Towards real-time 4D radiation dosimetry on an MRI-Linac.

4D radiation dosimetry using a highly radiation-sensitive polymer gel dosimeter with real-time quantitative magnetic resonance imaging (MRI) readout is presented as a technique to acquire the accumulated radiation dose distribution during image-guided radiotherapy on an MRI-Linac. Optimized T 2-weighted Turbo-Spin-Echo (TSE) scans are converted into quantitative ΔR 2 maps and subsequently to radiation dose maps. The concept of temporal uncertainty is introduced as a metric of effective temporal resolution. A mathematical framework is presented to optimize the echo time of the TSE sequence in terms of dose resolution, and the trade-off between temporal resolution and dose resolution is discussed. The current temporal uncertainty achieved with the MAGAT gel dosimeter on a 1 T MRI-Linac is 3.8 s which is an order of magnitude better than what has been achieved until now. The potential of real-time 4D radiation dosimetry in a theragnostic MRI-Linac is demonstrated for two scenarios: an irradiation with three coplanar beams on a head phantom and a dynamic arc treatment on a cylindrical gel phantom using a rotating couch. The dose maps acquired on the MRI-Linac are compared with a treatment plan and with dose maps acquired on a clinical 3 T MRI scanner. 3D gamma map evaluations for the different modalities are provided. While the presented method demonstrates the potential of gel dosimetry for tracking the dose delivery during radiotherapy in 4D, a shortcoming of the MAGAT gel dosimeter is a retarded dose response. The effect of non-ideal radiofrequency pulses resulting from limitations in the specific absorption rate or B1-field inhomogeneity on the TSE acquired ΔR 2 values is analysed experimentally and by use of computational modelling with a Bloch simulator.

Physico-chemical properties and optimization of the deformable FlexyDos3D radiation dosimeter.

Deformable 3D radiation dosimetry is receiving growing interest for the validation of image-guided radiotherapy treatments (IGRT) of moving and deformable targets. Previously, a proof-of-concept of a flexible anthropomorphic 3D dosimeter called 'FlexyDos3D' has been demonstrated. One of the concerns with respect to the FlexyDos3D dosimeter is its dose-response instability. The effect of different formulations of the dosimeter on its stability were investigated. A stable formulation for the dosimeter was found by optimising the ratios of curing agent and base of the silicone matrix between 3% and 4.5% [w/w] curing agent. The effects of elevated curing temperatures and times upon the dosimetric properties were also investigated and the dose-response was found to be independent of curing times for curing times over an hour at 120 °C. 1H NMR spectra of the dosimeter chemical constituents and the effect of radiation dose were determined. The evaporation and diffusion rates of chloroform in the dosimeter were determined and are the likely cause of the dosimeters depth-dose profile uncertainties. A composition for a stable silicone dosimeter which can be cured quickly at elevated temperatures was found, demonstrating the potential for 3D printing of patient-specific dosimeters. However, it is suggested that another radical initiator be used in future formulations of the dosimeter.

FlexyDos3D: a deformable anthropomorphic 3D radiation dosimeter: radiation properties.

Three dimensional radiation dosimetry has received growing interest with the implementation of highly conformal radiotherapy treatments. The radiotherapy community faces new challenges with the commissioning of image guided and image gated radiotherapy treatments (IGRT) and deformable image registration software.A new three dimensional anthropomorphically shaped flexible dosimeter, further called 'FlexyDos3D', has been constructed and a new fast optical scanning method has been implemented that enables scanning of irregular shaped dosimeters. The FlexyDos3D phantom can be actuated and deformed during the actual treatment. FlexyDos3D offers the additional advantage that it is easy to fabricate, is non-toxic and can be molded in an arbitrary shape with high geometrical precision.The dosimeter formulation has been optimized in terms of dose sensitivity. The influence of the casting material and oxygen concentration has also been investigated. The radiophysical properties of this new dosimeter are discussed including stability, spatial integrity, temperature dependence of the dosimeter during radiation, readout and storage, dose rate dependence and tissue equivalence.

Characterisation of OSL and OSLN droplets for dosimetry.

