Measured Dose Distributions Research Articles

Feasibility of Large Multi-Leaf Collimator in Stereotactic Radiosurgery/Stereotactic Radiotherapy: A Single Center Experience

OBJECTIVE This study investigated the feasibility of using a large multi- leaf collimator (MLC) in a C-arm based linear accelerator for stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). METHODS Patient Specific Quality Assurance was conducted on 69 patients treated with a single lesion SRS/SRT measuring dose distribution using patient-specific plans with SRS MapCHECK®. Statistics were used to analyze the significance of correlation among dosimetric parameters, included Conformity Index (CI), Gradient Index (GI), plan complexity, and Gamma passing rate (GPR) in an absolute dose (AD) and relative dose (RD). confidence limit (CL) was also calculated to evaluate the performance of a large multileaf collimator (MLC) in SRS/SRT. RESULTS Planning target volumes (PTVs) ranged between 0.34 cm3 and 30.42 cm3. The study found a value of CIICRU, CIPaddick, and GI of 1.29 ± 0.17, 0.77±0.10 and 5.24±2.18 (mean±SD), respectively, significant correlations were found between PTV sizes and dosimetric parameters. Values of GPR2%/2mm were 92.42±3.74 (AD), 96.38±3.24 (RD), whereas GPR2%/1mm were 82.03±6.69 (AD), 89.64±7.26 (RD). No significant correlation was found between plan complexity and GPR. CL values were 85.09% (AD), 90.03% (RD) for GPR2%/2mm and 68.92% (AD), 75.41% (RD) for GPR2%/1mm. CONCLUSIONS This study assessed the feasibility of using a large MLC for a single lesion SRS/SRT across various PTV sizes. The values of CI and GI decreased for a small lesion. While the large MLC performed adequately across different PTV sizes, the CL value of RD GPR at 2%/1 mm fell below 90%. This indicates that the contribution of PTV margin might be consi-dered for a large MLC in SRS/SRT. KEYWORDS stereotactic radiosurgery, stereotactic radiotherapy, multi- leaf collimator, dosimetric parameter, gamma analysis

Thermoluminescence properties of Cr, Si, and Mg co-doped Al2O3 ceramics plates under X-ray irradiation

The thermoluminescence (TL) properties and precise dose distribution measurement capabilities of Cr, Si, and Mg co-doped Al2O3 ceramics (Al2O3:Cr,Si,Mg) plates were investigated under X-ray irradiation. The co-doping of Si and Mg significantly enhanced the TL sensitivity, approximately doubling it compared to conventional Al2O3:Cr plates, due to the creation of new trapping levels. The TL dose response was proportional in the dose range of 0.5 to 5 Gy, and off-axis ratio (OAR) measurements confirmed the high spatial resolution and accuracy of the plates to reproduce the radiation distributions. This study is the first to evaluate TL plates of this size (200 × 200 mm2) that utilize Al2O3 as the host material, and demonstrate their significant potential for radiotherapy dosimetry systems. This significant contribution highlights the potential of Al2O3:Cr,Si,Mg ceramic plates to transform dosimetry systems for radiotherapy by providing a combination of high sensitivity, spatial resolution, and robustness. The results of this study lay the groundwork for the development and practical application of large-area TL imaging devices in medical dose verification.

Feasibility of volumetric-modulated arc therapy gating for cardiac radioablation using real-time ECG signal acquisition and a dynamic phantom.

