Reading of gafchromic EBT-3 film using an overhead scanner.

Gafchromic film, a commercially available radiochromic film, has been developed and widely used as an effective tool for radiation dose verification and quality assurance in radiotherapy. However, the orientation effect in scanning a film remains a concern for practical application in beam profile monitoring. To resolve this issue, the authors introduced a novel method using an overhead scanner (OHS) coupled with a tracing light board instead of a conventional flatbed scanner (FBS) to read Gafchromic EBT3 films. We investigated the orientation effect of the EBT3 film with a regular hexagonal shape after irradiation with 5 Gy x-rays (160 kV, 6.3 mA) and compared the digitized images acquired using a commercially available OHS (CZUR Aura) and a conventional FBS (EPSON GT-X980). As a result, RGB color intensities acquired from the OHS showed significantly lower orientation effect of the color intensities of RGB components than those from FBS. This finding indicates the high potential of the proposed method for achieving more precise two-dimensional dosimetry. Further studies are required to confirm the effectiveness of this method under different irradiation conditions over a wider dose range.

A preliminary study of multispectral Cherenkov imaging and a Fricke-xylenol orange gel film (MCIFF) for online, absolute dose measurement.

BACKGROUND: Cherenkov luminescence imaging has shown potential for relative dose distribution and field verification in radiation therapy. However, to date, limited research utilizing Cherenkov luminescence for absolute dose calibration has been conducted owing to uncertainties arising from camera positioning and tissue surface optical properties. PURPOSE: This paper introduces a novel approach to multispectral Cherenkov luminescence imaging combined with Fricke-xylenol orange gel (FXG) film, termed MCIFF, which can enable online full-field absolute dose measurement. By integrating these two approaches, MCIFF allows for calibration of the ratio between two spectral intensities with absorbed dose, thereby enabling absolute dose measurement. METHODS: All experiments are conducted on a Varian Clinac 23EX, utilizing an electron multiplying charge-coupled device (EMCCD) camera and a two-way image splitter for simultaneous capture of two-spectral Cherenkov imaging. In the first part of this study, the absorbance curves of the prepared FXG film, which receives different doses, are measured using a fluorescence spectrophotometer to verify the correlation between absorbance and dose. In the second part, the FXG film is positioned directly under the radiation beam to corroborate the dose measurement capacity of MCIFF across various beams. In the third part, the feasibility of MCIFF is tested in actual radiotherapy settings via a humanoid model, demonstrating its versatility with various radiotherapy materials. RESULTS: The results of this study indicate that the logarithmic ratios of spectral intensities at wavelengths of 550 ± 50 and 700 ± 100 nm accurately reflect variations in radiation dose (R2 > 0.96) across different radiation beams, particle energies, and dose rates. The slopes of the fitting lines remain consistent under varying beam conditions, with discrepancies of less than 8%. The optical profiles obtained using the MCIFF exhibit a satisfactory level of agreement with the measured results derived from the treatment planning system (TPS) and EBT3 films. Specifically, for photon beams, the lateral distances between the 80% and 20% isodose lines, referred to as the penumbra (P80-20) values, obtained through TPS, EBT3 films, and MCIFF, are determined as 0.537, 0.664, and 0.848 cm, respectively. Similarly, for electron beams, the P80-20 values obtained through TPS, EBT3 films, and MCIFF are found to be 0.432, 0.561, and 0.634 cm, respectively. Furthermore, imaging of the anthropomorphic phantom demonstrates the practical application of MCIFF in real radiotherapy environments. CONCLUSION: By combining an FXG film with Cherenkov luminescence imaging, MCIFF can calibrate Cherenkov luminescence to absorbed dose, filling the gap in online 2D absolute dose measurement methods in clinical practice, and providing a new direction for the clinical application of optical imaging to radiation therapy.

A protocol for accurate radiochromic film dosimetry using Radiochromic.com.