In spite of considerable progress in neutron dosimetry, there is no dosemeter that is capable of measuring neutron doses independently of the neutron spectrum with good accuracy. Carbon-doped aluminium oxide (Al2O3:C) is a sensitive material for ionising radiation (beta-ray, X ray and electron) and has been used for applications in personal and medical dosimetry as an optically stimulated luminescence (OSL) dosemeter. Al2O3:C has a low sensitivity to neutron radiation; this prevents its application to neutron fields, representing a disadvantage of Al2O3:C-OSL when compared with LiF, which is used as a thermoluminescent detector. Recently an improvement for neutron dosimetry (Passmore and Kirr. Neutron response characterisation of an OSL neutron dosemeter. Radiat. Prot. Dosim. 2011; 144: 155-60) uses Al2O3:C coated with (6)Li2CO3 (OSLN),which gives the high-sensitive response as known for Al2O3:C with the advantage of being also sensitive to thermal neutrons. In this article, the authors compare small-size detectors (droplets) of Al2O3:C (OSL) and of Al2O3:C+(6)Li2CO3 (OSLN) and discuss the advantages and drawbacks of both materials, regarding size vs. response.

Flip angle optimization for dynamic contrast-enhanced MRI-studies with spoiled gradient echo pulse sequences.

Spoiled gradient echo pulse (SPGRE) sequences are commonly used in dynamic contrast-enhanced MRI (DCE-MRI) studies to measure the contrast agent concentration in a tissue of interest over time. However, due to improper tuning of the SPGRE parameters, concentration uncertainty can be very high, even at high signal-to-noise ratio in the MR measurement. In this work, an optimization procedure is proposed for selecting the optimal value of the SPGRE-flip angle FA(opt), given the expected concentration range. The optimization condition ensures that every concentration in the assumed range has the lowest possible uncertainty. By decoupling the R(1)- and R*(2)-effects caused by the presence of the contrast agent, a contour plot has been generated from which FA(opt) can be read off for any study design. Investigation of ten recent DCE-MRI studies showed that improper flip angle selection unnecessarily increases the concentration uncertainty, up to 742% and 72% on average for the typical physiological concentration ranges of 0-2 mM in tumour tissue and 0-10 mM in blood, respectively. Simulations show that the reduced noise levels on the concentration curves, observed at the optimal flip angle, effectively increase the precision of the kinetic parameters estimates (up to 82% for K(trans), 82% for ν(e) and 92% for ν(p) in the case of an individually measured arterial input function (AIF), up to 53% for K(trans), 59% for ν(e) and 67% for ν(p) in the case of a standard AIF). In vivo experiments confirm the potential of flip angle optimization to increase the reproducibility of the kinetic parameter estimates.

19F MRI oximetry: simulation of perfluorocarbon distribution impact.

In (19)F MRI oximetry, a method used to image tumour hypoxia, perfluorocarbons serve as oxygenation markers. The goal of this study is to evaluate the impact of perfluorocarbon distribution and concentration in (19)F MRI oximetry through a computer simulation. The simulation studies the correspondence between (19)F measured (pO(FNMR)(2)) and actual tissue oxygen tension (pO(2)) for several tissue perfluorocarbon distributions. For this, a Krogh tissue model is implemented which incorporates the presence of perfluorocarbons in blood and tissue. That is, in tissue the perfluorocarbons are distributed homogeneously according to Gaussian diffusion profiles, or the perfluorocarbons are concentrated in the capillary wall. Using these distributions, the oxygen tension in the simulation volume is calculated. The simulated mean oxygen tension is then compared with pO(FNMR)(2), the (19)F MRI-based measure of pO(2) and with pO(0)(2), pO(2) in the absence of perfluorocarbons. The agreement between pO(FNMR)(2) and actual pO(2) is influenced by vascular density and perfluorocarbon distribution. The presence of perfluorocarbons generally gives rise to a pO(2) increase in tissue. This effect is enhanced when perfluorocarbons are also present in blood. Only the homogeneous perfluorocarbon distribution in tissue with no perfluorocarbons in blood guarantees small deviations of pO(FNMR)(2) from pO(2). Hence, perfluorocarbon distribution in tissue and blood has a serious impact on the reliability of (19)F MRI-based measures of oxygen tension. In addition, the presence of perfluorocarbons influences the actual oxygen tension. This finding may be of great importance for further development of (19)F MRI oximetry.

Radio-physical properties of micelle leucodye 3D integrating gel dosimeters.

