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DOE OSTI2014

SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy. Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film dosimetry and gamma comparison to DICOM RTDose files has been demonstrated as suitable to fulfil this need.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-264: Preliminary Results On New Optically Stimulated Luminescent Materials for Proton Therapy Dosimetry

Purpose: The objective of this work is to test the premise that luminescence materials with less under-response to proton beams can be identified by testing their dose response to low-LET radiation. The goal is to develop new Optically Stimulated Luminescence (OSL) materials with improved response for proton therapy dosimetry. Methods: We first measured the dose response of new OSL materials, synthesized in our laboratory, to low-LET radiation (beta rays from a {sup 90}Sr/{sup 90}Y source) and selected two materials having different OSL saturation characteristics and good dosimetric properties, namely MgB4O7:Ce,Li and MgO:Li. Commercial Al2O3:C was also used for comparison. These materials were then irradiated at several depths along a pristine proton beam. The luminescence responses of the materials, relative to the entrance response, were compared with the depth dose profile measured by a multiple-layer ion chamber. Results: The OSL signals of MgB4O7:Ce,Li and MgO:Li were characterized for signal stability, dose response, and response to a clinical proton beam. The materials were also compared with the commercial Al2O3:C. The signals from both MgB4O7:Ce,Li and MgO:Li were relatively stable after a one day delay following irradiation. The low-LET dose response of the materials showed that, over the dose range investigated (up to ∼800 Gy), MgB4O7:Ce,Li did not saturate, whereas MgO:Li and Al2O3:C saturated at doses of ∼100 Gy. MgB4O7:Ce,Li showed less underresponse to proton beams than MgO:Li and Al2O3:C. Conclusion: In general the material with the highest saturation doses for low-LET radiation (MgB4O7:Ce,Li) showed the least under-response to proton beams, which suggests that it may be possible to develop better OSL materials for proton dosimetry if the dose response can be controlled during synthesis. Nevertheless, the degree in which the response to proton beams can be controlled remains to be determined. The research is funded by the Oklahoma Center for the Advancement of Science and Technology (OCAST), project number HR12-055.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-407: Evaluation of Four Commercial Dosimetry Systems for Routine Patient-Specific Tomotherapy Delivery Quality Assurance

Purpose: The purpose of this project was to evaluate the performance of four commercially available dosimetry systems for Tomotherapy delivery quality assurance (DQA). Methods: Eight clinical patient plans were chosen to represent a range of treatment sites and typical clinical plans. Four DQA plans for each patient plan were created using the TomoTherapy DQA Station (Hi-Art version 4.2.1) on CT images of the ScandiDose Delta4, IBA MatriXX Evolution, PTW Octavius 4D and Sun Nuclear ArcCHECK phantoms. Each detector was calibrated following the manufacture-provided procedure. No angular response correction was applied. All DQA plans for each detector were delivered on the Tomotherapy Hi-Art unit in a single measurement session but on different days. The measured results were loaded into the vendor supplied software for each QA system for comparison with the TPS-calculated dose. The Gamma index was calculated using 3%/3mm, 2%/2mm with 10% dose threshold of maximum TPS calculated dose. Results: Four detector systems showed comparable gamma pass rates for 3%/3m, which is recommended by AAPM TG119 and commonly used within the radiotherapy community. The averaged pass rates ± standard deviation for all DQA plans were (98.35±1.97)% for ArcCHECK, (99.9%±0.87)% for Matrix, (98.5%±5.09)% for Octavius 4D, (98.7%±1.27)% for Delata4. The rank of the gamma pass rate for individual plans was consistent between detectors. Using 2%/2mm Gamma criteria for analysis, the Gamma pass rate decreased on average by 9%, 8%, 6.6% and 5% respectively. Profile and Gamma failure map analysis using the software tools from each dosimetry system indicated that decreased passing rate is mainly due to the threading effect of Tomo plan. Conclusion: Despite the variation in detector type and resolution, phantom geometry and software implementation, the four systems demonstrated similar dosimetric performance, with the rank of the gamma pass rate consistent for the plans considered.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-411: Characterization of Novel Water-Equivalent PRESAGE for Megavoltage and Kilovoltage X-Ray Beam Dosimetry

