Normoxic polymer gel dosimetry using less toxic monomer of N-isopropyl acrylamide and X-ray computed tomography for radiation therapy applications

Background

Polymer gel dosimetry has been used extensively in radiation therapy for its capability in depicting a three dimensional view of absorbed dose distribution. However, more studies are required to find less toxic and more efficient polymers for application in radiotherapy dosimetry.

Aim

The purpose of this work was to evaluate the N-isopropyl acrylamide (NIPAM) gel dosimetric characteristics and optimize the protocol for X-ray computed tomography (CT) imaging of gel dosimeters for radiation therapy application.

Material and methods

A polymer gel dosimeter based on NIPAM monomer was prepared and irradiated with ⁶⁰Co photons. The CT number changes following irradiation were extracted from CT images obtained with different sets of imaging parameters.

Results

The results showed the dose sensitivity of ΔN_CT (H) = 0.282 ± 0.018 (H Gy⁻¹) for NIPAM gel dosimeter. The optimized set of imaging exposure parameters was 120 kV_p and 200 mA with the 10 mm slice thickness. Results of the depth dose measurement with gel dosimeter showed a great discrepancy with the actual depth dose data.

Conclusion

According to the current study, NIPAM-based gel dosimetry with X-ray CT imaging needs more technical development and formulation refinement to be used for radiation therapy application.     

Three-dimensional quality assurance of IMRT prostate plans using gel dosimetry

Intensity modulated radiotherapy (IMRT) is one of the most modern radiation therapy treatment techniques. Although IMRT can deliver high and complex conformational doses to the tumor volume, its implementation requires rigorous quality assurance (QA) procedures that include a dosimetric pre-treatment verification of individual patient planning. This verification usually involves measuring a small volume of absolute dose with an ionization chamber and checking bi-dimensional fluency with an array of detectors. The planning technique has tri-dimensional characteristics, but no tridimensional dosimetry has been established in the clinical routine. One strategy to perform three-dimensional dosimetry is to use polymeric gels associated with magnetic resonance imaging to evaluate dose distribution. Here, we have compared the results of conventional QA procedures involving one- and two-dimensional dosimetry to the results of three-dimensional dosimetry conducted with MAGIC-f gel in 10 cases of prostate cancer IMRT planning. More specifically, we used the gamma index (3%/3 mm) to compare the results of three-dimensional dosimetry to the expected dose distributions obtained with the treatment planning system. Except for one IMRT treatment plan, the gel dosimetry results agreed with the conventional quality control and provided an overview of dose distribution in the target volume.     

A new less toxic polymer gel dosimeter: Radiological characteristics and dosimetry properties

PurposeA new polymer gel dosimeter recipe was investigated that may be more suitable for widespread applications than polyacrylamide gel dosimeters, since the extremely toxic acrylamide has been replaced with the less harmful monomer 2-Acrylamido 2-Methyl Propane Sulfonic acid (AMPS).MethodsThe new formulation was named PAMPSGAT. The MRI response (R2) of the dosimeters was analyzed for conditions of varying dose, dose rate, and temperature during scanning. Radiological properties of the PAMPSGAT polymer gel dosimeter were investigated.ResultsThe dose-response (R2) of AMPS/Bis appears to be linear over a dose range 10–40 Gy. The percentage of difference between the R2 values for imaging at 15 °C and MRI room temperature is about 4.6% for vial with 40 Gy absorbed dose which decreased to less than 1% for imaging at 20 °C. The percentage difference of Zeff of PAMPSGAT gel and soft tissue was less than 1% in the practical energy range (100 KeV–100 MeV). The electron density of the PAMPSGAT polymer gel was 2.9% higher than that of muscle. Results showed that the sensitivity of PAMPSGAT polymer gel dosimeter irradiated by ⁶⁰Co (energy = 1.25 MeV) is about 27.7% higher than that of irradiated using a 6 MeV Linac system.ConclusionsTemperature during MRI scanning has a small effect on the R2 response of the PAMPSGAT polymer gel dosimeter. Results confirmed tissue equivalency of the PAMPSGAT polymer gel dosimeter in most practical energy range. The PAMPSGAT polymer gel dosimeter response depends on energy and dose rate.     

