Verification of proton range, position, and intensity in IMPT with a 3D liquid scintillator detector system.

PURPOSE: Intensity-modulated proton therapy (IMPT) using spot scanned proton beams relies on the delivery of a large number of beamlets to shape the dose distribution in a highly conformal manner. The authors have developed a 3D system based on liquid scintillator to measure the spatial location, intensity, and depth of penetration (energy) of the proton beamlets in near real-time. METHODS: The detector system consists of a 20 × 20 × 20 cc liquid scintillator (LS) material in a light tight enclosure connected to a CCD camera. This camera has a field of view of 25.7 by 19.3 cm and a pixel size of 0.4 mm. While the LS is irradiated, the camera continuously acquires images of the light distribution produced inside the LS. Irradiations were made with proton pencil beams produced with a spot-scanning nozzle. Pencil beams with nominal ranges in water between 9.5 and 17.6 cm were scanned to irradiate an area of 10 × 10 cm square on the surface of the LS phantom. Image frames were acquired at 50 ms per frame. RESULTS: The signal to noise ratio of a typical Bragg peak was about 170. Proton range measured from the light distribution produced in the LS was accurate to within 0.3 mm on average. The largest deviation seen between the nominal and measured range was 0.6 mm. Lateral position of the measured pencil beam was accurate to within 0.4 mm on average. The largest deviation seen between the nominal and measured lateral position was 0.8 mm; however, the accuracy of this measurement could be improved by correcting light scattering artifacts. Intensity of single proton spots were measured with precision ranging from 3 % for the smallest spot intensity (0.005 MU) to 0.5 % for the largest spot (0.04 MU). CONCLUSIONS: Our LS detector system has been shown to be capable of fast, submillimeter spatial localization of proton spots delivered in a 3D volume. This system could be used for beam range, intensity and position verification in IMPT.

On the use of polychromatic cameras for high spatial resolution spectral dose measurements.

Objective.Despite the demonstrated benefits of hyperspectral formalism for stem effect corrections in the context of fiber dose measurements, this approach has not been yet translated into volumetric measurements where cameras are typically used for their distinguishing spatial resolution. This work investigates demosaicing algorithms for polychromatic cameras based spectral imaging.Approach.The scintillation and Cherenkov signals produced in a radioluminescent phantom are imaged by a polychromatic camera and isolated using the spectral formalism. To do so, five demosaicing algorithms are investigated from calibration to measurements: a clustering method and four interpolation algorithms. The resulting accuracy of scintillation and Cherenkov images is evaluated with measurements of the differences (mean ± standard deviation) between the obtained and expected signals from profiles drawn across a scintillation spot. Signal-to-noise ratio and signal-to-background ratio are further measured and compared in the resulting scintillation images. Finally, the resulting differences on the scintillation signal from a 0.2 × 0.2 cm2region-of-interest (ROI) were reported.Main results.Clustering, OpenCV, bilinear, Malvar and Menon demosaicing algorithms respectively yielded differences of 3 ± 5%, 1 ± 3%, 1 ± 3%, 1 ± 2% and 2 ± 4% in the resulting scintillation images. For the Cherenkov images, all algorithms provided differences below 1%. All methods enabled measurements over the detectability (SBR > 2) and sensitivity (SNR > 5) thresholds with the bilinear algorithm providing the best SNR value. Clustering, OpenCV, bilinear, Malvar and Menon demosaicing algorithms respectively provided differences on the ROI analysis of 7 ± 5%, 3 ± 2%, 3 ± 2%, 4 ± 2%, 7 ± 3%.Significance.Radioluminescent signals can accurately be isolated using a single polychromatic camera. Moreover, demosaicing using a bilinear kernel provided the best results and enabled Cherenkov signal subtraction while preserving the full spatial resolution of the camera.

Deformable scintillation dosimeter I: challenges and implementation using computer vision techniques.

