeters were studied using two different reading methods of magnetic resonance imaging (MRI) and X-ray computed tomography (X-ray CT).

MATERIAL AND METHODS

In this experimental study, in addition to making the NIPAM polymer gel dosimeter, a new formulation of normoxic polymer gel dosimeter, which named MAGAT gel, was investigated. The gels were irradiated with 6 MV in low doses, including1, 1.5, 1.75, 2 and 2.5 Gy. MRI and X-ray CT did the reading of gel dosimeters a day after irradiation using an elevated protocol.

RESULTS

The dose sensitivities of 0.92 HGy^-1 and 0.47 HGy^-1 were obtained for new MAGAT and NIPAM polymer gel dosimeters, respectively, based on the X-ray CT reading modality. The use of MRI reading modality and the dose sensitivities were 0.74 S^-1Gy^-1 and 0.27 S^-1Gy^-1 for new MAGAT and NIPAM polymer gel dosimeters, respectively.

CONCLUSION

The new formulation of MAGAT polymer gel with a suitable protocol of gel reading has a better response.

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.

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.

A review study on application of gel dosimeters in low energy radiation dosimetry

INTRODUCTION

The accuracy of dose delivered to tumors and surrounding normal tissues is vital in either radiotherapy using low energy photons and radiological techniques as well as radiotherapy with mega voltage energies. This systematic review focuses on applications of gel dosimetry in low energy radiation contexts applied either through radiotherapy or interventional radiology.

METHODS

Literature was reviewed based on electronic databases: Google Scholar, Scopus, Embase, PubMed, Science Direct, Research Gate and IOP science. The search was conducted on relevant terms in the title and keywords. 82 articles related to our criteria has been extracted and included in the study.

RESULTS

The findings demonstrated that almost all types of gel dosimeters had an acceptable accuracy and high resolution in low energy radiation contexts with their own limitations and advantages.

CONCLUSION

Gel dosimeters compete well with other conventional dosimeters in terms of tissue equivalence and energy dependence; however, choosing the best gel dosimeter for use in low energy radiation dosimetry depends on their different limitation and advantages. There are some general features about each gel group which can help to select the suitable gel related to our work. For example, methacrylic acid based gel dosimeters show higher sensitivity compared to other types of gel dosimeters but have more toxicity and are dose rate dependent in the range of dose rates applied in low energy contexts. In addition, Fricke gel dosimeters exhibit less sensitivity while they are independent of dose rate and energy applied in low energy situations.

Development and Application of MAGIC-f Gel in Cancer Research and Medical Imaging

Much of the complex medical physics work requires radiation dose delivery, which requires dosimeters to accurately measure complex three-dimensional dose distribution with good spatial resolution. MAGIC-f polymer gel is one of the emerging new dosimeters widely used in medical physics research. The purpose of this study was to present an overview of polymer gel dosimetry, using MAGIC-f gel, including its composition, manufacture, imaging, calibration, and application to medical physics research. In this review, the history of polymer gel development is presented, along with the applications so far. Moreover, the most important experiments/applications of MAGIC-f polymer gel are discussed to illustrate the behavior of gel on different conditions of irradiation, imaging, and manufacturing techniques. Finally, various future works are suggested based on the past and present works on MAGIC-f gel and polymer gel in general, with the hope that these bits of knowledge can provide important clues for future research on MAGIC-f gel as a dosimeter.

Synchrotron X-ray Irradiation of a Rat’s Head Model: Monte Carlo Study of Chromatic Gel Dosimetry

Accurate treatment planning in radiotherapy essentially decreases damage to healthy tissue surrounding the tumor. Due to plans to use a direct, highly collimated, narrow beam with high intensity to treat small area tumors, researchers have studied microbeam radiation therapy extensively. Using a synchrotron beam as the radiation source may help to limit damage, but treatment planning using computerized simulations and dosimetry is still necessary to achieve optimal results. For this purpose, PDA-gel dosimeters were developed and their sensitivity around a 150 keV induced synchrotron X-ray radiation beam was examined via Monte Carlo simulations using the EGS5 code system. The microbeam development is now at the animal study stage. In this study, we simulate the irradiation of a rat’s brain. The simulation results obtained spectra for two types of PDA-gel dosimeters that were compared with the spectrum obtained in a modelized brain tumor of a rat. Additionally, percentage depth dose curves were calculated for the brain tissue and the two gels. Correction equations for the dosimeters were obtained from the dose-difference plots. For further references, these equations can be used to calculate the actual dose in a brain tumor in a rat. The Monte Carlo simulations demonstrate that PDA-gel dosimeters can be used for treatment planning using synchrotron irradiations.