Characteristics of a novel polymer gel dosimeter formula for MRI scanning: Dosimetry,toxicity and temporal stability of response

The present study intended to investigate the composition of a new polymer gel dosimeter. The new composition would be more suitable for a wide range of applications in comparison to polyacrylamide gel dosimeter since its extremely toxic acrylamide has been replaced with less harmful monomer i.e. 2-Acrylamido-2-MethylPropane Sulfonic acid (AMPS). To this end, the PAGAT gel dosimeter formula was used as a basis to test the new formulation of polymer gel dosimeter with a different monomer (AMPS) instead of acrylamide by using the %6 T and %50 C to the formula. The new formulation was named PAMPSGAT (Poly AMPS, Gelatin and THPC) polymer gel dosimeter. Moreover, the MRI response (R₂) of dosimeters was analyzed in terms of different dose range as well as post-irradiation time. The results indicated that the dose-response (R₂) of AMPS/Bis had a linear trend over a wide dose range. Furthermore, the results showed an acceptable temporal stability for the new polymer gel dosimeter.     

A novel method for dose distribution registration using fiducial marks made by a megavoltage beam in film dosimetry for intensity-modulated radiation therapy quality assurance

PurposePhotographic film is widely used for the dose distribution verification of intensity-modulated radiation therapy (IMRT). However, analysis for verification of the results is subjective. We present a novel method for marking the isocenter using irradiation from a megavoltage (MV) beam transmitted through slits in a multi-leaf collimator (MLC).MethodsWe evaluated the effect of the marking irradiation at 500 monitor units (MU) on the total transmission through the MLC using an ionization chamber and Radiochromic Film. Film dosimetry was performed for quality assurance (QA) of IMRT plans. Three methods of registration were used for each film: marking by irradiating with an MV beam through slits in the MLC (MLC-IC); marking with a fabricated phantom (Phantom-IC); and a subjective method based on isodose lines (Manual). Each method was subjected to local γ-analysis.ResultsThe effect of the marking irradiation on the total transmission was 0.16%, as measured by a ionization chamber at a 10-cm depth in a solid phantom, while the inter-leaf transmission was 0.3%, determined from the film. The mean pass rates for each registration method agreed within ±1% when the criteria used were a distance-to-agreement (DTA) of 3 mm and a dose difference (DD) of 3%. For DTA/DD criteria of 2 mm/3%, the pass rates in the sagittal plane were 96.09 ± 0.631% (MLC-IC), 96.27 ± 0.399% (Phantom-IC), and 95.62 ± 0.988% (Manual).ConclusionThe present method is a versatile and useful method of improving the objectivity of film dosimetry for IMRT QA.     

Polymer gel dosimeters for pretreatment radiotherapy verification using the three-dimensional gamma evaluation and pass rate maps

Polymer gel dosimeters (PGDs) have been widely studied for use in the pretreatment verification of clinical radiation therapy. However, the readability of PGDs in three-dimensional (3D) dosimetry remain unclear. In this study, the pretreatment verifications of clinical radiation therapy were performed using an N-isopropyl-acrylamide (NIPAM) PGD, and the results were used to evaluate the performance of the NIPAM PGD on 3D dose measurement. A gel phantom was used to measure the dose distribution of a clinical case of intensity-modulated radiation therapy. Magnetic resonance imaging scans were performed for dose readouts. The measured dose volumes were compared with the planned dose volume. The relative volume histograms showed that relative volumes with a negative percent dose difference decreased as time elapsed. Furthermore, the histograms revealed few changes after 24 h postirradiation. For the 3%/3 mm and 2%/2 mm criteria, the pass rates of the 12- and 24-h dose volumes were higher than 95%, respectively. This study thus concludes that the pass rate map can be used to evaluate the dose-temporal readability of PGDs and that the NIPAM PGD can be used for clinical pretreatment verifications.     