Plastic scintillation detectors are increasingly used to measure dose distributions in the context of radiotherapy treatments. Their water-equivalence, real-time response and high spatial resolution distinguish them from traditional detectors, especially in complex irradiation geometries. Their range of applications could be further extended by embedding scintillators in a deformable matrix mimicking anatomical changes. In this work, we characterized signal variations arising from the translation and rotation of scintillating fibers with respect to a camera. Corrections are proposed using stereo vision techniques and two sCMOS complementing a CCD camera. The study was extended to the case of a prototype real-time deformable dosimeter comprising an array of 19 scintillating fibers. The signal to angle relationship follows a gaussian distribution (FWHM = 52°) whereas the intensity variation from radial displacement follows the inverse square law. Tracking the position and angle of the fibers enabled the correction of these spatial dependencies. The detecting system provides an accuracy and precision of respectively 0.08 mm and 0.3 mm on the position detection. This resulted in an uncertainty of 2° on the angle measurement. Displacing the dosimeter by ±3 cm in depth resulted in relative intensities of 100 ± 10% (mean ± standard deviation) to the reference position. Applying corrections reduced the variations thus resulting in relative intensities of 100 ± 1%. Similarly, for lateral displacements of ±3 cm, intensities went from 98 ± 3% to 100 ± 1% after the correction. Therefore, accurate correction of the signal collected by a camera imaging the output of scintillating elements in a 3D volume is possible. This work paves the way to the development of real-time scintillator-based deformable dosimeters.

Deformable scintillation dosimeter: II. Real-time simultaneous measurements of dose and tracking of deformation vector fields.

Anatomical motion and deformation pose challenges to the understanding of the delivered dose distribution during radiotherapy treatments. Hence, deformable image registration (DIR) algorithms are increasingly used to map contours and dose distributions from one image set to another. However, the lack of validation tools slows their clinical adoption, despite their commercial availability. This work presents a novel water-equivalent deformable dosimeter that simultaneously measures the dose distribution and tracks deformation vector fields (DVF). The dosimeter in made of an array of 19 scintillating fiber detectors embedded in a cylindrical elastomer matrix. It is imaged by two pairs of stereoscopic cameras tracking the position and angulation of the scintillators, while measuring the dose. The resulting system provides a precision of 0.3 mm on DVF measurements. The dosimeter was irradiated with 5 × 3, 4 × 3 and 3 × 3 cm26 MV photon beams in both fixed and deformed conditions. The measured DVF was compared to the one computed with a DIR algorithm (Plastimatch). The deviations between the computed and measured DVFs was below 1.5 mm. As for dose measurements, the dosimeter acquired the dose distribution in fixed and deformed conditions within 1% of the treatment planning system calculation and complementary dose validation using the Hyperscint dosimetry system. Using the demonstrated qualities of scintillating detectors, we developed a real-time, water-equivalent deformable dosimeter. Given it's sensor tracking position precision and dose measurements accuracy, the developed detector is a promising tools for the validation of DIR algorithms as well as dose distribution measurements under fixed and deformed conditions.

Mucosal Bacteria Modulate Candida albicans Virulence in Oropharyngeal Candidiasis.

