3D dosimetric validation of ultrasound-guided radiotherapy with a dynamically deformable abdominal phantom

ObjectivesThe purpose of this study was to dosimetrically benchmark gel dosimetry measurements in a dynamically deformable abdominal phantom for intrafraction image guidance through a multi-dosimeter comparison. Once benchmarked, the study aimed to perform a proof-of-principle study for validation measurements of an ultrasound image-guided radiotherapy delivery system.MethodsThe phantom was dosimetrically benchmarked by delivering a liver VMAT plan and measuring the 3D dose distribution with DEFGEL dosimeters. Measured doses were compared to the treatment planning system and measurements acquired with radiochromic film and an ion chamber. The ultrasound image guidance validation was performed for a hands-free ultrasound transducer for the tracking of liver motion during treatment.ResultsGel dosimeters were compared to the TPS and film measurements, showing good qualitative dose distribution matches, low γ values through most of the high dose region, and average 3%/5 mm γ-analysis pass rates of 99.2%(0.8%) and 90.1%(0.8%), respectively. Gel dosimeter measurements matched ion chamber measurements within 3%. The image guidance validation study showed the measurement of the treatment delivery improvements due to the inclusion of the ultrasound image guidance system. Good qualitative matching of dose distributions and improvements of the γ-analysis results were observed for the ultrasound-gated dosimeter compared to the ungated dosimeter.ConclusionsDEFGEL dosimeters in phantom showed good agreement with the planned dose and other dosimeters for dosimetric benchmarking. Ultrasound image guidance validation measurements showed good proof-of-principle of the utility of the phantom system as a method of validating ultrasound-based image guidance systems and potentially other image guidance methods.     

Measuring output factors and beam profiles formed by multileaf collimators using Fricke gel dosimeter

The accuracy and precision are necessary factors in radiotherapy, especially for measurements involving output factors and beam profiles; in this case multileaf collimators (MLCs) and dosimeter systems are not employed to obtain an adequate absorbed dose. In this work, output factors and beam profiles using multileaf collimators were obtained through the Fricke Xylenol Gel (FXG) dosimeter irradiated with 6 MV photon beams. From the results, FXG dosimetry demonstrated to be an adequate dosimetric tool for radiotherapy applications using MLC.     

In vivo EBT radiochromic film dosimetry of electron beam for Total Skin Electron Therapy (TSET)

EBT radiochromic films were used to determine skin-dose maps for patients undergone Total Skin Electron Therapy (TSET). Gafchromic EBT radiochromic film is one of the newest radiation-induced auto-developing photon and electron-beam analysis films available for therapeutic radiation dosimetry in radiotherapy applications. EBT films can be particularly useful in TSET; due to patient morphology, underdosed regions typically occur, and the radiochromic film represents a suitable candidate for monitoring them.In this study, TSET was applied to treat cutaneous T-cell lymphoma. The technique for TSET was implemented by using an electron beam with a nominal energy of 6 MeV. The patient was treated in a standing position using dual angled fields in order to obtain the greatest dose uniformity along the patient's longitudinal axis. The electron beam energy was degraded by a PMMA filter. The in vivo dose distribution was determined through the use of EBT films, as well as of thermoluminescent dosimeters for comparison (TLDs). EBT results showed a reasonable agreement with TLDs data.     

A pilot study of a postal dosimetry system using the Fricke dosimeter for research irradiators

Cobalt-60 irradiators and soft X-ray machines are frequently used for research purposes, but the dosimetry is not always performed using the recommended protocols. This may lead to confusing and untrustworthy results within the conducted research. Postal dosimetry systems have already been approved by the IAEA, with thermoluminescence dosimeters (TLD) and optically stimulated luminescence (OSL) as the most commonly used dosimeter systems in these cases. The present study tests the Fricke dosimeter properties as a potential system to be used in postal dosimetry for a project using research irradiators. The Fricke solution was prepared according to the literature, and the linearity and fading tests were performed accordingly. All calculated doses were measured using a NE2571 Farmer ionization chamber as a reference. Doses ranging from 25 to 300 Gy were delivered by a research irradiator, with 150 kV and 22 mA to the Fricke solutions inside polyethylene (PE) bags (4 × 4 × 0.2 cm³). The results compared with the ionization chamber showed a linear response to the range of doses used. Fading tests showed no significant difference for the absorbed doses over 9 days, with a maximum difference of 1.5% found between days 0 and 3. The Fricke dosimeter presented good linearity, for low and high doses, and low uncertainties for the fading even for 9 days after irradiation. These preliminary results are motivating, and as the next step, we intend to design a postal dosimetry system using the PE bags of Fricke solution.     