Purpose: To introduce and characterize novel water-equivalent PRESAGE dosimeters for megavoltage and kilovoltage X-ray beam dosimetry. Methods: Three novel metal-optimized PRESAGE dosimeters referred to as MO-PRESAGE 1, 2 and 3 were formulated. The radiological properties were key factors that were considered when formulating the new dosimeters. All formulations were prepared in spectrophotometric cuvettes, irradiated with a 6 MV X-ray beam, and the change in optical density was measured using a spectrophotometer. Their sensitivity, post-response stability, and water equivalency were investigated. Results: The results showed that all three formulations exhibited radiological properties closer to water than any of the commercially available PRESAGE formulations. For example, the novel MO-PRESAGE 1, 2 and 3 have mass densities only 3.9-4.4% higher than that of water, whereas the mass density for the commercial formulation is 5.3% higher. The novel formulations have almost identical Zeff values to that of water (7.42), while the Zeff for the commercial formulation was 3.7% higher than that of water. In addition, the MO-PRESAGE 3 formulation showed mass and energy attenuation coefficients that deviated from those of water by less than 50% relative to the commercial formulation. Furthermore, the reduced Zeff of the three different MOPRESAGE formulations resulted in a maximum variation in the probability of photoelectric absorption of 1.3 times than of water, compared to 1.8 times that of water for the commercial formulation. MO-PRESAGE 3 was also more sensitive to radiation than the other two new formulations introduced in this work due to the presence of alkylbromide radical initiators in the MO-PRESAGE 3 formulation. Conclusion: All three novel MOPRESAGE dosimeter formulations displayed excellent radiological properties, superior to any of the commercially available PRESAGE formulations and thus can be used for the dosimetry of clinical megavoltage and kilovoltage X-ray beams.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-494: A MOSFET-Based In-Vivo Dosimetry System for MR Image-Guided Radiation Therapy (MR-IGRT)

Purpose: To determine if a MOSFET based in-vivo dosimetry system can be used for patients undergoing MR-IGRT. Methods: Standard and high sensitivity MOSFET detectors were used for in-field and out-of-field measurements respectively. The systems were benchmarked and calibrated against a calibrated ionization chamber on a standard 6 MV linear accelerator, and then on the MR-IGRT system. Known doses were delivered to a water phantom with the MOSFETs placed between the top of the phantom and underneath a layer of bolus and water equivalent plastic, using a 6 MV beam and a {sup 6} {sup 0}Co MR-IGRT beam. The latter was performed with and without real-time MRI-guidance during the beam delivery (MRIGRT). Results: The in-field dosimeter response was linear from 50-500 cGy with little evidence of energy dependence or change in response due to the permanent static magnetic field of the MR-IGRT system. The detector response varied by < 2% between 6 MV and {sup 6} {sup 0}Co without image guided delivery. The out-of-field dosimeter response was linear from 1-50 cGy; however the detectors did display dose rate and energy dependence as the response varied by > 20% depending on distance from isocenter used during calibration. Therefore, to use the dosimeters for out-of-field measurements they must be calibrated out-of-field. Regardless of the detector orientation in the coronal plan, the response of the MOSFETs during MRI-guided delivery increased by 5% due to induced currents from the dynamic magnetic field present with image guidance. During the MRI-guided delivery, some loss in image quality was seen when the MOSFETs were present in the imaging plane. This was mitigated by using a handheld reader without a transmitting wireless receiver. Conclusion: A MOSFET-based in-vivo dosimetry system can be used for patients receiving MR-IGRT; however the change in detector response due to the dynamic magnetic field requires a special calibration.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-497: Semi-Automated in Vivo Radiochromic Film Dosimetry Using a Novel Image Processing Algorithm