BACKGROUND: Radiochromic films have many applications in radiology and radiation therapy. Generally, the dosimetry system for radiochromic film dosimetry is composed of radiochromic films, flatbed scanner, and film analysis software. The purpose of this work is to present the effectiveness of a protocol for accurate radiochromic film dosimetry using Radiochromic.com as software for film analysis. MATERIALS AND METHODS: Procedures for image acquisition, lot calibration, and dose calculation are explained and analyzed. Radiochromic.com enables state-of-the-art models and corrections for radiochromic film dosimetry, such as the Multigaussian model for multichannel film dosimetry, and lateral, inter-scan, and re-calibration corrections of the response. RESULTS: The protocol presented here provides accurate dose results by mitigating the sources of uncertainty that affect radiochromic film dosimetry. CONCLUSIONS: Appropriate procedures for film and scanner handling in combination with Radiochromic.com as software for film analysis make easy and accurate radiochromic film dosimetry feasible.

Clinical utility of Gafchromic film in an MRI-guided linear accelerator.

BACKGROUND: The purpose of this study is to comprehensively evaluate the suitability of Gafchromic EBT3 and EBT-XD film for dosimetric quality assurance in 0.35 T MR-guided radiotherapy. METHODS: A 0.35 T magnetic field strength was utilized to evaluate magnetic field effects on EBT3 and EBT-XD Gafchromic films by studying the effect of film exposure time within the magnetic field using two timing sequences and film not exposed to MR, the effect of magnetic field exposure on the crystalline structure of the film, and the effect of orientation of the film with respect to the bore within the magnetic field. The orientation of the monomer crystal was qualitatively evaluated using scanning electron microscopy (SEM) compared to unirradiated film. Additionally, dosimetric impact was evaluated through measurements of a series of open field irradiations (0.83 × 0.83-cm2 to 19.92 × 19.92-cm2) and patient specific quality assurance measurements. Open fields were compared to planned dose and an independent dosimeter. Film dosimetry was applied to twenty conventional and twenty stereotactic body radiotherapy (SBRT) patient specific quality assurance cases. RESULTS: No visual changes in crystal orientation were observed in any evaluated SEM images nor were any optical density differences observed between films irradiated inside or outside the magnetic field for both EBT3 and EBT-XD film. At small field sizes, the average difference along dose profiles measured in film compared to the same points measured using an independent dosimeter and to predicted treatment planning system values was 1.23% and 1.56%, respectively. For large field sizes, the average differences were 1.91% and 1.21%, respectively. In open field tests, the average gamma pass rates were 99.8% and 97.2%, for 3%/3 mm and 3%/1 mm, respectively. The median (interquartile range) 3%/3 mm gamma pass rates in conventional QA cases were 98.4% (96.3 to 99.2%), and 3%/1 mm in SBRT QA cases were 95.8% (95.0 to 97.3%). CONCLUSIONS: MR exposure at 0.35 T had negligible effects on EBT3 and EBT-XD Gafchromic film. Dosimetric film results were comparable to planned dose, ion chamber and diode measurements.

Evaluation of monoxide film-based dosimeters for surface dose detection in electron therapy.

Generally, electron therapy is applied to tumors on or close to the skin surface. However, this causes a variety of skin-related side effects. To alleviate the risk of these side effects, clinical treatment uses skin dosimeters to verify the therapeutic dose. However, dosimeters suffer from poor accuracy, because their attachment sites are approximated with the help of naked eyes. Therefore, a dosimeter based on a flexible material that can adjust to the contours of the human body is required. In this study, the reproducibility, linearity, dose-rate dependence, and percentage depth ionization (PDI) of PbO and HgO film-based dosimeters are evaluated to explore their potential as large-scale flexible dosimeters. The results demonstrate that both dosimeters deliver impressive reproducibility (within 1.5%) and linearity (≥ 0.9990). The relative standard deviations of the dose-rate dependence of the PbO and HgO dosimeters were 0.94% and 1.16% at 6 MeV, respectively, and 1.08% and 1.25% at 9 MeV, respectively, with the PbO dosimeter outperforming the 1.1% of existing diodes. The PDI analysis of the PbO and HgO dosimeters returned values of 0.014 cm (-0.074 cm) and 0.051 cm (-0.016 cm), respectively at 6 MeV (9 MeV) compared to the thimble chamber and R50. Therefore, the maximum error of each dosimeter is within the allowable range of 0.1 cm. In short, the analysis reveals that the PbO dosimeter delivers a superior performance relative to its HgO counterpart and has strong potential for use as a surface dosimeter. Thus, flexible monoxide materials have the necessary qualities to be used for dosimeters that meet the requisite quality assurance standards and can satisfy a variety of radiation-related applications as flexible functional materials.