Characterization of novel polydiacetylene gel dosimeter for radiotherapy

Polymer gel dosimeters are instrumental for clinical and research applications in radiotherapy. These dosimeters possess the unique ability to record dose distribution in three dimensions. A Polymer gel dosimeter is composed of organic molecules in a gel matrix, which upon irradiation polymerize to form a conjugated polymer with optical absorbance proportional to the irradiated dose. Other required characteristics of a radiotherapy clinical dosimeter are soft-tissue equivalency, linear dose-response in a range of clinical treatments, and long term stability for the duration of the analysis. The dosimeter presented in this paper is based on diacetylene bearing fatty acid aggregates embedded in a soft-tissue equivalent gel matrix, Phytagel™, which upon irradiation polymerize to form a blue phase polydiacetylene with a strong optical absorption. Initial characterization showed that PDA-gel irradiated with 160 kV x-ray responded linearly to the irradiated dose, and the calculated diffusion coefficient is [Formula: see text] what is very low. It was also found that the percentage depth dose (PDD) curve of the PDA-gel in a 4 × 4 cm² field, irradiated with 6 MV x-rays, was with good agreement with the literature. PDA-gel has the potential to detect absorbed dose in a range of clinical radiological irradiation regimes.

Clinical radiotherapy application of N-vinylpyrrolidone-containing 3D polymer gel dosimeters with remote external MR-reading

PURPOSE

Advanced 3D dosimetry is required for verifications of complex dose distributions in modern radiotherapy. Two 3D polymer gel dosimeters, coupled with magnetic resonance (MR) imaging (3 T MRI) readout and data processing with polyGeVero® software, were tested for the verification of calculated 3D dose distributions by a treatment planning system (TPS) and ArcCHECK®-3DVH®, related to eradication of a lung tumour.

METHODS

N-vinylpyrrolidone-containing 3D polymer gel dosimeters were used: VIC (containing ascorbic acid and copper sulfate pentahydrate) and VIC-T (containing tetrakis(hydroxymethyl)phosphonium chloride). Three remote centers were involved in the dosimeters preparation and irradiation (Poland), and MRI (Austria). Cross beam calibration of the dosimeters and verification of a 3D dose distribution calculated with an Eclipse External Beam TPS and ArcCHECK®-3DVH® were performed. The 3D-to-3D comparisons of the VIC and VIC-T with TPS and ArcCHECK®-3DVH® along with ArcCHECK®-3DVH® versus TPS dose matrixes were performed with the aid of the polyGeVero® by analyzing dose profiles, isodoses lines, gamma index, gamma angle, dose difference, and related histograms.

RESULTS

The measured MR-relaxation rate (R₂ = 1/T₂) for the dosimeters relates to the dose, as follows: R₂ = 0.0928 ± 0.0008 [Gy^-1 s^-1] × D [Gy] + 2.985 ± 0.012 [s^-1] (VIC) and 0.1839 ± 0.0044 [Gy^-1 s^-1] × D [Gy] + 2.519 ± 0.053 [s^-1] (VIC-T). The 3D-to-3D comparisons revealed a good agreement between the measured and calculated 3D dose distributions.

CONCLUSIONS

VIC and VIC-T with 3T MRI readout and polyGeVero® showed potential for verifications of calculated irradiation plans. The results obtained suggest the implementation of the irradiation plan for eradication of the lung tumour.

Improvement of sensitivity of X-ray CT reading method for polymer gel in radiation therapy

Background

Three dimensional (3D) dosimetry methods are useful for advanced radiotherapy techniques such as stereotactic radiosurgery (SRS) and high dose rate (HDR) brachytherapy. Polymer gel is one of the more reliable 3D dosimetry techniques. More studies are needed to improve the efficiency of polymer gels for their application in dosimetry.

Aim

In the current study, the best protocol for reading of N-isopropyl acrylamide (NIPAM) polymer gel by X-ray computed tomography (CT) was implemented for application in radiotherapy.

