Evaluation of a LED-based flatbed document scanner for radiochromic film dosimetry in transmission mode.

Flatbed scanners are the most frequently used reading instrument for radiochromic film dosimetry because its low cost, high spatial resolution, among other advantages. These scanners use a fluorescent lamp and a CCD array as light source and detector, respectively. Recently, manufacturers of flatbed scanners replaced the fluorescent lamp by light emission diodes (LED) as a light source. The goal of this work is to evaluate the performance of a commercial flatbed scanner with LED based source light for radiochromic film dosimetry. Film read out consistency, response uniformity, film-scanner sensitivity, long term stability and total dose uncertainty was evaluated. In overall, the performance of the LED flatbed scanner is comparable to that of a cold cathode fluorescent lamp (CCFL). There are important spectral differences between LED and CCFL lamps that results in a higher sensitivity of the LED scanner in the green channel. Total dose uncertainty, film response reproducibility and long-term stability of LED scanner are slightly better than those of the CCFL. However, the LED based scanner has a strong non-uniform response, up to 9%, that must be adequately corrected for radiotherapy dosimetry QA. The differences in light emission spectra between LED and CCFL lamps and its potential impact on film-scanner sensitivity suggest that the design of a dedicated flat-bed scanner with LEDs may improve sensitivity and dose uncertainty in radiochromic film dosimetry.

Experimental determination of field factors ([Formula: see text]) for small radiotherapy beams using the daisy chain correction method.

Recently, Alfonso et al proposed a new formalism for the dosimetry of small and non-standard fields. The proposed new formalism is strongly based on the calculation of detector-specific beam correction factors by Monte Carlo simulation methods, which accounts for the difference in the response of the detector between the small and the machine specific reference field. The correct calculation of the detector-specific beam correction factors demands an accurate knowledge of the linear accelerator, detector geometry and composition materials. The present work shows that the field factors in water may be determined experimentally using the daisy chain correction method down to a field size of 1 cm × 1 cm for a specific set of detectors. The detectors studied were: three mini-ionization chambers (PTW-31014, PTW-31006, IBA-CC01), three silicon-based diodes (PTW-60018, IBA-SFD and IBA-PFD) and one synthetic diamond detector (PTW-60019). Monte Carlo simulations and experimental measurements were performed for a 6 MV photon beam at 10 cm depth in water with a source-to-axis distance of 100 cm. The results show that the differences between the experimental and Monte Carlo calculated field factors are less than 0.5%-with the exception of the IBA-PFD-for field sizes between 1.5 cm × 1.5 cm and 5 cm × 5 cm. For the 1 cm × 1 cm field size, the differences are within 2%. By using the daisy chain correction method, it is possible to determine measured field factors in water. The results suggest that the daisy chain correction method is not suitable for measurements performed with the IBA-PFD detector. The latter is due to the presence of tungsten powder in the detector encapsulation material. The use of Monte Carlo calculated [Formula: see text] is encouraged for field sizes less than or equal to 1 cm × 1 cm for the dosimeters used in this work.

Properties of a commercial PTW-60019 synthetic diamond detector for the dosimetry of small radiotherapy beams.

A CVD based radiation detector has recently become commercially available from the manufacturer PTW-Freiburg (Germany). This detector has a sensitive volume of 0.004 mm(3), a nominal sensitivity of 1 nC Gy(-1) and operates at 0 V. Unlike natural diamond based detectors, the CVD diamond detector reports a low dose rate dependence. The dosimetric properties investigated in this work were dose rate, angular dependence and detector sensitivity and linearity. Also, percentage depth dose, off-axis dose profiles and total scatter ratios were measured and compared against equivalent measurements performed with a stereotactic diode. A Monte Carlo simulation was carried out to estimate the CVD small beam correction factors for a 6 MV photon beam. The small beam correction factors were compared with those obtained from stereotactic diode and ionization chambers in the same irradiation conditions The experimental measurements were performed in 6 and 15 MV photon beams with the following square field sizes: 10 × 10, 5 × 5, 4 × 4, 3 × 3, 2 × 2, 1.5 × 1.5, 1 × 1 and 0.5 × 0.5 cm. The CVD detector showed an excellent signal stability (<0.2%) and linearity, negligible dose rate dependence (<0.2%) and lower response angular dependence. The percentage depth dose and off-axis dose profiles measurements were comparable (within 1%) to the measurements performed with ionization chamber and diode in both conventional and small radiotherapy beams. For the 0.5 × 0.5 cm, the measurements performed with the CVD detector showed a partial volume effect for all the dosimetric quantities measured. The Monte Carlo simulation showed that the small beam correction factors were close to unity (within 1.0%) for field sizes ≥1 cm. The synthetic diamond detector had high linearity, low angular and negligible dose rate dependence, and its response was energy independent within 1% for field sizes from 1.0 to 5.0 cm. This work provides new data showing the performance of the CVD detector compared against a high spatial resolution diode. It also presents a comparison of the CVD small beam correction factors with those of diode and ionization chamber for a 6 MV photon beam.

Effect of the embolization material in the dose calculation for stereotactic radiosurgery of arteriovenous malformations.