End-to-end dosimetric audit: A novel procedure developed for Irish HDR brachytherapy centres

PurposeA dosimetric audit of Ir-192 high dose rate (HDR) brachytherapy remote after-loading units was carried out in 2019. All six brachytherapy departments on the island of Ireland participated in an end-to-end test and in a review of local HDR dosimetry procedures.Materials and methodsA 3D-printed customised phantom was created to position the following detectors at known distances from the HDR source: a Farmer ionization chamber, GafChromic film and thermoluminescent dosimeters (TLDs). Dedicated HDR applicator needles were used to position an Ir-192 source at 2 cm distance from these detectors. The end-to-end dosimetry audit pathway was performed at each host site and included the stages of imaging, applicator reconstruction, treatment planning and delivery. Deviations between planned and measured dose distributions were quantified using gamma analysis methods. Local procedures were also discussed between auditors and hosts.ResultsThe mean difference between Reference Air Kerma Rate (RAKR) measured during the audit and RAKR specified by the vendor source certificate was 1.3%. The results of end-to-end tests showed a mean difference between calculated and measured dose of 2.5% with TLDs and less than 0.5% with Farmer chamber measurements. GafChromic films showed a mean gamma passing rates of >95% for plastic and metal applicators with 2%/1 mm global tolerance criteria.ConclusionsThe results of this audit indicate dosimetric consistency between centres. The ‘end to end’ dosimetry audit methodology for HDR brachytherapy has been successfully implemented in a multicentre environment, which included different models of Ir-192 sources and different treatment planning systems.The ability to create a 3D-printed water-equivalent phantom customised to accurately position all three detector types simultaneously at controlled distances from the Ir-192 source under evaluation gives good reproducibility for end-to-end methodology.     

Radiochromic films for dental CT dosimetry: A feasibility study

Dental CT dose evaluations are commonly performed using thermoluminescent dosimeters (TLD) inside anthropomorphic phantoms. Radiochromic films with good sensitivity in the X-ray diagnostic field have recently been developed and are commercially available as GAFCHROMIC XR-QA. There are potential advantages in the use of radiochromic films such as a more comprehensive dosimetry thanks to the adjustable size of the film samples. The purpose of this study was to investigate the feasibility of using radiochromic films for dental CT dose evaluations.Film samples were cut with a width of 5 mm and a length of 25 mm (strips), the same size as the Alderson Rando anthropomorphic phantom holes used in this study. Dental CT dose measurements were performed using simultaneously both TLD and radiochromic strips in the same phantom sites. Two equipment types were considered for dental CT examinations: a 16 slice CT and a cone beam CT. Organ equivalent doses were then obtained averaging the measurements from the sites of the same organ and effective doses were calculated using ICRP 103 weighting factors. The entire procedure was repeated four times for each CT in order to compare also the repeatability of the two dosimeter types.A linear correlation was found between the absorbed dose evaluated with radiochromic films and with TLD, with slopes of 0.930 and 0.944 (correlation r > 0.99). The maximum difference between the two dosimeter’s measurements was 25%, whereas the average difference was 7%. The measurement repeatability was comparable for the two dosimeters at cumulative doses above 15 mGy (estimated uncertainty at 1 sigma level of about 5%), whereas below this threshold radiochromic films show a greater dispersion of data, of about 10% at 1 sigma level. We obtained, using respectively Gafchromic and TLD measurements, effective dose values of 107 μSv and 117 μSv (i.e. difference of 8.6%) for the cone beam CT and of 523 μSv and 562 μSv (i.e. difference of 7%) for the multislice CT.This study demonstrates the feasibility of radiochromic films for dental CT dosimetry, pointing out a good agreement with the results obtained using TLD, with potential advantages and the chance of a more extensive dose investigation.     

