Cherenkov emission (CE) is a visible blueish light emitted in water mediums irradiated by most radiotherapy treatment beams. However, CE is produced anisotropically which currently imposes a ...geometrical constraint uncertainty for dose measurements. In this work, polarization imaging is proposed and described as a method enabling precise 2D dose measurements using CE. CE produced in a water tank is imaged from four polarization angles using a camera coupled to a rotating polarizer. Using Malus' law, the polarized component of CE is isolated and corrected with Monte Carlo calculated CE polar and azimuthal angular distributions. Projected dose measurements resulting from polarization-corrected CE are compared to equivalent radiochromic film measurements. Overall, agreement between polarized corrected CE signal and films measurements is found to be within 3%, for projected percent depth dose (PPDD) and profiles at the different tested energies (Formula: see text: 6 and Formula: see text, eFormula: see text: 6 and 18Formula: see text). In comparison, raw Cherenkov emission presented deviations up 60% for electron beam PPDDs and 20% for photon beams PPDDs. Finally, a degree of linear polarization between 29% and 47% was measured for CE in comparison to Formula: see text% for scintillation. Hence, polarization imaging is found to be a promising and powerful method for improved radio-luminescent dose measurements with possible extensions to signal separation.
The charge of Task Group 186 (TG-186) is to provide guidance for early adopters of model-based dose calculation algorithms (MBDCAs) for brachytherapy (BT) dose calculations to ensure practice ...uniformity. Contrary to external beam radiotherapy, heterogeneity correction algorithms have only recently been made available to the BT community. Yet, BT dose calculation accuracy is highly dependent on scatter conditions and photoelectric effect cross-sections relative to water. In specific situations, differences between the current water-based BT dose calculation formalism (TG-43) and MBDCAs can lead to differences in calculated doses exceeding a factor of 10. MBDCAs raise three major issues that are not addressed by current guidance documents: (1) MBDCA calculated doses are sensitive to the dose specification medium, resulting in energy-dependent differences between dose calculated to water in a homogeneous water geometry (TG-43), dose calculated to the local medium in the heterogeneous medium, and the intermediate scenario of dose calculated to a small volume of water in the heterogeneous medium. (2) MBDCA doses are sensitive to voxel-by-voxel interaction cross sections. Neither conventional single-energy CT nor ICRU/ICRP tissue composition compilations provide useful guidance for the task of assigning interaction cross sections to each voxel. (3) Since each patient-source-applicator combination is unique, having reference data for each possible combination to benchmark MBDCAs is an impractical strategy. Hence, a new commissioning process is required. TG-186 addresses in detail the above issues through the literature review and provides explicit recommendations based on the current state of knowledge. TG-43-based dose prescription and dose calculation remain in effect, with MBDCA dose reporting performed in parallel when available. In using MBDCAs, it is recommended that the radiation transport should be performed in the heterogeneous medium and, at minimum, the dose to the local medium be reported along with the TG-43 calculated doses. Assignments of voxel-by-voxel cross sections represent a particular challenge. Electron density information is readily extracted from CT imaging, but cannot be used to distinguish between different materials having the same density. Therefore, a recommendation is made to use a number of standardized materials to maintain uniformity across institutions. Sensitivity analysis shows that this recommendation offers increased accuracy over TG-43. MBDCA commissioning will share commonalities with current TG-43-based systems, but in addition there will be algorithm-specific tasks. Two levels of commissioning are recommended: reproducing TG-43 dose parameters and testing the advanced capabilities of MBDCAs. For validation of heterogeneity and scatter conditions, MBDCAs should mimic the 3D dose distributions from reference virtual geometries. Potential changes in BT dose prescriptions and MBDCA limitations are discussed. When data required for full MBDCA implementation are insufficient, interim recommendations are made and potential areas of research are identified. Application of TG-186 guidance should retain practice uniformity in transitioning from the TG-43 to the MBDCA approach.
The goal of this study was to evaluate the nature of the stem effect light produced within an optical fiber, to quantify its composition, and to evaluate the efficiency of the chromatic technique to ...remove the stem effect. Spectrometry studies were performed during irradiations of a bare PMMA optical fiber with kilovoltage x-rays from a superficial therapy unit, an Ir-192 high-dose-rate brachytherapy source, a Co-60 external-therapy unit, and megavoltage electrons and x-rays from a linear accelerator. Stem effect spectra can be accurately modeled by a linear combination of the Cerenkov light and fluorescence emitted spectra. Fluorescence light contributes more for lower-energy modalities. Cerenkov light contributes more as the energy increases above the threshold for its production. The chromatic stem effect removal technique is accurate in most of the situations. However, noticeable differences were obtained between very specific high-energy irradiation conditions. It would be advantageous to implement an additional channel in the chromatic stem effect removal chain or implement a spectral approach to independently remove the Cerenkov and the fluorescence components from the signal of interest. This would increase the accuracy and versatility of the actual chromatic stem effect removal technique.