Oropharyngeal candidiasis (OPC) is the most prevalent oral infection in immunocompromised patients, primarily associated with Candida albicans. Increasing evidence points to a significant role of mucosal bacteria on the transition of C. albicans from commensal to pathogenic. In this work, we hypothesized that changes in the abundance or composition of the mucosal bacterial microbiota induced by dietary sucrose during the development of OPC can modulate C. albicans virulence. C. albicans burdens and mucosal lesions were evaluated in a mouse cortisone immunosuppression model amended with sucrose. We also analyzed the mucosal bacterial composition using 16S rRNA gene sequencing and culture methods. In immunocompetent mice, sucrose significantly increased total bacterial burdens and reduced alpha diversity, by increasing the relative abundance of mitis group streptococci. In immunocompromised mice, C. albicans infection was associated with a significantly reduced bacterial alpha diversity due to an increase in the relative abundance of enterococci. When exposed to dietary sucrose, these mice had reduced C. albicans burdens and reduced bacterial alpha diversity, associated with an increase in the relative abundance of Lactobacillus. SparCC correlation networks showed a significant negative correlation between Lactobacillus and Enterococcus in all Candida-infected mice. Depletion of lactobacilli with antibiotic treatment partially restored C. albicans burdens in mice receiving sucrose. In coculture in vitro experiments, mouse oral Lactobacillus johnsonii isolates inhibited growth of Enterococcus faecalis isolates and C. albicans. These results support the hypothesis that the sucrose-induced attenuation of C. albicans virulence was a result of changes in the mucosal bacterial microbiome characterized by a reduction in enterococci and an increase in lactobacilli. IMPORTANCE By comparing Candida albicans virulence and the mucosal bacterial composition in a mouse oral infection model, we were able to dissect the effects of the host environment (immunosuppression), infection with C. albicans, and local modulating factors (availability of sucrose as a carbon source) on the mucosal bacterial microbiome and its role on fungal virulence. We showed that changes in endogenous microbial communities in response to sucrose can lead to attenuation of fungal disease. We also showed that Lactobacillus johnsonii may curtail Candida virulence both by inhibiting its growth and by inhibiting the growth of potentially synergistic bacteria such as enterococci. Our results support the concept that Candida pathogenesis should be viewed in the contexts of both a susceptible host and a mucosal bacterial microbiota conducive to virulence.

Experimental validation of a Monte Carlo proton therapy nozzle model incorporating magnetically steered protons.

The purpose of this study is to validate the accuracy of a Monte Carlo calculation model of a proton magnetic beam scanning delivery nozzle developed using the Geant4 toolkit. The Monte Carlo model was used to produce depth dose and lateral profiles, which were compared to data measured in the clinical scanning treatment nozzle at several energies. Comparisons were also made between measured and simulated off-axis profiles to test the accuracy of the model's magnetic steering. Comparison of the 80% distal dose fall-off values for the measured and simulated depth dose profiles agreed to within 1 mm for the beam energies evaluated. Agreement of the full width at half maximum values for the measured and simulated lateral fluence profiles was within 1.3 mm for all energies. The position of measured and simulated spot positions for the magnetically steered beams agreed to within 0.7 mm of each other. Based on these results, we found that the Geant4 Monte Carlo model of the beam scanning nozzle has the ability to accurately predict depth dose profiles, lateral profiles perpendicular to the beam axis and magnetic steering of a proton beam during beam scanning proton therapy.

Determination of prospective displacement-based gate threshold for respiratory-gated radiation delivery from retrospective phase-based gate threshold selected at 4D CT simulation.

Four-dimensional (4D) computed tomography (CT) imaging has found increasing importance in the localization of tumor and surrounding normal structures throughout the respiratory cycle. Based on such tumor motion information, it is possible to identify the appropriate phase interval for respiratory gated treatment planning and delivery. Such a gating phase interval is determined retrospectively based on tumor motion from internal tumor displacement. However, respiratory-gated treatment is delivered prospectively based on motion determined predominantly from an external monitor. Therefore, the simulation gate threshold determined from the retrospective phase interval selected for gating at 4D CT simulation may not correspond to the delivery gate threshold that is determined from the prospective external monitor displacement at treatment delivery. The purpose of the present work is to establish a relationship between the thresholds for respiratory gating determined at CT simulation and treatment delivery, respectively. One hundred fifty external respiratory motion traces, from 90 patients, with and without audio-visual biofeedback, are analyzed. Two respiratory phase intervals, 40%-60% and 30%-70%, are chosen for respiratory gating from the 4D CT-derived tumor motion trajectory. From residual tumor displacements within each such gating phase interval, a simulation gate threshold is defined based on (a) the average and (b) the maximum respiratory displacement within the phase interval. The duty cycle for prospective gated delivery is estimated from the proportion of external monitor displacement data points within both the selected phase interval and the simulation gate threshold. The delivery gate threshold is then determined iteratively to match the above determined duty cycle. The magnitude of the difference between such gate thresholds determined at simulation and treatment delivery is quantified in each case. Phantom motion tests yielded coincidence of simulation and delivery gate thresholds to within 0.3%. For patient data analysis, differences between simulation and delivery gate thresholds are reported as a fraction of the total respiratory motion range. For the smaller phase interval, the differences between simulation and delivery gate thresholds are 8 +/- 11% and 14 +/- 21% with and without audio-visual biofeedback, respectively, when the simulation gate threshold is determined based on the mean respiratory displacement within the 40%-60% gating phase interval. For the longer phase interval, corresponding differences are 4 +/- 7% and 8 +/- 15% with and without audiovisual biofeedback, respectively. Alternatively, when the simulation gate threshold is determined based on the maximum average respiratory displacement within the gating phase interval, greater differences between simulation and delivery gate thresholds are observed. A relationship between retrospective simulation gate threshold and prospective delivery gate threshold for respiratory gating is established and validated for regular and nonregular respiratory motion. Using this relationship, the delivery gate threshold can be reliably estimated at the time of 4D CT simulation, thereby improving the accuracy and efficiency of respiratory-gated radiation delivery.