Recently, novel radiochromic leucodye micelle hydrogel dosimeters were introduced in the literature. In these studies, gel measured electron depth dose profiles were compared with ion chamber depth dose data, from which it was concluded that leucocrystal violet-type dosimeters were independent of dose rate. Similar conclusions were drawn for leucomalachite green-type dosimeters, only after pre-irradiating the samples to a homogeneous radiation dose. However, in our extensive study of the radio-physical properties of leucocrystal violet- and leucomalachite green-type dosimeters, a significant dose rate dependence was found. For a dose rate variation between 50 and 400 cGy min(-1), a maximum difference of 75% was found in optical dose sensitivity for the leucomalachite green-type dosimeter. Furthermore, the measured optical dose sensitivity of the leucomalachite green-type dosimeter was four times lower than the value previously reported in the literature. For the leucocrystal violet-type dosimeter, a maximum difference in optical dose sensitivity of 55% was found between 50 and 400 cGy min(-1). A modified composition of the leucomalachite green-type dosimeter is proposed. This dosimeter is composed of gelatin, sodium dodecyl sulfate, chloroform, trichloroacetic acid and leucomalachite green. The optical dose sensitivity amounted to 4.375 × 10(-5) cm(-1) cGy(-1) (dose rate 400 cGy min(-1)). No energy dependence for photon energies between 6 and 18 MV was found. No temperature dependence during readout was found notwithstanding a temperature dependence during irradiation of 1.90 cGy °C(-1) increase on a total dose of 100 cGy. The novel gel dosimeter formulation exhibits an improved spatial stability (2.45 × 10(-7) cm(2) s(-1) (= 0.088 mm(2) h(-1))) and good water/soft tissue equivalence. Nevertheless, the novel formulation was also found to have a significant, albeit reduced, dose rate dependence, as a maximum difference of 33% was found in optical dose sensitivity when the dose rate varied between 50 and 400 cGy min(-1). By pre-irradiating the novel leucomalachite green-type dosimeter to 500 cGy, the apparent difference in dose response between 200 and 400 cGy min(-1) was eliminated, similar to earlier findings. However, a dose response difference of 38% between 50 and 200 cGy min(-1) was still measured. On the basis of these experimental results it is concluded that the leucodye micelle gel dosimeter is not yet optimal for dose verifications of high precision radiation therapy treatments. This study, however, indicates that the dose rate dependence has a potential for improvement. Future research is necessary to further minimize the dose rate dependence through extensive chemical analysis and optimization of the gel formulation. Some insights into the physicochemical mechanisms were obtained and are discussed in this paper.

Polymer gel dosimetry.

Polymer gel dosimeters are fabricated from radiation sensitive chemicals which, upon irradiation, polymerize as a function of the absorbed radiation dose. These gel dosimeters, with the capacity to uniquely record the radiation dose distribution in three-dimensions (3D), have specific advantages when compared to one-dimensional dosimeters, such as ion chambers, and two-dimensional dosimeters, such as film. These advantages are particularly significant in dosimetry situations where steep dose gradients exist such as in intensity-modulated radiation therapy (IMRT) and stereotactic radiosurgery. Polymer gel dosimeters also have specific advantages for brachytherapy dosimetry. Potential dosimetry applications include those for low-energy x-rays, high-linear energy transfer (LET) and proton therapy, radionuclide and boron capture neutron therapy dosimetries. These 3D dosimeters are radiologically soft-tissue equivalent with properties that may be modified depending on the application. The 3D radiation dose distribution in polymer gel dosimeters may be imaged using magnetic resonance imaging (MRI), optical-computerized tomography (optical-CT), x-ray CT or ultrasound. The fundamental science underpinning polymer gel dosimetry is reviewed along with the various evaluation techniques. Clinical dosimetry applications of polymer gel dosimetry are also presented.

Radiological properties of the PRESAGE and PAGAT polymer dosimeters.

The radiological properties of the PRESAGE and PAGAT polymer dosimeters have been investigated and their water equivalence determined for use in radiotherapy dosimetry. The radiological water equivalence of each of the polymer dosimeters was determined by comparing the photon and electron interaction cross-sections over the 10 keV-20 MeV energy range and by Monte Carlo modelling the depth dose from a linear accelerator using the BEAMnrc software package. PRESAGE was found to have an effective Z-value and mass density (kgm(-3)) approximately 17% and 10% higher than water, respectively. A maximum difference of 85% was discovered in the photoelectric interaction probability curve of PRESAGE when compared to water over the energy range 10-100 keV, partially due to the Z(3) dependence of the photoelectric effect. The mass radiative stopping power ratios and mass scattering power ratios were both found to have less than 9% difference from water. The depth dose for PRESAGE from a 6MV photon beam had an absolute percentage difference to water of less than 2% and a relative percentage difference of less than 8%. The mass density of PAGAT was found to be 2.6% higher than water due to its high gelatine and monomer concentration. The cross-sectional attenuation and absorption coefficient ratios were found to be within 5% for energies between 10 and 100 keV and within 1% for energies between 100 keV and 20 MeV. The mass collisional stopping power, mass radiative stopping power and mass scattering power ratios were all less than 1% over the energy range studied. The depth dose had an absolute percentage difference to water of less than 1% and a relative percentage difference of less than 2.5%. These results indicate that the PAGAT polymer gel formulation is more radiological water equivalent than the PRESAGE formulation. However, the PRESAGE dosimeter offers some advantages in terms of ease of use and its lack of water equivalence may be overcome with dosimetric correction factors.