Stereotactic arrythmia radioablation (STAR) is a noninvasive technique to treat ventricular tachycardia (VT). Management of cardiorespiratory motion plays an essential role in VT-STAR treatments to improve treatment outcomes by reducing positional uncertainties and increasing dose conformality. Use of an electrocardiogram (ECG) signal, acquired in real-time, as a surrogate to gate the beam has the potential to fulfil that intent. To investigate the gated delivery of volumetric-modulated arc therapy (VMAT) for STAR on a TrueBeam linear accelerator (linac) using a real-time acquired ECG signal and a dynamic cardiac phantom. Dosimetric characteristics of a 6 MV flattening filter free (FFF) beam from a Varian TrueBeam linac were initially evaluated under high-frequency gating scenarios relevant to cardiac rhythms with respect to dose linearity, beam output, and energy quality. A microcontroller board was used to interface and gate the linac, sending a beam on/off signal. For real-time cardiac gated measurements, an AD8232 Heart Monitor board was used to acquire the ECG signal and synchronize the VMAT delivery to an ArcCHECK detector to a specific phase of the cardiac cycle. Gated dose distributions were compared against those acquired for a non-gated delivery mode. An in-house dynamic cardiac phantom was developed to simulate cardiorespiratory motion that correlates target position with the signal to gate the beam. Measured dose distributions using gafchromic film were also compared against the static (reference) mode in different scenarios with and without gating. Maximum difference in dose per monitor unit (MU) was found to be no greater than 1% as compared to static mode with variation in the chamber response within 0.2% in the range of 50 MUs to 200 MUs. Maximum percentage differences for the beam output and beam qualiy index (TPR20,10) between gated and non-gated modes were 0.91% and -0.44%, respectively. Comparison of delivered dose distributions for the VMAT plan without gating versus ECG synchronized gating modes provided a passing rate 98% for the gamma analysis with 1% relative dose difference, 1mm distance-to-agreement criteria. For the synchronization of dose delivery with target position, passing rates were 98%, 97%, and 99% for the axial, coronal, and sagittal planes, respectively, when gating the beam based on target position for cardiac motion only, for 3%, 3mm tolerance as compared to static mode. Without gating the beam, passing rates of the respective plans are 97%, 94%, and 99% for the cardiac motion only, and 67%, 57%, and 55% when including respiratory component of motion. A 6 MV-FFF TrueBeam is stable for performing gating in STAR under high-frequency gate windows within typical cardiac cycles. Agreement between measured dose distributions for a VMAT plan in static and ECG-synchronized deliveries and between static and target-position gated modes shows that the proposed methodology is feasible and can be implemented on a TrueBeam platform.

A quantification of the electron return effect using Monte Carlo simulations and experimental measurements for the MRI-linac

The integration of magnetic resonance (MR) imaging and linear accelerators into hybrid treatment systems has made MR-guided radiation therapy a clinical reality. This work aims to evaluate the influence of the Electron Return Effect (ERE) on the dose distributions. This study was conducted using MRIdian (ViewRay, Cleveland, Ohio) system. Monte-Carlo simulations (MCs) and experimental measurements with EBT3 Gafchromic films were performed to investigate the dose distribution in a slab water phantom with and without a 2-cm air gap. Plus, MCs took into account different field sizes and a lung gap. A gamma analysis compared calculated versus measured dose distributions. The MCs have shown an increase of the ERE with the radiation field size both in Percent Depth Dose (PDD) and crossline direction. As concerns to the PDD direction, the smallest field for which there was a significant dose accumulation was 4.15×4.15 cm2both for air-gap (13.5%) and lung-gap (3.3%). The largest field for which there was a significant dose accumulation was 24.07×24.07 cm2both for air-gap (39.7%) and lung-gap (4.9%). Instead for the crossline direction, the smallest field for which there was a significant dose accumulation was 2.49×2.49 cm2both for air-gap (8.6% ) and lung-gap (0.5%). The largest field for which there was a significant dose accumulation was 24.07×24.07 cm2both for air-gap (46.2%) and lung-gap (4.2%). PDD and crossline profiles showed good agreement with a gamma-passing rate higher than 91.15% for 2%/2 mm. The ERE can be adequately calculated by MC dose calculation platform available in the MRIdian Treatment Planning System. The MCs show an increase of the ERE directly proportional with the radiation field size. Good agreement was observed between the experimental measurements and calculated dose distributions.

A Tissue‐Equivalent, Reusable Dosimeter for 3D Verification of Radiotherapy

AbstractA new tissue‐equivalent, reusable material for dosimetric verification of radiotherapy is developed and characterized. The material comprises a hydrogel matrix containing copper‐doped lithium fluoride nanoparticles that exhibit optically stimulated luminescence (OSL). Using a laser light sheet and a sensitive camera equipped with appropriate filters, the OSL signal is read out layer by layer thus constructing the 3D dose distribution. The good tissue equivalence allows the new material to register the dose from a prescribed treatment plan as if delivered to a patient. Cubic dosimeters measuring 50 × 50 × 50 mm3 are developed and used to measure 3D dose distributions (from voxels measuring 0.8 × 0.8 × 1.0 mm3) with a statistical dose precision of 5% at 100 Gy dose levels. The spatial precision of offsets in dose gradients between planned and measured dose distributions is below the voxel size. A 3% / 3 mm gamma analysis between a prescribed treatment plan and the retrieved and corrected readout yields a pass rate of 89.5%. Light scattering within the dosimetric volume affects the dosimeter performance, indicating the potential for future improvements of spatial and dose precision. In conclusion, the dosimeter system shows high promise for future clinical validation of radiotherapy.