Validation of GEANT4, an object-oriented Monte Carlo toolkit, for simulations in medical physics.

GEANT4 (GEometry ANd Tracking 4) is an object-oriented Monte Carlo simulation toolkit that has been developed by a worldwide collaboration of scientists. It simulates the passage of particles through matter. In order to validate GEANT4 for medical physics applications, different simulations are conducted. The results are compared to published results based on three Monte Carlo codes widely used in medical physics: MCNP, EGS4, and EGSnrc. When possible, the simulation results are also compared to experimental data. Different geometries are tested (multilayer and homogeneous phantoms), different sources considered (point-source and broad parallel beam), and different primary particles simulated (photons and electrons) at different energies. For the heterogeneous media, there are notable differences between the Monte Carlo codes reaching up to over 5% in relative difference. For the monoenergetic electrons in a homogeneous medium, the difference between GEANT4 and the experimental measurements is similar to the difference between EGSnrc and the experimental measurements; for the depth-dose curves, the difference expressed as a fraction of the peak dose is always smaller than 4%. We conclude that GEANT4 is a promising Monte Carlo simulation toolkit for low-energy medical applications.

A simplified technique for obtaining purified peripheral lymphocytes from chickens.

A simplified technique for isolating purified avian peripheral lymphocytes using a Ficoll-diatrizoate density is described. The procedure requires only 2 ml. of blood, can be completed in 5 min., and is suitable for the repeated testing of relatively large numbers of birds.

SU-E-J-85: Anthropomorphic Development for Intermodality Deformation Algorithms Validation.

PURPOSE: Radiation therapy is often based on a single treatment plan calculated on patient's anatomy at the time of the simulation scan. Deformation algorithms offer the possibility to register initial treatment plan on a daily CBCT. This way, the planning can be adapted to the evolution of patient anatomy. Validation of deformable image registration algorithms (DRA) ideally requires the use of phantoms offering some deformation possibilitiesMethods: An anthropomorphic, pelvic phantom was built to test volume variation (bladder), deformation of contours (prostate) and translation (all organs). Algorithms must be able to perform intermodality registration. Therefore, images were acquired for both CT and CBCT. The phantom has been created in a way to allow total control of the deformation amplitude. Each of the three types of deformations studied were realized independently and scanned in a manner to have the same initial and deformed images set for each modality. RESULTS: Two algorithm systems were use to compare their efficiency; an open-source software, a toolbox for registration that offers parameter adjustment and a commercial system with limited control for user. The phantom provides us usable images for DRA validation. For a 2 cm mass center organ translation, the first one reduced 98% of the distance while the other only performed 60%. For a 100 ml volume variation, we get 88% and 62%. CONCLUSIONS: Comparison of each intermodal deformation registration performed by the two algorithm systems show how control on parameters improves registration quality. DRA allow the initial planning adaptation on different deformations which occur in human body.