Correction of lateral response artifacts from flatbed scanners for dual-channel radiochromic film dosimetry.

In this study, we evaluated the inter-unit variability of the lateral response artifact for multiple flatbed scanners, focusing on the dual-channel method, and investigated the correction method of the lateral non-uniformity. Four scanners with A3+ paper-size and five scanners with A4 paper-size were evaluated. To generate the dose-response curves, small pieces of the Gafchromic EBT3 and EBT-XD films were irradiated, and five of the pieces were repeatedly scanned by moving them on the scanner to evaluate the lateral non-uniformity. To calculate the dose distribution accounting for the lateral non-uniformity, linear functions of the correction factor, representing the difference between the pixel values at offset position and the scanner midline, were calculated for red and blue color channels at each lateral position. Large variations of the lateral non-uniformity among the scanners were observed, even for the same model of scanner. For high dose, red color showed pixel value profiles similar to symmetric curves, whereas the profiles for low dose were asymmetric. The peak positions changed with dose. With correction of the lateral non-uniformity, the dose profiles of the pyramidal dose distribution measured at various scanner positions and that calculated with a treatment planning system showed almost identical profile shapes at all high-, middle- and low-dose levels. The dual-channel method used in this study showed almost identical dose profiles measured with all A3+ and A4 paper-size scanners at any positions when the corrections were applied for each color channel.

Quantification of narrow band UVB radiation doses in phototherapy using diacetylene based film dosimeters.

Narrow band ultraviolet B (NB UVB) radiation doses are administered during phototherapy for various dermatological ailments. Precise quantification of these doses is vital because the absorbed irradiation can cause adverse photochemical reactions which can lead to potential phototherapeutic side effects. The paper presents development of diacetylene based dosimeter for the determination of therapeutic NB UVB doses during phototherapy. The amide terminated diacetylene analogues have been synthesized by tailoring them with different functional groups. The synthesized diacetylene monomers have been introduced in a polyvinyl alcohol binder solution to obtain a film dosimeter. The influence of different headgroups on the colorimetric response to UV radiation has been studied. Among all the synthesized diacetylene analogues, the naphthylamine substituted diacetylene exhibited excellent color transition from white to blue color at 100 mJ cm-2 NB UVB radiation dose. The developed amide films can be easily pasted on multiple sites of the patient's skin to monitor doses during phototherapy simultaneously at different anatomical regions. The digital image processing of the scanned images of the irradiated films facilitates rapid dose measurement which enables facile implementation of the developed film dosimeters and promising application in routine clinical dosimetry.

3D printing for dosimetric optimization and quality assurance in small animal irradiations using megavoltage X-rays.

PURPOSE: New therapeutic options in radiotherapy (RT) are often explored in preclinical in-vivo studies using small animals. We report here on the feasibility of modern megavoltage (MV) linear accelerator (LINAC)-based RT for small animals using easy-to-use consumer 3D printing technology for dosimetric optimization and quality assurance (QA). METHODS: In this study we aimed to deliver 5×2Gy to the half-brain of a rat using a 4MV direct hemi-field X-ray beam. To avoid the beam's build-up in the target and optimize dosimetry, a 1cm thick, customized, 3D-printed bolus was used. A 1:1 scale copy of the rat was 3D printed based on the CT dataset as an end-to-end QA tool. The plan robustness to HU changes was verified. Thermoluminescent dosimeters (TLDs), for both MV irradiations and for kV imaging doses, and a gafchromic film were placed within the phantom for dose delivery verifications. The phantom was designed using a standard treatment planning software, and was irradiated at the LINAC with the target aligned using kV on-board imaging. RESULTS: The plan was robust (dose difference<1% for HU modification from 0 to 250). Film dosimetry showed a good concordance between planned and measured dose, with the steep dose gradient at the edge of the hemi-field properly aligned to spare the contralateral half-brain. In the treated region, the mean TLDs percentage dose differences (±2 SD) were 1.3% (±3.8%) and 0.9% (±1.7%) beneath the bolus. The mean (±2 SD) out-of-field dose measurements was 0.05Gy (±0.02Gy) for an expected dose of 0.04Gy. Imaging doses (2mGy) still spared the contralateral-brain. CONCLUSIONS: Use of consumer 3D-printers enables dosimetry optimization and QA assessment for small animals MV RT in preclinical studies using standard LINACS.