A Fast 3D Range-Modulator Delivery Approach: Validation of the FLUKA Model on a Varian ProBeam System Including a Robustness Analysis

A 3D range-modulator (RM), optimized for a single energy and a specific target shape, is a promising and viable solution for the ultra-fast dose delivery in particle therapy. The aim of this work was to investigate the impact of potential beam and modulator misalignments on the dose distribution. Moreover, the FLUKA Monte Carlo model, capable of simulating 3D RMs, was adjusted and validated for the 250 MeV single-energy proton irradiation from a Varian ProBeam system. A 3D RM was designed for a cube target shape rotated 45° around two axes using a Varian-internal research version of the Eclipse treatment planning software, and the resulting dose distribution was simulated in a water phantom. Deviations from the ideal alignment were introduced, and the dose distributions from the modified simulations were compared to the original unmodified one. Finally, the FLUKA model and the workflow were validated with base-line data measurements and dose measurements of the manufactured modulator prototype at the HollandPTC facility in Delft. The adjusted FLUKA model, optimized particularly in the scope of a single-energy FLASH irradiation with a PMMA pre-absorber, demonstrated very good agreement with the measured dose distribution resulting from the 3D RM. Dose deviations resulting from modulator-beam axis misalignments depend on the specific 3D RM and its shape, pin aspect ratio, rotation angle, rotation point, etc. A minor modulator shift was found to be more relevant for the distal dose distribution than for the spread-out Bragg Peak (SOBP) homogeneity. On the other hand, a modulator tilt (rotation away from the beam axis) substantially affected not only the depth dose profile, transforming a flat SOBP into a broad, Gaussian-like distribution with increasing rotation angle, but also shifted the lateral dose distribution considerably. This work strives to increase awareness and highlight potential pitfalls as the 3D RM method progresses from a purely research concept to pre-clinical studies and human trials. Ensuring that gantry rotation and the combined weight of RM, PMMA, and aperture do not introduce alignment issues is critical. Given all the other range and positioning uncertainties, etc., not related to the modulator, the RM must be aligned with an accuracy below 1° in order to preserve a clinically acceptable total uncertainty budget. Careful consideration of critical parameters like the pin aspect ratio and possibly a novel robust modulator geometry optimization are potential additional strategies to mitigate the impact of positioning on the resulting dose. Finally, even the rotated cube 3D modulator with high aspect ratio pin structures (~80 mm height to 3 mm pin base width) was found to be relatively robust against a slight misalignment of 0.5° rotation or a 1.5 mm shift in one dimension perpendicular to the beam axis. Given a reliable positioning and QA concept, the additional uncertainties introduced by the 3D RM can be successfully managed adopting the concept into the clinical routine.

Flexible and Ecological Cotton-Based Dosimeter for 2D UV Surface Dose Distribution Measurements.

This work presents a 2D radiochromic dosimeter for ultraviolet (UV) radiation measurements, based on cotton fabric volume-modified with nitroblue tetrazolium chloride (NBT) as a radiation-sensitive compound. The developed dosimeter is flexible, which allows it to adapt to various shapes and show a color change from yellowish to purple-brown during irradiation. The intensity of the color change depends on the type of UV radiation and is the highest for UVC (253.7 nm). It has been shown that the developed dosimeters (i) can be used for UVC radiation dose measurements in the range of up to 10 J/cm2; (ii) can be measured in 2D using a flatbed scanner; and (iii) can have the obtained images after scanning be filtered with a medium filter to improve their quality by reducing noise from the fabric structure. The developed cotton-NBT dosimeters can measure UVC-absorbed radiation doses on objects of various shapes, and when combined with a dedicated computer software package and a data processing method, they form a comprehensive system for measuring dose distributions for objects with complex shapes. The developed system can also serve as a comprehensive method for assessing the quality and control of UV radiation sources used in various industrial processes.