WE-G-BRB-05: On the Importance of Fluorescence Within the Stem Effect of Scintillation Detectors.

PURPOSE: To quantify the nature and composition of the light produced in optical fibers under different irradiation conditions and evaluate its impact on dosimetry. METHODS: Irradiation of a bare PMMA optical fiber (Mitsubishi ESKA Premier) was performed using a superficial therapy unit, an Ir-192 HDR brachytherapy source, a Co-60 external-beam unit as well as photon and electron beams from a linear accelerator. Spectra of the radiation-induced visible light in the fiber were acquired and signals were compared as a function of depth and irradiation type. Irradiation of a 75 kVp beam from the superficial therapy unit was used to isolate the fluorescence spectrum. Isolation of the Cerenkov spectrum component was obtained from irradiation of a 15 MeV electron beam at a 45 degree angle. Relative composition in fluorescence and Cerenkov of the stem effect light has been determined for all irradiations. RESULTS: The total stem effect spectra can be represented by a linear superposition of the fluorescence and Cerenkov spectra. The fluorescence contribution was shown to strongly differ between the superficial therapy unit (99%±1%), the Ir-192 HDR source (25%±3%) and higher energy irradiations (3%±2%). Variations within each energy regime (kV, HDR brachytherapy and MV) were small at 3% or lower. These were observed for irradiations at angle or when the fiber was near the surface. This study suggests it is better to calibrate the stem effect of a scintillation detector using the same irradiation modality. CONCLUSIONS: Stem effect light was shown to be composed of fluorescence and Cerenkov light in different proportions depending on the geometry of the experimental setup, nature of the irradiation, and irradiation energy. Calibrating detectors separately for fluorescence and Cerenkov may lead to better performance of the stem effect removal technique.

WE-G-BRB-04: BEST IN PHYSICS (THERAPY) - A Novel Multi-Point Plastic Scintillation Detector for in Vivo Dosimetry and Quality Assurance in Radiation Therapy.

PURPOSE: To develop a novel multi-point plastic scintillation detector (mPSD) capable of accurately measuring dose at multiple positions simultaneously with the use of a single optical guide. METHODS: We built a new generation of plastic scintillation detectors composed of multiple scintillating elements along a same optical transmission line. Three different scintillating fibers were optically coupled to a single collecting optical fiber. A primary challenge for this new type of detector is that the output signal is a superposition of multiple scintillation spectra and contaminating elements. Acquisition with a spectrometry setup allows for the implementation of a new hyperspectral approach that accounts for each light-emitting component separately, and allows spectral unmixing. The mPSD and an ion chamber were irradiated in a water phantom with a 6 MV photon beam. Profiles and depth-dose curves were measured and compared between detectors. This detector and the corresponding calibration approach were also applied to Ir- 192 HDR brachytherapy. RESULTS: Doses measured with the mPSD were in good agreement with the ion chamber measurements for external beam irradiations. Average relative differences of (2.3±1.1)%, (1.6±0.4)% and (0.32±0.19)% were observed for each scintillating element. The mPSD measurements tended to be at least as accurate as published measurements from single-point PSDs. For the Ir-192 HDR brachytherapy application, the average difference between the treatment planning system and the measurements were (4.6±1.0)% per dwell-position and (2.1±1.0)% per catheter. The accuracy of each scintillating element was shown to depend on light attenuation and on the similarity of its scintillation spectrum in comparison to the other light emitters. CONCLUSIONS: The feasibility and accuracy of mPSDs using a single transmission line was demonstrated. In addition to well-documented advantages of single-point PSDs, the multi-point capability of this single-fiber detector makes mPSDs a very promising new technique for quality assurance and on-line in vivo dosimetry.

Sci-Thur PM: YIS - 10: A new optically encoded single-fiber plastic scintillation detector for multi-point radiation dosimetry.