Methodology for radiochromic film analysis using FilmQA Pro and ImageJ.

Radiochromic film (RCF) has several advantageous characteristics which make it an attractive dosimeter for many clinical tasks in radiation oncology. However, knowledge of and strict adherence to complicated protocols in order to produce accurate measurements can prohibit RCF from being widely adopted in the clinic. The purpose of this study was to outline some simple and straightforward RCF fundamentals in order to help clinical medical physicists perform accurate RCF measurements. We describe a process and methodology successfully used in our practice with the hope that it saves time and effort for others when implementing RCF in their clinics. Two RCF analysis software programs which differ in cost and complexity, the commercially available FilmQA Pro package and the freely available ImageJ software, were used to show the accuracy, consistency and limitations of each. The process described resulted in a majority of the measurements across a wide dose range to be accurate within ± 2% of the intended dose using either FilmQA Pro or ImageJ.

Small-field dosimetry with a high-resolution 3D scanning water phantom system for the small animal radiation research platform SARRP: a geometrical and quantitative study.

Improvements in dosimetry in preclinical radiation research facilitate the application of results to the newest radiotherapy techniques, reducing gaps that hinder translation. Currently, guidelines for small-field kV photon dosimetry of small animal irradiators have not been published, and most of the publications are based on radiochromic film dosimetry. In this study, we evaluated the performance of four detectors, three ionization chambers (ICs): (PTW Advanced Markus, PTW Semiflex 31010, PTW PinPoint-3D 31016) and one solid-state detector (PTW 60017 unshielded Diode E) regarding their suitability for relative dosimetry of the small animal radiation research platform SARRP (220 kVp). The measurements were performed in a high-resolution 3D scanning phantom, centering the detectors in the field following the in-plane and cross-plane profiles method at two depths. Depth dose curves (PDDs) and profiles were measured in water for field sizes ranging from 40 × 40 mm2 to 5 × 5 mm2. Quantitative analysis was performed through global and local dose differences (DDs) between the PDDs and the Advanced Markus parallel plate IC data and through the gamma index (γ) criteria for profiles compared against data from EBT3 films provided by the manufacturer. Compared to the Advanced Markus IC, the PDD results suggest that PinPoint-3D is suitable for depth measurements at this beam quality, even near the surface, with agreements better than 1%. Semiflex 31010 was accurate to within 1.5% for measurements deeper than 5 mm. Diode E showed a dramatic DD and should not be recommended for the field sizes and kVp evaluated in this study. In agreement with γ analyses, PinPoint-3D and Diode E are good candidates for profile measurements of field sizes from 40 × 40 mm2 to 10 × 10 mm2. For 5 × 5 mm2 profiles, only Diode E showed good results, making it a recommended detector for profile measurements.

COMPARISON OF DIFFERENT TECHNIQUES FOR EVALUATION OF DOSE DISTRIBUTIONS IN RADIOTHERAPY USING RADIOCHROMIC EBT3 FILMS.

In radiotherapy, radiochromic films can be used for verification of delivery of dose distributions calculated by treatment planning systems. The main objective of this work was to compare three different techniques for evaluation of dose distributions for prostate cancer treatment plans using radiochromic EBT3 films. These techniques are: red channel evaluation taking into account only a response of irradiated film (R), red channel evaluation taking into account a response of unirradiated and irradiated film (Rcor) and multichannel evaluation in FilmQA software (RGB). Also comparison between film and MatriXX measurement was performed. Comparison showed that gamma analysis passing rates strongly depend on evaluation technique and on a model of scanner for digitizing films. The highest gamma passing rates were obtained with red channel evaluation taking into account a response of unirradiated and irradiated film using Epson V750 scanner (Rcor) and multichannel evaluation in FilmQA using Epson 11000XL scanner.

Scattering of therapeutic radiation in the presence of craniofacial bone reconstruction materials.