An assessment of a 3D EPID-based dosimetry system using conventional two- and three-dimensional detectors for VMAT

PurposeTo provide a 3D dosimetric evaluation of a commercial portal dosimetry system using 2D/3D detectors under ideal conditions using VMAT.MethodsA 2D ion chamber array, radiochromic film and gel dosimeter were utilised to provide a dosimetric evaluation of transit phantom and pre-treatment ‘fluence’ EPID back-projected dose distributions for a standard VMAT plan. In-house 2D and 3D gamma methods compared pass statistics relative to each dosimeter and TPS dose distributions.ResultsFluence mode and transit EPID dose distributions back-projected onto phantom geometry produced 2D gamma pass rates in excess of 97% relative to other tested detectors and exported TPS dose planes when a 3%, 3 mm global gamma criterion was applied. Use of a gel dosimeter within a glass vial allowed comparison of measured 3D dose distributions versus EPID 3D dose and TPS calculated distributions. 3D gamma comparisons between modalities at 3%, 3 mm gave pass rates in excess of 92%. Use of fluence mode was indicative of transit results under ideal conditions with slightly reduced dose definition.Conclusions3D EPID back projected dose distributions were validated against detectors in both 2D and 3D. Cross validation of transit dose delivered to a patient is limited due to reasons of practicality and the tests presented are recommended as a guideline for 3D EPID dosimetry commissioning; allowing direct comparison between detector, TPS, fluence and transit modes. The results indicate achievable gamma scores for a complex VMAT plan in a homogenous phantom geometry and contributes to growing experience of 3D EPID dosimetry.     

Feasibility study of the Fricke chemical dosimeter as an independent dosimetric system for the small animal radiation research platform (SARRP)

For the small animal radiation research platform (SARRP) with X-ray beams in the medium energy range (tube operating voltage at 220 kVp), reference dosimetry is based on the AAPM TG-61 recommendations following the in-phantom method. The objective of this study was to evaluate the feasibility of the Fricke solution as a dosimeter to determine the absorbed dose to water. Feasibility studies at this X-ray energy range are not widely available. We evaluated the accuracy, dose linearity and dose rate dependence in a comparison with an NE 2571 Farmer ionization chamber (IC) and measurements in water. The G(Fe³⁺) factor was calculated from the curve fitting of the chemical yields for two radioactive sources (¹⁹²Ir and ⁶⁰Co) and one X-ray system with a tube operating at 150 and 250 kVp. The same methodology was followed for the dependence of the G(Fe³⁺) value on the energy and the dose agreement assessment for 180 and 200 kVp in the SARRP. The Fricke system exhibits a good linear response over the range of 5–70 Gy and an accuracy better than 2% for a 2 Gy/min dose rate. The dose rate dependence is smaller than 1% for dose rates greater than 1 Gy/min. The dependence of the G(Fe³⁺) value on the energy is smaller than 0.41%, with dose agreements better than 2%. The feasibility of the dosimeter for measurements at high doses and high dose rates makes it a suitable tool for dosimetric verifications in several preclinical irradiation configurations.     

Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy

PurposeTo characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator.MethodsThe dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.).The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors.ResultsA good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under ⁶⁰Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R₅₀ values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes.ConclusionsThe microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions.     

A comparative dosimetry study of an alanine dosimeter with a PTW PinPoint chamber at ultra-high dose rates of synchrotron radiation

The use of synchrotron X-ray sources provides innovative approaches in radiation therapy. The unique possibility to generate quasi-parallel beams promoted the development of microbeam radiation therapy (MRT), an innovative approach able to reduce damages to normal tissues while delivering considerable doses in the lesion. Accurate dosimetry in broad-beam configuration (prior to the spatial fractionation of the incident X-ray fan) is very challenging at ultra-high dose rate synchrotron sources.The available reference dosimetry protocol based on the use of a PTW PinPoint ionization chamber was compared with alanine dosimetry at the European Synchrotron Radiation Facility (ESRF) ID17 Biomedical beamline, an orthovoltage X-ray source with an average dose rate of 11.6 kGy/s. Reference dose measurements of the alanine pellets were performed at the National Centre for Radiation Research and Technology (NCRRT) ⁶⁰Co facility in Egypt. All alanine dosimeters were analysed by an electron paramagnetic resonance spectrometer.We determined a relative response r_ESRF = 0.932 ± 0.027 (1σ) of the alanine pellets irradiated at the ESRF compared to the ⁶⁰Co facility. Considering the appropriate corrections for the ESRF polychromatic spectrum and the different field size used, our result is in agreement with the previous work of Waldeland et al. for which the utilised alanine contained the same amount of binder, and it is consistent with the works of Anton et al. and Butler et al. for which the utilised alanine contained a higher amount of binder.We confirm that alanine is an appropriate dosimeter for ultra-high dose rate calibration of orthovoltage X-ray sources.     