Purpose: To validate an automated image processing algorithm designed to detect the center of radiochromic film used for in vivo film dosimetry against the current gold standard of manual selection. Methods: An image processing algorithm was developed to automatically select the region of interest (ROI) in *.tiff images that contain multiple pieces of radiochromic film (0.5x1.3cm{sup 2}). After a user has linked a calibration file to the processing algorithm and selected a *.tiff file for processing, an ROI is automatically detected for all films by a combination of thresholding and erosion, which removes edges and any additional markings for orientation. Calibration is applied to the mean pixel values from the ROIs and a *.tiff image is output displaying the original image with an overlay of the ROIs and the measured doses. Validation of the algorithm was determined by comparing in vivo dose determined using the current gold standard (manually drawn ROIs) versus automated ROIs for n=420 scanned films. Bland-Altman analysis, paired t-test, and linear regression were performed to demonstrate agreement between the processes. Results: The measured doses ranged from 0.2-886.6cGy. Bland-Altman analysis of the two techniques (automatic minus manual) revealed a bias of -0.28cGy and a 95% confidence interval of (5.5cGy,-6.1cGy). These values demonstrate excellent agreement between the two techniques. Paired t-test results showed no statistical differences between the two techniques, p=0.98. Linear regression with a forced zero intercept demonstrated that Automatic=0.997*Manual, with a Pearson correlation coefficient of 0.999. The minimal differences between the two techniques may be explained by the fact that the hand drawn ROIs were not identical to the automatically selected ones. The average processing time was 6.7seconds in Matlab on an IntelCore2Duo processor. Conclusion: An automated image processing algorithm has been developed and validated, which will help minimize user interaction and processing time of radiochromic film used for in vivo dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-509: Validation of the Use of OSLD for Carbon Beam Remote Dosimetry

Purpose: To describe the commissioning of Aluminum Oxide Optically Stimulated Luminescent Dosimeters (OSLD) for the use in Carbon beam remote dosimetry for centers participating in NCI-funded cooperative group clinical trials. Methods: As Carbon therapy centers express interest in participating in cooperative group clinical trials, the Imaging and Radiation Oncology Core Group (IROC) Houston QA Center (formerly RPC) is developing a way to remotely monitor the machine output of these Carbon facilities. OSLD have been commissioned for photon, electron and proton dosimetry, so an experiment was designed to commission the same dosimeters for Carbon. OSLD were irradiated in a Carbon therapy beam produced by the Siemens synchrotron at the Heidelberg Ion Therapy facility in Heidelberg, Germany. The OSLD were placed in acrylic phantoms, imaged with a CT scanner, and plans were developed using the Siemens treatment planning system. The OSLD were irradiated in uniform fields with maximum energies of 216, 301, and 402 MeV and at dose levels of 50, 100, 200 and 300 cGy. Results: The response of the OSLD in the Carbon beam, as compared to the Cobalt-60 reference condition, required an energy correction of 1.85 to account for the particle correction. OSLD dose calculations typically have a linearity correction to account for the change in response relative to the change in dose delivered. However, the response of the OSLD in the Carbon beam was found to be independent of the dose level; thus the linearity correction is 1.00. Conclusion: IROC Houston has commissioned OSLD for the use of remote output checks for Carbon therapy facilities to help ensure consistency across clinical trial participants. Work supported by grant CA10953 (NCI, DHHS)

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-QI-15: Single Point Dosimetry by Means of Cerenkov Radiation Energy Transfer (CRET)

Purpose: Cerenkov light is generated when a charged particles with energy greater then 250 keV, moves faster than the speed of light in a given medium. Both x-ray photons and electrons produce optical Cerenkov photons during the static megavoltage linear accelerator (LINAC) operational mode. Recently, Cerenkov radiation gained considerable interest as possible candidate as a new imaging modality. Optical signals generated by Cerenkov radiation may act as a surrogate for the absorbed superficial radiation dose. We demonstrated a novel single point dosimetry method for megavoltage photon and electron therapy utilizing down conversion of Cerenkov photons. Methods: The custom build signal characterization system was used: a sample holder (probe) with adjacent light tight compartments was connected via fiber-optic cables to a photon counting photomultiplier tube (PMT). One compartment contains a medium only while the other contains medium and red-shifting nano-particles (Q-dots, nanoclusters). By taking the difference between the two signals (Cerenkov photons and CRET photons) we obtain a measure of the down-converted light, which we expect to be proportional to dose as measured with an adjacent ion chamber. Experimental results are compared to Monte Carlo simulations performed using the GEANT4 code. Results: The signal correlation between CR signal, CRET readings and dose produced by LINAC at a single point were investigated. The experimental results were compared with simulations. The dose linearity, signal to noise ratio and dose rate dependence were tested with custom build CRET based probe. Conclusion: Performance characteristics of the proposed single point CRET based probe were evaluated. The direct use of the induced Cerenkov emission and CRET in an irradiated single point volume as an indirect surrogate for the imparted dose was investigated. We conclude that CRET is a promising optical based dosimetry method that offers advantages over those already proposed.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-CAMPUS-T-05: Preliminary Results On a 2D Dosimetry System Based On the Optically Stimulated Luminescence of Al2O3