PURPOSE: To develop a new multi-point plastic scintillation detector (mPSD) that allows for simultaneous dose measurements at multiple points and uses a single optical guide. MATERIALS AND METHODS: Two different prototypes were built. A two-point mPSD was built and light discrimination was based on the use of multiple color filters at the outputs of a network of optical fiber splitters. Light intensity was measured by an EMCCD camera. For the three-point mPSD, the light discrimination setup was replaced by a low-noise spectrometer. Depth-dose and profiles measurements were obtained on a 6 MV photon beam with the mPSDs inside a water phantom. An ion chamber was also used for comparison purpose. Finally, the three-point mPSD was tested under an Ir-192 high-dose-rate (HDR) brachytherapy dose delivery and compared to the treatment planning system. RESULTS: A good agreement was found between the measured and expected dose for both mPSDs. The average relative differences to the ion chamber measurement for the two-point mPSD were of (2.4 ± 1.6)% and (1.3 ± 0.8)%. For the three-point mPSD, these differences were of (2.3±1.1)%, (1.6±0.4)% and (0.32±0.19)%. The latter mPSD was shown very versatile, being able to measure dose from HDR brachytherapy with an average accuracy of (2.3±1.0)% per catheter. CONCLUSIONS: The practical feasibility of mPSDs using a single optical guide has been demonstrated under irradiation from a 6 MV photon beam and an Ir-192 HDR brachytherapy source. Their application for pre-treatment quality assurance and in vivo dosimetry will be various.

Sci-Thur PM: YIS - 05: Tomographic dosimetry using scintillating fibers and its application to 2D and 3D dosimetry.

PURPOSE: To present the proof of concept and the experimental validation of tomographic dosimetry (tomodosimetry), where a tomographic acquisition of the incident deposited dose is performed using long scintillating fibers. METHOD: 2D tomodosimetry: 50 long scintillating fibers were aligned on a 20cm diameter disk inside a 30cm diameter masonite phantom. 3D tomodosimetry: 128 long scintillating fibers of various orientation were simulated on the surface of two cylindrical regions of radius 7.5 and 3.75cm inside a 20cm diameter, 20cm long cylindrical phantom. In both case, the dose projections were acquire each 5 degrees over a 180 degrees (2D) or 360 degrees (3D) rotation of the device, and the dose in each scintillating fiber plane was reconstructed using a total variation minimization reconstruction iterative algorithm at a resolution of 1×1mm2 . The 3D dose was obtained by interpolating between in each cylindrical plane in the 3D prototype. RESULTS: 3%/3mm gamma tests conducted in the isocentre plane for both configurations achieved a success rate of more than 99% of the dose pixels in the region over 50% of the maximum dose. Absolute dose differences in the high dose low gradient region of each scintillating fiber plane were on average below 1% for the 2D configuration and below 1.3% for the 3D configuration. CONCLUSIONS: This work illustrates the potential and capacity of scintillating fiber based 2D and 3D tomodosimeters. The presented methodology allows for millimeter resolution dosimetry in a whole 2D plane or 3D volumes in real-time using only a limited number of detectors.

Sci-Thur AM: Planning - 02: Validation of XiO's eMC module using Gafchromic EBT3 films and triple channel dosimetry.

The aim of this study is to validate the electron Monte Carlo module implemented in XiO, a treatment planning system commercialized by Elekta CMS inc. Two types of phantoms were investigated: homogeneous water phantoms with irregular surfaces and phantoms containing slab and 3D heterogeneities. The phantoms were CT scanned, and dose to water calculations were performed in the eMC module using 2 ×2 × 2 mm2 voxels and a mean relative statistical uncertainty of 0.5%. Concurrently, Gafchromic EBT3 film measurements were performed in the same phantoms. To obtain reliable absolute dose readings from the films, a new method using triple channel dosimetry in the Film QA Pro software was developed. The accuracy of the proposed method was determined empirically and an uncertainty of ±1.5% was found over the range [75, 800] cGy. Dose comparisons between film and simulations were done using an in-house MATLAB program. XiO's eMC module provides accurate dose distributions in the presence of surface irregularities and slab heterogeneities for 12 MeV beams. In the presence of 3D heterogeneities, the percent dose difference comparisons highlighted the need to perform 3D gamma comparisons. In conclusion, the electron Monte Carlo module offered in the XiO treatment planning system is promising and could greatly improve the accuracy of clinical dose calculations. The validation of the software is ongoing, notably concerning more complex phantom geometries. Small field calculations, oblique incidences and cutout factors will also be investigated.