PURPOSE: Radiation scattering from bone reconstruction materials can cause problems from prolonged healing to osteoradionecrosis. Glass fiber reinforced composite (FRC) has been introduced for bone reconstruction in craniofacial surgery but the effects during radiotherapy have not been previously studied. The purpose of this study was to compare the attenuation and back scatter caused by different reconstruction materials during radiotherapy, especially FRC with bioactive glass (BG) and titanium. METHODS: The effect of five different bone reconstruction materials on the surrounding tissue during radiotherapy was measured. The materials tested were titanium, glass FRC with and without BG, polyether ether ketone (PEEK) and bone. The samples were irradiated with 6 MV and 10 MV photon beams. Measurements of backscattering and dose changes behind the sample were made with radiochromic film and diamond detector dosimetry. RESULTS: An 18% dose enhancement was measured with a radiochromic film on the entrance side of irradiation for titanium with 6 MV energy while PEEK and FRC caused an enhancement of 10% and 4%, respectively. FRC-BG did not cause any measurable enhancement. The change in dose immediately behind the sample was also greatest with titanium (15% reduction) compared with the other materials (0-1% enhancement). The trend is similar with diamond detector measurements, titanium caused a dose enhancement of up to 4% with a 1 mm sample and a reduction of 8.5% with 6 MV energy whereas FRC, FRC-BG, PEEK or bone only caused a maximum dose reduction of 2.2%. CONCLUSIONS: Glass fiber reinforced composite causes less interaction with radiation than titanium during radiotherapy and could provide a better healing environment after bone reconstruction.

Two-dimensional solid-state array detectors: A technique for in vivo dose verification in a variable effective area.

PURPOSE: We introduce a technique that employs a 2D detector in transmission mode (TM) to verify dose maps at a depth of dmax in Solid Water. TM measurements, when taken at a different surface-to-detector distance (SDD), allow for the area at dmax (in which the dose map is calculated) to be adjusted. METHODS: We considered the detector prototype "MP512" (an array of 512 diode-sensitive volumes, 2 mm spatial resolution). Measurements in transmission mode were taken at SDDs in the range from 0.3 to 24 cm. Dose mode (DM) measurements were made at dmax in Solid Water. We considered radiation fields in the range from 2 × 2 cm2 to 10 × 10 cm2 , produced by 6 MV flattened photon beams; we derived a relationship between DM and TM measurements as a function of SDD and field size. The relationship was used to calculate, from TM measurements at 4 and 24 cm SDD, dose maps at dmax in fields of 1 × 1 cm2 and 4 × 4 cm2 , and in IMRT fields. Calculations were cross-checked (gamma analysis) with the treatment planning system and with measurements (MP512, films, ionization chamber). RESULTS: In the square fields, calculations agreed with measurements to within ±2.36%. In the IMRT fields, using acceptance criteria of 3%/3 mm, 2%/2 mm, 1%/1 mm, calculations had respective gamma passing rates greater than 96.89%, 90.50%, 62.20% (for a 4 cm SSD); and greater than 97.22%, 93.80%, 59.00% (for a 24 cm SSD). Lower rates (1%/1 mm criterion) can be explained by submillimeter misalignments, dose averaging in calculations, noise artifacts in film dosimetry. CONCLUSIONS: It is possible to perform TM measurements at the SSD which produces the best fit between the area at dmax in which the dose map is calculated and the size of the monitored target.

Experimental evaluation of a radiation dose management system-integrated 3D skin dose map by comparison with XR-RV3 Gafchromic® films.

OBJECTIVE: To assess the interactive Skin Dose Map® tool (SDMTool) integrated to the radiation dose management system (RDMS) DoseWatch® with Gafchromic® films for implementation in routine practice. METHODS: A retrospective dose estimation software SDMTool was used to calculate Peak Skin Dose (PSD) and display the patient skin dose distribution. PSD was calculated with a triangle mesh of 0.055 cm2 resolution on ICRP 110 male anthropomorphic phantom and with a square ROI of 1 cm2 on flat phantom. The tool uses Radiation Dose Structured Reports (RDSR) data to model exposure events and calculate the PSD per event. The PSD and the skin dose distribution estimated with SDMTool were evaluated in comparison with Gafchromic® films positioned under the PMMA phantom (20 cm) for 13 configurations. Measurements were performed on a Philips system. Statistical analysis were carried out to compare PSDFilm and PSDSDM. RESULTS: Average differences between PSDFilm and PSDSDM were 6% ±â€¯6% (range from -3% to 22%) for flat phantom and 5% ±â€¯7% (range from -3% to 25%) for ICRP phantom. Concordance was good between the measured PSDFilm and the estimated PSDSDM with Lin's coefficient estimation and 95% Confidence Interval of 0.979 [0.875; 0.984] for flat phantom and 0.977 [0.877; 0.985] for ICRP phantom. Dose map representations are concordant for 11 of the 13 tests on PMMA phantom. Disparities arose from the limitations of the RSDR format: table displacement during fluoroscopy events and the use of wedge filter. CONCLUSION: The results found in this experimental evaluation show that the SDMTool is a suitable alternative to Gafchromic® film to calculate PSD.