Characterisation of two new radiochromic gel dosimeters TruView™ and ClearView™ in combination with the vista™ optical CT scanner: A feasibility study

PurposeThis study aims at characterising the properties of TruView™ and ClearView™ two new gel dosimeters (Modus Medical Devices Inc.) and at studying the feasibility of relative dosimetry using these dosimeters and the Vista™ Optical CT scanner to accurately evaluate dose.MethodsIn this work, we investigated key dosimetric aspects (dose response, energy and dose rate dependence) and stability of these radiochromic gels initiated in preliminary works (Huet et al., 2017; Colnot et al., 2017) using spectrophotometric measurements. Moreover, by mean of optical CT scanning (Vista™), their performances to measure relative depth dose (PDD) and cross profiles were analysed.ResultsTruView™ and ClearView™ present a linear dose response up to 20 Gy and up to 80 Gy respectively, independent of both photon beam energy (4–18 MV) and dose rate (up to 9.9 Gy/min) (Huet et al., 2017; Colnot et al., 2017). ClearView™ response proves to be stable for a week post-irradiation and uniform within the batch whereas TruView™ presents an unstable but uniform response. Optical CT scanning generates errors due to stray light that need to be corrected in order to use these gels; ClearView™ scanning particularly requires important precautions. After corrections, those gels used in combination with the Vista™ scanner show promising spatial and dosimetric precision (dose difference <5%). Finally, TruView™ is reusable and presents excellent reproducible response (maximum 3% difference) and the ClearView™ dosimeter presents good spatial stability (0.5% difference after 6 days).ConclusionThis study provides important knowledge about two gel dosimeters presenting interesting dosimetric properties. A study is ongoing to benchmark those promising candidates for clinical dose verification.     

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.     

A dosimetry method in the transverse plane of HDR Ir-192 brachytherapy source using gafchromic EBT2 film

Radiochromic film dosimetry is increasingly used in brachytherapy applications for its higher resolution ability as compared to other experimental methods. The present study was aimed to assess the accuracy and suitability of use of the improved radiochromic film model, Gafchromic EBT2, to evaluate the dose distribution in the transverse plane of microselectron HDR ¹⁹²Ir source.A specially designed and locally fabricated Polymethyl methacrylate (PMMA) phantom was used in this work for the experimental measurement of dose distribution around the source in its transverse plane. The AAPM TG-43U1 recommended radial dose function, g (r), and dose rate constant, Λ, for the source were measured using Gafchromic EBT2 film and thermoluminescent dosimeters (TLD). The EBT2 film measured dosimetric quantities were validated against their values obtained from the TLD measurements and previously published values for the same source available in literature.The dose rate constant and radial dose function for microselectron HDR ¹⁹²Ir source obtained from Gafchromic EBT2 film measurements are in agreement with their TLD measured results within 3.9% and 2.8% respectively. They also agree within the accepted range of uncertainty with their experimental and Monte Carlo calculated results reported in literature.This work demonstrates the suitability of using Gafchromic EBT2 film dosimetry in characterization of dose distribution in the transverse plane of HDR Ir-192 source. This is a more efficient method than TLD dosimetry at discrete and distant positions. Relative to TLD dosimetry, it is found to be better reproducible, easy to use and a less expensive method of dosimetry.     

Estimation of extremely small field radiation dose for brain stereotactic radiotherapy using the Vero4DRT system

The purpose of this study was a dosimetric validation of the Vero4DRT for brain stereotactic radiotherapy (SRT) with extremely small fields calculated by the treatment planning system (TPS) iPlan (Ver.4.5.1; algorithm XVMC). Measured and calculated data (e.g. percentage depth dose [PDD], dose profile, and point dose) were compared for small square fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm² using ionization chambers of 0.01 or 0.04 cm³ and a diamond detector. Dose verifications were performed using an ionization chamber and radiochromic film (EBT3; the equivalent field sizes used were 8.2, 8.7, 8.9, 9.5, and 12.9 mm²) for five brain SRT cases irradiated with dynamic conformal arcs.The PDDs and dose profiles for the measured and calculated data were in good agreement for fields larger than or equal to 10 × 10 mm² when an appropriate detector was chosen. The dose differences for point doses in fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm² were +0.48%, +0.56%, −0.52%, and +11.2% respectively. In the dose verifications for the brain SRT plans, the mean dose difference between the calculated and measured doses were −0.35% (range, −0.94% to +0.47%), with the average pass rates for the gamma index under the 3%/2 mm criterion being 96.71%, 93.37%, and 97.58% for coronal, sagittal, and axial planes respectively.The Vero4DRT system provides accurate delivery of radiation dose for small fields larger than or equal to 10 × 10 mm².     