Poster - Thur Eve - 35: Characterization of performance of two deformable registration software.

PURPOSE: To evaluate the performance of two deformable registration softwares (a commercial and an open source software) using cone-beam computed tomography (CBCT) images. METHODS: We used a set of 34 lung patients with generally large tumors each having between 1 and 20 CBCT scans. A radiation oncologist resident contoured GTVs on each CBCTs using planning CT contours as reference. Deformable registrations were performed on CT scans to adapt it to the first CBCT of each patient independently with both software. Then each CBCT was registered to the next CBCT. Contour structures have been deformed in the process for the commercial software and for the open source software contours have been drawn manually on deformed images. RESULTS: Mean remaining volume (±SD) for manual GTV contours was 59 ± 32 %. GTVs obtained with the open source software were closer to the manual GTV in size than the commercial software. Mean relative errors on volume were 45 ± 60 % for the commercial system (33 patients) and 9 ± 2 % for the open source software (6 patients). Relative errors for the commercial software increased exponentially with the volume reduction but were constant over all CBCT for the open source software. Mean Jaccard and Dice's index were 0.57 and 0.71 for the commercial software (24 patients) and 0.80 and 0.88 for the open source software (6 patients). CONCLUSION: Open source software shown tendency to give better results than commercial software but was slower than the commercial software.

SU-E-T-265: Reducing Pacemaker Doses with a Lead Sheet: A Multi-Detector Study.

PURPOSE: Evaluate the usability of lead shielding to reduce the dose to pacemakers. The efficiency and risk of this type of skin block will be presented. METHODS: A solid water phantom was used and all measurements were made at a depth of 0.5 cm for 6 MV and 23 MV photon beams. Measurements were performed with a parallel plate ion chamber and with a plastic scintillation detector (PSD) prototype. Measurements were made for fields of 10, 20 and 30 cm square. For every field, measurements were made in increment of 5 cm from the center of the field to the edge of the 60 cm long phantom for anterior and posterior beams. All measures have been made with and without a 1.6 mm of lead shielding wrapped in a thermoplastic. RESULTS: For all measurements, both detectors agree to 0.6%, well within the uncertainties of the detectors. With antero-posterior fields, the benefit of shielding is more important at 23MV (reduction of dose by65%) compared to 6MV (reduction of dose by 46%) when the shielding is out of the field. For distances larger than 35 cm, no benefits are measured. In the case were the lead is completely inside the fields, the dose is increased by the presence of shielding. The same observation is made for postero-anterior fields. For shielding out of field, the dose is slightly increased. CONCLUSIONS: The used of lead shielding with antero-posterior field is advised and provided an easy way to decrease dose to pacemaker. For a postero-anterior field, it is preferable to avoid shielding, but it could be used if it stays outside fields in the case of a multiple beams treatment. PSD has been shown to be an excellent candidate for in vivo monitoring dose to pacemakers and also site like foetus.

WE-G-BRB-06: Real-Time Radiation Field Tracking Using Long Scintillating Fibers.