Material and methods

The NIPAM gel was made and irradiated by 6 MV. Its reading was done by the X-ray CT after 24 h and the information examined by using the MATLAB software. In the present work, the different effects of slice thicknesses and voltages were investigated for its lower toxicity of NIPAM polymer gel. The results of a recipe of different filtering on the response curve of polymer gel was investigated.

Results

The measured dose sensitivity was Δ N C T H  = 0.29 ± 0.01 H G y - 1 for the NIPAM dosimeter. The best sensitivity was achieved for 120 kVp and the slice thickness of 10 mm. The greater slice thickness gained more desirable sensitivity. This process was repeated by using different filtering with different thicknesses to obtain the best sensitivity.

Conclusions

The sensitivity of X-ray CT reading technique of NIPAM Polymer gel depended on the slice thickness and kVp. The wiener2 filtering was useful to improving sensitivity.

Basic Properties of a New Polymer Gel for 3D-Dosimetry at High Dose-Rates Typical for FFF Irradiation Based on Dithiothreitol and Methacrylic Acid (MAGADIT): Sensitivity, Range, Reproducibility, Accuracy, Dose Rate Effect and Impact of Oxygen Scavenger

The photon induced radical-initiated polymerization in polymer gels can be used for high-resolution tissue equivalent dosimeters in quality control of radiation therapy. The dose (D) distribution in radiation therapy can be measured as a change of the physical measurement parameter T2 using T2-weighted magnetic resonance imaging. The detection by T2 is relying on the local change of the molecular mobility due to local polymerization initiated by radicals generated by the ionizing radiation. The dosimetric signals R2 = 1/T2 of many of the current polymer gels are dose-rate dependent, which reduces the reliability of the gel for clinical use. A novel gel dosimeter, based on methacrylic acid, gelatin and the newly added dithiothreitol (MAGADIT) as an oxygen-scavenger was analyzed for basic properties, such as sensitivity, reproducibility, accuracy and dose-rate dependence. Dithiothreitol features no toxic classification with a difference to THPC and offers a stronger negative redox-potential than ascorbic acid. Polymer gels with three different concentration levels of dithiothreitol were irradiated with a preclinical research X-ray unit and MR-scanned (T2) for quantitative dosimetry after calibration. The polymer gel with the lowest concentration of the oxygen scavenger was about factor 3 more sensitive to dose as compared to the gel with the highest concentration. The dose sensitivity (α = ∆R2/∆D) of MAGADIT gels was significantly dependent on the applied dose rate D˙ (≈48% reduction between D˙ = 0.6 Gy/min and D˙ = 4 Gy/min). However, this undesirable dose-rate effect reduced between 4–8 Gy/min (≈23%) and almost disappeared in the high dose-rate range (8 ≤ D˙≤ 12 Gy/min) used in flattening-filter-free (FFF) irradiations. The dose response varied for different samples within one manufacturing batch within 3%–6% (reproducibility). The accuracy ranged between 3.5% and 7.9%. The impact of the dose rate on the spatial integrity is demonstrated in the example of a linear accelerator (LINAC) small sized 5 × 10 mm² 10 MV photon field. For MAGADIT the maximum shift in the flanks in this field is limited to about 0.8 mm at a FFF dose rate of 15 Gy/min. Dose rate sensitive polymer gels likely perform better at high dose rates; MAGADIT exhibits a slightly improved performance compared to the reference normoxic polymer gel methacrylic and ascorbic acid in gelatin initiated by copper (MAGIC) using ascorbic acid.

Study of the formulation optimization and reusability of a MAGAT gel dosimeter

PURPOSE

This study aims to optimize the formulation of a methacrylic acid gelatine and tetrakis (hydroxymethyl) phosphonium chloride (MAGAT) gel dosimeter to achieve acceptable dosimetric characteristics and the lowest final costs. This study also evaluates the reusability of the dosimeter.

METHODS

The MAGAT gel dosimeter formulation was optimized. Tetrakis (hydroxymethyl) phosphonium chloride (THPC) concentrations (2, 5, 8, 10, 20, and 65 mM), methacrylic acid (MA) concentrations (2.0, 2.5, 3.0, 3.5, and 4.0% w/w) and gelatin concentrations (4.36, 6.45, 8.36, and 10.45% w/w) were evaluated to provide an adequate dosimetric response. The final dosimeter formulation linearity and dose rate dependence were evaluated. The reutilization methodology of the optimized gel formulation, but containing 2 mM of THPC, which was previously irradiated with a dose of 2 Gy, is also presented.