Measurement of ionising radiation dose absorbed by bones by using a bone-imitating polymer gel dosimeter

Three-dimensional radiotherapy dosimetry allows for high-resolution dose distribution measurements using dosimeters imitating various tissues. This work concerns bone-imitating dosimeters. The following are investigated: (i) manufacturing of bone-imitating dosimeters with two types of calcium hydroxyapatite, (ii) dose response characteristics after irradiation with a 6 MV photon beam, and (iii) tissue equivalence. The main findings include the dosimetric compositions with two types of calcium hydroxyapatite. For 18 % of one type of hydroxyapatite, the dosimeter imitates trabecular bone. For much higher concentrations (>40 %, another hydroxyapatite), the dosimeter approaches the properties of dense bone. The dynamic dose response is not greater than 30 Gy, the linear dose range is <20 Gy (computed tomography and nuclear magnetic resonance measurements), and the dose sensitivity is 0.11–0.18 Gy−1 s −1 (nuclear magnetic resonance measurements) for different weight fractions of hydroxyapatites. In summary, a bone-imitating polymer gel dosimeter can be used to measure the radiation dose in radiotherapy.

Diffusion Correction in Fricke Hydrogel Dosimeters: A Deep Learning Approach with 2D and 3D Physics-Informed Neural Network Models.

In this work an innovative approach was developed to address a significant challenge in the field of radiation dosimetry: the accurate measurement of spatial dose distributions using Fricke gel dosimeters. Hydrogels are widely used in radiation dosimetry due to their ability to simulate the tissue-equivalent properties of human tissue, making them ideal for measuring and mapping radiation dose distributions. Among the various gel dosimeters, Fricke gels exploit the radiation-induced oxidation of ferrous ions to ferric ions and are particularly notable due to their sensitivity. The concentration of ferric ions can be measured using various techniques, including magnetic resonance imaging (MRI) or spectrophotometry. While Fricke gels offer several advantages, a significant hurdle to their widespread application is the diffusion of ferric ions within the gel matrix. This phenomenon leads to a blurring of the dose distribution over time, compromising the accuracy of dose measurements. To mitigate the issue of ferric ion diffusion, researchers have explored various strategies such as the incorporation of additives or modification of the gel composition to either reduce the mobility of ferric ions or stabilize the gel matrix. The computational method proposed leverages the power of artificial intelligence, particularly deep learning, to mitigate the effects of ferric ion diffusion that can compromise measurement precision. By employing Physics Informed Neural Networks (PINNs), the method introduces a novel way to apply physical laws directly within the learning process, optimizing the network to adhere to the principles governing ion diffusion. This is particularly advantageous for solving the partial differential equations that describe the diffusion process in 2D and 3D. By inputting the spatial distribution of ferric ions at a given time, along with boundary conditions and the diffusion coefficient, the model can backtrack to accurately reconstruct the original ion distribution. This capability is crucial for enhancing the fidelity of 3D spatial dose measurements, ensuring that the data reflect the true dose distribution without the artifacts introduced by ion migration. Here, multidimensional models able to handle 2D and 3D data were developed and tested against dose distributions numerically evolved in time from 20 to 100 h. The results in terms of various metrics show a significant agreement in both 2D and 3D dose distributions. In particular, the mean square error of the prediction spans the range 1×10-6-1×10-4, while the gamma analysis results in a 90-100% passing rate with 3%/2 mm, depending on the elapsed time, the type of distribution modeled and the dimensionality. This method could expand the applicability of Fricke gel dosimeters to a wider range of measurement tasks, from simple planar dose assessments to intricate volumetric analyses. The proposed technique holds great promise for overcoming the limitations imposed by ion diffusion in Fricke gel dosimeters.

3D small-scale dosimetry and tumor control of 225Ac radiopharmaceuticals for prostate cancer