Microstructural analysis of foam by use of NMR R2 dispersion.

The spin-spin relaxation rate R2 (=1/T2) in hydrogel foams measured by use of a multiple spin echo sequence is found to be dependent on the echo time spacing. This property, referred to as R2-dispersion, originates to a large extent from molecular self-diffusion of water within internal field gradients that result from magnetic susceptibility differences between the gel and air phase. Another contribution to the R2 relaxation rate is surface relaxation. Numerical simulations are performed to investigate the relation between the foam microstructure (the mean air bubble radius and standard deviation of the air bubble radius) and foam composition properties (such as magnetic susceptibilities, diffusion coefficient and surface relaxivity) at one hand and the R2-dispersion at the other hand. The simulated R2-dispersions of gel foam are in agreement with the measured R2-dispersions. By correlating the R2-dispersion parameters and simulated microstructure properties a semi-empirical relationship is obtained that enables the mean air bubble size to be derived from measured R2-dispersion curves. The R2-derived mean air bubble size of a hydrogel foam is in agreement with the bubble size measured with X-ray micro-CT. This illustrates the feasibility of using 1H R2-dispersion measurements to determine the size of air bubbles in hydrogel foams and of alveoli in lung tissue.

The influence of cooling rate on the accuracy of normoxic polymer gel dosimeters.

Polymer gel dosimeters offer a wide range of applications in the three-dimensional verification of complex radiation dose distributions such as in intensity-modulated radiotherapy (IMRT). With the release of polymer gel dosimeters that can be fabricated in normal atmospheric ('normoxic') conditions, the gel manufacturing process has been significantly simplified. Gel dosimeters are calibrated by use of a series of calibration vials irradiated with known doses or by use of a calibration phantom with a known dose distribution. The overall accuracy of the polymer gel dosimeters is determined by different dosimetric properties. In this study, we show the influence of the temperature history during storage of the gel dosimeter on the dose response curve for two gel dosimeters using the monomers acrylamide/N,N'-methylene-bis-acrylamide (nPAG) and methacrylic acid (nMAG) respectively and bis[tetrakis(hydroxymethyl)phosphonium]sulphate (THP) as antioxidant in both gel dosimeters. This study reveals that differences in temperature history after fabrication of normoxic polymer gel dosimeters may compromise the dosimetric accuracy. It was found that the acrylamide based gel dosimeter (nPAG) is less dependent on the post-manufacture temperature history than the methacrylic acid based gel dosimeter (nMAG). The importance of an equal temperature history for the gel dosimeter and calibration vials is emphasized by this study. A reproducibility study has also been performed on the nPAG gel dosimeter when additional efforts are made to control the temperature changes upon cooling.

The fundamental radiation properties of normoxic polymer gel dosimeters: a comparison between a methacrylic acid based gel and acrylamide based gels.

Polymer gel dosimeters offer a wide range of applications in the three-dimensional verification of complex dose distributions such as in intensity-modulated radiotherapy. One of the major difficulties with polymer gel dosimeters is their sensitivity to oxygen, as oxygen inhibits the radiation-induced polymerization reaction. For several years, oxygen was removed from the gels by bubbling the sol with inert gases for several hours during the gel fabrication. Also, the gel had to be poured in containers with low oxygen permeability and solubility. Recently, it was found that these technical difficulties can easily be solved by adding an antioxidant to the gel. These gels are called 'normoxic' gels as they can be produced under normal atmospheric conditions. In this study several properties of polymer gel dosimeters have been investigated: the dose sensitivity, the temporal and spatial stability of the gel, the sensitivity of the dose response to temperature during irradiation and during MR imaging, the energy dependence and the dose-rate dependence. This study reveals that the normoxic polymer gel dosimeter based on methacrylic acid (nMAG) studied in this work has inferior radiation properties as compared to the polyacrylamide gelatine (PAG) gel dosimeters. It is shown that from the three different gel dosimeters investigated in this study, the nPAG gel dosimeter results in a less sensitive gel dosimeter but with superior radiation properties as compared to the nMAG gel dosimeter. The importance of investigating relevant radiation properties of gel dosimeters apart from the radiation sensitivity-prior to their use for dosimetric validation experiments-is illustrated and emphasized throughout this study. Other combinations of monomer and gelling agent may result in more reliable normoxic polymer gel dosimeters.