KCl:Dy phosphor for thermoluminescence dosimetry of ionizing radiation

The thermoluminescence (TL) characterizations of γ‐irradiated KCl:Dy phosphor for radiation dosimetry are reported. All phosphors were synthesized via a wet chemical route. Minimum fading of TL intensity is recorded in the prepared material. TL in samples containing different concentrations of Dy impurity was studied at different γ‐irradiation doses. Peak TL intensities varied sublinearly with γ‐ray dose in all samples, but were linear between 0.08 to 0.75 kGy for the KCl:Dy (0.1 mol%) sample. This material may be useful for dosimetry within this range of γ‐ray dose. TL peak height was found to be dependant on the concentration (0.05–0.5 mol%) of added Dy in the host. Copyright © 2012 John Wiley & Sons, Ltd.     

Optimisation of reconstruction,volumetry and dosimetry for 99mTc-SPECT and 90Y-PET images: Towards reliable dose-volume histograms for selective internal radiation therapy with 90Y-microspheres

PurposeIn Selective Internal Radiation Therapy (SIRT), ^99mTc-MAA SPECT images are commonly used to predict microspheres distribution but recent works used ⁹⁰Y-microspheres PET images. Nevertheless, evaluation of the predictive power of ^99mTc-MAA has been hampered by the lack of reliable comparisons between ^99mTc-SPECT and ⁹⁰Y-PET images. Our aim was to determine the “in situ” optimisation procedure in order to reliably compare ^99mTc-SPECT and ⁹⁰Y-PET images and achieve optimal personal dosimetry.MethodsWe acquired ^99mTc-SPECT/CT and ⁹⁰Y-PET/CT images of NEMA and Jaszczak phantoms. We found the best reconstruction parameters for quantification and for volume estimations. We determined adaptive threshold curves on the volumetric reconstruction. We copied the optimised volumes on the quantitative reconstruction, named here the “cross volumes” technique. Finally, we compared ^99mTc-SPECT and ⁹⁰Y-PET Dose Volume Histograms.ResultsOur “in situ” optimisation procedure decreased errors on volumes and quantification (from −44.2% and −15.8% to −3.4% and −3.28%, respectively, for the 26.5 mL PET phantom sphere). Moreover, ^99mTc-SPECT and ⁹⁰Y-PET DVHs were equivalent only after the optimisation procedure (difference in mean dose <5% for the three biggest spheres).ConclusionsThis work showed that a preliminary “in situ” phantom study was necessary to optimise volumes and quantification of ^99mTc-SPECT and ⁹⁰Y-PET images and allowed to achieve a reliable comparison between patient treatment planning and post implant dosimetry, notably by the use of the “cross volumes” technique. Methodology developed in this work will enable robust evaluations of the predictive power of ^99mTc-SPECT, as well as dose-response relationship and side effects in SIRT treatments.     

Versatility of thermoluminescence materials and radiation dosimetry – A review

Thermoluminescence (TL) materials exhibit a wide range of applications in different areas such as personal dosimetry, environmental dosimetry, medical research etc. Doping of different rare earth impurities in different hosts is responsible for changing the properties of materials useful for various applications in different fields. These materials can be irradiated by different types of beams such as γ‐rays, X‐rays, electrons, neutrons etc. Various radiation regimes, as well as their dose–response range, play an important role in thermoluminescence dosimetry. Several TL materials, such as glass, microcrystalline, nanostructured inorganic materials and recently developed materials, are reviewed and described in this article.     