PURPOSE: To ensure the quality assurance of small field, dynamic radiotherapy, we present and validate a radiation tracking system based on long scintillating fibers that allows for the real-time measurement of the position and energetic fluence of a small incident radiation field. METHOD: We aligned 60 parallel scintillating fibers on a thin grooved acrylic slab with a 100-cm source-to-fibers distance. Both ends of each scintillating fiber were coupled to clear optical fibers to enable light collection by a single CCD camera using an f/0.95, 50 mm focal length lens. Using a small, static photon radiation field of 2×2 cm2 of a Varian Clinac iX, we changed the interaction position on the prototype using the linac treatment couch. The interaction position parallel and perpendicular to the scintillating fiber array were deduced using the optical attenuation of the scintillating fibers. The energetic fluence of the incident field was calculated from the fibers light fluxes, corrected for the position dependent optical attenuation and scintillation efficiency. RESULTS: Considering a treatment couch positioning error of ±0.5 mm, the system was able to measure the field position with a mean error of 0.1 mm perpendicular and 0.8 mm parallel to the scintillating fiber array. The maximum error measured using this setup was of 0.13 mm perpendicular and 3.2 mm parallel to the scintillating fiber array. The energetic fluence was determined with a mean error of 0.5% and a maximum error of 2.2%. CONCLUSIONS: This work demonstrates the capacity of a long scintillating fibers array to detect in real-time both the position and the energetic fluence of an incident small radiation field. Such methodology would allow for the real-time tracking of small field in both photon and particle radiation therapy.

Determination of the quenching correction factors for plastic scintillation detectors in therapeutic high-energy proton beams.

Plastic scintillation detectors (PSDs) have many advantages over other detectors in small field dosimetry due to their high spatial resolution, excellent water equivalence and instantaneous readout. However, in proton beams, the PSDs undergo a quenching effect which makes the signal level reduced significantly when the detector is close to the Bragg peak where the linear energy transfer (LET) for protons is very high. This study measures the quenching correction factor (QCF) for a PSD in clinical passive-scattering proton beams and investigates the feasibility of using PSDs in depth-dose measurements in proton beams. A polystyrene-based PSD (BCF-12, ϕ0.5 mm × 4 mm) was used to measure the depth-dose curves in a water phantom for monoenergetic unmodulated proton beams of nominal energies 100, 180 and 250 MeV. A Markus plane-parallel ion chamber was also used to get the dose distributions for the same proton beams. From these results, the QCF as a function of depth was derived for these proton beams. Next, the LET depth distributions for these proton beams were calculated by using the MCNPX Monte Carlo code, based on the experimentally validated nozzle models for these passive-scattering proton beams. Then the relationship between the QCF and the proton LET could be derived as an empirical formula. Finally, the obtained empirical formula was applied to the PSD measurements to get the corrected depth-dose curves and they were compared to the ion chamber measurements. A linear relationship between the QCF and LET, i.e. Birks' formula, was obtained for the proton beams studied. The result is in agreement with the literature. The PSD measurements after the quenching corrections agree with ion chamber measurements within 5%. PSDs are good dosimeters for proton beam measurement if the quenching effect is corrected appropriately.

Sci-Sat AM: Brachy - 07: Plastic scintillation detector validation for kV dosimetry.

PURPOSE: To characterize the plastic scintillation detectors (PSDs) response in the diagnostic energy range. A fast and adaptable method for real-time dosimetry in superficial x-ray therapy and interventional radiology is proposed. METHOD: A PSD (1 mm diameter and 10 mm long) is coupled to a 5 m long optical fiber. Scintillation photons are guided to a polychromatic photodiode which provides an electrical current proportional to the input light signal. If the incident energy spectrum is known, the dose measured in the PSD's polystyrene sensitive volume can be converted to score dose in any other media such as air, water or soft tissues using the large cavity theory (LCT). A software simulating x-ray tube spectra and filtration has been benchmarked and is used for analysis. The method is confirmed by Monte Carlo simulations. RESULTS: PSDs cannot be assumed energy independent with low-energy photons as a factor 2 has been observed in the energy response between 80 kVp and 150 kVp. When the dose is converted to the desired medium, the PSD's energy dependence is compensated and a 2.1% standard deviation was observed upon the studied energy ranges, which is inside the measurement and calculation uncertainties. Percent depth dose (PDD) measurements are in good agreement with Monte Carlo simulations and results can be improved if the proposed method is applied to compensate beam hardening. CONCLUSION: PSDs present great potential for real-time dose measurements with radiologic photon energy.