RESULTS

The optimized mass concentration of the dosimeter consists of 88.60% deionized water, 8.36% gelatin, 3.00% of MA and 0.04% THPC (5 mM). It presents a linear response for doses up to 10 Gy with a 1.16 Gy^-1 s^-1 sensitivity. A maximum sensitivity variation of less than 4.0% was found when varying the dose rate of the radiation beams from 300 to 500 cGy/min. It was possible to reuse the dosimeter, however the sensitivity decreased by 15% from the first to the second irradiation.

CONCLUSIONS

A low-cost MAGAT gel dosimeter with optimized formulation that responds to radiation in a dose range of 0 to 10 Gy with small dose-rate dependence is presented. The MAGAT gel can be reused after a 2 Gy irradiation.

Raman spectroscopy as a tool to evaluate oxygen effects on the response of polymer gel dosimetry

Currently, advanced dosimeters like polymer gels are capable of obtaining reliable and accurate 3D dose distributions from correlations with the different polymerization degrees induced by incident radiation. Samples of polymer gel dosimeters are commonly read out using magnetic resonance imaging or optical methods like visible light transmission or laser computed tomography. Alternatively, this work proposes and evaluates the implementation of Raman spectroscopy to provide direct information on the effect of oxygen permeating through the walls of phantoms on the polymerization initiated by irradiation in three types of polymer gel dosimeters, namely NIPAM, ITABIS and PAGAT. The aim of the present study is to provide better and complete interpretations using three different containers, adequate for integral, 2D and 3D dose mapping. Moreover, Raman spectroscopy has been used to analyze the well-known effect of oxygen inhibition on the different polymer gel dosimeters remarking the importance of avoiding air exposition during sample storage and readout. Dose-response curves for different polymer gels were obtained in terms of measurements with a calibrated ionization chamber. Additionally, dedicated Monte Carlo simulations were performed aimed at characterizing dose for different X-ray irradiation setups, providing also suitable information to evaluate oxygen diffusion through the sample wall. The obtained results were contrasted with optical transmission readout as well as Monte Carlo simulations attaining very good agreements for all dosimeter types.

Quantitative magnetic resonance elastography for polymer-gel dosimetry phantoms

Commonly dose-responses of conventional dosimetric methods are affected by a saturation dose and are known to be limited when the delivered dose is relatively high. In contrast, elastic properties of polymer-gel dosimeter phantoms play major roles in a new dosimetry technique using magnetic resonance elastography (MRE). A single volume of polymer-gel dosimeter solution containing methacrylic and ascorbic acid in gelatin initiated by copper was prepared. The material was subsequently stored in cylindrical containers for future use as a biological tissue-mimicking phantom material. The phantom material was irradiated with gamma rays, where absorbed doses of 10-50 Gy were delivered. To study the dynamic elastic behaviour, periodic mechanical external forces of 100-400 Hz were applied to generate shear waves in the samples. The radiation-induced changes in the shear modulus of the samples were estimated from wave-displacement images and converted to elastograms. The smallest and largest shear modulus values were approximately 2.10 ± 0.64 and 35.26 ± 2.85 kPa, respectively. The dynamic elastic response of the polymer-gel dosimeters showed an increased dependency with frequency. A linear relationship (R² = 0.996) was observed between the integrated area and the absorbed dose of the samples. The elastograms clearly showed that the largest shear modulus values were in the irradiated region of the polymer-gel dosimeter phantoms. Quantitative values of the shear modulus of polymer-gel dosimeters were estimated using MRE.

A systematic review of clinical applications of polymer gel dosimeters in radiotherapy

Radiotherapy has rapidly improved because of the use of new equipment and techniques. Hence, the appeal for a feasible and accurate three-dimensional (3D) dosimetry system has increased. In this regard, gel dosimetry systems are accurate 3D dosimeters with high resolution. This systematic review evaluates the clinical applications of polymer gel dosimeters in radiotherapy. To find the clinical applications of polymer gel dosimeters in radiotherapy, a full systematic literature search was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in electronic databases up to January 31, 2017, with use of search-related terms in the titles and abstracts of articles. A total of 765 articles were screened in accordance with our inclusion and exclusion criteria. Eventually, 53 articles were included in the study. The findings show that most clinical applications of polymer gel dosimeters relate to external radiotherapy. Most of the gel dosimeters studied have acceptable dose accuracy as a 3D dosimeter with high resolution. It is difficult to judge which is the best polymer gel dosimeter to use in a clinical setting, because each gel dosimeter has advantages and limitations. For example, methacrylic acid-based gel dosimeters have high dose sensitivity and low toxicity, while their dose response is beam energy dependent; in contrast, N-isopropylacrylamide gel dosimeters have low dose resolution, but their sensitivity is lower and they are relatively toxic.