Evaluation of Gafchromic EBT2 film for the measurement of anisotropy function for high-dose-rate 192Ir brachytherapy source with respect to thermoluminescent dosimetry

Aim

The aim of this work was to assess the suitability of the use of a Gafchromic EBT2 film for the measurement of anisotropy function for microSelectron HDR ¹⁹²Ir (classic) source with a comparative dosimetry method using a Gafchromic EBT2 film and thermoluminescence dosimeters (TLDs).

Background

Sealed linear radiation sources are commonly used for high dose rate (HDR) brachytherapy treatments. Due to self-absorption and oblique filtration of radiation in the source capsule material, an inherent anisotropy is present in the dose distribution around the source which can be described by a measurable two-dimensional anisotropy function, F(r, θ).

Materials and methods

Measurements were carried out in a specially designed and locally fabricated PMMA phantom with provisions to accommodate miniature LiF TLD rods and EBT2 film dosimeters at identical radial distances with respect to the ¹⁹²Ir source.

Results

The data of anisotropy function generated by the use of the Gafchromic EBT2 film method are in agreement with their TLD measured values within 4%. The produced data are also consistent with their experimental and Monte Carlo calculated results for this source available in the literature.

Conclusion

Gafchromic EBT2 film was found to be a feasible dosimeter in determining anisotropy in the dose distribution of ¹⁹²Ir source. It offers high resolution and is a viable alternative to TLD dosimetry at discrete points. The method described in this paper is useful for comparing the performances of detectors and can be applied for other brachytherapy sources as well.     

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.     

Simplification of head and neck volumetric modulated arc therapy patient-specific quality assurance,using a Delta4 PT

Background/AimIn many facilities, intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT) use intensity-modulated beams, formed by a multi-leaf collimator (MLC). In IMRT and VMAT, MLC and linear accelerator errors (both geometric and dose), can significantly affect the doses administered to patients. Therefore, IMRT and VMAT treatment plans must include the use of patient-specific quality assurance (QA) before treatment to confirm dose accuracy.Materials and methodsIn this study, we compared and analyzed the results of dose verification using a multi-dimensional dose verification system Delta4 PT, an ionization chamber dosimeter, and gafchromic film, using data from 52 patients undergoing head and neck VMAT as the test material.ResultBased on the results of the absolute dose verification for the ionization chamber dosimeter and Delta4 PT, taking an axial view, the upper limit of the 95% confidence interval was 3.13%, and the lower limit was −3.67%, indicating good agreement. These results mean that as long as absolute dose verification for the axial view does not deviate from this range, Delta4 PT can be used as an alternative to an ionization chamber dosimeter for absolute dose verification. When we then reviewed dose distribution verification, the pass rate for Delta4 PT was acceptable, and was less varied than that of gafchromic film.ConclusionThis results in that provided the pass rate result for Delta4 PT does not fall below 96%, it can be used as a substitute for gafchromic film in dose distribution verification. These results indicate that patient-specific QA could be simplified.     

Occupational radiation dose of personnel involved in sentinel node biopsy procedure

