Abstract
PurposeThis study aims to assess the accuracy of source position verification during high‐dose rate (HDR) prostate brachytherapy using a novel, in‐house developed two‐dimensional (2D) diode array (the Magic Plate), embedded exactly below the patient within a carbon fiber couch. The effect of tissue inhomogeneities on source localization accuracy is examined.MethodMonte Carlo (MC) simulations of 12 source positions from a HDR prostate brachytherapy treatment were performed using the Geant4 toolkit. An Ir‐192 Flexisource (Isodose Control, Veenendaal, the Netherlands) was simulated inside a voxelized patient geometry, and the dose deposited in each detector of the Magic Plate evaluated. The dose deposited in each detector was then used to localize the source position using a proprietary reconstruction algorithm.ResultsThe accuracy of source position verification using the Magic Plate embedded in the patient couch was found to be affected by the tissue inhomogeneities within the patient, with an average difference of 2.1 ± 0.8 mm (k = 1) between the Magic Plate predicted and known source positions. Recalculation of the simulations with all voxels assigned a density of water improved this verification accuracy to within 1 mm.ConclusionSource position verification using the Magic Plate during a HDR prostate brachytherapy treatment was examined using MC simulations. In a homogenous geometry (water), the Magic Plate was able to localize the source to within 1 mm, however, the verification accuracy was negatively affected by inhomogeneities; this can be corrected for by using density information obtained from CT, making the proposed tool attractive for use as a real‐time in vivo quality assurance (QA) device in HDR brachytherapy for prostate cancer.
Highlights
When used in combination with external beam radiotherapy (EBRT) in the form of a boost, high-dose rate (HDR) brachytherapy has been shown to be a safe and effective treatment modality for intermediate- and high-risk prostate cancer.[1,2] Despite recent technological developments in the field of brachytherapy, such as image-guided brachytherapy,[3,4] treatment planning,[5] electromagnetic tracking,[6] and applicator development,[7,8,9] poor execution of HDR prostate brachytherapy can still have a significant effect on patient outcomes
In a homogenous geometry, the Magic Plate was able to localize the source to within 1 mm, the verification accuracy was negatively affected by inhomogeneities; this can be corrected for by using density information obtained from CT, making the proposed tool attractive for use as a real‐time in vivo quality assurance (QA) device in HDR brachytherapy for prostate cancer
Purpose: This study aims to assess the accuracy of source position verification during high-dose rate (HDR) prostate brachytherapy using a novel, in-house developed two-dimensional (2D) diode array, embedded exactly below the patient within a carbon fiber couch
Summary
When used in combination with external beam radiotherapy (EBRT) in the form of a boost, high-dose rate (HDR) brachytherapy has been shown to be a safe and effective treatment modality for intermediate- and high-risk prostate cancer.[1,2] Despite recent technological developments in the field of brachytherapy, such as image-guided brachytherapy,[3,4] treatment planning,[5] electromagnetic tracking,[6] and applicator development,[7,8,9] poor execution of HDR prostate brachytherapy can still have a significant effect on patient outcomes. There are a number of published documents by the International Commission on Radiological Protection (ICRP)[10,11] as well as the International Atomic Energy Association (IAEA)[12] describing errors that have occurred in HDR brachytherapy. Many of these errors are related to human miscalculations, and less often, due to machine or computational malfunction. The likelihood of remote afterloader malfunction is generally considered extremely low; small deviations from the plan in source dwell position and time can result in significant errors in the dose delivered to the patient.[13]
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