Comparison of pre-treatment and in-vivo dosimetry for advanced radiotherapy of prostate cancer

BackgroundThe usage of advanced radiotherapy techniques requires validation of a previously calculated dose with the precise delivery with a linear accelerator. This study aimed to review and evaluate new verification methods of dose distribution. Moreover, our purpose was to define an internal protocol of acceptance for in-vivo measurements of dose distribution.Materials and methodsThis study included 43 treatment plans of prostate cancer calculated using the Monte Carlo algorithm. All plans were delivered using the Volumetric Modulated Arc Therapy (VMAT) technique of advanced radiotherapy by the linear accelerator Elekta VersaHD. The dose distribution was verified using: MatriXX, iViewDose, and in-vivo measurements. The verification also included recalculation of fluence maps of quality assurance plans in another independent algorithm.ResultsThe acceptance criterion of 95% points of dose in agreement was found for pre-treatment verification using MatriXX; the average γ value was 99.09 ± 0.93 (SD) and 99.64 ± 0.35 (SD) for recalculation in the Collapse Cone algorithm. Moreover, using the second algorithm in the verification process showed a positive correlation ρ = 0.58, p < 0.001. However, verification using iViewDose in a phantom and in-vivo did not meet this γ-pass rate.ConclusionsEvaluation of gamma values for in-vivo measurements utilizing iViewDose software was helpful to establish an internal dosimetry protocol for prostate cancer treatments. We assumed value at a minimum of 50% points of the dose in agreement with the 3%/3 mm criterion as an acceptable compliance level. The recalculated dose distribution of QA plans in regard to the Collapse Cone algorithm in the other treatment planning system can be used as a pre-treatment verification method used by a medical physicist in their daily work. The effectiveness of use in iViewDose software, as a pre-treatment tool, is still debatable, unlike the MatriXX device.     

Tridimensional dose evaluation of the respiratory motion influence on breast radiotherapy treatments using conformal radiotherapy,forward IMRT,and inverse IMRT planning techniques

PurposeTo evaluate the respiratory motion influence on the tridimensional (3D) dose delivery to breast-shaped phantoms using conformal radiotherapy (3D-RT), Field-in Field (FiF), and IMRT planning techniques.MethodsThis study used breast-shaped phantoms filled with MAGIC-f gel dosimeter to simulate the breast, and an oscillation platform to simulate the respiratory motion. The platform allowed motion in the anterior-posterior direction with oscillation amplitudes of 0.34 cm, 0.88 cm, and 1.22 cm. CT images of the static phantom were used for the 3D-RT, FiF, and IMRT treatment planning. Five phantoms were prepared and irradiated for each planning technique evaluated. Phantom 1 was irradiated static, phantoms 2–4 were irradiated moving with the three different motion amplitudes, and phantom 5 was used as a reference. The 3D dose distributions were obtained by relaxometry of magnetic resonance imaging, and the respiratory motion influence in the doses distribution was accessed by gamma evaluations (3%/3mm/15% threshold) comparing the measurements of the phantoms irradiated under movement with the static ones.ResultsThe mean gamma approvals for three oscillatory amplitudes were 96.44%, 93.23%, and 91.65%; 98.42%, 95.66%, and 94.31%; and 94.49%, 93.51%, and 86.62% respectively for 3D-RT, FiF and IMRT treatments. A gamma results profile per slice along the phantom showed that for FiF and IMRT irradiations, most of the failures occurred in the central region of the phantom.ConclusionsBy increasing the respiratory motion movement, the dose distribution variations for the three planning techniques were more pronounced, being the FiF technique variations the smallest one.     

Characterization of noise and digitizer response variability in radiochromic film dosimetry. Impact on treatment verification

PurposeTo study how noise and scanner response variability affect radiochromic film dosimetry.MethodsFive treatment plans were analyzed in this work with two different multichannel protocols: the multichannel algorithm of Mayer et al. and the efficient protocol of Lewis et al.Results and conclusionThe multichannel protocol of Mayer et al. is not able to compensate variability in scanner response, which is an important issue for radiochromic film dosimetry. The efficient protocol compensates variations of scanner response, so dose values and gamma scores become more accurate and reproducible. The compensation of digitizer scan variability of the efficient protocol, together with time averaging improve radiochromic film dosimetry. Noise is related to selected resolution in the scanner, our results show that if high resolution measurements are required, de-noising should be considered.     