On the relation between the spatial dose integrity and the temporal instability of polymer gel dosimeters.

When irradiating a polymer gel dosimeter to relatively high doses, edge enhancing effects (overshoots) may be noticed near dose gradients, resulting in a loss of spatial dose integrity. These overshoots are believed to be a consequence of monomers diffusing into the high-dose region, where they react with long-living macroradicals. Macroradicals may also be responsible for the temporal chemical instability of post-irradiation polymerization that occurs in the polymer gel dosimeter. In this study, a mathematical model is proposed that simulates the edge enhancing effect. The model is based on the hypothesis that the macroradicals are responsible for both the temporal instability and loss of spatial dose integrity. All input parameters for the model are obtained from independent experiments. The edge enhancing effect is studied both experimentally and theoretically for polymer gel dosimeters with various gelatin concentrations. The change in the edge enhancement is also investigated over post-irradiation time. Comparisons between polymer gel measurements and simulations confirm the hypothesis that there is a strong relation between the spatial and temporal instabilities.

Validation and application of polymer gel dosimetry for the dose verification of an intensity-modulated arc therapy (IMAT) treatment.

Polymer gel dosimetry was used to assess an intensity-modulated arc therapy (IMAT) treatment for whole abdominopelvic radiotherapy. Prior to the actual dosimetry experiment, a uniformity study on an unirradiated anthropomorphic phantom was carried out. A correction was performed to minimize deviations in the R2 maps due to radiofrequency non-uniformities. In addition, compensation strategies were implemented to limit R2 deviations caused by temperature drift during scanning. Inter- and intra-slice R2 deviations in the phantom were thereby significantly reduced. This was verified in an investigative study where the same phantom was irradiated with two rectangular superimposed beams: structural deviations between gel measurements and computational results remained below 3% outside high dose gradient regions; the spatial shift in those regions was within 2.5 mm. When comparing gel measurements with computational results for the IMAT treatment, dose deviations were noted in the liver and right kidney, but the dose-volume constraints were met. Root-mean-square differences between both dose distributions were within 5% with spatial deviations not more than 2.5 mm. Dose fluctuations due to gantry angle discretization in the dose computation algorithm were particularly noticeable in the low-dose region.

The effect of water molecular self-diffusion on quantitative high-resolution MRI polymer gel dosimetry.

In polymer gel dosimetry, magnetic resonance imaging (MRI) is used to determine the spin-spin relaxation rate (R2) which in turn can be correlated with absorbed dose to provide a map of the spatial distribution of the absorbed dose in the irradiated dosimeter. High accuracy, precision and reproducibility of these dose maps are essential. Moreover, for dose verification around brachytherapy sources used for intravascular brachytherapy, a high spatial resolution is required (typically 0.01-0.1 mm). To achieve these microscopic resolutions, strong imaging gradients are applied. The Brownian motion of water molecules in the presence of these strong magnetic field gradients causes an attenuation of the MR signal. When using a multiple spin-echo sequence, this may result in a significant deviation in the measured R2. The diffusion-related change in R2 at high resolutions was investigated experimentally and correlated with predictions that were obtained numerically and algebraically. Diffusion weighting is determined by the self-diffusion coefficient D, and imaging parameters, quantified by the b-factor. The b-factor was calculated for a multiple spin-echo sequence for different gradient strengths and gradient pulse durations. The variations in R2 that were observed when changing the matrix size and slice thickness are explained. It is shown that a linear correlation between the matrix size and the variation in R2 is based on the diffusion weighting caused by the read-out gradients and slice selective gradients. In conclusion, the essence of taking into account molecular self-diffusion to quantify variations in the measured dose-R2 response when using high-resolution MRI in polymer gel dosimetry is emphasized.

Attenuation of diagnostic energy photons by polymer gel dosimeters.

