Computed Tomography Readout Research Articles

Patient-specific quality assurance in SBRT treatments using 3D polymer gel dosimetry

In stereotactic body radiation therapy (SBRT), patient-specific quality assurance (PSQA) is required due to the complex dose distributions delivered. In this context, polymer gels are considered reliable as a three-dimensional dosimeter. This work used polymer MAGIC-gel sealed in 2 mm thin-wall glass spheres to assess the three-dimensional (3D) dose distribution imparted to patients and compared the results with that provided by the treatment planning system. Four SBRT treatments targeting vertebral, ilium, pelvic lymph node and lung regions were selected for this study. A computed tomography (CT) scan of each glass sphere was obtained, and the patient treatment plan was superimposed on the glass sphere CT image. Thereafter, the spheres were irradiated under similar conditions to the patient using a Varian TrueBeam linear accelerator. A high-spatial resolution optical CT scanner was used to read the glass sphere containing the gel. Planned and delivered 3D dose distributions were compared quantitatively through 3D gamma passing rates at several selected acceptance criteria and qualitatively through the evaluation of dose-profiles, isodose-curves, and dose-volume histograms. We observed that the overall 3D gamma passing rate exceeded 90% at acceptance criteria of 2% dose difference and 2 mm distance-to-agreement for a dose threshold of 20%. The results of this study suggest that the polymer MAGIC-gel sealed in thin-wall glass spheres in conjunction with the optical CT readout method is a suitable PSQA system for SBRT treatments.

End-to-end quality assurance for stereotactic radiotherapy with Fricke-Xylenol orange-Gelatin gel dosimeter and dual-wavelength cone-beam optical CT readout

PurposeThe end-to-end (E2E) quality assurance (QA) test is a unique tool for validating the treatment chain undergone by patients in external radiotherapy. It should be conducted in three dimensions (3D) to get accurate results. This study aims to implement these tests with Fricke-Xylenol orange-Gelatin (FXG) gel dosimeter and a newly developed dual-wavelength reading method on the Vista16™ optical Computed Tomography (CT) scanner (ModusQA) for three treatment techniques in stereotactic radiotherapy, on Novalis (Varian) and CyberKnife (Accuray) linear accelerators. MethodsThe tests were performed in head phantoms. Gel measurements were compared with planned dose distributions and measured by film and ion chamber measurements by plotting isodose curves and dose profiles, and by conducting a 3D local gamma-index analysis (2%/2mm criteria). ResultsGamma passing rates were higher than 95 %. Point dose differences between treatment planning and gel and ion chamber measurements at the isocenter were < 2.3 % for both treatments delivered on the Novalis accelerator, while this difference was higher than 4 % for the treatment delivered on the CyberKnife, highlighting a small overdosing of the tumor volume. A good agreement was observed between gel and film dose profiles. ConclusionsThis study presents the successful implementation of 3D E2E QA tests for stereotactic radiotherapy with FXG gel dosimetry and a dual-wavelength reading method on an optical CT scanner. This dosimetric method provides 3D absolute dose distributions in the 0.25 – 10 Gy dose range with a high spatial resolution and a dose uncertainty of around 2 % (k=1).

Fricke-Xylenol orange-Gelatin gel characterization with dual wavelength cone-beam optical CT scanner for applications in stereotactic and dynamic radiotherapy

PurposeThis study is about the development of a new dual wavelength reading method of Fricke-Xylenol orange-Gelatin (FXG) gel dosimeters on the Vista16™ optical Computed Tomography (CT) scanner to perform 3D dose distribution measurements in stereotactic and dynamic radiotherapy treatments. MethodsThe dosimetric characteristics of an optimized FXG gel composition and its optical CT readout have been evaluated. A dual wavelength reading method has been developed on the CT scanner at wavelengths 590 nm and 633 nm. Small-field dose profile measurements with FXG gel and microDiamond (PTW) detectors were compared by γ-index analysis (0.5%/0.5 mm) to validate this method. ResultsThis reading method exhibits linear calibration curves in the 0–4 Gy and 2–10 Gy dose ranges at 590 nm and 633 nm respectively. The absorbed dose values below 4 Gy, measured at 590 nm, and those above 4 Gy, measured at 633 nm, are combined to plot a complete profile. A γ passing rate of 93.4% was achieved. ConclusionsThe new reading method of FXG gel dosimeters has been implemented on the Vista16™ scanner to span absorbed doses representative of stereotactic and dynamic radiotherapy treatments and enable 3D measurements in tumor volumes and surrounding healthy tissues. Small-field profile measurements validated this reading method as FXG gel dosimeters and microDiamond detectors were in very close agreement. This dosimetric method is a promising candidate for 3D quality assurance end-to-end tests in stereotactic and dynamic radiotherapy.

