Development of a novel and low-cost anthropomorphic pelvis phantom for 3D dosimetry in radiotherapy.

Purpose: The aim of this study was to construct a low-cost, anthropomorphic, and 3D-printed pelvis phantom and evaluate the feasibility of its use to perform 3D dosimetry with commercially available bead thermoluminescent dosimeters (TLDs). Material and methods: A novel anthropomorphic female phantom was developed with all relevant pelvic organs to position the bead TLDs. Organs were 3D-printed using acrylonitrile butadiene styrene. Phantom components were confirmed to have mass density and computed tomography (CT) numbers similar to relevant tissues. To find out clinically required spatial resolution of beads to cause no perturbation effect, TLDs were positioned with 2.5, 5, and 7.5 mm spacing on the surface of syringe. After taking a CT scan and creating a 4-field conformal radiotherapy plan, 3 dose planes were extracted from the treatment planning system (TPS) at different depths. By using a 2D-gamma analysis, the TPS reports were compared with and without the presence of beads. Moreover, the bead TLDs were placed on the organs' surfaces of the pelvis phantom and exposed to high-dose-rate (HDR) Co source. TLDs' readouts were compared with the TPS calculated doses, and dose surface histograms (DSHs) of organs were plotted.Results: 3D-printed phantom organs agreed well with body tissues regarding both their design and radiation properties. Furthermore, the 2D-gamma analysis on the syringe showed more than 99% points passed 3%- and 3-mm criteria at different depths. By calculating the integral dose of DSHs, the percentage differences were -1.5%, 2%, 5%, and 10% for uterus, rectum, bladder, and sigmoid, respectively. Also, combined standard uncertainty was estimated as 3.5% (k= 1). Conclusions: A customized pelvis phantom was successfully built and assessed to confirm properties similar to body tissues. Additionally, no significant perturbation effect with different bead resolutions was presented by the external TPS, with 0.1 mm dose grid resolution

Measurement of a wide-range of X-ray doses using specialty doped silica fibres

Using six types of tailor-made doped optical fibres, we carry out thermoluminescent (TL) studies of X-rays, investigating the TL yield for doses from 20 mGy through to 50 Gy. Dosimetric parameters were investigated for nominal 8 wt% Ge doped fibres that in two cases were co-doped, using B in one case and Br in the other. A comparative measurement of surface analysis has also been made for non-annealed and annealed capillary fibres, use being made of X-ray Photoelectron Spectroscopy (XPS) analysis. Comparison was made with the conventional TL phosphor LiF in the form of the proprietary product TLD-100, including dose response and glow curves investigated for X-rays generated at 60 kVp over a dose range from 2 cGy to 50 Gy. The energy response of the fibres was also performed for X-rays generated at peak accelerating potentials of 80 kVp, 140 kVp, 250 kVp and 6 MV photons for an absorbed dose of 2 Gy. Present results show the samples to be suitable for use as TL dosimeters, with good linearity of response and a simple glow curve (simple trap) distribution. It has been established that the TL performance of an irradiated fibre is not only influenced by radiation parameters such as energy, dose-rate and total dose but also the type of fibre

Developments in production of silica-based thermoluminescence dosimeters

This work addresses purpose-made thermoluminescence dosimeters (TLD) based on doped silica fibres and sol–gel nanoparticles, produced via Modified Chemical Vapour Deposition (MCVD) and wet chemistry techniques respectively. These seek to improve upon the versatility offered by conventional phosphor-based TLD forms such as that of doped LiF. Fabrication and irradiation-dependent factors are seen to produce defects of differing origin, influencing the luminescence of the media. In coming to a close, we illustrate the utility of Ge-doped silica media for ionizing radiation dosimetry, first showing results from gamma-irradiated Ag-decorated nanoparticles, in the particular instance pointing to an extended dynamic range of dose. For the fibres, at radiotherapy dose levels, we show high spatial resolution (0.1 mm) depth-dose results for proton irradiations. For novel microstructured fibres (photonic crystal fibres, PCFs) we show first results from a study of undisturbed and technologically modified naturally occurring radioactivity environments, measuring doses of some 10 s of μGy over a period of several months

Characterisation and novel applications of glass beads as dosimeters in radiotherapy.

The intent of external beam radiotherapy is to deliver as high a radiation dose as possible to tumour volume whilst minimizing the dose to surrounding normal tissues. Recent development of techniques such as intensity modulated radiation therapy (IMRT) and stereotactic ablative body radiotherapy (SABR) aim to extend this capability. The main feature of these techniques is to use beams which often contain small fields and very steep dose gradients. These present several dosimetric challenges including loss of charge particle equilibrium (CPE), partial occlusion of the direct-beam source and steep fall-off in dose in the penumbra. Dosimeters which are small in size relative to the radiation field dimensions are recommended for such conditions. The particular glass beads studied herein have several potentially favourable physical characteristics; they are small in size (1 to 3 mm diameter), chemically inert, inexpensive, readily available and reusable. The dosimetric characterisation of glass beads has been obtained by irradiating them in various radiotherapy beams of kilo-voltage and mega-voltage photons, megavoltage electrons, protons and carbon ions. They exhibit minimal fading compared with commercial LiF thermo-luminescent (TL) dosimeters, have high TL light transparency, high sensitivity and a large dynamic dose range that remains linear from 1 cGy to 100 Gy They have also been shown to be independent of dose rate and beam incidence angle, as well as having a low variation in response with energy over a range of megavoltage photon and electron beams. The latter characteristic is of importance, where spectral changes may occur as a function of field size and off axis location and for the use of dosimeters in postal audit situations where each institution may have slightly different quality index (QI) for their respective photon energies thus ensuring that the calibration is still valid. These properties suggest their practical use as TL dosimeters for radiotherapy dosimetry. Investigations have been performed to evaluate the feasibility of using glass beads in treatment plan verification, small field radiation dosimetry and postal dosimetry audit

