Evaluation of a synthetic single-crystal diamond detector for relative dosimetry on the Leksell Gamma Knife Perfexion radiosurgery system

Purpose: To evaluate the new commercial PTW-60019 synthetic single-crystal microDiamond detector (PTW, Freiburg, Germany) for relative dosimetry measurements on a clinical Leksell Gamma Knife Perfexion radiosurgery system. Methods: Detector output ratios (DORs) for 4 and 8 mm beams were measured using a micro- Diamond (PTW-60019), a stereotactic unshielded diode [IBA stereotactic field detector (SFD)], a shielded diode (IBA photon field detector), and GafChromic EBT3 films. Both parallel and transversal acquisition directions were considered for PTW-60019 measurements. Measured DORs were compared to the new output factor reference values for Gamma Knife Perfexion (0.814 and 0.900 for 4 and 8 mm, respectively). Profiles in the three directions were also measured for the 4 mm beam to evaluate full width at half maximum (FWHM) and penumbra and to compare them with the corresponding Leksell GammaPlan profiles. Results: FWHM and penumbra for PTW-60019 differed from the calculated values by less than 0.2 and 0.3 mm, for the parallel and transversal acquisitions, respectively. GafChromic films showed FWHM and penumbra within 0.1 mm. The output ratio obtained with the PTW-60019 for the 4 mm field was 1.6% greater in transverse direction compared to the nominal value. Comparable differences up to 0.8% and 1.0% for, respectively, GafChromic films and SFD were found. Conclusions: The microDiamond PTW-60019 is a suitable detector for commissioning and routine use of Gamma Knife with good agreement of both DORs and profiles in the three directions

Développement d'un dosimètre diamant pour une mesure de la dose absorbée dans les mini-faisceaux utilisés en radiothérapie stéréotaxique.

Stereotactic radiotherapy is a relatively recent technique used for the treatment of small benign and malignant tumors with small radiation beams. The clinical efficiency of this technique has been proved. However, the measurement of absolute and relative dose in small beams is not possible currently due to the lack of suited detectors for these measurements. In small beam dosimetry, the detector has to be as close as possible to tissue equivalence and exhibit a small detection volume due to the lack of lateral electronic equilibrium. Characteristics of diamond (water equivalent material Z=6, high density) make it an ideal candidate to fulfil most of small beam dosimetry requirements. In this thesis, we developed a dosimeter prototype for small beams, based on CVD synthetic single crystal diamond. The diamond samples were characterized optically and their detection properties were investigated under X-rays and alpha-particles. First diamond dosimeter prototypes were tested with small beams produced by several stereotactic machines. Studies using Monte Carlo simulations were performed in order to optimize the parameters involved in the detector response in small beams. This leaded to a final diamond dosimeter prototype that respects all radiotherapy centers requirements, in both standard and small beams.La radiothérapie stéréotaxique est une technique de pointe relativement récente utilisée pour le traitement de tumeurs bénignes ou malignes de petites dimensions employant des mini-faisceaux. L'efficacité clinique de cette technique est prouvée et n'est pas remise en cause, cependant il n'existe pas actuellement de dosimètre véritablement approprié permettant de caractériser ces faisceaux de petites dimensions par des mesures précises de dose absolue et relative. Le problème du manque d'équilibre électronique latéral rencontré en mini-faisceaux entraîne principalement les contraintes suivantes pour le dosimètre : équivalence-eau et petit volume de détection. Les caractéristiques du diamant (faible numéro atomique Z=6, densité élevée d'atomes) en font un candidat idéal. Au cours de cette thèse, nous avons développé un prototype de dosimètre pour mini-faisceaux à partir de diamant monocristallin synthétique CVD. Les échantillons ont été caractérisés optiquement par différentes techniques et leurs propriétés de détection ont été étudiées sous rayonnement X et sous particules. Une série de premiers prototypes a été développée et testée sur plusieurs machines de stéréotaxie. Une étape d'optimisation de ces premiers dosimètres diamant a ensuite été réalisée notamment par l'utilisation de simulations Monte Carlo. L'optimisation des différents paramètres entrant en jeu dans la réponse du dosimètre en mini-faisceaux a permis d'aboutir à un prototype final de dosimètre diamant. Ce prototype répond au cahier des charges rédigé par les physiciens médicaux des centres hospitaliers, aussi bien en champs standards qu'en mini-faisceaux

Development of a diamond dosimeter for measuring the absorbed dose in small beams used in stereotactic radiotherapy