Radiopharmaceutical therapy using α\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\upalpha$$\\end{document}-emitting 225\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{225}$$\\end{document}Ac is an emerging treatment for patients with advanced metastatic cancers. Measurement of the spatial dose distribution in organs and tumors is needed to inform treatment dose prescription and reduce off-target toxicity, at not only organ but also sub-organ scales. Digital autoradiography with α\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\upalpha$$\\end{document}-sensitive detection devices can measure radioactivity distributions at 20–40 μm\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\upmu {\\hbox {m}}$$\\end{document} resolution, but anatomical characterization is typically limited to 2D. We collected digital autoradiographs across whole tissues to generate 3D dose volumes and used them to evaluate the simultaneous tumor control and regional kidney dosimetry of a novel therapeutic radiopharmaceutical for prostate cancer, [225Ac]Ac-Macropa-PEG4-YS5, in mice. 22Rv1 xenograft-bearing mice treated with 18.5 kBq of [225Ac]Ac-Macropa-PEG4-YS5 were sacrificed at 24 h and 168 h post-injection for quantitative α\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\upalpha$$\\end{document}-particle digital autoradiography and hematoxylin and eosin staining. Gamma-ray spectroscopy of biodistribution data was used to determine temporal dynamics and 213\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{213}$$\\end{document}Bi redistribution. Tumor control probability and sub-kidney dosimetry were assessed. Heterogeneous 225\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{225}$$\\end{document}Ac spatial distribution was observed in both tumors and kidneys. Tumor control was maintained despite heterogeneity if cold spots coincided with necrotic regions. 225\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{225}$$\\end{document}Ac dose-rate was highest in the cortex and renal vasculature. Extrapolation of tumor control suggested that kidney absorbed dose could be reduced by 41% while maintaining 90% TCP. The 3D dosimetry methods described allow for whole tumor and organ dose measurements following 225\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{225}$$\\end{document}Ac radiopharmaceutical therapy, which correlate to tumor control and toxicity outcomes.

Effect of modulation factor and low dose threshold level on gamma pass rates of single isocenter multi-target SRT treatment plans.

SRS MapCHECK (SMC) is a commercially available patient-specific quality assurance (PSQA) tool for stereotactic radiosurgery (SRS) applications. This study investigates the effects of degree of modulation, location off-axis, and low dose threshold (LDT) selection on gamma pass rates (GPRs) between SMC and treatment planning system, Analytical Anisotropic Algorithm (AAA), or Vancouver Island Monte Carlo (VMC++ algorithm) system calculated dose distributions. Volumetric-modulated arc therapy (VMAT) plans with modulation factors (MFs) ranging from 2.7 to 10.2 MU/cGy were delivered to SMC at isocenter and 6cm off-axis. SMC measured dose distributions were compared against AAA and VMC++ via gamma analysis (3%/1mm) with LDT of 10% to 80% using SNC Patient software. Comparing on-axis SMC dose against AAA and VMC++ with LDT of 10%, all AAA-calculated plans met the acceptance criteria of GPR≥90%, and only one VMC++ calculated plan was marginally outside the acceptance criteria with pass rate of 89.1%. Using LDT of 80% revealed decreasing GPR with increasing MF. For AAA, GPRs reduced from 100% at MF of 2.7 MU/cGy to 57% at MF of 10.2 MU/cGy, and for VMC++ calculated plans, the GPRs reduced from 89% to 60% in the same MF range. Comparison of SMC dose off-axis against AAA and VMC++ showed more pronounced reduction of GPR with increasing MF. For LDT of 10%, AAA GPRs reduced from 100% to 83% in the MF range of 2.7 to 9.8 MU/cGy, and VMC++ GPR reduced from 100% to 91% in the same range. With 80% LDT, GPRs dropped from 100% to 42% for both algorithms. MF, dose calculation algorithm, and LDT selections are vital in VMAT-based SRT PSQA. LDT of 80% enhances sensitivity of gamma analysis for detecting dose differences compared to 10% LDT. To achieve better agreement between calculated and SMC dose, it is recommended to limit the MF to 4.6 MU/cGy on-axis and 3.6 MU/cGy off-axis.

Unbalanced core detector (UCD): a novel direct-reading dosimeter for FLASH radiotherapy

FLASH radiotherapy (FRT) is a novel radiotherapy technique based on dose rates that are several orders of magnitude greater than those used in conventional radiotherapy (40 Gy/s vs. 0.5–5 Gy/min). FRT is still in its preclinical and early clinical stage of development. However these studies indicate that FRT is more effective in sparing normal tissues from radiation-related side effects, as compared to conventional radiotherapy. This is the so-called "FLASH effect" and was observed with multi-MeV electron beams. Before FRT is made available to humans, more basic research is needed to fully understand its radiobiology fundamentals. Meanwhile, suitable radiation sources and dosimetric tools are gradually becoming available. Within this framework, INFN-LNF developed the Unbalanced Core Detector (UCD), a novel type of electron dosimeter designed to operate in the FRT domain. UCD main characteristics are the nearly isotropic response, the independence from the electron energy, the very high radiation resistance, the linearity up to dose rates of MGy/s and the possibility to record the time evolution of a single radiation pulse. UCD was tested using 7 and 9 MeV electron beams produced with the ElectronFlash accelerator from Sordina IORT Technologies (SIT S.p.A.) in Aprilia, Italy. UCD was used to measure dose distributions in a water phantom. The results well compare to those obtained with a flashDiamond detector from PTW.