Purpose: To develop a precise 2D dose mapping technique based on the optically stimulated luminescence (OSL) from Al{sub 2}O{sub 3} films for medical applications. Methods: A 2D laser scanning reader was developed using fast F{sup +}-center (lifetime of <7 ns) and slow F-center (lifetime of 35 ms) OSL emission from newly developed Al{sub 2}O{sub 3} films (Landauer Inc.). An algorithm was developed to correct images for both material and system properties. Since greater contribution of the F??-center emission in the recorded signal increases the readout efficiency and robustness of image corrections, Al{sub 2}O{sub 3}:C,Mg film samples are being investigated in addition to Al{sub 2}O{sub 3}:C samples. Preliminary investigations include exposure of the films to a 6 MV photon beam at 10 cm depth in solid water phantom with an SSD of 100 cm, using a 10 cm × 10 cm flat field or a 4 cm × 4 cm field with a 60° wedge filter. Kodak EDR2 radiographic film and EBT2 Gafchromic film were also exposed for comparison. Results: The results indicate that the algorithm is able to correct images and calculate 2D dose. For the wedge field irradiation, the calculated dose at the center of the field was 0.9 Gy for Al{sub 2}O{sub 3}:C and 0.87 Gy for Al{sub 2}O{sub 3}:C,Mg, whereas, the delivered dose was 0.95 Gy. A good qualitative agreement of the dose profiles was obtained between the OSL films and EDR2 and EBT2 films. Laboratory tests using a beta source suggest that a large dynamic range (10{sup −2}−10{sup 2} Gy) can be achieved using this technique. Conclusion: A 2D dosimetry system and an in-house image correction algorithm were developed for 2D film dosimetry in medical applications. The system is in the preliminary stage of development, but the data demonstrates the feasibility of this approach. This work was supported by Landauer, Inc.

36 MATERIALS SCIENCE↗
DOE OSTI2014

TU-C-BRE-10: A Streamlined Approach to EPID Transit Dosimetry

Purpose: To investigate the feasibility of a simple and efficient transit dosimetry method using the electronic portal imaging device (EPID) for dose delivery error detection and prevention. Methods: In the proposed method, 2D reference transit images are generated for comparison with online images acquired during treatment. Reference transit images are generated by convolving through-air EPID measurements of each field with pixel-specific kernels selected from a library of pre-calculated Monte Carlo pencil kernels of varying radiological thickness. The kernel used for each pixel is selected based on the calculated radiological thickness of the patient along a line joining the pixel and the virtual source. The accuracy of the technique was evaluated in flat homogeneous and heterogeneous plastic water phantoms, a heterogeneous cylindrical phantom, and an anthropomorphic head phantom. Gamma criteria of 3%/3 mm was used to quantify the accuracy of the technique for the various cases. Results: An average of 99.9% and 99.7% of the points in the comparison between the measured and predicted images passed a 3%/3mm gamma for the homogeneous and heterogeneous plastic water phantoms, respectively. 97.1% of the points passed for the analysis of the heterogeneous cylindrical phantom. For the anthropomorphic head phantom, an average of 97.8% of points passed the 3%/3mm gamma criteria for all field sizes. Failures were observed primarily in areas of drastic thickness or material changes and at the edges of the fields. Conclusion: The data suggest that the proposed transit dosimetry method is a feasible approach to in vivo dose monitoring. Future research efforts could include implementation for more complex fields and sensitivity testing of the method to setup errors and changes in anatomy. Oncology Data Systems provided partial funding support but did not participate in the collection or analysis of data.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