La radiothérapie stéréotaxique est une technique de pointe relativement récente utilisée pour le traitement de tumeurs bénignes ou malignes de petites dimensions employant des mini-faisceaux. L'efficacité clinique de cette technique est prouvée et n'est pas remise en cause, cependant il n'existe pas actuellement de dosimètre véritablement approprié permettant de caractériser ces faisceaux de petites dimensions par des mesures précises de dose absolue et relative. Le problème du manque d'équilibre électronique latéral rencontré en mini-faisceaux entraîne principalement les contraintes suivantes pour le dosimètre : équivalence-eau et petit volume de détection. Les caractéristiques du diamant (faible numéro atomique Z=6, densité élevée d'atomes) en font un candidat idéal. Au cours de cette thèse, nous avons développé un prototype de dosimètre pour mini-faisceaux à partir de diamant monocristallin synthétique CVD. Les échantillons ont été caractérisés optiquement par différentes techniques et leurs propriétés de détection ont été étudiées sous rayonnement X et sous particules. Une série de premiers prototypes a été développée et testée sur plusieurs machines de stéréotaxie. Une étape d'optimisation de ces premiers dosimètres diamant a ensuite été réalisée notamment par l'utilisation de simulations Monte Carlo. L'optimisation des différents paramètres entrant en jeu dans la réponse du dosimètre en mini-faisceaux a permis d'aboutir à un prototype final de dosimètre diamant. Ce prototype répond au cahier des charges rédigé par les physiciens médicaux des centres hospitaliers, aussi bien en champs standards qu'en mini-faisceaux.Stereotactic radiotherapy is a relatively recent technique used for the treatment of small benign and malignant tumors with small radiation beams. The clinical efficiency of this technique has been proved. However, the measurement of absolute and relative dose in small beams is not possible currently due to the lack of suited detectors for these measurements. In small beam dosimetry, the detector has to be as close as possible to tissue equivalence and exhibit a small detection volume due to the lack of lateral electronic equilibrium. Characteristics of diamond (water equivalent material Z=6, high density) make it an ideal candidate to fulfil most of small beam dosimetry requirements. In this thesis, we developed a dosimeter prototype for small beams, based on CVD synthetic single crystal diamond. The diamond samples were characterized optically and their detection properties were investigated under X-rays and alpha-particles. First diamond dosimeter prototypes were tested with small beams produced by several stereotactic machines. Studies using Monte Carlo simulations were performed in order to optimize the parameters involved in the detector response in small beams. This leaded to a final diamond dosimeter prototype that respects all radiotherapy centers requirements, in both standard and small beams

Response of synthetic diamond detectors in proton, carbon, and oxygen ion beams.

PURPOSE: In this work, the LET-dependence of the response of synthetic diamond detectors is investigated in different particle beams. METHOD: Measurements were performed in three nonmodulated particle beams (proton, carbon, and oxygen). The response of five synthetic diamond detectors was compared to the response of a Markus or an Advanced Markus ionization chamber. The synthetic diamond detectors were used with their axis parallel to the beam axis and without any bias voltage. A high bias voltage was applied to the ionization chambers, to minimize ion recombination, for which no correction is applied (+300 V and +400 V were applied to the Markus and Advanced Markus ionization chambers respectively). RESULTS: The ratio between the normalized response of the synthetic diamond detectors and the normalized response of the ionization chamber shows an under-response of the synthetic diamond detectors in carbon and oxygen ion beams. No under-response of the synthetic diamond detectors is observed in protons. For each beam, combining results obtained for the five synthetic diamond detectors and considering the uncertainties, a linear fit of the ratio between the normalized response of the synthetic diamond detectors and the normalized response of the ionization chamber is determined. The response of the synthetic diamond detectors can be described as a function of LET as (-6.22E-4 ± 3.17E-3) • LET + (0.99 ± 0.01) in proton beam, (-2.51E-4 ± 1.18E-4) • LET + (1.01 ± 0.01) in carbon ion beam and (-2.77E-4 ± 0.56E-4) • LET + (1.03 ± 0.01) in oxygen ion beam. Combining results obtained in carbon and oxygen ion beams, a LET dependence of about 0.026% (±0.013%) per keV/μm is estimated. CONCLUSIONS: Due to the high LET value, a LET dependence of the response of the synthetic diamond detector was observed in the case of carbon and oxygen beams. The effect was found to be negligible in proton beams, due to the low LET value. The under-response of the synthetic diamond detector may result from the recombination of electron/hole in the thin synthetic diamond layer, due to the high LET-values. More investigations are required to confirm this assumption

Validation of Monte Carlo dose calculation algorithm for CyberKnife multileaf collimator.