Feasibility study for the development of multilayered solar cells for proton linear energy transfer depth profile measurement.

Previous study proposed a method to measure linear energy transfer (LET) at specific points using the quenching magnitude of thin film solar cells. This study was conducted to propose a more advanced method for measuring the LET distribution. This study focuses on evaluating the feasibility of estimating the proton LET distribution in proton therapy. The feasibility of measuring the proton LET and dose distribution simultaneously using a single-channel configuration comprising two solar cells with distinct quenching constants is investigated with the objective of paving the way for enhanced proton therapy dosimetry. Two solar cells with different quenching constants were used to estimate the proton LET distribution. Detector characteristics (e.g., dose linearity and dose-rate dependency) of the solar cells were evaluated to assess their suitability for dosimetry applications. First, using a reference beam condition, the quenching constants of the two solar cells were determined according to the modified Birks equation. The signal ratios of the two solar cells were then evaluated according to proton LET in relation to the estimated quenching constants. The proton LET distributions of six test beams were obtained by measuring the signal ratios of the two solar cells at each depth, and the ratios were evaluated by comparing them with those calculated by Monte Carlo simulation. The detector characterization of the two solar cells including dose linearity and dose-rate dependence affirmed their suitability for use in dosimetry applications. The maximum difference between the LET measured using the two solar cells and that calculated by Monte Carlo simulation was 2.34keV/µm. In the case of the dose distribution measured using the method proposed in this study, the maximum difference between range measured using the proposed method and that measured using a multilayered ionization chamber was 0.7mm. The expected accuracy of simultaneous LET and dose distribution measurement using the method proposed in this study were estimated to be 3.82%. The signal ratios of the two solar cells, which are related to quenching constants, demonstrated the feasibility of measuring LET and dose distribution simultaneously. The feasibility of measuring proton LET and dose distribution simultaneously using two solar cells with different quenching constants was demonstrated. Although the method proposed in this study was evaluated using a single channel by varying the measuring depth, the results suggest that the proton LET and dose distribution can be simultaneously measured if the detector is configured in a multichannel form. We believe that the results presented in this study provide the envisioned transition to a multichannel configuration, with the promise of substantially advancing proton therapy's accuracy and efficacy in cancer treatment.

Correction method for depth and field size dependence in Octavius 1000 SRS patient-specific QA

Stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) are advanced techniques capable of delivering higher doses of radiation precisely to small and complex targets. As these higher doses are delivered, the significance of patient-specific quality assurance becomes increasingly crucial to ensure both the effectiveness and safety of treatment. This study investigates the depth and field size dependence in Octavius 1000 SRS patient-specific quality assurance (PSQA), which is vital for ensuring accuracy in modern radiotherapy treatments. It comprehensively compares the performance of the Octavius 1000 SRS array against standard treatment planning system calculations, focusing on various field sizes and depths. An extensive measurement process was performed, wherein output factors were analyzed across a range of field sizes, from very small (1 × 1 cm2) to larger fields (10 × 10 cm2), at different depths (5 cm, 10 cm, and 15 cm). Our results highlighted significant variations in the measurement accuracy, dependent on the field size and depth, which underscored the challenge involved in ensuring precise dosimetry in PSQA for small fields. The largest discrepancy observed was 2.65% for a 1 × 1 cm2 field size at a depth of 15 cm. Based on these findings, a novel correction method tailored for small field sizes and varying depths was proposed. This method enhances the accuracy and reliability of PSQA in advanced radiotherapy to ensure that the delivered dose conforms closely to the planned dose, which is a critical aspect in treatments targeting small and complex tumor volumes. Through the proposed correction, this study aims to bridge the gap between calculated and measured dose distributions, thus contributing significantly to the refinement of PSQA processes in radiotherapy.