Basic features of VIC-T dosimeter with spiral CT readout, CT scanning conditions and data processing with a new polyGeVero-CT software package

This work reports on the results obtained for VIC-T dosimeter for radiotherapy dosimetry (17 % (w/v) N-vinylpyrrolidone, 8 % (w/v) N,N′-methylenebisacrylamide, 12 % (w/v) tert-butyl alcohol, 5 % (w/v) gelatine, 0.02 % (w/v) hydroquinone and 14 mM tetrakis (hydroxymethyl) phosphonium chloride (THPC)) measured with a spiral computed tomography (CT). Optimal spiral CT protocol, CT measurements conditions and image processing are provided. Basic features of VIC-T are discussed such as a calibration relation and dose resolution with respect to former N-vinylpyrrolidone containing dosimeters. Both adopted data processing performed with a new polyGeVero®-CT software package and its features are reported.

Improving the quality of reconstructed X-ray CT images of polymer gel dosimeters: zero-scan coupled with adaptive mean filtering.

This study evaluated the feasibility of combining the 'zero-scan' (ZS) X-ray computed tomography (CT) based polymer gel dosimeter (PGD) readout with adaptive mean (AM) filtering for improving the signal to noise ratio (SNR), and to compare these results with available average scan (AS) X-ray CT readout techniques. NIPAM PGD were manufactured, irradiated with 6 MV photons, CT imaged and processed in Matlab. AM filter for two iterations, with 3×3 and 5×5 pixels (kernel size), was used in two scenarios (a) the CT images were subjected to AM filtering (pre-processing) and these were further employed to generate AS and ZS gel images, and (b) the AS and ZS images were first reconstructed from the CT images and then AM filtering was carried out (post-processing). SNR was computed in an ROI of 30×30 for different pre and post processing cases. Results showed that the ZS technique combined with AM filtering resulted in improved SNR. Using the previously-recommended 25 images for reconstruction the ZS pre-processed protocol can give an increase of 44% and 80% in SNR for 3×3 and 5×5 kernel sizes respectively. However, post processing using both techniques and filter sizes introduced blur and a reduction in the spatial resolution. Based on this work, it is possible to recommend that the ZS method may be combined with pre-processed AM filtering using appropriate kernel size, to produce a large increase in the SNR of the reconstructed PGD images.

Radiation-induced refraction artifacts in the optical CT readout of polymer gel dosimeters.

The objective of this work is to demonstrate imaging artifacts that can occur during the optical computed tomography (CT) scanning of polymer gel dosimeters due to radiation-induced refractive index (RI) changes in polyacrylamide gels. A 1 L cylindrical polyacrylamide gel dosimeter was irradiated with 3 × 3 cm(2) square beams of 6 MV photons. A prototype fan-beam optical CT scanner was used to image the dosimeter. Investigative optical CT scans were performed to examine two types of rayline bending: (i) bending within the plane of the fan-beam and (ii) bending out the plane of the fan-beam. To address structured errors, an iterative Savitzky-Golay (ISG) filtering routine was designed to filter 2D projections in sinogram space. For comparison, 2D projections were alternatively filtered using an adaptive-mean (AM) filter. In-plane rayline bending was most notably observed in optical CT projections where rays of the fan-beam confronted a sustained dose gradient that was perpendicular to their trajectory but within the fan-beam plane. These errors caused distinct streaking artifacts in image reconstructions due to the refraction of higher intensity rays toward more opaque regions of the dosimeter. Out-of-plane rayline bending was observed in slices of the dosimeter that featured dose gradients perpendicular to the plane of the fan-beam. These errors caused widespread, severe overestimations of dose in image reconstructions due to the higher-than-actual opacity that is perceived by the scanner when light is bent off of the detector array. The ISG filtering routine outperformed AM filtering for both in-plane and out-of-plane rayline errors caused by radiation-induced RI changes. For in-plane rayline errors, streaks in an irradiated region (>7 Gy) were as high as 49% for unfiltered data, 14% for AM, and 6% for ISG. For out-of-plane rayline errors, overestimations of dose in a low-dose region (∼50 cGy) were as high as 13 Gy for unfiltered data, 10 Gy for AM, and 3.1 Gy for ISG. The ISG routine also addressed unrelated artifacts that previously needed to be manually removed in sinogram space. However, the ISG routine blurred reconstructions, causing losses in spatial resolution of ∼5 mm in the plane of the fan-beam and ∼8 mm perpendicular to the fan-beam. This paper reveals a new category of imaging artifacts that can affect the optical CT readout of polyacrylamide gel dosimeters. Investigative scans show that radiation-induced RI changes can cause significant rayline errors when rays confront a prolonged dose gradient that runs perpendicular to their trajectory. In fan-beam optical CT, these errors manifested in two ways: (1) distinct streaking artifacts caused by in-plane rayline bending and (2) severe overestimations of opacity caused by rays bending out of the fan-beam plane and missing the detector array. Although the ISG filtering routine mitigated these errors better than an adaptive-mean filtering routine, it caused unacceptable losses in spatial resolution.