TU-F-BRE-05: Experimental Determination of K Factor in Small Field Dosimetry

Purpose: Small-field dosimetry is challenging due to charged-particle disequilibrium, source occlusion and more importantly finite size of detectors. IAEA/AAPM has published approach to convert detector readings to dose by k factor. Manufacturers have been trying to provide various types of micro-detectors that could be used in small fields. However k factors depends on detector perturbations and are derived using Monte Carlo simulation. PTW has introduced a microDiamond for small-field dosimetry. An experimental approach is presented to derive the k factor for this detector. Methods: PTW microDiamond is a small volume detector with 1.1 mm radius and 1.0 micron thick synthetic diamond. Output factors were measured from 1×1cm2 to 12×12 cm2 on a Varian machine at various depths using various micro-detectors with published k factors. Dose is calculated as reading * K. Assuming k factor is accurate, output factor should be identical with every micro-detectors. Hence published k values (Francescon et al Med Phys 35, 504-513,2008) were used to covert readings and then output factors were computed. Based on the converged curve from other detectors, k factor for microDiamond was computed versus field size. Results: Traditional output factors as ratio of readings normalized to 10×10 cm2 differ significantly for micro-detectors for fields smaller than 3×3 cm2 which are now being used extensively. When readings are converted to dose, the output factor is independent of detector. Based on this method, k factor for microDiamond was estimated to be nearly constant 0.993±0.007 over varied field sizes. Conclusion: Our method provides a unique opportunity to determine the k factor for any unknown detector. It is shown that even though k factor depends on machine type due to focal spot, however for fields ≥1×1 cm2 this method provides accurate evaluation of k factor. Additionally microDiamond could be used with assumption that k factor is nearly unity.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗
DOE OSTI2014

Radiation dosimetry in digital breast tomosynthesis: Report of AAPM Tomosynthesis Subcommittee Task Group 223

The radiation dose involved in any medical imaging modality that uses ionizing radiation needs to be well understood by the medical physics and clinical community. This is especially true of screening modalities. Digital breast tomosynthesis (DBT) has recently been introduced into the clinic and is being used for screening for breast cancer in the general population. Therefore, it is important that the medical physics community have the required information to be able to understand, estimate, and communicate the radiation dose levels involved in breast tomosynthesis imaging. For this purpose, the American Association of Physicists in Medicine Task Group 223 on Dosimetry in Tomosynthesis Imaging has prepared this report that discusses dosimetry in breast imaging in general, and describes a methodology and provides the data necessary to estimate mean breast glandular dose from a tomosynthesis acquisition. In an effort to maximize familiarity with the procedures and data provided in this Report, the methodology to perform the dose estimation in DBT is based as much as possible on that used in mammography dose estimation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Confirmation of a realistic reactor model for BNCT dosimetry at the TRIGA Mainz

Purpose: In order to build up a reliable dose monitoring system for boron neutron capture therapy (BNCT) applications at the TRIGA reactor in Mainz, a computer model for the entire reactor was established, simulating the radiation field by means of the Monte Carlo method. The impact of different source definition techniques was compared and the model was validated by experimental fluence and dose determinations. Methods: The depletion calculation code ORIGEN2 was used to compute the burn-up and relevant material composition of each burned fuel element from the day of first reactor operation to its current core. The material composition of the current core was used in a MCNP5 model of the initial core developed earlier. To perform calculations for the region outside the reactor core, the model was expanded to include the thermal column and compared with the previously established ATTILA model. Subsequently, the computational model is simplified in order to reduce the calculation time. Both simulation models are validated by experiments with different setups using alanine dosimetry and gold activation measurements with two different types of phantoms. Results: The MCNP5 simulated neutron spectrum and source strength are found to be in good agreement with the previous ATTILA model whereas the photon production is much lower. Both MCNP5 simulation models predict all experimental dose values with an accuracy of about 5%. The simulations reveal that a Teflon environment favorably reduces the gamma dose component as compared to a polymethyl methacrylate phantom. Conclusions: A computer model for BNCT dosimetry was established, allowing the prediction of dosimetric quantities without further calibration and within a reasonable computation time for clinical applications. The good agreement between the MCNP5 simulations and experiments demonstrates that the ATTILA model overestimates the gamma dose contribution. The detailed model can be used for the planning of structural modifications in the thermal column irradiation channel or the use of different irradiation sites than the thermal column, e.g., the beam tubes.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗
DOE OSTI2015