An integrated system for measuring 3D dose distributions of carbon-ion pencil beams in regular QA practice

The accurate measurement of three-dimensional (3D) dose distribution of carbon-ion pencil beams in water is crucial for regular quality assurance (QA) practice. Although ionization chambers scanned in a water tank is conventionally used for this purpose, these measuring methods are time-consuming and labor-intensive. In addition, the beam of Heavy Ion Medical Machine (HIMM) changes continuously in each extracted duration, these methods cannot obtain the accurate 3D dose distribution. To solve these problems, an integrated system (PBDOSE) is conceived and established, which employs multi-strip ionization chambers (MSICs) to measure 2D lateral profile dose distributions. The lateral profile dose distribution in the context of various depths is measured by a mobile MSIC and normalized by the measurement of a reference MSIC to reduce the effect of beam instability. On this basis, a 3D dose distribution is created by stacking those profiles in depth direction. By conducting a single depth scan within 3 min at HIMM, information such as the 3D dose distribution, lateral contour images, the Bragg curve, beam spot size, beam position, incident direction, and energy of the beam can be obtained. The Bragg curve acquired from PBDOSE with statistical uncertainties of 1.5% was almost identical to those measured by a commercial water phantom. Besides that, the lateral profiles revealed a remarkable agreement with Gafchromic EBT3 film measurements within differences less than 0.1 mm. PBDOSE shows great prospects in the accurate and efficient measurement of 3D dose distribution for carbon-ion therapy, and the clinical application of this system will improve the efficiency of regular QA procedures to a great extent.

The delivery assessment for small targets on Halcyon radiotherapy system - Measured and calculated dose comparison.

With the ever-increasing requirements of accuracy and personalization of radiotherapy treatments, stereotactic radiotherapy (SRT) with volumetric modulated arc therapy (VMAT) on O-ring Halcyon radiotherapy system could potentially provide a fast, safe, and feasible treatmentoption. The purpose of this study was to assess the delivery of Halcyon VMAT plans for small targets. Well-defined VMAT-SRT plans were created on Halcyon radiotherapy system with the stacked and staggered dual-layer MLC design for the film measurement set-up and the target sizes and shapes designed to emulate the targets of the stereotactic treatments. The planar dose distributions were acquired with film measurements and compared to a current clinical reference dose calculation with AcurosXB (v18.0, Varian Medical Systems) and to Monte Carlo simulations. With the collapsed arc versions of the VMAT-SRT plans, the uncertainty in dose delivery due to the multileaf collimator (MLC) without the gantry rotation could be separated andanalyzed. The target size was mainly limited by the resolution originated from the design of the MLC leaves. The results of the collapsed arc versions of the plans show good consistency among measured, calculated, and simulated dose distributions. With the full VMAT plans, the agreement between calculated and simulated dose distributions was consistent with the collapsed arc versions. The measured dose distribution agreed with the calculated and simulated dose distributions within the target regions, but considerable local differences were observed in the margins of the target. The largest differences located in the steep gradient regions presumably originating from the deviation of the isocenter. The potential of the Halcyon radiotherapy system for VMAT-SRT delivery was evaluated and the study revealed valuable insights on the machine characteristics with thedelivery.

Deep learning approach for diffusion correction in Fricke hydrogel dosimeters

In recent years studies on Fricke gel dosimeters have demonstrated their potential in performing fast measurements of 3D spatial dose distributions. These dosimeters work by oxidising ferrous (Fe2+) ions to ferric (Fe3+) ions, which can be read by magnetic resonance or optical techniques. However, the accuracy of these measurements can be affected by the diffusion of Fe3+ ions within the gel matrix, causing image blurring. To overcome this issue, the study proposes a computational method using artificial intelligence (AI) and specifically deep learning (DL). The method is based on Physics Informed Neural Networks (PINNs), which are effective in solving partial differential equations, especially in inverse problems. The PINNs are optimised using physical equations as loss functions, allowing them to predict real-life phenomena like ion diffusion in Fricke gel. The idea is to solve the backward diffusion equation using a PINN model and predict the initial condition, providing as input the spatial distribution of Fe3+ ions at measurement time T, the boundary conditions and the diffusion coefficient D of Fe3+ ions inside the medium. The method was first tested using 1D simulated data in diffusion processes, achieving a mean squared error of 1−4×10−4a.u. in step-wise and rectangular distributions. It was then tested using experimental data, achieving a mean squared error of 2×10−4OD2. The technique here proposed is very promising for overcoming the limits due to the diffusion of Fe3+ ions in Fricke gel dosimeters.

