The use of radiochromic film (RCF) dosimetry in radiation therapy is extensive due to its high level of achievable accuracy for a wide range of dose values and its suitability under a variety of ...measurement conditions. However, since the publication of the 1998 AAPM Task Group 55, Report No. 63 on RCF dosimetry, the chemistry, composition, and readout systems for RCFs have evolved steadily. There are several challenges in using the new RCFs, readout systems and validation of the results depending on their applications. Accurate RCF dosimetry requires understanding of RCF selection, handling and calibration methods, calibration curves, dose conversion methods, correction methodologies as well as selection, operation and quality assurance (QA) programs of the readout systems. Acquiring this level of knowledge is not straight forward, even for some experienced users. This Task Group report addresses these issues and provides a basic understanding of available RCF models, dosimetric characteristics and properties, advantages and limitations, configurations, and overall elemental compositions of the RCFs that have changed over the past 20 yr. In addition, this report provides specific guidelines for data processing and analysis schemes and correction methodologies for clinical applications in radiation therapy.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Thermoluminescent dosimeters (TLD) and optically stimulated luminescent dosimeters (OSLD) are practical, accurate, and precise tools for point dosimetry in medical physics applications. The charges ...of Task Group 191 were to detail the methodologies for practical and optimal luminescence dosimetry in a clinical setting. This includes: (a) to review the variety of TLD/OSLD materials available, including features and limitations of each; (b) to outline the optimal steps to achieve accurate and precise dosimetry with luminescent detectors and to evaluate the uncertainty induced when less rigorous procedures are used; (c) to develop consensus guidelines on the optimal use of luminescent dosimeters for clinical practice; and (d) to develop guidelines for special medically relevant uses of TLDs/OSLDs such as mixed photon/neutron field dosimetry, particle beam dosimetry, and skin dosimetry. While this report provides general guidelines for TLD and OSLD processes, the report provides specific details for TLD‐100 and nanoDotTM dosimeters because of their prevalence in clinical practice.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Abstract Background Optically stimulated luminescent dosimeters (OSLDs) can be bleached and reused, but questions remain about the effects of repeated bleaching and fractionation schedules on OSLD ...performance. Purpose The aim of this study was to investigate how light sources with different wavelengths and different fractionation schemes affect the performance of reused OSLDs. Methods OSLDs ( N = 240) were irradiated on a cobalt‐60 beam in different step sizes until they reached an accumulated dose of 50 Gy. Between irradiations they were bleached using light sources of different wavelengths: the Imaging and Radiation Oncology Core (IROC) bleaching system (our control); monochromatic red, green, yellow, and blue lights; and a polychromatic white light. Sensitivity and linearity‐based correction factors were determined as a function of dose step‐size. The rate of signal removal from different light sources was characterized by sampling these OSLDs at various time points during their bleaching process. Relative doses were calculated according to the American Association of Physicists in Medicine Task Group‐191. Signal repopulation was investigated by irradiating OSLDs ( N = 300) to various delivered doses of 2, 10, 20, 30, 40, and 50 Gy in a single fraction, bleached with one of the colors, and read over time. Fractionation effects were evaluated by irradiating OSLDs up to 30 Gy in different size steps. After reading, the OSLDs were bleached following IROC protocol. OSLDs ( N = 40) received irradiations in 5, 10, 15, 30 Gy fractions until they had an accumulated dose of 30 Gy; The sensitivity response of these OSLDs was compared with reference OSLDs that had no accumulated dose. Results Light sources with polychromatic spectrums (IROC and white) bleached OSLDs faster than did sources with monochromatic spectra. Polychromatic light sources (white light and IROC system) provided the greatest dose stability for OSLDs that had larger amounts of accumulated dose. Signal repopulation was related to the choice of bleaching light source, timing of bleaching, and amount of accumulated dose. Changes to relative dosimetry were more pronounced in OSLDs that received larger fractions. At 5‐Gy fractions and above, all OSLDs had heightened sensitivity, with OSLDs exposed to 30‐Gy fractions being 6.4% more sensitive than reference dosimeters. Conclusions The choice of bleaching light plays a role in how fast an OSLD is bleached and how much accumulated dose an OSLD can be exposed to while maintaining stable signal sensitivity. We have expanded upon investigations into signal repopulation to show that bleaching light plays a role in the migration of deep traps to dosimetric traps after bleaching. Our research concludes that the bleaching light source and fractionation need to be considered when reusing OSLD.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The purpose of this study was to summarize the findings of anthropomorphic proton phantom irradiations analyzed by the Imaging and Radiation Oncology Core Houston QA Center (IROC Houston).