The interest in fiber Bragg gratings dosimeters for radiotherapy dosimetry lies in their (i) submillimeter size, (ii) multi-points dose measurements, and (iii) customizable spatial resolution. ...However, since the radiation measurement relies on the thermal expansion of the surrounding polymer coating, such sensors are strongly temperature dependent, which needs to be accounted for; otherwise, the errors on measurements can be higher than the measurements themselves. In this paper, we test and compare four techniques for temperature compensation: two types of dual grating techniques using different coatings, a pre-irradiation and post-irradiation temperature drift technique, which is used for calorimetry, and finally, we developed a real-time interpolated temperature gradient for the multi-points dosimetry technique. We show that, over these four tested techniques, the last one outperforms the others and allows for real-time temperature correction when an array of 13 fiber Bragg gratings spatially extending over the irradiation zone is used. For a 20 Gy irradiation, this technique reduces the measurement errors from 200% to about 10%, making it suitable for a radiotherapy dose range. Temperature correction for medical low-dose range dosimetry is a first in our field and is essential for clinical FBG dosimetry applications.
Purpose:
Patient‐specific quality assurance (QA) of dynamic radiotherapy delivery would gain from being performed using a 3D dosimeter. However, 3D dosimeters, such as gels, have many disadvantages ...limiting to quality assurance, such as tedious read‐out procedures and poor reproducibility. The purpose of this work is to develop and validate a novel type of high resolution 3D dosimeter based on the real‐time light acquisition of a plastic scintillator volume using a plenoptic camera. This dosimeter would allow for the QA of dynamic radiation therapy techniques such as intensity‐modulated radiation therapy (IMRT) or volumetric‐modulated arc therapy (VMAT).
Methods:
A Raytrix R5 plenoptic camera was used to image a 10 × 10 × 10 cm3 EJ‐260 plastic scintillator embedded inside an acrylic phantom at a rate of one acquisition per second. The scintillator volume was irradiated with both an IMRT and VMAT treatment plan on a Clinac iX linear accelerator. The 3D light distribution emitted by the scintillator volume was reconstructed at a 2 mm resolution in all dimensions by back‐projecting the light collected by each pixel of the light‐field camera using an iterative reconstruction algorithm. The latter was constrained by a beam's eye view projection of the incident dose acquired using the portal imager integrated with the linac and by physical consideration of the dose behavior as a function of depth in the phantom.
Results:
The absolute dose difference between the reconstructed 3D dose and the expected dose calculated using the treatment planning software Pinnacle3 was on average below 1.5% of the maximum dose for both integrated IMRT and VMAT deliveries, and below 3% for each individual IMRT incidences. Dose agreement between the reconstructed 3D dose and a radiochromic film acquisition in the same experimental phantom was on average within 2.1% and 1.2% of the maximum recorded dose for the IMRT and VMAT delivery, respectively.
Conclusions:
Using plenoptic camera technology, the authors were able to perform millimeter resolution, water‐equivalent dosimetry of an IMRT and VMAT plan over a whole 3D volume. Since no moving parts are required in the dosimeter, the incident dose distribution can be acquired as a function of time, thus enabling the validation of static and dynamic radiation delivery with photons, electrons, and heavier ions.
In this work, a generic rigorous Bayesian formalism is introduced to predict the most likely path of any ion crossing a medium between two detection points. The path is predicted based on a ...combination of the particle scattering in the material and measurements of its initial and final position, direction and energy. The path estimate's precision is compared to the Monte Carlo simulated path. Every ion from hydrogen to carbon is simulated in two scenarios, (1) where the range is fixed and (2) where the initial velocity is fixed. In the scenario where the range is kept constant, the maximal root-mean-square error between the estimated path and the Monte Carlo path drops significantly between the proton path estimate (0.50 mm) and the helium path estimate (0.18 mm), but less so up to the carbon path estimate (0.09 mm). However, this scenario is identified as the configuration that maximizes the dose while minimizing the path resolution. In the scenario where the initial velocity is fixed, the maximal root-mean-square error between the estimated path and the Monte Carlo path drops significantly between the proton path estimate (0.29 mm) and the helium path estimate (0.09 mm) but increases for heavier ions up to carbon (0.12 mm). As a result, helium is found to be the particle with the most accurate path estimate for the lowest dose, potentially leading to tomographic images of higher spatial resolution.
Fiber Bragg gratings (FBGs) are valuable dosimeters for doses up to 100 kilograys (kGy), but have hardly been used for the low-dose range of a few grays (Gy) required in medical radiation dosimetry. ...We report that embedding a doped silica fiber FBG in a polymer material allows a minimum detectable dose of 0.3 Gy for γ-radiation. Comparing the detector response for different doped silica fibers with various core doping, we obtain an independent response, in opposition to what is reported for high-dose range. We hypothesized that the sensor detection is based on the radio-induced thermal expansion of the surrounding polymer. Hence, we used a simple physical model based on the thermal and mechanical properties of the surrounding polymer and obtained good accordance between measured and calculated values for different compositions and thicknesses. We report that over the 4 embedding polymers tested, polyether ether ketone and polypropylene have respectively the lowest (0.056 pm/Gy) and largest sensitivity (0.087 pm/Gy). Such FBG-based dosimeters have the potential to be distributed along the fiber to allow multipoint detection while having a sub-millimeter size that could prove very useful for low-dose applications, in particular for radiotherapy dosimetry.