Evaluation and clinical implementation of in vivo dosimetry for kV radiotherapy using radiochromic film and micro-silica bead thermoluminescent detectors

Purpose: kV radiotherapy treatment calculations are based on flat, homogenous, full-scatter reference conditions. However, clinical treatments often include surface irregularities and inhomogeneities, causing uncertainty. Therefore, confirmation of actual delivered doses in vivo is valuable. The current study evaluates, and implements, radiochromic film and micro silica bead TLD for in vivo kV dosimetry. Methods: The kV energy and dose response of EBT3 film and silica bead TLD was established and uncertainty budgets determined. In vivo dosimetry measurements were made for a consecutive series of 30 patients using the two dosimetry systems. Results: Energy dependent calibration factors were required for both dosimetry systems. The standard uncertainty estimate for in vivo measurement with film was 1.7% and for beads was 1.5%. The mean measured dose was 2.1% for film and 2.6% for beads compared to prescription. Deviations up to 9% were found in cases of large surface irregularity, or with underlying air cavities or bone. Dose shielding by beads could be clinically relevant at low kV energies and superficial depths. Conclusions: Both film and beads may be used to provide in vivo verification of delivered doses in kV radiotherapy, particularly for complex situations that are not well represented by standard reference condition calculation

A multicentre ‘end to end’ dosimetry audit of motion management (4DCT-defined motion envelope) in radiotherapy

Purpose: External dosimetry audit is valuable for the assurance of radiotherapy quality. However, motion management has not been rigorously audited, despite its complexity and importance for accuracy. We describe the first end-to-end dosimetry audit for non-SABR (stereotactic ablative body radiotherapy) lung treatments, measuring dose accumulation in a moving target, and assessing adequacy of target dose coverage. Materials and methods: A respiratory motion lung-phantom with custom-designed insert was used. Dose was measured with radiochromic film, employing triple-channel dosimetry and uncertainty reduction. The host’s 4DCT scan, outlining and planning techniques were used. Measurements with the phantom static and then moving at treatment delivery separated inherent treatment uncertainties from motion effects. Calculated and measured dose distributions were compared by isodose overlay, gamma analysis, and we introduce the concept of ‘dose plane histograms’ for clinically relevant interpretation of film dosimetry. Results: 12 radiotherapy centres and 19 plans were audited: conformal, IMRT (intensity modulated radiotherapy) and VMAT (volumetric modulated radiotherapy). Excellent agreement between planned and static-phantom results were seen (mean gamma pass 98.7% at 3% 2 mm). Dose blurring was evident in the moving-phantom measurements (mean gamma pass 88.2% at 3% 2 mm). Planning techniques for motion management were adequate to deliver the intended moving-target dose coverage. Conclusions: A novel, clinically-relevant, end-to-end dosimetry audit of motion management strategies in radiotherapy is reported

Wearable glass beads for in vivo dosimetry of total skin electron irradiation treatments

Glass beads have recently been proposed for use as radiation therapy dosimeters. Glass beads have a number of characteristics that make them suitable for in vivo skin dose measurements, including an ability to be worn on a string, and therefore avoid possible patient discomfort that may result from the use of adhesives. In this study, their use for in vivo dose measurements in total skin electron irradiation treatments has been tested. First, the dosimetric properties of cylindrical beads with a 3 mm diameter were characterised using electron fields produced by a linear accelerator. The mean individual bead reproducibility was demonstrated to be within 3%; and a batch variation of 7% was observed. The beads were shown to have a linear dose response, and both dose rate and beam energy independence, within the measurement uncertainty. Phantom measurements were then performed for a total skin electron irradiation beam arrangement, and results compared against optically stimulated luminescent dosimeters at five anatomical sites. For a majority of measurement locations, agreement within 3% was observed between the two dosimetry techniques, demonstrating the feasibility of glass beads as in vivo dosimeters for total skin electron irradiation; though further investigation may be needed to minimise uncertainty in results

Wearable glass beads for in vivo dosimetry of total skin electron irradiation treatments

Glass beads have recently been proposed for use as radiation therapy dosimeters. Glass beads have a number of characteristics that make them suitable for in vivo skin dose measurements, including an ability to be worn on a string, and therefore avoid possible patient discomfort that may result from the use of adhesives. In this study, their use for in vivo dose measurements in total skin electron irradiation treatments has been tested. First, the dosimetric properties of cylindrical beads with a 3 mm diameter were characterised using electron fields produced by a linear accelerator. The mean individual bead reproducibility was demonstrated to be within 3%; and a batch variation of 7% was observed. The beads were shown to have a linear dose response, and both dose rate and beam energy independence, within the measurement uncertainty. Phantom measurements were then performed for a total skin electron irradiation beam arrangement, and results compared against optically stimulated luminescent dosimeters at five anatomical sites. For a majority of measurement locations, agreement within 3% was observed between the two dosimetry techniques, demonstrating the feasibility of glass beads as in vivo dosimeters for total skin electron irradiation; though further investigation may be needed to minimise uncertainty in results