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PURPOSE: To evaluate the feasibility of an open-source, semi-automated, and reproducible vertex placement tool to improve the efficiency of lattice radiotherapy (LRT) planning. We used polymer gel dosimetry with a Cone Beam CT (CBCT) readout to commission this LRT technique. MATERIAL AND METHODS: We generated a volumetric modulated arc therapy (VMAT)-based LRT plan on a 2 L NIPAM polymer gel dosimeter using our Eclipse Acuros version 15.6 AcurosXB beam model, and also recalculated the plan with a pre-clinical Acuros v18.0 dose calculation algorithm with the enhanced leaf modelling (ELM). With the assistance of the MAAS-SFRThelper software, a lattice vertex diameter of 1.5 cm and center-to-center spacing of 3 cm were used to place the spheres in a hexagonal, closed packed structure. The verification plan included four gantry arcs with 15°, 345°, 75°, 105° collimator angles. The spheres were prescribed 20 Gy to 50% of their combined volume. The 6 MV Flattening Filter Free beam energy was used to deliver the verification plan. The dosimetric accuracy of the LRT delivery was evaluated with 1D dose profiles, 2D isodose maps, and a 3D global gamma analysis. RESULTS: Qualitative comparisons between the 1D dose profiles of the Eclipse plan and measured gel showed good consistency at the prescription dose mark. The average diameter measured 13.3 ± 0.2 mm (gel for v15.6), 12.6 mm (v15.6 plan), 13.1 ± 0.2 mm (gel for v18.0), and 12.3 mm (v18.0 plan). 3D gamma analysis showed that all gamma pass percent were > 95% except at 1% and 2% at the 1 mm distance to agreement criteria. CONCLUSION: This study presents a novel application of gel dosimetry in verifying the dosimetric accuracy of LRT, achieving excellent 3D gamma results. The treatment planning was facilitated by publicly available software that automatically placed the vertices for consistency and efficiency.
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This work presents an approach to the fast determination of a medical accelerator irradiation isocenter as a quality assurance (QA) procedure in radiotherapy. The isocenter determination tool is the tissue equivalent high-resolution 3D polymer gel dosimeter (PABIGnx) in a dedicated container combined with kilovoltage imaging systems and the polyGeVero-CT software package (v. 1.2, GeVero Co., Poland). Two accelerators were employed: Halcyon and TrueBeam (Varian, USA), both equipped with cone beam computed tomography (CBCT) and iterative reconstruction CBCT (iCBCT) algorithms. The scope of this work includes: (i) the examination of factors influencing image quality (reconstruction algorithms and modes), radiation field parameters (dose and multi-leaf collimator (MLC) gaps), fiducial markers, signal averaging for reconstruction algorithms and the scanning time interval between consecutive scans, (ii) the examination of factors influencing the isocenter determination, image processing (signal averaging, background subtraction, image filtering) and (iii) an isocenter determination report using a 2D and 3D approach. An optimized protocol and isocenter determination conditions were found. The time and effort required to determine the isocenter are discussed.
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This work presents the features of the PABIGnx 3D polymer gel dosimeter. It consists of two cross-linkers: poly(ethylene glycol) diacrylate (PEGDA), as one biacrylic component, and N,N'-methylenebisacrylamide (MBA), which is another cross-linker often used in 3D dosimeters. Additionally, it contains oxygen scavenges of copper sulfate pentahydrate and ascorbic acid. All ingredients are embedded in a physical gel matrix of gelatine. Upon irradiation, the biacrylic cross-linking agents (PEGDA and MBA) undergo radical polymerisation and cross-linking, which is manifested by the appearance of the opacity of the intensity related to the absorbed dose. PABIGnx was irradiated with an oncological source of ionising radiation, and analysed by using a nuclear magnetic resonance (0.5 T). The following characteristics were obtained: (i) linear and dynamic dose-response of 0.5 to ~18 Gy and 40 Gy, respectively, (ii) dose sensitivity of 0.071 ± 0.001 Gy-1 s-1, (iii) integral 3D dose distribution for at least 24 days after irradiation, (iv) adequate batch-to-batch reproducibility, (v) dose-response independent of irradiation with 6 MV photons, 15 MV photons, 6 MV photons FFF of 0.0168-0.1094 Gy/s dose rates, and (vi) soft tissue equivalence. The study showed that the features of PABIGnx confirm its suitability for use in 3D radiotherapy dosimetry.
RESUMEN
PURPOSE: The purpose of this work was to examine the suitability of VIPARnd polymer gel-9.4 T magnetic resonance microimaging system for high spatial resolution dose distribution measurements. METHODS: The VIPARnd samples (3 cm in outside diameter and 12 cm in height) were exposed to ionizing radiation by using a linear accelerator (Varian TrueBeam, USA; 6 MV x-ray beam). In the calibration stage, nine gel dosimeter vials were irradiated in a water phantom homogenously to the doses from 1.5 to 30 Gy in order to obtain R2-dose relation. In the verification stage, two gel dosimeter vials were irradiated in the half beam penumbra area of 10 × 10 cm radiation field using the amount of monitor units appropriate to deliver 20 Gy at the field center. The gels were imaged on a vertical 9.4 T magnetic resonance (MR) microimaging scanner using single slice and multislice (9 slices) multiecho (90 × 7 ms) sequences at the spatial resolutions of 0.2-0.4 × 0.2-0.4 × 3 mm3 and 0.2-0.4 × 0.2-0.4 × 1 mm3 respectively. The gels were subjected to microimaging during the period of two weeks after irradiation. The reference data consisted of the dose profiles measured using the diode dosimetry, radiochromic film, ionization chamber, and the water phantom system. RESULTS: The VIPARnd -9.4 T MR microimaging system was characterized by the dose sensitivity of 0.067 ± 0.002 Gy-1 s-1 at day 3 after irradiation. The dose resolution at 10 Gy (at P = 95%) was equal to 0.42 Gy at day 3 after irradiation using a single slice sequence (0.2 × 0.2 × 3 mm3 ) and 2.0 Gy at day 4 after irradiation using a multislice sequence (0.2 × 0.2 × 1 mm3 ) for one signal acquisition (measurement time: 15 min). These values were improved by ~1.4-fold when using four signal acquisitions in the single slice sequence, and by ~2.78-fold for 12 signal acquisitions in the multislice sequence. Furthermore, decreasing the in-plane resolution from 0.2 × 0.2 mm2 to 0.4 × 0.4 mm2 resulted in a dose resolution of 0.3 Gy and 1 Gy at 10 Gy (at P = 95%) for one signal acquisition in the single slice and multislice sequences respectively (measurement time: 7.5 min). As reveals from the gamma index analysis the dose distributions measured at days 3-4 postirradiation using both VIPARnd verification phantoms agree with the data obtained using a silicon diode, assuming 1 mm/5% criterion. A good interphantom reproducibility of the polymer gel dosimetry was proved by monitoring of two phantoms up to 10 days after irradiation. However, the agreement between the dose distributions measured using the diode and polymer gel started to get worse from day 5 after irradiation. CONCLUSION: The VIPARnd -9.4T MR microimaging system allows to obtain dose resolution of 0.42 Gy at 10 Gy (at P = 95%) for a spatial resolution of 0.2 × 0.2 × 3 mm3 (acquisition time: 15 min). Further studies are required to improve a temporal stability of the gel-derived dose distribution.
