Verification of dose distribution in high dose-rate brachytherapy for cervical cancer using a normoxic N-vinylpyrrolidone polymer gel dosimeter.

The polymer gel dosimeter has been proposed for use as a 3D dosimeter for complex dose distribution measurement of high dose-rate (HDR) brachytherapy. However, various shapes of catheter/applicator for sealed radioactive source transport used in clinical cases must be placed in the gel sample. The absorbed dose readout for the magnetic resonance (MR)-based polymer gel dosimeters requires calibration data for the dose-transverse relaxation rate (R2) response. In this study, we evaluated in detail the dose uncertainty and dose resolution of three calibration methods, the multi-sample and distance methods using the Ir-192 source and the linear accelerator (linac) method using 6MV X-rays. The use of Ir-192 sources increases dose uncertainty with steep dose gradients. We clarified that the uniformly irradiated gel sample improved the signal-to-noise ratio (SNR) due to the large slice thickness of MR images and could acquire an accurate calibration curve using the linac method. The curved tandem and ovoid applicator used for intracavitary irradiation of HDR brachytherapy for cervical cancer were reproduced with a glass tube to verify the dose distribution. The results of comparison with the treatment planning system (TPS) calculation by gamma analysis on the 3%/2 mm criterion were in good agreement with a gamma pass rate of 90%. In addition, the prescription dose could be evaluated accurately. We conclude that it is easy to place catheter/applicator in the polymer gel dosimeters, making them a useful tool for verifying the 3D dose distribution of HDR brachytherapy with accurate calibration methods.

Verification of dose distribution in high-dose-rate brachytherapy using a nanoclay-based radio-fluorogenic gel dosimeter.

Dose distributions have become more complex with the introduction of image-guided brachytherapy in high-dose-rate (HDR) brachytherapy treatments. Therefore, to correctly execute HDR, conducting a quality assurance programme for the remote after-loading system and verifying the dose distribution in the patient treatment plan are necessary. The characteristics of the dose distribution of HDR brachytherapy are that the dose is high near the source and rapidly drops when the distance from the source increases. Therefore, a measurement tool corresponding to the characteristic is required. In this study, using an Iridium-192 (Ir-192) source, we evaluated the basic characteristics of a nanoclay-based radio-fluorogenic gel (NC-RFG) dosimeter that is a fluorescent gel dosimeter using dihydrorhodamine 123 hydrochloride as a fluorescent probe. The two-dimensional dose distribution measurements were performed at multiple source positions to simulate a clinical plan. Fluorescence images of the irradiated NC-RFG were obtained at a high resolution (0.04 mm pixel-1) using a gel scanner with excitation at 465 nm. Good linearity was confirmed up to a dose range of 100 Gy without dose rate dependence. The dose distribution measurement at the five-point source position showed good agreement with the treatment planning system calculation. The pass ratio by gamma analysis was 92.1% with a 2%/1 mm criterion. The NC-RFG dosimeter demonstrates to have the potential of being a useful tool for quality assurance of the dose distribution delivered by HDR brachytherapy. Moreover, compared with conventional gel dosimeters such as polymer gel and Fricke gel dosimeters it solves the problems of diffusion, dose rate dependence and inhibition of oxygen-induced reactions. Furthermore, it facilitates dose data to be read in a short time after irradiation, which is useful for clinical use.

Visualization of Low-Level Gamma Radiation Sources Using a Low-Cost, High-Sensitivity, Omnidirectional Compton Camera.

We present experimental protocols for visualizing various low-level gamma radiation sources in the ambient environment. Experiments were conducted by using a low-cost, high-sensitivity, omnidirectional, gamma-ray imaging Compton camera. In the laboratory, the position of a sub-MeV gamma radiation source such as 137Cs can easily be monitored via omnidirectional gamma-ray imaging obtained by the Compton camera. In contrast, a stationary, wall-mounted dose rate monitor cannot always successfully monitor such a source. Furthermore, we successfully demonstrated the possibility of visualizing the radioactivity movement in the environment, for example, the movement of a patient injected with 18F-fluorodeoxyglucose (18F-FDG) in a nuclear medicine facility. In the Fukushima field, we easily obtained omnidirectional gamma-ray images concerned with the distribution on the ground of low-level radioactive contamination by radioactive cesium released by the Fukushima Daiichi nuclear power plant accident in 2011. We demonstrate clear advantages of using our procedure with this camera to visualize gamma-ray sources. Our protocols can further be used to discover low-level gamma radiation sources, in place of stationary dose rate monitors and/or portable survey meters used conventionally.

