Detection of therapeutic radiation in three-dimensions

Feasibility of a Reusable Radiochromic Dosimeter

The current practice for patient-specific quality assurance (QA) uses ion chambers or diode arrays primarily because of their ease of use and reliability. A standard routine compares the dose distribution measured in a phantom with the dose distribution calculated by the treatment planning system for the same experimental conditions. For the particular problems encountered in the treatment planning of complex radiotherapy techniques, such as small fields/segments and dynamic delivery systems, additional tests are required to verify the accuracy of dose calculations. The dose distribution verification should be throughout the total 3D dose distribution for a high dose gradient in a small, irradiated volume, instead of the standard practice of one to several planes with 2D radiochromic (GAFChromic) film. To address this issue, we have developed a 3D radiochromic dosimeter that improves the rigor of current QA techniques by providing high-resolution, complete 3D verification for a wide range of clinical applications. The dosimeter is composed of polyurethane, a radical initiator, and a leuco dye, which is radiolytically oxidized to a dye absorbing at 633 nm. Since this chemical dosimeter is single-use, it represents a significant expense. The purpose of this research is to develop a cost-effective reusable dosimeter formulation. Based on prior reusability studies, three promising dosimeter formulations were studied using small volume optical cuvettes and irradiated to known clinically relevant doses of 0.5–10 Gy. After irradiation, the change in optical density was measured in a spectrophotometer. All three formulations retained linearity of optical density response to radiation upon re-irradiations. However, only one formulation retained dose sensitivity upon at least five re-irradiations, making it ideal for further evaluation as a 3D dosimeter.

Performance of the cone beam computed tomography-based patient positioning system on the Gamma Knife Icon™

PURPOSE

Cone beam computed tomography (CBCT) imaging has been implemented on the Leksell Gamma Knife^® Icon™ for assessing patient positioning in mask-based Gamma Knife radiosurgery. The purpose of this study was to evaluate the performance of the CBCT-based patient positioning system as a tool for frameless Gamma Knife radiosurgery.

METHODS

Daily quality assurance (QA) CBCT precision test results from a 12-month period were analyzed for the geometric accuracy and the stability of the imager. The performance of the image acquisition module and the image registration algorithm was evaluated using an anthropomorphic head phantom (CIRS Inc., Norfolk, VA) and a XYZR axis manual positioning stage (TOAUTO Inc., Guangdong, China). The head phantom was fixed on a mask adaptor and manually translated in the X, Y, Z directions or rotated around the X, Y, Z axes in the range of ±10 mm or ±10º. A CBCT scan was performed after each manual position setup followed by an image registration to the reference scan. To assess the overall setup uncertainties in fractionated treatment, two cylindrical Presage phantoms (Heuris Inc., Skillman, NJ) of 15 cm diameter and 10 cm height were irradiated with identical prescription dose and shot placement following standard mask-based treatment workflow according to two different fraction schedules: a single fraction treatment of 7.5 Gy and a 5-fraction treatment with 1.5 Gy per fraction.

RESULTS

The averaged vector deviations of the four marks from their preset values are 0.087, 0.085, 0.095, and 0.079 mm from the 212 daily QA tests. The averaged displacements in the X, Y, Z coordinates and the pitch, yaw, roll angles from the image registration tests are 0.23, 0.27, 0.14, 0.32º, 0.19º, 0.31º from the manual setup. The corresponding maximum differences are 0.41, 0.33, 0.29 mm, 0.45º, 0.31º, and 0.43º, respectively. Compared to the treatment plan using the 2% & 1 mm criteria, the averaged 2D Gamma passing rate is 98.25% for the measured dose distribution from the Presage phantom with 1-fraction irradiation and 95.12% for the 5-fraction irradiation. The averaged Gamma passing rates are 99.53% and 98.16% for the 1-fraction and 5-fraction irradiations using the 2% & 2 mm criteria.

CONCLUSIONS

The CBCT imager and the image registration algorithm can reproduce phantom position with <0.5 mm/0.5º uncertainty. A systematic contribution from the interfraction phantom repositioning procedure was observed in the Gamma analysis over the irradiated volumes of two end-to-end test phantoms.