A nanogel sensor for colorimetric fluorescence measurement of ionizing radiation doses

A polyacrylamide-based nanogel sensor was constructed for spectral and visual colorimetric fluorescence measurement of ionizing radiation doses.

A Polymer-Gel Eye-Phantom for 3D Fluorescent Imaging of Millimetre Radiation Beams

We have filled a 24 mm diameter glass sphere with a transparent polymer-gel that is radio-fluorogenic, i.e., it becomes (permanently) fluorescent when irradiated, with an intensity proportional to the local dose deposited. The gel consists of >99.9% tertiary-butyl acrylate (TBA), pre-polymerized to ~15% conversion, and ~100 ppm maleimido-pyrene (MPy). Its dimensions and physical properties are close to those of the vitreous body of the human eye. We have irradiated the gel with a 3 mm diameter, 200 kVp X-ray beam with a dose rate of ~1 Gy/min. A three-dimensional (3D) (video) view of the beam within the gel has been constructed from tomographic images obtained by scanning the sample through a thin sheet of UV light. To minimize optical artefacts, the cell was immersed in a square tank containing a refractive-index-matching medium. The 20⁻80% penumbra of the beam was determined to be ~0.4 mm. This research was a preparatory investigation of the possibility of using this method to monitor the millimetre diameter proton pencil beams used in ocular radiotherapy.

Substituting gelatine with Pluronic F-127 matrix in 3D polymer gel dosimeters can improve nuclear magnetic resonance, thermal and optical properties

This work discusses the substitution of a gelatine physical gel matrix with a matrix made of poly(ethylene oxide)-block-poly(propylene oxide)-block-poly(ethylene oxide) (Pluronic F-127) in five 3D radiotherapy polymer gel dosimeters: MAGAT, PAGAT, NIPAM, VIPAR^nd (VIP) and VIPAR^CT (VIC). The current research outcomes showed that not each polymer gel dosimeter could be manufactured with Pluronic F-127. Two of the polymer gel dosimeters (PAGAT and VIP) containing the Pluronic F-127 matrix allowed for some proper dose response for radiotherapy dosimetry (a response to a dose range of e.g. 0‒50 Gy). The new best performing Pluronic-based polymer gel dosimeters were characterised by improved nuclear magnetic resonance properties, when being compared to gels with gelatine matrix at the same monomer content. These are: (i) a ~33% higher dose sensitivity; (ii) a comparable or slightly higher linear and dynamic dose range and (iii) a lower (new VIP composition, VIP3) or equivocal (new PAGAT composition, PAGAT2-Pluronic) dose threshold. However, there might be optimised gelatine based polymer dosimeters demonstrating even better sensitivity. UV-vis spectrophotometry measurements revealed that Pluronic matrices ensure six-times lower (VIP3-Pluronic) and eight-times lower (PAGAT2-Pluronic) absorbance (at 400 nm) of non-irradiated gels compared to gelatine matrices, which makes the new polymer gel dosimeters optically improved in comparison to their corresponding gelatine-based compositions. The differences in absorption reduce for higher wavelengths. Differential scanning calorimetry measurements revealed the following temperature stability ranges for the gels: (i) VIP with gelatine matrix: 0 °C‒26 °C, (ii) VIP3 with Pluronic matrix: 13.8 °C-55.2 °C, (iii) PAGAT2 with gelatine matrix: 0 °C-80 °C and (iv) PAGAT2 with Pluronic matrix: 21.4 °C-55.2 °C. In conclusion, Pluronic F-127 is an attractive co-polymer to serve as a substitute for the gelatine matrix in some 3D polymer gel dosimeters.