Optical biosensor consisting of glutathione-S-transferase for detection of captan

The optical biosensor consisting of a glutathione-S-transferase (GST)-immobilized gel film was developed to detect captan in contaminated water. The sensing scheme was based on the decrease of yellow product, s-(2,4-dinitrobenzene) glutathione, produced from substrates, 1-chloro-2,4-dinitrobenzene (CDNB) and glutathione (GSH), due to the inhibition of GST reaction by captan. Absorbance of the product as the output of enzyme reaction was detected and the light was guided through the optical fibers. The enzyme reactor of the sensor system was fabricated by the gel entrapment technique for the immobilized GST film. The immobilized GST had the maximum activity at pH 6.5. The optimal concentrations of substrates were determined with 1 mM for both of CDNB and GSH. The optimum concentration of enzyme was also determined with 100 μg/ml. The activity of immobilized enzyme was fairly sustained during 30 days. The proposed biosensor could successfully detect the captan up to 2 ppm and the response time to steady signal was about 15 min.     

Use of an interactive carbohydrate polymer phenomenon for the separation of polyoxometalates

Keggin type polyoxometalates (POMs) have been proposed as agents for improving the feasibility of oxygen bleaching technique used in producing cellulose fibre in the wood pulping industry. To investigate the possible interactions between carbohydrate polymers and POMs, several different POM anions were eluted through a column containing dextran chromatography gel (Sephadex G-50). Solutions of KCl (0.05 and 0.10 mol/l) and NaCl (0.10 mol/l) were used as eluents. The elution volumes (V_e) of all the POMs tested were found to be greater than the V_e of the internal standard, glycine. The V_e of the POMs increased along with increasing electrolyte concentration. When eluted with 0.10 mol/l KCl solution, the V_e were greater than the respective values of the same POMs eluted with 0.10 mol/l NaCl solution. These facts suggest that POM and the Sephadex gel form complexes, and that the tendency for this to take place depends on the type and concentration of cations present in the system. The method described in this paper may be useful in analysing and purifying mixtures of POMs.     

Development of patient-specific 3D models from histopathological samples for applications in radiation therapy

The biological effects of ionizing radiation depend on the tissue, tumor type, radiation quality, and patient-specific factors. Inter-patient variation in cell/nucleus size may influence patient-specific dose response. However, this variability in dose response is not well investigated due to lack of available cell/nucleus size data. The aim of this study was to develop methods to derive cell/nucleus size distributions from digital images of 2D histopathological samples and use them to build digital 3D models for use in cellular dosimetry.Nineteen of sixty hematoxylin and eosin stained lung adenocarcinoma samples investigated passed exclusion criterion to be analyzed in the study. A difference of gaussians blob detection algorithm was used to identify nucleus centers and quantify cell spacing. Hematoxylin content was measured to determine nucleus radius. Pouring simulations were conducted to generate one-hundred 3D models containing volumes of equivalent cell spacing and nuclei radius to those in histopathological samples.The nuclei radius distributions of non-tumoral and cancerous regions appearing in the same slide were significantly different (p < 0.01) in all samples analyzed. The median nuclear-cytoplasmic ratio was 0.36 for non-tumoral cells and 0.50 for cancerous cells. The average cellular and nucleus packing densities in the 3D models generated were 65.9% (SD: 1.5%) and 13.3% (SD: 0.3%) respectively.Software to determine cell spacing and nuclei radius from histopathological samples was developed. 3D digital tissue models containing volumes with equivalent cell spacing, nucleus radius, and packing density to cancerous tissues were generated.     