A total of ...103 phantoms were irradiated by proton therapy centers participating in clinical trials. The anthropomorphic phantoms simulated heterogeneous anatomy of a head, liver, lung, prostate, and spine. Treatment plans included those for scattered, uniform scanning, and pencil beam scanning beam delivery modalities using 5 different treatment planning systems. For every phantom irradiation, point doses and planar doses were measured using thermoluminescent dosimeters (TLD) and film, respectively. Differences between measured and planned doses were studied as a function of phantom, beam delivery modality, motion, repeat attempt, treatment planning system, and date of irradiation.
The phantom pass rate (overall, 79%) was high for simple phantoms and lower for phantoms that introduced higher levels of difficulty, such as motion, multiple targets, or increased heterogeneity. All treatment planning systems overestimated dose to the target, compared to TLD measurements. Errors in range calculation resulted in several failed phantoms. There was no correlation between treatment planning system and pass rate. The pass rates for each individual phantom are not improving over time, but when individual institutions received feedback about failed phantom irradiations, pass rates did improve.
The proton phantom pass rates are not as high as desired and emphasize potential deficiencies in proton therapy planning and/or delivery. There are many areas for improvement with the proton phantom irradiations, such as treatment planning system dose agreement, range calculations, accounting for motion, and irradiation of multiple targets.
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GEOZS, IJS, NUK, OILJ, UL, UM, UPUK
The American Association of Physicists in Medicine (AAPM) formed Task Group 178 (TG‐178) to perform the following tasks: review in‐phantom and in‐air calibration protocols for gamma stereotactic ...radiosurgery (GSR), suggest a dose rate calibration protocol that can be successfully utilized with all gamma stereotactic radiosurgery (GSR) devices, and update quality assurance (QA) protocols in TG‐42 (AAPM Report 54, 1995) for static GSR devices. The TG‐178 report recommends a GSR dose rate calibration formalism and provides tabulated data to implement it for ionization chambers commonly used in GSR dosimetry. The report also describes routine mechanical, dosimetric, and safety checks for GSR devices, and provides treatment process quality assurance recommendations. Sample worksheets, checklists, and practical suggestions regarding some QA procedures are given in appendices. The overall goal of the report is to make recommendations that help standardize GSR physics practices and promote the safe implementation of GSR technologies.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Natural hydrogen is known to be generated in the crust by water/rock interactions, especially the oxidation of iron-rich rock or radiolysis. However, other sources, especially deeper ones, exist. In ...the context of subduction, the dehydration of the slab, the destabilization of the NH4, and the hydration of the mantle wedge above the subducting lithosphere may generate H2. We present here a compilation of the known gases in the central part of the Pacific subduction and the results of a first field acquisition dedicated to H2 measurements in Bolivia between La Paz and South Lipez. Various zones have been studied: the emerging thrust faults of the western borders of the Eastern Cordillera, the Sajama area that corresponds to the western volcanic zone near the Chile border northward from the Uyuni Salar, and finally, the Altiplano-Puna Volcanic Complex in South Lipez. Soil gas measurement within and around the Salar itself was not fully conclusive. North of the Uyuni Salar, the gases are very rich in CO2, enriched in N2 and poor in H2. On the opposite, southward, all the samples contain some H2; the major gas is nitrogen, which may overpass 90% after air correction, and the CO2 content is very limited. On the western border of the Cordillera, the δC13 isotope varies between −5 and −13‰, and it is not surprisingly compatible with volcanic gas, as well as with asthenospheric CO2. The methane content is close to 0, and only a few points reach 1%. The isotopes (−1‰) indicate an abiotic origin, and it is thus related to deep H2 presence. The high steam flow in the geothermal area of South Lipez combined with the H2 content in the water results in at least 1 ton of H2 currently released per day from each well and may deserve an evaluation of its economic value. The nitrogen content, as in other subduction or paleo-subduction areas, questions the slab alteration.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The Radiological Physics Center (RPC) has functioned continuously for 38 years to assure the National Cancer Institute and the cooperative groups that institutions participating in ...multi-institutional trials can be expected to deliver radiation treatments that are clinically comparable to those delivered by other institutions in the cooperative groups. To accomplish this, the RPC monitors the machine output, the dosimetry data used by the institutions, the calculation algorithms used for treatment planning, and the institutions' quality control procedures. The methods of monitoring include on-site dosimetry review by an RPC physicist and a variety of remote audit tools. The introduction of advanced technology clinical trials has prompted several study groups to require participating institutions and personnel to become credentialed, to ensure their familiarity and capability with techniques such as three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic body radiotherapy, and brachytherapy. The RPC conducts a variety of credentialing activities, beginning with questionnaires to evaluate an institution's understanding of the protocol and their capabilities. Treatment-planning benchmarks are used to allow the institution to demonstrate their planning ability and to facilitate a review of the accuracy of treatment-planning systems under relevant conditions. The RPC also provides mailable anthropomorphic phantoms to verify tumor dose delivery for special treatment techniques. While conducting these reviews, the RPC has amassed a large amount of data describing the dosimetry at participating institutions. Representative data from the monitoring programs are discussed, and examples are presented of specific instances in which the RPC contributed to the discovery and resolution of dosimetry errors.