High resolution radiochromic film dosimetry: Comparison of a microdensitometer and an optical microscope.

PURPOSE: Microbeam radiation therapy is a developing technique that promises superior tumour control and better normal tissue tolerance using spatially fractionated X-ray beams only tens of micrometres wide. Radiochromic film dosimetry at micrometric scale was performed using a microdensitometer, but this instrument presents limitations in accuracy and precision, therefore the use of a microscope is suggested as alternative. The detailed procedures developed to use the two devices are reported allowing a comparison. METHODS: Films were irradiated with single microbeams and with arrays of 50 µm wide microbeams spaced by a 400 µm pitch, using a polychromatic beam with mean energy of 100 keV. The film dose measurements were performed using two independent instruments: a microdensitometer (MDM) and an optical microscope (OM). RESULTS: The mean values of the absolute dose measured with the two instruments differ by less than 5% but the OM provides reproducibility with a standard deviation of 1.2% compared to up to 7% for the MDM. The resolution of the OM was determined to be ~ 1 to 2 µm in both planar directions able to resolve pencil beams irradiation, while the MDM reaches at the best 20 µm resolution along scanning direction. The uncertainties related to the data acquisition are 2.5-3% for the OM and 9-15% for the MDM. CONCLUSION: The comparison between the two devices validates that the OM provides equivalent results to the MDM with better precision, reproducibility and resolution. In addition, the possibility to study dose distributions in two-dimensions over wider areas definitely sanctions the OM as substitute of the MDM.

Characterization of radiochromic films as a micrometer-resolution dosimeter by confocal Raman spectroscopy.

PURPOSE: Micrometer spatial resolution dosimetry has become inevitable for advanced radiotherapy techniques. A new approach using radiochromic films was developed to measure a radiation dose at a micrometer spatial resolution by confocal Raman spectroscopy. METHODS: The commercial radiochromic films (RCF), EBT3 and EBT-XD, were irradiated with known doses using 50, 100, 200, and 300 kVp, and 6-MV x rays. The dose levels ranged from 0.3 to 50 Gy. The Raman mapping technique developed in our early study was used to readout an area of 100 × 100 µm2 on RCF with improved lateral and depth resolutions with confocal Raman spectrometry. The variation in Raman spectra of C-C-C deformation and C≡C stretching modes of diacetylene polymers around 676 and 2060 cm-1 , respectively, as a function of therapeutic x-ray doses, was measured. The single peak (SP) of C≡C and the peak ratio (PR) of C≡C band height to C-C-C band height with a spatial resolution of 10 µm on both types of RCF were evaluated, averaged, and plotted as a function of dose. An achievable spatial resolution, clinically useful dose range, dosimetric sensitivity, dose uniformity, and postirradiation stability as well as the orientation, energy, and dose rate dependence, of both types of RCFs, were characterized by the technique developed in this study. RESULTS: A spatial resolution on RCF achieved by SP and PR methods was ~4.5 and ~2.9 µm, respectively. Raman spectroscopy data showed dose nonuniformity of ~11% in SP method and <3% in PR method. The SP method provided dose ranges of up to ~10 and ~20 Gy for EBT3 and EBT-XD films, respectively while the PR method up to ~30 and ~50 Gy. The PR method diminished the orientation effect. The percent difference between landscape and portrait orientations for the EBT3 and the EBT-XD films at 4 Gy had an acceptable level of 1.2% and 2.4%, respectively. With both SP and PR methods, the EBT3 and the EBT-XD films showed weak energy (within ~10% and ~3% for SP and PR methods, respectively) and dose rate dependence (within ~5% and ~3% for SP and PR methods, respectively) and had a stable response after 24-h postirradiation. CONCLUSIONS: A technique for micrometer-resolution dosimetry was successfully developed by detecting radiation-induced Raman shift on EBT3 and EBT-XD. Both types of RCFs were suitable for micrometer-resolution dosimetry using CRS. With CRS both lateral and depth resolutions on RCF were improved. The PR method provided superior characteristics in dose uniformity, dose ranges, orientation dependence, and laser effect for both types of RCFs. The overall dosimetric characteristics of the RCFs determined by this technique were similar to those known by optical density scanning. The CRS with the PR method is advantageous over other the traditional scanning systems as a spatial resolution of <10 µm on RCF can be achieved with less deviations.