Model-based versus specific dosimetry in diagnostic context: Comparison of three dosimetric approaches

Purpose: The dosimetric assessment of novel radiotracers represents a legal requirement in most countries. While the techniques for the computation of internal absorbed dose in a therapeutic context have made huge progresses in recent years, in a diagnostic scenario the absorbed dose is usually extracted from model-based lookup tables, most often derived from International Commission on Radiological Protection (ICRP) or Medical Internal Radiation Dose (MIRD) Committee models. The level of approximation introduced by these models may impact the resulting dosimetry. The aim of this work is to establish whether a more refined approach to dosimetry can be implemented in nuclear medicine diagnostics, by analyzing a specific case. Methods: The authors calculated absorbed doses to various organs in six healthy volunteers administered with flutemetamol ({sup 18}F) injection. Each patient underwent from 8 to 10 whole body 3D PET/CT scans. This dataset was analyzed using a Monte Carlo (MC) application developed in-house using the toolkit GATE that is capable to take into account patient-specific anatomy and radiotracer distribution at the voxel level. They compared the absorbed doses obtained with GATE to those calculated with two commercially available software: OLINDA/EXM and STRATOS implementing a dose voxel kernel convolution approach. Results: Absorbed doses calculated with GATE were higher than those calculated with OLINDA. The average ratio between GATE absorbed doses and OLINDA’s was 1.38 ± 0.34 σ (from 0.93 to 2.23). The discrepancy was particularly high for the thyroid, with an average GATE/OLINDA ratio of 1.97 ± 0.83 σ for the six patients. Differences between STRATOS and GATE were found to be higher. The average ratio between GATE and STRATOS absorbed doses was 2.51 ± 1.21 σ (from 1.09 to 6.06). Conclusions: This study demonstrates how the choice of the absorbed dose calculation algorithm may introduce a bias when gamma radiations are of importance, as is the case in nuclear medicine diagnostics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Incorporating multislice imaging into x-ray CT polymer gel dosimetry

Purpose: To evaluate multislice computed tomography (CT) scanning for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD) and to establish a baseline assessment of image noise and uniformity in an unirradiated gel dosimeter. Methods: A 16-slice CT scanner was used to acquire images through a 1 L cylinder filled with water. Additional images were collected using a single slice machine. The variability in CT number (N{sub CT}) associated with the anode heel effect was evaluated and used to define a new slice-by-slice background subtraction artifact removal technique for CT PGD. Image quality was assessed for the multislice system by evaluating image noise and uniformity. The agreement in N{sub CT} for slices acquired simultaneously using the multislice detector array was also examined. Further study was performed to assess the effects of increasing x-ray tube load on the constancy of measured N{sub CT} and overall scan time. In all cases, results were compared to the single slice machine. Finally, images were collected throughout the volume of an unirradiated gel dosimeter to quantify image noise and uniformity before radiation is delivered. Results: Slice-by-slice background subtraction effectively removes the variability in N{sub CT} observed across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image noise was higher for the multislice system compared to the single slice scanner, but overall image quality was comparable between the two systems. Further study showed N{sub CT} was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thicknesses examined. In addition, the multislice system was found to eliminate variations in N{sub CT} due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Images acquired through an unirradiated, active gel revealed N{sub CT} varies between the top and bottom of the 1 L cylinder as well as across the diameter of the cylinder by up to 7 HU. Conclusions: Multislice CT imaging has been evaluated for CT PGD and found to be the superior technique compared to single slice imaging in terms of the time required to complete a scan and the tube load characteristics associated with each scanning method. The implementation of multislice scanning is straightforward and expected to facilitate routine gel dosimetry measurements for complex dose distributions in modern RT centers.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Fiber-optic detector for real time dosimetry of a micro-planar x-ray beam