Dose distribution verification in high-dose-rate brachytherapy using a highly sensitive normoxic N-vinylpyrrolidone polymer gel dosimeter.

Rapid technological advances in high-dose-rate brachytherapy have led to a requirement for greater accuracy in treatment planning system calculations and in the verification of dose distributions. In high-dose-rate brachytherapy, it is important to measure the dose distribution in the low-dose region at a position away from the source in addition to the high-dose range in the proximity of the source. The aim of this study was to investigate the accuracy of a treatment plan designed for prostate cancer in the low-dose range using a normoxic N-vinylpyrrolidone-based polymer gel (VIPET gel) dosimeter containing inorganic salt as a sensitizer (iVIPET). The dose response was evaluated on the basis of the transverse relaxation rate (R2) measured by magnetic resonance scanning. In the verification of the treatment plan, gamma analysis showed that the dose distributions obtained from the polymer gel dosimeter were in good agreement with those calculated by the treatment planning system. The gamma passing rate according to the 2%/2 mm criterion was 97.9%. The iVIPET gel dosimeter provided better accuracy for low doses than the normal VIPET gel dosimeter, demonstrating the potential to be a useful tool for quality assurance of the dose distribution delivered by high-dose-rate brachytherapy.

Automated source tracking with a pinhole imaging system during high-dose-rate brachytherapy treatment.

The transportation accuracy of sealed radioisotope sources influences the therapeutic effect of high-dose-rate (HDR) brachytherapy. We have developed a pinhole imaging system for tracking an Ir-192 radiation source during HDR brachytherapy treatment. Our system consists of a dual-pinhole collimator, a scintillator, and a charge-coupled device (CCD) camera. We acquired stereo-shifted images to infer the source position in three dimensions using a dual pinhole collimator with 1.0 mm diameter pinholes. The CCD camera captured consecutive images of scintillation light that corresponds to the source positions every 2 s. The system automatically tracks scintillation light points using template-matching technique and measured the source positions therefrom. By integrating a series of CCD images, we could infer the source dwell time from the pixel values in the integrated image. We investigated the tracking accuracy of our system in monitoring simulated brachytherapy as it would be performed for cervical cancer by using water as a stand-in for human tissue. Ir-192 pellet was moved through a water tank using tandem and ovoid applicators. The CCD camera captured clear images of the scintillation light produced by the underwater Ir-192 source in conditions equivalent to common clinical situations. The differences between the measured and the reference 3D source positions and dwell times were 1.5 ± 0.7 mm and 0.8 ± 0.4 s, respectively. This system has the potential to track in vivo Ir-192 source in real time and may prove a useful tool for quality assurance during HDR brachytherapy treatments in clinical settings.

[Study of fast acquisition technique for heavy ion CT system based on the measurement of residual range distribution].

We proposed a new technique for the fast acquisition heavy ion CT (HICT) system based on the measurement of residual range distribution using an intensifying screen and charge coupled device camera. The previously used fast acquisition HICT system had poor electron density resolution. In the new technique, the range shifter thickness is varied over the required dynamic range in the spill of the heavy ion beam at each projection angle and the residual range distribution is determined by a series of acquisition data. We examined the image quality using the contrast noise ratio and the noise power spectrum, and estimated the electron density resolution, using a low-contrast phantom for measurement of electron density resolution. The image quality of the new technique was superior to that of the previous fast acquisition HICT system. Furthermore, the relative electron density resolution was 0.011, which represented an improvement of about 12-fold. Therefore we showed that the new technique was potentially useful in clinical use of HICT, including treatment and quality assurance of heavy ion therapy.

Effect of J coupling and T2 Relaxation in Assessing of Methyl Lactate Signal using PRESS Sequence MR Spectroscopy.