Extended field radiotherapy measurements in a single shot using a BaFBr-based OSL-film.

This work evaluated the use of a class solution specific calibration for an extra-large BaFBr-based optically stimulated luminescence film (OSL; 43 × 35 cm2; Z eff = 4.55). The clinical need for such large dosimeters follows from the increased use of extended-field radiation therapy (EFRT). E.g. for prostate cancer EFRT is currently used in the first prospective trial investigating the benefit of adding elective irradiation of the para-aortic lymph nodes in pN1 prostate cancer. The full extent of these EFRT dose distributions is not covered by the well-established standard sized radiochromic film or 2D detector arrays. Here we investigate an OSL calibration methodology, that tackles BaFBr-based OSL's inherent energy dependence by a class solution specific calibration. 10 EFRT treatment plans used in the PART trial were investigated. One plan was used to build a class solution specific bilinear calibration model, that distinguishes between in-field and penumbra dose contributions. The effect of this calibration was evaluated with respect to a standard linear calibration, using standard IMRT patterns, the nine remaining patient plans, and to smaller prostate treatment plans. A single OSL-dosimeter could be reused for all measurements. The dosimeter captured the full extent of the dose distributions (maximum EFRT field size = 33.5 cm). The bilinear correction reduced the residual dose differences from above 10% to an average of 0.7% (max 3.6%) in comparison with a Monte Carlo simulation. Consequently global gamma agreement scores (3%-3 mm) of 95.5% ± 2.7% were reached. A more strict local evaluation resulted in an average gamma-agreement score of 93.3% ± 3.2%. The BaFBr-based OSL film, with reduced Z eff requires a class-solution specific correction. The current work shows that such a correction can be as simple as a bilinear residual dose correction driven by the measured signal. As far as we know this is the first 2D dosimeter combining reusability, a sub-mm resolution, and a size covering the typical EFRT treatment plans.

Leuco crystal violet-Pluronic F-127 3D radiochromic gel dosimeter.

This work reports results related to the manufacturing and optimisation of a leuco crystal violet (LCV)-Pluronic F-127 radiochromic gel dosimeter suitable for 3D radiotherapy dosimetry. A feature of this gel is that the natural gelatine polymer, which is most often used as a matrix in 3D dosimeters, is substituted with Pluronic F-127 synthetic copolymer (poly(ethylene oxide)-block-poly(propylene oxide)-block-poly(ethylene oxide). Pluronic F-127 ensures a higher transparency than gelatine, which may be beneficial for optical computed tomography readout, and improves the thermal properties in the temperature range above ~30 °C at which the gelatine physical gel converts to a solution. The optimal composition obtained comprises 2 mM LCV, 4 mM 4-(1,1,3,3-tetramethylbutyl)phenyl-polyethylene glycol (Triton X-100), 17 mM trichloroacetic acid (TCAA) and 25% Pluronic F-127. Its main dose-response features are 4‒150 Gy linear dose range (150 Gy was the maximal dose applied to gels in this work), 0.0070 Gy-1 cm-1 dose sensitivity (derived from absorbance (600 nm) = f (dose) for 6 MeV electrons, 0.88(3) Gy s-1 and 0.0156 Gy-1 cm-1 derived from optical density (Δµ) = f (dose) for 6 MV x-rays, 0.1010 Gy s-1), low initial colour (initial absorbance = 0.0429) and a diffusion coefficient of crystal violet (CV) in LCV-Pluronic of 0.054 ± 0.023 mm2 h-1. Raman spectroscopy was used to characterize LCV-Pluronic chemical changes after irradiation. Differential scanning calorimetry (DSC) revealed that LCV-Pluronic is stable in temperatures between approximately 11 °C and 56 °C. Irradiation of LCV-Pluronic gel impacts on its first sol-gel transition temperature and the thermal effect of this process-both increased with absorbed dose, which might be related to the degradation of Pluronic. LCV-Pluronic is a promising 3D dosimeter for ionising radiation applications. Further work is needed to improve LCV-Pluronic response in the low dose region, and characterize potential effects of pH, temperature during irradiation, and radiation quality/dose rate on dose response characteristics.