To commission and evaluate the Monte Carlo (MC) dose calculation algorithm for the CyberKnife equipped with a multileaf collimator (MLC). We created a MC model for the MLC using an integrated module of the CyberKnife treatment planning software (TPS). Two parameters could be optimized: the maximum energy and the source full width at half-maximum (FWHM). The optimization was performed by minimizing the differences between the measured and the MC calculated tissue phantom ratios and profiles. MLC plans were calculated in the TPS with the MC algorithm and irradiated on different phantoms. The dose was measured using an A1SL ionization chamber and EBT3 Gafchromic films, and then compared to the TPS dose to obtain dose differences (ΔD). Finally, patient-specific quality assurances (QA) were performed with global gamma index criteria of 3%/1 mm. The maximum energy and source FWHM showing the best agreement with measurements were 6.4 MeV and 1.8 mm. The output factors calculated with these parameters gave an agreement within ±1% with measurements. The ΔD showed that MC model systematically underestimated the dose with an average of -1.5% over all configurations tested. For depths deeper than 12 cm, the ΔD increased, up to -3.0% (maximum at 15.5 cm depth). The MC model for MLC of CyberKnife is clinically acceptable but underestimates the delivered dose by an average of -1.5%. Therefore, we recommend using the MC algorithm with the MLC only in heterogeneous regions and for shallow-seated tumors

Dosimetric characteristics of four PTW microDiamond detectors in high-energy proton beams

International audienceSmall diamond detectors are useful for the dosimetry of high-energy proton beams. However, linear energy transfer (LET) dependence has been observed in the literature with such solid state detectors. A novel synthetic diamond detector has recently become commercially available from the manufacturer PTW-Freiburg (PTW microDiamond type 60019). This study was designed to thoroughly characterize four microDiamond detectors in clinical proton beams, in order to investigate their response and their reproducibility in high LET regions. Very good dosimetric characteristics were observed for two of them, with good stability of their response (deviation less than 0.4% after a pre-irradiation dose of approximately 12 Gy), good repeatability (coefficient of variation of 0.06%) and a sensitivity of approximately 0.85 nC Gy(-1). A negligible dose rate dependence was also observed for these two microDiamonds with a deviation of the sensitivity less than 0.7% with respect to the one measured at the reference dose rate of 2.17 Gy min(-1), in the investigated dose rate range from 1.01 Gy min(-1) to 5.52 Gy min(-1). Lateral dose profile measurements showed the high spatial resolution of the microDiamond oriented with its stem perpendicular to the beam axis and with its small sensitive thickness of about 1 mu m in the scanning profile direction. Finally, no significant LET dependence was found with these two diamond dosimeters in comparison to a reference ionization chamber (model IBA PPC05). These good results were in accordance to the literature. However, this study showed also a non reproducibility between the devices in terms of stability, sensitivity and LET dependence, since the two other microDiamonds characterized in this work showed different dosimetric characteristics making them not suitable for proton beam dosimetry with a maximum difference of the peak-to-plateau ratio of 6.7% relative to the reference ionization chamber in a clinical 138 MeV proton beam

Dose indicator for CyberKnife image-guided radiation therapy.

The purpose of this study was to calculate dose distributions from CyberKnife image-guided radiation therapy (IGRT) for brain, H&N, lung, and pelvis treatment regions and use them to extract the corresponding effective dose and estimate-related risk. We developed a CyberKnife IGRT kV beam model in a standard treatment planning system and validated it against measurements in heterogeneous phantoms. Five brain, five head and neck, five thorax, and 10 (five male and five female) pelvis patient computed tomographies (CTs) were contoured. The dose distribution resulting from different CyberKnife IGRT protocols was calculated. From them, the effective dose was calculated according to ICRP publication Nr 103, using the average dose to contoured organs. The corresponding risk factors were calculated. Entrance surface dose (ESD) was also calculated and compared with existing data. The maximum effective dose produced by CyberKnife IGRT protocols was 0.8 mSv (brain), 1.9 mSv (H&N), 20.2 (pelvis), and 42.4 mSv (thorax) per fraction for a risk estimate of 0.004% (brain), 0.01% (H&N), 0.1% (pelvis), and 0.2% (thorax). Calculated ESD were compatible with existing data. Dose calculation models for CyberKnife IGRT kV beams were implemented in a clinical treatment planning system and validated in water and heterogeneous phantoms. We determined the effective dose and the related risk estimate resulting from CyberKnife IGRT protocols for brain, head and neck, thorax, and pelvis cases. The effective doses calculated for CyberKnife IGRT protocols were similar to those obtained for cone beam CT protocols on conventional C-arm linear accelerators, except for extreme irradiation conditions for thorax cases (140 kV X-ray tube tension)