It is reported in the literature that the material used in an embolization of an arteriovenous malformation (AVM) can attenuate the radiation beams used in stereotactic radiosurgery (SRS) up to 10% to 15%. The purpose of this work is to assess the dosimetric impact of this attenuating material in the SRS treatment of embolized AVMs, using Monte Carlo simulations assuming clinical conditions. A commercial Monte Carlo dose calculation engine was used to recalculate the dose distribution of 20 AVMs previously planned with a pencil beam dose calculation algorithm. Dose distributions were compared using the following metrics: average, minimal and maximum dose of AVM, and 2D gamma index. The effect in the obliteration rate was investigated using radiobiological models. It was found that the dosimetric impact of the embolization material is less than 1.0 Gy in the prescription dose to the AVM for the 20 cases studied. The impact in the obliteration rate is less than 4.0%. There is reported evidence in the literature that embolized AVMs treated with SRS have low obliteration rates. This work shows that there are dosimetric implications that should be considered in the final treatment decisions for embolized AVMs.

Radiation transmission, leakage and beam penumbra measurements of a micro-multileaf collimator using GafChromic EBT film.

Micro-multileaf collimator systems coupled to linear accelerators for radioneurosurgery treatments require a rigorous dosimetric characterization in order to be used in 3D conformal and intensity modulated stereotactic radiosurgery and radiotherapy applications. This characterization involves high precision measurements of leaf transmission, leakage and beam penumbra through the collimation system and requires the use of detectors with high spatial resolution, high sensitivity and practically no energy dependence. In this work the use of GafChromic EBT radiochromic film to measure the basic dosimetric properties of the m3-mMLC (BrainLAB, Germany) micro-multileaf collimator system integrated to a 6 MV linear accelerator, is reported. Results show that average values of transmission and leakage radiation are 0.93 +/- 0.05% and 1.08 +/- 0.08%, respectively. The 80-20% beam penumbra were found to be 2.26 +/- 0.11 mm along the leaf side (perpendicular to leaf motion) and 2.31 +/- 0.11 mm along the leaf end (parallel to leaf motion) using square field sizes ranging from 9.1 to 1.8 cm. These measurements are in agreement with values reported in the literature for the same type of mMLC using different radiation detectors.

Intracranial arteriovenous malformations treated with LINAC-based conformal radiosurgery: validation of the radiosurgery-based arteriovenous malformation score as a predictor of outcome.

OBJECTIVE: To validate the radiosurgery-based arteriovenous malformation score (RBAS) as a predictor of outcome in patients with arteriovenous malformations (AVMs) treated with LINAC-based conformal radiosurgery. METHODS: We analysed 40 patients with a mean follow-up of 22 months. One patient (2.5%) pertained to Spetzler-Martin Grade I, 11 (27.5%) to Grade II, 19 (47.5%) to Grade III, eight (20%) to Grade IV and one (2.5%) to grade V. The mean RBAS was 2.0 (range: 0.76-5.56). The mean obliteration prediction index (OPI) and the Karlsson index (KI) were 0.74 (range: 0.2-2.86) and 109.48 (range: 3.0-350.7) respectively. Outcomes were analysed according to the OPI, KI and RBAS. RESULTS: We analysed different cutoff points in the RBAS and found a significant difference to predict the outcome in four scores: 1.2, 1.6, 1.7 and 1.8. In the group with RBAS < or = 1.8, 13 (68%) had an excellent outcome and six (33%) did not, while with RBAS>1.8, seven (32%) had an excellent outcome and 14 (67%) did not (p = 0.02). We did not find any correlation between Spetzler-Martin grading scale or OPI and outcome (p = 0.7 and p = 0.3 respectively). The KI predicted the excellent outcome in 8/9 patients (89%) with KI < or = 27 and in 12/31 patients (39%) with KI>27 (p = 0.08). CONCLUSION: The RBAS seems to be a good predictor of outcome in patients with AVMs treated with LINAC-based conformal radiosurgery as in patients treated with Gamma Knife. It remains only to find the best cutoff point based on a larger series and longer follow-up.

Intracranial arteriovenous malformations treated with linear accelerator-based conformal radiosurgery: clinical outcome and prediction of obliteration.

BACKGROUND: Little is written about the clinical outcome and predictor factors of obliteration and treatment success in patients with intracranial AVMs treated with LINAC-based conformal radiosurgery in Mexican institutions. METHODS: We analyzed 40 patients with intracranial AVMs with a mean follow-up of 29 (range, 23-34) months. Seven AVMs (17.5%) had a volume <1 cm(3); 10 (25%), 1 to 4 cm(3); 13 (32.5%), 4.1 to 10 cm(3); and 10 (25%), >10 cm(3). The mean prescription dose was 15.4 Gy. Twenty-six patients (68%) presented hemorrhage before treatment; 4 (10%), chronic headache; 14 (35%), seizures; and 3(8%), neurologic deficit. RESULTS: Seven patients (17.5%) underwent objective clinical improvement. Thirty patients (75%) remained without clinical changes. Three patients (7.5%) developed edema and 1 (2.5%) had a rebleeding after treatment. Twenty-five patients (63%) presented complete obliteration of the AVM. A successful treatment (obliteration without a new deficit) was obtained in 23 (58%) of the cases. The percentage of obliteration was in <1 cm(3) (86%), 1 to 4 cm(3) (80%), 4.1 to 10 cm(3) (54%), and >10 cm(3) (40%), without a significant difference between groups (P = .1). Patients with RBAS of 1.9, 48%; the successful treatment in the former resulted in 79% and, in the latter, 38% (P = .08 and P = .02, respectively). CONCLUSIONS: The clinical outcome was similar to other series. The RBAS seems to be a good predictor of obliteration and successful treatment in patients with AVMs treated with LINAC-based conformal radiosurgery.