Radiological tissue equivalence of deformable silicone-based chemical radiation dosimeters (FlexyDos3D).

FlexyDos3D, a silicone-based chemical radiation dosimeter, has great potential to serve as a three-dimensional (3D) deformable dosimetric tool to verify complex dose distributions delivered by modern radiotherapy techniques. To facilitate its clinical application, its radiological tissue needs to be clarified. In this study we investigated its tissue-equivalence in comparison with water and Solid Water (RMI457). We found that its effective and mean atomic numbers were 40% and 20% higher and the total interaction probabilities for kV x-ray photons were larger than those of water respectively. To assess the influence of its over-response to kV photons, its HU value was measured by kV computed tomography (CT) and was found higher than all the soft-tissue substitutes. When applied for dose calculation without correction, this effect led to an 8% overestimation in electron density via HU-value mapping and 0.65% underestimation in target dose. Furthermore, depth dose curves (PDDs) and off-axis ratios (profiles) at various beam conditions as well as the dose distribution of a full-arc VMAT plan in FlexyDos3D and reference materials were simulated by Monte Carlo, where the results showed great agreement. As indicated, FlexyDos3D exhibits excellent radiological water-equivalence for clinical MV x-ray dosimetry, while its nonwater-equivalent effect for low energy x-ray dosimetry requires necessary correction. The key findings of this study provide pertinent reference for further FlexyDos3D characterization research.

Characterization of EBT3 radiochromic films for dosimetry of proton beams in the presence of magnetic fields.

PURPOSE: Radiochromic film dosimetry is extensively used for quality assurance in photon and proton beam therapy. So far, GafchromicTM EBT3 film appears as a strong candidate to be used in future magnetic resonance (MR) based therapy systems. The response of Gafchromic EBT3 films in the presence of magnetic fields has already been addressed for different MR-linacs systems. However, a detailed evaluation of the influence of external magnetic fields on the film response and calibration curves for proton therapy has not yet been reported. This study aims to determine the dose responses of EBT3 films for clinical proton beams exposed to magnetic field strengths up to 1 T in order to investigate the feasibility of EBT3 film as an accurate dosimetric tool for a future MR particle therapy system (MRPT). METHODS: The dosimetric characteristics of EBT3 films were studied for a proton beam passing through magnetic field strengths of B = 0, 0.5, and 1 T. Absorbed dose calibration and measurements were performed using clinical proton beams in the nominal energy range of 62.4-252.6 MeV. Irradiations were done using an in-house developed PMMA slab phantom placed in the center of a dipole research magnet. Monte Carlo (MC) simulations using the GATE/Geant4 toolkit were performed to predict the effect of magnetic fields on the energy deposited by proton beams in the phantom. Planned and measured doses from 3D box cube irradiations were compared to assess the accuracy of the dosimetric method using EBT3 films with/without the external magnetic field. RESULTS: Neither for the mean pixel value nor for the net optical density, any significant deviations were observed due to the presence of an external magnetic field (B ≤ 1T) for doses up to 10 Gy. Dose-response curves for the red channel were fitted by a three-parameter function for the field-free case and for B = 1T, showing for both cases an R-square coefficient of unity and almost identical fitting parameters. Independently of the magnetic field, EBT3 films showed an under-response as high as 8% in the Bragg peak region, similarly to previously reported effects for particle therapy. No noticeable influence of the magnetic field strength was observed on the quenching effect of the EBT3 films. CONCLUSIONS: For the first time detailed absorbed dose calibrations of EBT3 films for proton beams in magnetic field regions were performed. Results showed that EBT3 films represent an attractive solution for the dosimetry of a future MRPT system. As film response functions for protons are not affected by the magnetic field strenght, they can be used for further investigations to evaluate the dosimetric effects induced due to particle beams bending in magnetic fields regions.