Monte Carlo (MC) dose calculations are performed on patient geometries derived from computed tomography (CT) images. For most available MC codes, the Hounsfield units (HU) in each voxel of a CT image ...have to be converted into mass density (rho) and material type. This is typically done with a (HU; rho) calibration curve which may lead to mis-assignment of media. In this work, an improved material segmentation using dual-energy CT-based material extraction is presented. For this purpose, the differences in extracted effective atomic numbers Z and the relative electron densities rho(e) of each voxel are used. Dual-energy CT material extraction based on parametrization of the linear attenuation coefficient for 17 tissue-equivalent inserts inside a solid water phantom was done. Scans of the phantom were acquired at 100 kVp and 140 kVp from which Z and rho(e) values of each insert were derived. The mean errors on Z and rho(e) extraction were 2.8% and 1.8%, respectively. Phantom dose calculations were performed for 250 kVp and 18 MV photon beams and an 18 MeV electron beam in the EGSnrc/DOSXYZnrc code. Two material assignments were used: the conventional (HU; rho) and the novel (HU; rho, Z) dual-energy CT tissue segmentation. The dose calculation errors using the conventional tissue segmentation were as high as 17% in a mis-assigned soft bone tissue-equivalent material for the 250 kVp photon beam. Similarly, the errors for the 18 MeV electron beam and the 18 MV photon beam were up to 6% and 3% in some mis-assigned media. The assignment of all tissue-equivalent inserts was accurate using the novel dual-energy CT material assignment. As a result, the dose calculation errors were below 1% in all beam arrangements. Comparable improvement in dose calculation accuracy is expected for human tissues. The dual-energy tissue segmentation offers a significantly higher accuracy compared to the conventional single-energy segmentation.
Purpose Recently, our GPU-based multi-criteria optimization (gMCO) algorithm has been integrated in a graphical user interface (gMCO-GUI) that allows real-time plan navigation through a ...gMCO-generated set of Pareto-optimal plans for high-dose-rate (HDR) brachytherapy. This work reports on the commissioning of the gMCO algorithm into clinical workflow. Material and methods Our MCO workflow was validated against Oncentra Prostate v. 4.2.2 (OcP) and Oncentra Brachy v. 4.6.0 (OcB). 40 HDR prostate brachytherapy patients (20 with OcP and 20 with OcB) were retrospectively re-planned with gMCO algorithm by generating 2,000 Pareto-optimal plans. A single gMCO treatment plan was exported using gMCO-GUI plan navigation tools. The optimized dwell positions and dwell times of gMCO plans were exported via DICOM RTPLAN files to OcP/OcB, where final dosimetry was calculated. TG43 implementation in gMCO was validated against the consensus data of flexisource. Five analytical shapes were used as the ground truth for volume calculations. Dose-volume histogram (DVH) curves generated by gMCO were compared with the ones generated by OcP/OcB. 3D dose distributions (and isodose lines) were validated against OcP/OcB using dice similarity coefficient (DSC), 95% undirected Hausdorff distance (95% HD), and analysis. Results Differences between –0.4% and 0.3% were observed between gMCO calculated dose rates and the flexisource consensus data. gMCO volumes were within ±2% agreement in 3/5 volumes (deviations within –2.9% and 0.1%). For 9 key DVH indices, the differences between gMCO and OcP/OcB were within ±1.2%. Regarding the accuracy of key isodose lines, the mean DSC was greater than 0.98, and the mean 95% HD was below 0.4 mm. The fraction of voxels with ≤ 1 was greater than 99% for all cases with 1%/1 mm threshold. Conclusions The GPU-based MCO workflow was successfully integrated into the clinical workflow and validated against OcP and OcB.
In the present study, we have presented and validated a plastic scintillation detector (PSD) system designed for real-time multiprobe in vivo measurements.
The PSDs were built with a dose-sensitive ...volume of 0.4 mm(3). The PSDs were assembled into modular detector patches, each containing five closely packed PSDs. Continuous dose readings were performed every 150 ms, with a gap between consecutive readings of <0.3 ms. We first studied the effect of electron multiplication. We then assessed system performance in acrylic and anthropomorphic pelvic phantoms.
The PSDs were compatible with clinical rectal balloons and were easily inserted into the anthropomorphic phantom. With an electron multiplication average gain factor of 40, a twofold increase in the signal/noise ratio was observed, making near real-time dosimetry feasible. Under calibration conditions, the PSDs agreed with the ion chamber measurements to 0.08%. Precision, evaluated as a function of the total dose delivered, ranged from 2.3% at 2 cGy to 0.4% at 200 cGy.
Real-time PSD measurements are highly accurate and precise. These PSDs can be mounted onto rectal balloons, transforming these clinical devices into in vivo dose detectors without modifying current clinical practice. Real-time monitoring of the dose delivered near the rectum during prostate radiotherapy should help radiation oncologists protect this sensitive normal structure.
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