IntroductionSentinel node biopsy is a procedure used for axillary nodal staging in breast cancer surgery. The process uses radioactive ^99mTc isotope for mapping the sentinel node(s) and all the staff involved in the procedure is potentially exposed to ionizing radiation. The colloid for radiolabelling (antimone-sulphide) with ^99mTc isotope (half-life 6 h) is injected into the patient breast. The injection has activity of 18.5 MBq. The surgeon removes the primary tumor and detects active lymph nodes with gamma detection unit. The tumor as well as the active nodal tissue is transferred to pathologist for the definitive findings. The aim of the study was to measure dose equivalents to extremities and whole body for all staff and suggest practice improvement in order to minimize exposure risk.Materials and methodsThe measurements of the following operational quantities were performed: Hp(10) personal dose equivalent to whole body and Hp(0.07) to extremities for staff as well as ambiental dose for operating theatre and during injection.Hp(0.07) were measured at surgeon’s finger by ring thermoluminescent dosimeter (TLD) type MTS-N, and reader RADOS RE2000. Surgeon and nurse were wearing TLD personal dosimeter at the chest level. Anesthesiologist and anesthetist were wearing electronic personal dosimeters, while pathologist was wearing ring TLD while manipulating tissue samples.Electronic dosimeters used were manufactured by Polimaster, type PM1610.All TLD and electronic dosimeters data were reported, including background radiation. Background radiation was also monitored separately. Personal TLDs are standard for this type of personal monitoring, provided by accredited laboratory.Measurements of ambiental dose in workplaces of other staff involved around the patient was performed before the surgery took place, by calibrated survey meters manufactured by Atomtex, type 1667.The study involved two surgeons and one pathologist, two anesthesiologists and three anesthetists during two months period.Results and discussionThe doses received by all staff are evaluated using passive and active personal dosimeters and ambiental dose monitors and practice was improved based on results collected. Average annual whole body dose for all staff involved in the procedure was less than 0.8 mSv. Extremity dose equivalents to surgeon and pathologist were far below the limits set for professionally exposed (surgeon) and for public (pathologist).ConclusionsAlthough has proven to be very safe for all staff, additional measures for radiation protection, in accordance to ALARA principle (As Low As Reasonably Achievable) should be conducted. The recommendations for practice improvement with respect to radiation protection were issued.     

Dosimetric effects of brass mesh bolus on skin dose and dose at depth for postmastectomy chest wall irradiation

PurposeTo investigate the feasibility of using the brass mesh bolus as an alternative to tissue- equivalent bolus for post mastectomy chest wall cancer by characterizing the dosimetric effects of the 2-mm fine brass bolus on both the skin dose, the dose at depth and spatial distribution.Materials and methodsSurface dose and percent depth dose data were acquired for a 6 MV photon beam in a solid water phantom using MOSkin™, Gafchromic EBT3 film and an Advanced Markus ionization chamber. Data were acquired for the case of: no bolus, Face-up bass bolus, Face-down brass bolus, double brass bolus, 0.5 cm and 1.0 cm of Superflab TE bolus. The exit doses were also measured via MOSkin™ dosimeter and Markus ionization chamber. Gafchromic EBT3 film strips were used to plot dose profile at surface and 10 cm depth for Face-up brass, Face-down brass, double brass, 0.5 cm and 1.0 cm of Superflab TE bolus.ResultsThe surface dose measured via MOSkin™ dosimeter increased from 19.2 ± 1.0% to 63.1 ± 2.1% under Face-up brass discs, 51.2 ± 1.2% under Face-up brass spaces, 61.5 ± 0.5% under Face-down brass discs, and 41.3 ± 2.1% under Face-down brass spaces. The percentage difference in the dose measured under brass discs between Face-up versus Face-down was less than 2% for entrance dose and 10% for exit dose, whereas the percentage difference under brass spaces was approximately 3% for entrance dose and about 5% for the exit dose. Gafchromic EBT3 film strip measurements show that the mesh bolus produced ripple beam profiles due to the mesh brass construction.ConclusionsBrass bolus does not significantly change dose at depth (less than 0.5%), and the surface dose is increased similar to TE bolus. Considering this, brass mesh may be used as a substitute for TE bolus to increase superficial dose for chest wall tangent plans.     

Thermoluminescence characteristics of calcite with a Gaussian process regression model of machine learning

Thermoluminescence (TL) is defined as a luminescence phenomenon that can be detected when an insulator or semiconductor is thermally stimulated. Defective crystals store radiation until they are stimulated. Thermoluminescence is a method of monitoring the absorbed dose of dosimeters. The irradiation crystal is heated to 500°C to display the absorbed dose as a luminescent light. The TL dosimetric properties of calcite obtained from nature were investigated in this study. Machine learning was also examined using Gaussian process regression (GPR) for stimulated TL characteristics. According to the experimental output, the TL glow curve had two main peaks located at 90°C and 240°C with good dosimetric properties. In the four regression models of GPR, the data for the heating rate of 3°C s⁻¹ have the lowest residual.