Enhancing online dose distribution reconstruction in radiotherapy through sparse sampled rotating fiber arrays and deep learning

A optical fiber array dosimeter based on radiation-induced luminescence can be used in two-dimensional dose distribution measurements. However, using rotating fiber arrays introduces challenges in terms of online monitoring and variations in detector performance due to the long data acquisition time. This study aims to propose and demonstrate a novel method for online fast reconstruction of two-dimensional dose distributions in radiation therapy using projection data obtained from sparsely sampled rotating fiber arrays. The projection data were processed in both the projection and image domains to achieve restoration and noise reduction by deep learning techniques. The performance of the proposed method was evaluated using simulation data obtained by Monte Carlo toolkit Geant4 and experimental data obtained from a medical accelerator. Results showed that the method can successfully reconstruct dose distribution through sparse sampling and reduce the measurement time to one-sixth of the original. The peak signal-to-noise ratio, root mean square error, and structural similarity index were 23.72, 2.68, and 0.95, respectively. Additionally, the 3%/3 mm gamma pass rate reached 98.4% under specific irradiation conditions with a dose of at least 10% of the maximum dose. The integration of sparse sampling techniques, rotating fiber arrays, and deep learning techniques offers new possibilities for the fast and efficient reconstruction of two-dimensional dose distributions, ensuring high-quality radiotherapy outcomes.

Carbon ion mono-energetic and spread-out Bragg peak measurements using nanocomposite Fricke gel dosimeters with LET-independent response

This study investigates the LET-dependence of dose measurements performed with a nanocomposite Fricke gel (NC-FG) upon irradiation with carbon ion beams to address the problem of quenching of gel dosimeters in high-LET particle therapy. The preparation of the NC-FG in a simple gel preparation device was performed for atmospheric and anoxic environmental conditions and two different container materials. Irradiation was performed with carbon ion beams at energies of 133.39MeV/u or 194.87MeV/u, complemented by a modulated 10 mm carbon ion spread-out Bragg peak (SOBP) irradiation. The R1 profiles obtained from the MRI readout were compared to the treatment planning system and a 2D-ionisation chamber array measurement performed for the mono-energetic and SOBP irradiations, respectively. For different dose levels, no difference in the gel response was obtained for the 3D-printed plastic containers, while the glass vials exhibited a linear dose response. Additional use of the glove box changes produced similar results. For both the mono-energetic and the SOBP irradiation, a linear dose response without quenching was observed. For depths ranging up to the Bragg peak position, the mono-energetic profiles deviated by less than ±15% from the planned dose distribution, excluding the lowest entrance surface dose (ESD). For the SOBP profiles, the deviation from the measured dose distribution was less than ±10% for depths between 20 mm and 33 mm. This study presents a LET-independent measurement of mono-energetic carbon ion Bragg peaks and, for the first time, a LET-independent measurement of a carbon ion SOBP with the NC-FG prepared in a simple gel preparation device under atmospheric conditions. The NC-FG provides a possible solution for 3D dosimetry in carbon ion radiotherapy.

Dosimetric validation of SmART-RAD Monte Carlo modelling for x-ray cabinet radiobiology irradiators

Objective. Accuracy and reproducibility in the measurement of radiation dose and associated reporting are critically important for the validity of basic and preclinical radiobiological studies performed with kilovolt x-ray radiation cabinets. This is essential to enable results of radiobiological studies to be repeated, as well as enable valid comparisons between laboratories. In addition, the commonly used single point dose value hides the 3D dose heterogeneity across the irradiated sample. This is particularly true for preclinical rodent models, and is generally difficult to measure directly. Radiation transport simulations integrated in an easy to use application could help researchers improve quality of dosimetry and reporting. Approach. This paper describes the use and dosimetric validation of a newly-developed Monte Carlo (MC) tool, SmART-RAD, to simulate the x-ray field in a range of standard commercial x-ray cabinet irradiators used for preclinical irradiations. Comparisons are made between simulated and experimentally determined dose distributions for a range of configurations to assess the potential use of this tool in determining dose distributions through samples, based on more readily available air-kerma calibration point measurements. Main results. Simulations gave very good dosimetric agreement with measured depth dose distributions in phantoms containing both water and bone equivalent materials. Good spatial and dosimetric agreement between simulated and measured dose distributions was obtained when using beam-shaping shielding. Significance. The MC simulations provided by SmART-RAD provide a useful tool to go from a limited number of dosimetry measurements to detailed 3D dose distributions through a non-homogeneous irradiated sample. This is particularly important when trying to determine the dose distribution in more complex geometries. The use of such a tool can improve reproducibility and dosimetry reporting in preclinical radiobiological research.