Implementation and evaluation of a transit dosimetry system for treatment verification

PurposeTo evaluate a formalism for transit dosimetry using a phantom study and prospectively evaluate the protocol on a patient population undergoing 3D conformal radiotherapy.MethodsAmorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. The measured EPID dose map was back-projected using the planning CT images to calculate dose at pre-specified points within the patient using commercially available software, EPIgray (DOSIsoft, France). This software compared computed back-projected dose with treatment planning system dose. A series of tests were performed on solid water phantoms (linearity, field size effects, off-axis effects). 37 patients were enrolled in the prospective study.ResultsThe EPID dose response was stable and linear with dose. For all tested field sizes the agreement was good between EPID-derived and treatment planning system dose in the central axis, with performance stability up to a measured depth of 18 cm (agreement within −0.5% at 10 cm depth on the central axis and within −1.4% at 2 cm off-axis). 126 transit images were analysed of 37 3D-conformal patients. Patient results demonstrated the potential of EPIgray with 91% of all delivered fields achieved the initial set tolerance level of Δ_D of 0 ± 5-cGy or %Δ_D of 0 ± 5%.ConclusionsThe in vivo dose verification method was simple to implement, with very few commissioning measurements needed. The system required no extra dose to the patient, and importantly was able to detect patient position errors that impacted on dose delivery in two of cases.     

Thermoluminescence dosimeter (TLD) studies of Ca10K(PO4)7:Dy phosphor for applications in radiation dosimetry

This study reports the thermoluminescence (TL) aspects of Ca₁₀K(PO₄)₇:Dy phosphor synthesized using a wet chemical method for the first time. The X-ray diffraction (XRD) results confirm the formation of the desired crystalline phase. Surface morphological studies reveal the formation of polyhedrons and agglomerations having an average diameter of 200 nm, while energy dispersive X-ray spectroscopy (EDS) data show the presence and composition of the elements in appropriate amounts. The effect of Dy doping concentration has been studied on the TL properties with exposure to gamma radiations from the Co-60 source. The best TL response has been observed for 5 mol% Dy doping concentration. The glow curve is simple and consists of a single peak at 130°C. The effect of the heating rate has been studied on the TL glow curve, and the heating rate of 5°C/s shows the best TL response. The various TL properties such as annealing conditions, dose–response, TL linearity, fading, and reusability of the prepared phosphor have been studied to check its suitability as a good TL dosimeter (TLD). TL characterization of the phosphor reports that the TL response is linear from 5- to 2000 Gy. The results show that this phosphor can be a good TLD for the dosimetry of gamma radiations from Co-60.     

Use of solid and gel state 13C NMR spectroscopy for differentiation between agarophytes and carrageenophytes

Both solid state (CP-MAS) and gel state (using standard solution state conditions) ¹³C NMR spectroscopy have been used to characterize a range of red algae that produce either agar or carrageenan. These techniques allow rapid determination of phycocolloid type within the algal tissue before extensive and time-consuming extractions and fractionations are carried out.The gel state technique can be used on living or dried material. Gel state spectra give high resolution and, because of the expectation that they will be correlated with the extractable phycocolloid, provide promise of a powerful technique for screening potentially useful red algae.     

Temporal separation of Cerenkov radiation and scintillation using artificial neural networks in Clinical LINACs

The irradiation of scintillator-fiber optic dosimeters by clinical LINACs results in the measurement of scintillation and Cerenkov radiation. In scintillator-fiber optic dosimetry, the scintillation and Cerenkov radiation responses are separated to determine the dose deposited in the scintillator volume. Artificial neural networks (ANNs) were trained and applied in a novel single probe method for the temporal separation of scintillation and Cerenkov radiation. Six dose profiles were measured using the ANN, with the dose profiles compared to those measured using background subtraction and an ionisation chamber. The average dose discrepancy of the ANN measured dose was 2.2% with respect to the ionisation chamber dose and 1.2% with respect to the background subtraction measured dose, while the average dose discrepancy of the background subtraction dose was 1.6% with respect to the ionisation chamber dose. The ANNs performance was degraded when compared with background subtraction, arising from an inaccurate model used to synthesise ANN training data.