Sci-Fri PM: Dosimetry-01: Radiation-induced refraction artefacts in the optical CT readout of polymer gel dosimeters

Polymer gel dosimeters (PGDs) are a desirable tool for the verification of advanced radiotherapy treatments. Fully 3D, deformable, and tissue-equivalent, the PGD polymerizes wherever it absorbs dose. To measure the dose absorbed by a PGD, optical computed tomography (CT) can be used to evaluate, in full 3D, the opacity distribution that coincides with polymerization. In addition to an increase in opacity with dose, an increase in refractive index (RI) is also known to occur in irradiated polymer gels. The increase in RI is slight and was previously assumed insignificant. This work reveals the effects that radiation-induced RI changes can have on the optical CT readout of PGDs. A fan-beam optical CT scanner was used to image a cylindrical PGD irradiated by a pair of 3×3 cm{sup 2}, 6 MV photon beams in an orthogonal arrangement. Investigative scans were performed to evaluate refraction errors occurring: i) within the plane, and ii) out of the plane of the fan-beam. In-plane refraction was shown to cause distinct streaking artefacts along dose gradients (i.e. RI gradients) due to higher intensity rays being refracted into more opaque regions. Out-of-plane refraction was shown to produce severe, widespread artefacts due to rays missing the detector array. Anmore » iterative Savitzky-Golay filtering technique was developed to reduce both types of artefacts by specifically targeting structured errors in sinogram space. Results introduce a new category of imaging artefacts to be aware of when using optical CT for PGD readout.« less

Evaluating the Characteristics of a Novel DEMBIG Gel Dosimeter Using Computed Tomography

Over the last two decades, radiotherapy techniques have become more sophisticated. Three-dimensional (3-D) dose verification is required to ensure accurate dose delivery to the planning target volume. Gel dosimeters have the potential to measure the 3-D dose distribution and thus can be applicable in radiotherapy. In this study, we developed a novel DEMBIG gel dosimeter based on the 2-(Dimethylamino) ethyl acrylate (DEMA) monomer and used computed tomography (CT) to evaluate its characteristics. The DEMBIG gel was composed of 7% gelatin, 5% monomer, and 4% crosslinker. The gel response to a dose from 1 to 25 Gy was examined. The energy dependence, dose rate dependence, and spatial resolution were evaluated as well. After 24 h post-irradiation, the DEMBIG gel reached steady state. The average sensitivity at the photon energy of 6 MV was 0.459 HU/Gy (R <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> =0.995). The variations in sensitivity between 6-, 10-, and 15-MV photons were lower than 3%, and the difference in sensitivity between the dose rate of 100 and 600 MU/min was 28%. For a beam profile of 3 × 6 cm <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> and 6 MV, the 80%-20% penumbra for 0/5, 0/15, and 5/15 Gy can be around 2.73, 6.24, and 2.34 mm, respectively. We conclude that the DEMBIG gel dosimeter has high linearity of R <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> = 0.995 and high sensitivity of 0.459 HU/Gy. With CT readout, it could be used in clinical radiotherapy to verify the accuracy of 3-D dose delivery.

Investigation of the dose characteristics of an n-NIPAM gel dosimeter with computed tomography

Abstract Nowadays, radiotherapy attempts to deliver complex three-dimensional (3-D) dose distribution. The gel dosimeter, which can measure the 3-D dose output, is suitable for clinical use. This study developed an n-NIPAM gel dosimeter based on an N -isopropyl-acrylamide monomer, and used computed tomography (CT) to evaluate the characteristics of n-NIPAM gels. The n-NIPAM gel consisted of 6% gelatin, 5% monomer, and 2.5% cross-linker combined with 5 mM tetrakis (hydroxymethyl) phosphonium chloride (THPC) for deoxygenation. Dose responses of 2–15 Gy delivered by a linear accelerator were examined. Temporal instability, energy dependence, dose rate dependence, and spatial resolution were evaluated as well. Temporal instability appeared before 24 h post-irradiation. The maximum difference of sensitivity reached 33% for various dose rates from 100 to 500 cGy min −1 , while it was within 10% for X-ray energies from 6 to 15 MV. The average sensitivity of n-NIPAM under 6 MV and 400 cGy min −1 was 0.5689 HU Gy −1 , and the linearity ( R 2 =0.998) was comparable to that of the conventional NIPAM gels. For the spatial resolution, the edge spread distances were generally shorter than 6.5 mm for adjacent quadrants with different dose gradients of 5/10, 5/15, 10/20, and 15/20 Gy. We conclude that n-NIPAM has high linearity and high sensitivity. Although the energy dependence is minor, there is a slight dose rate dependence. The proposed dosimeter with CT readout is suitable in clinical radiotherapy to increase the accuracy of dose verification.

An overview of polymer gel dosimetry using x-ray CT

The use of x-ray computed tomography (CT) for the imaging of irradiated polymer gels was first introduced at the 1st international conference on radiotherapy gel dosimetry, DOSGEL99, and in a subsequent paper [1,2]. These works showed dose dependent contrast in CT images of irradiated polyacrylamide (PAG) gel, quantified a CT dose response for PAG gel and thereby established the potential of CT as an alternative to MRI and optical CT for gel read-out. The advantages of CT readout are practical ones: accessibility of CT to clinical radiation therapy environments, ease and speed of image acquisition, and a CT dose response that is stable and relatively insensitive to environmental factors. However, significant drawbacks include a very low sensitivity of CT number (H) to dose (~1%) and the fact that the act of imaging with CT will impart additional dose to the gel. Recent work has focused on means of understanding and minimizing these drawbacks.