PURPOSE: This work was aimed at quantification of lactate concentration using proton MR spectroscopy (MRS). We carried out a basic study to clarify the characteristics of signal change and T2 relaxation time of lactate that occur by J coupling in point resolved spectroscopy (PRESS) sequence. MATERIALS AND METHODS: Proton MRS was done for a water phantom containing 10 mmol/L creatine and lactate on a clinical 1.5 T MR system by using an asymmetric PRESS sequence. The coupling constant J was 7.35 Hz. In acquisitions, TE was varied from 68 ms up to 544 ms, with an increment of 68 ms (1/2J) and TR was fixed to 10000 ms. RESULTS: The shape and signal intensity of the lactate signal vary depending on its phase. The lactate signal intensity at TE 272 ms was higher than at TE 136 ms despite the longer TE. T2 relaxation times of lactate in the negative in-phase (TE 136 ms, TE 408 ms) and positive in-phase (TE 272 ms, TE 544 ms) were 1033 ms and 1042 ms, respectively (no significant differences), so that when the same phase was used, regardless of the phase condition, T2 relaxation behavior was not different. We considered that our results included over expression and loss of lactate signal depending on the phase. CONCLUSIONS: For evaluation of the lactate peak, we recommend the use of the positive in-phase signal because it is larger than the negative in-phase signal. The influence of the asymmetric PRESS sequence, which may cause loss and over expression of lactate signal, should be considered in the calculation of the quantification. The T2 relaxation time should be also considered in the calculation of the lactate value since it affects the value considerably.

[Wiener spectrum and relative electron density resolution in heavy ion CT based on measurement of residual range distribution].

The relative electron density resolution was discussed by the Wiener spectrum in the heavy ion CT image. The two-dimensional (2D) Wiener spectrum in the CT image was obtained from the one-dimensional (1D) Wiener spectrum of the measured residual range distribution of the water phantom for a single projection angle, and the relative electron density resolution in the CT image was calculated from the 2D Wiener spectrum. To examine the usefulness of this method, the relative electron density resolution was also estimated by other two methods; the calculation using the Wiener spectrum of the reconstructed image of the water phantom, and the estimation by the reconstructed image of the electron density resolution phantom. The result of the first method was similar to those of the other two methods. Therefore, it is useful to estimate the relative electron density resolution by the 1D Wiener spectrum of the measured residual range distribution of the water phantom for a single projection angle.

[Trial production of water substitute phantom considering the effect of light].

We have produced a novel water substitute phantom suitable for film dosimetry, while retaining the radiological property of a conventional water substitute phantom. The novel phantom excludes the effect of light, which is known to affect the accuracy of results on conventional phantoms. The effect of light was eliminated by appropriately adjusting the quantum of the carbon black to that of a conventional phantom material. Through comparison of the novel phantom with a conventional phantom it was shown that the absorbed dose determined by conventional phantom was 15% higher for 10 MV X-rays and 18% higher for an 18 MeV electron beam, attributable to the contamination of Cerenkov light. Although the net optical density of the film increased with time owing to the optical permeability of the phantom, that of the novel phantom did not vary with time. The novel phantom was therefore shown to be unaffected by such local light and by the optical transmission of the phantom.

Heavy ion CT system based on measurement of residual range distribution.

The heavy ion CT system is proposed which is based on measurement of the residual range distribution by a fluoroscopy detector consisting of an intensifying screen and a CCD video camera. To investigate the fundamental performance of the proposed system, the spatial and density resolutions of the CT image were evaluated. The heavy ion beam 12C accelerated up to 400 MeV/u by HIMAC was used in this study. A series of projection images of two types of phantoms (PMMA pipes with several sizes and various kinds of rods with different electron densities) were experimentally taken for five values of range shifter thickness at each projection angle. From these images, the residual range distribution was obtained and used to reconstruct CT images of the relative stopping power which were obtained by the filtered back projection method with the Shepp-Logan filter after noise reduction processing by the median filter. As a result, the spatial resolution was found to be less than 2 mm and the relative density resolution around the density of water was less than 0.07.