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GEOZS, IJS, NUK, OILJ, UL, UM, UPUK
To compare radiation machine measurement data collected by the Imaging and Radiation Oncology Core at Houston (IROC-H) with institutional treatment planning system (TPS) values, to identify ...parameters with large differences in agreement; the findings will help institutions focus their efforts to improve the accuracy of their TPS models.
Between 2000 and 2014, IROC-H visited more than 250 institutions and conducted independent measurements of machine dosimetric data points, including percentage depth dose, output factors, off-axis factors, multileaf collimator small fields, and wedge data. We compared these data with the institutional TPS values for the same points by energy, class, and parameter to identify differences and similarities using criteria involving both the medians and standard deviations for Varian linear accelerators. Distributions of differences between machine measurements and institutional TPS values were generated for basic dosimetric parameters.
On average, intensity modulated radiation therapy-style and stereotactic body radiation therapy-style output factors and upper physical wedge output factors were the most problematic. Percentage depth dose, jaw output factors, and enhanced dynamic wedge output factors agreed best between the IROC-H measurements and the TPS values. Although small differences were shown between 2 common TPS systems, neither was superior to the other. Parameter agreement was constant over time from 2000 to 2014.
Differences in basic dosimetric parameters between machine measurements and TPS values vary widely depending on the parameter, although agreement does not seem to vary by TPS and has not changed over time. Intensity modulated radiation therapy-style output factors, stereotactic body radiation therapy-style output factors, and upper physical wedge output factors had the largest disagreement and should be carefully modeled to ensure accuracy.
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GEOZS, IJS, NUK, OILJ, UL, UM, UPUK
To determine whether in-house patient-specific intensity modulated radiation therapy quality assurance (IMRT QA) results predict Imaging and Radiation Oncology Core (IROC)-Houston phantom results.
...IROC Houston's IMRT head and neck phantoms have been irradiated by numerous institutions as part of clinical trial credentialing. We retrospectively compared these phantom results with those of in-house IMRT QA (following the institution's clinical process) for 855 irradiations performed between 2003 and 2013. The sensitivity and specificity of IMRT QA to detect unacceptable or acceptable plans were determined relative to the IROC Houston phantom results. Additional analyses evaluated specific IMRT QA dosimeters and analysis methods.
IMRT QA universally showed poor sensitivity relative to the head and neck phantom, that is, poor ability to predict a failing IROC Houston phantom result. Depending on how the IMRT QA results were interpreted, overall sensitivity ranged from 2% to 18%. For different IMRT QA methods, sensitivity ranged from 3% to 54%. Although the observed sensitivity was particularly poor at clinical thresholds (eg 3% dose difference or 90% of pixels passing gamma), receiver operator characteristic analysis indicated that no threshold showed good sensitivity and specificity for the devices evaluated.
IMRT QA is not a reasonable replacement for a credentialing phantom. Moreover, the particularly poor agreement between IMRT QA and the IROC Houston phantoms highlights surprising inconsistency in the QA process.
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GEOZS, IJS, NUK, OILJ, UL, UM, UPUK
Anticancer potential and a prebiotic effect of fructan mixtures from Agave salmiana (branched) and chicory inulin (linear) were evaluated to different mass fractions 1/0, 0/1, 0.5/0.5, 0.75/0.25, ...0.25/0.75, respectively, in three concentrations: 2, 3.5, and 5 mg/mL. The viability, proliferation, and apoptosis of human colon cell lines, CRL1831 (healthy), HT29 (cancerous grade 1-2), and SW480 (cancerous grade 3-4), were evaluated by absorbance assays. Lactobacillus acidophilus and Bifidobacterium longum subsp. infantis growth was determined by spectrophotometry at 600 nm. The lactic acid and short-chain fatty acids (SCFAs) production was determined by the HPLC method. Fructan mixtures (inulin/agave, 0.25/0.75) showed a synergic effect on viability, proliferation, and decreased apoptosis in healthy colon cells (CRL1831) at 5 mg/mL. An increase (p < 0.05) of apoptosis in HT29 and SW480 was observed with inulin/agave (0/1) at 3.5 mg/mL and inulin/agave (0.5/0.5), respectively. The proliferation of L. acidophilus and B. longum subsp. infantis was better when the agave fructans were in a higher proportion than inulin. Lactic acid was the highest metabolite produced by L. acidophilus and acetic acid by B. longum subsp. infantis. Fructan mixtures induced SW480 and HT29 cells to apoptosis without toxic effects on healthy cells and improved bacteria proliferation and metabolite production.
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