Polymer gel dosimetry by nuclear Overhauser enhancement (NOE) magnetic resonance imaging

The response to radiation of polymer gel dosimeters has previously been measured by magnetic resonance imaging (MRI) in terms of changes in the water transverse relaxation rate (R _2w) or magnetization transfer (MT) parameters. Here we report a new MRI approach, based on detecting nuclear Overhauser enhancement (NOE) mediated saturation transfer effects, which can also be used to detect radiation and measure dose distributions in MAGIC-f (Methacrylic and Ascorbic Acid and Gelatin Initiated by Copper Solution with formaldehyde) polymer gels. Results show that the NOE effects produced by low powered radiofrequency (RF) irradiation at specific frequencies offset from water may be quantified by appropriate measurements and over a useful range depend linearly on the radiation dose. The NOE effect likely arises from the polymerization of methacrylic acid monomers which become less mobile, facilitating dipolar through-space cross-relaxation and/or relayed magnetization exchange between polymer and water protons. Our study suggests a potential new MRI method for polymer gel dosimetry.

Dosimetric verification and quality assurance for intensity-modulated radiation therapy using Gafchromic® EBT3 film

Purpose

This study aimed to examine the dosimetric properties of Gafchromic® EBT3 film and intensity-modulated radiation therapy quality assurance (IMRT QA).

Materials and methods

Beams characteristics dosimetric properties and 20 IMRT plans were created and irradiated on Varian dual-energy DHX-S Linac for 6 and 15 MV energies. EBT3 films were analysed using ‘film Pro QA 2014’ software.

Results

The dosimetric comparison of EBT3 film (for red channel dosimetry) and ionisation ion chamber measurement showed that average deviations of symmetry, flatness, central axis, penumbra (left) and penumbra (right) of dose profile were 0·18, 1·34, 0·49%, 3·68 and 3·61 mm for 6 MV and 0·10, 1·3, 0·45, 2·65 and 2·71 mm for 15 MV, respectively. The blue and green channels dosimetry showed greater dose deviation as compared with red channel. IMRT QA verification plan complied about 95% at all different criteria. Reproducibility, stability and face orientation of film were within 1·4% for red channel.

Conclusions

The results advocate that the film can be used not only for dosimetric assessment but also as a reliable IMRT QA tool.

Determining the mechanical properties of a radiochromic silicone-based 3D dosimeter

New treatment modalities in radiotherapy (RT) enable delivery of highly conformal dose distributions in patients. This creates a need for precise dose verification in three dimensions (3D). A radiochromic silicone-based 3D dosimetry system has recently been developed. Such a dosimeter can be used for dose verification in deformed geometries, which requires knowledge of the dosimeter's mechanical properties. In this study we have characterized the dosimeter's elastic behaviour under tensile and compressive stress. In addition, the dose response under strain was determined. It was found that the dosimeter behaved as an incompressible hyperelastic material with a non-linear stress/strain curve and with no observable hysteresis or plastic deformation even at high strains. The volume was found to be constant within a 2% margin at deformations up to 60%. Furthermore, it was observed that the dosimeter returned to its original geometry within a 2% margin when irradiated under stress, and that the change in optical density per centimeter was constant regardless of the strain during irradiation. In conclusion, we have shown that this radiochromic silicone-based dosimeter's mechanical properties make it a viable candidate for dose verification in deformable 3D geometries.

Three-dimensional radiation dosimetry using polymer gel and solid radiochromic polymer: From basics to clinical applications

Accurate dose measurement tools are needed to evaluate the radiation dose delivered to patients by using modern and sophisticated radiation therapy techniques. However, the adequate tools which enable us to directly measure the dose distributions in three-dimensional (3D) space are not commonly available. One such 3D dose measurement device is the polymer-based dosimeter, which changes the material property in response to radiation. These are available in the gel form as polymer gel dosimeter (PGD) and ferrous gel dosimeter (FGD) and in the solid form as solid plastic dosimeter (SPD). Those are made of a continuous uniform medium which polymerizes upon irradiation. Hence, the intrinsic spatial resolution of those dosimeters is very high, and it is only limited by the method by which one converts the dose information recorded by the medium to the absorbed dose. The current standard methods of the dose quantification are magnetic resonance imaging, optical computed tomography, and X-ray computed tomography. In particular, magnetic resonance imaging is well established as a method for obtaining clinically relevant dosimetric data by PGD and FGD. Despite the likely possibility of doing 3D dosimetry by PGD, FGD or SPD, the tools are still lacking wider usages for clinical applications. In this review article, we summarize the current status of PGD, FGD, and SPD and discuss the issue faced by these for wider acceptance in radiation oncology clinic and propose some directions for future development.