Purpose: Here, the authors describe a dosimetry measurement technique for microbeam radiation therapy using a nanoparticle-terminated fiber-optic dosimeter (nano-FOD). Methods: The nano-FOD was placed in the center of a 2 cm diameter mouse phantom to measure the deep tissue dose and lateral beam profile of a planar x-ray microbeam. Results: The continuous dose rate at the x-ray microbeam peak measured with the nano-FOD was 1.91 ± 0.06 cGy s{sup −1}, a value 2.7% higher than that determined via radiochromic film measurements (1.86 ± 0.15 cGy s{sup −1}). The nano-FOD-determined lateral beam full-width half max value of 420 μm exceeded that measured using radiochromic film (320 μm). Due to the 8° angle of the collimated microbeam and resulting volumetric effects within the scintillator, the profile measurements reported here are estimated to achieve a resolution of ∼0.1 mm; however, for a beam angle of 0°, the theoretical resolution would approach the thickness of the scintillator (∼0.01 mm). Conclusions: This work provides proof-of-concept data and demonstrates that the novel nano-FOD device can be used to perform real-time dosimetry in microbeam radiation therapy to measure the continuous dose rate at the x-ray microbeam peak as well as the lateral beam shape.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Measurement of stray radiation within a scanning proton therapy facility: EURADOS WG9 intercomparison exercise of active dosimetry systems

Purpose: To characterize stray radiation around the target volume in scanning proton therapy and study the performance of active neutron monitors. Methods: Working Group 9 of the European Radiation Dosimetry Group (EURADOS WG9—Radiation protection in medicine) carried out a large measurement campaign at the Trento Centro di Protonterapia (Trento, Italy) in order to determine the neutron spectra near the patient using two extended-range Bonner sphere spectrometry (BSS) systems. In addition, the work focused on acknowledging the performance of different commercial active dosimetry systems when measuring neutron ambient dose equivalents, H{sup ∗}(10), at several positions inside (8 positions) and outside (3 positions) the treatment room. Detectors included three TEPCs—tissue equivalent proportional counters (Hawk type from Far West Technology, Inc.) and six rem-counters (WENDI-II, LB 6411, RadEye™ NL, a regular and an extended-range NM2B). Meanwhile, the photon component of stray radiation was deduced from the low-lineal energy transfer part of TEPC spectra or measured using a Thermo Scientific™ FH-40G survey meter. Experiments involved a water tank phantom (60 × 30 × 30 cm{sup 3}) representing the patient that was uniformly irradiated using a 3 mm spot diameter proton pencil beam with 10 cm modulation width, 19.95 cm distal beam range, and 10 × 10 cm{sup 2} field size. Results: Neutron spectrometry around the target volume showed two main components at the thermal and fast energy ranges. The study also revealed the large dependence of the energy distribution of neutrons, and consequently of out-of-field doses, on the primary beam direction (directional emission of intranuclear cascade neutrons) and energy (spectral composition of secondary neutrons). In addition, neutron mapping within the facility was conducted and showed the highest H{sup ∗}(10) value of ∼51 μSv Gy{sup −1}; this was measured at 1.15 m along the beam axis. H{sup ∗}(10) values significantly decreased with distance and angular position with respect to beam axis falling below 2 nSv Gy{sup −1} at the entrance of the maze, at the door outside the room and below detection limit in the gantry control room, and at an adjacent room (<0.1 nSv Gy{sup −1}). Finally, the agreement on H{sup ∗}(10) values between all detectors showed a direct dependence on neutron spectra at the measurement position. While conventional rem-counters (LB 6411, RadEye™ NL, NM2-458) underestimated the H{sup ∗}(10) by up to a factor of 4, Hawk TEPCs and the WENDI-II range-extended detector were found to have good performance (within 20%) even at the highest neutron fluence and energy range. Meanwhile, secondary photon dose equivalents were found to be up to five times lower than neutrons; remaining nonetheless of concern to the patient. Conclusions: Extended-range BSS, TEPCs, and the WENDI-II enable accurate measurements of stray neutrons while other rem-counters are not appropriate considering the high-energy range of neutrons involved in proton therapy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

Dosimetric characterization of two radium sources for retrospective dosimetry studies

Purpose: During the first part of the 20th century, {sup 226}Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two {sup 226}Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg {sup 226}Ra tube and a 10 mg {sup 226}Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a {sup 226}Ra point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including g{sub L}(r), F(r, θ), Λ, and s{sub K}] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%–15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%–25%. Conclusions: The results provided here facilitate retrospective dosimetry studies of {sup 226}Ra using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.

07 ISOTOPE AND RADIATION SOURCES↗