Post-irradiation changes in the linear attenuation coefficient, mu, of polymer gel dosimeters give rise to a change which can be measured with x-ray computed tomography. Polymer gel dosimeters were manufactured consisting of 3% (by weight) acrylamide and 3% N,N'-methylene-bis-acrylamide comonomers dissolved in aqueous gelatin (5% gelatin by total weight and 89% de-ionized distilled water). Mu was measured in a collimated radiation beam of photons from an 241Am source. Density, rho, of polymer gel dosimeters was measured using volumetric flasks with capillary stoppers. The measured post-irradiation data of mu was plotted against the data of rho for different batches, and linear least squares fits gave r2 values of 0.99605 and 0.99953, with P values of less than 0.001. This confirms that the post-irradiation change in mu is proportional to that of rho. The change in rho implies a change in volume regardless of the evaluation modality of the polymer gel dosimeter.

A basic study of some normoxic polymer gel dosimeters.

Polymer gel dosimeters offer a wide range of potential applications in the three-dimensional verification of complex dose distribution such as in intensity-modulated radiotherapy (IMRT). Until now, however, polymer gel dosimeters have not been widely used in the clinic. One of the reasons is that they are difficult to manufacture. As the polymerization in polymer gels is inhibited by oxygen, all free oxygen has to be removed from the gels. For several years this was achieved by bubbling nitrogen through the gel solutions and by filling the phantoms in a glove box that is perfused with nitrogen. Recently another gel formulation was proposed in which oxygen is bound in a metallo-organic complex thus removing the problem of oxygen inhibition. The proposed gel consists of methacrylic acid, gelatin, ascorbic acid, hydroquinone and copper(II)sulphate and is given the acronym MAGIC gel dosimeter. These gels are fabricated under normal atmospheric conditions and are therefore called 'normoxic' gel dosimeters. In this study, a chemical analysis on the MAGIC gel was performed. The composition of the gel was varied and its radiation response was evaluated. The role of different chemicals and the reaction kinetics are discussed. It was found that ascorbic acid alone was able to bind the oxygen and can thus be used as an anti-oxidant in a polymer gel dosimeter. It was also found that the anti-oxidants N-acetyl-cysteine and tetrakis(hydroxymethyl)phosphonium were effective in scavenging the oxygen. However, the rate of oxygen scavenging is dependent on the anti-oxidant and its concentration with tetrakis(hydroxymethyl)phosphonium being the most reactive anti-oxidants. Potentiometric oxygen measurements in solution provide an easy way to get a first impression on the rate of oxygen scavenging. It is shown that cupper(II)sulphate operates as a catalyst in the oxidation of ascorbic acid. We, therefore, propose some new normoxic gel formulations that have a less complicated chemical formulation than the MAGIC gel.

Optimization of multiple spin-echo sequences for 3D polymer gel dosimetry.

The overall performance of polymer gel dosimeters for three-dimensional radiation dosimetry is determined by the temporal and spatial stability of the gels, dose sensitivity and image quality with respect to both systematic and stochastic deviations. The dose resolution (D(p)delta) is determined by the dose sensitivity and the signal-to-noise ratio (SNR) in the dose images. The dose sensitivity can be altered by changing the chemical composition of the polymer gel. The SNR is determined by the scanner and the imaging sequence. In the dose verification of conformal radiotherapy treatments the chosen number of slices may reach a number of 10-20. For these experiments, to obtain a sufficient SNR within a reasonable measurement time using a certain MR scanner, the imaging sequence should be optimized. A few other studies have emphasized the importance of optimizing the imaging sequence with respect to dose resolution (D(p)delta) or SNR but do not give quantitative values for the optimal sequence parameters for scanning a polymer gel dosimeter in three dimensions. In this paper, it is proved that a multiple spin-echo sequence is preferable to a single spin-echo sequence. It is also shown that when using a multiple spin-echo sequence it is not the inter-echo time that should be optimized but the number of echoes. An algebraical expression is derived for the dose resolution in terms of sequence parameters. A mathematical formalism and look-up tables are provided that can be used to optimize both a single and a slice-selective multiple spin-echo sequence to acquire a set of dose images at various locations. The use of the optimization protocol is illustrated by some examples. The optimization protocol enables the user to derive the optimal sequence parameters to acquire a set of dose maps obtained by quantitative T2 imaging for each polymer gel dosimeter within the shortest time possible.

Dose-response stability and integrity of the dose distribution of various polymer gel dosimeters.

In this study the stability of different polymer gel dosimeters is investigated. Further to a previous chemical stability study on a (6%T, 50%C) PAG gel, the change in slope and intercept of the linear part of the R2-dose plot is recorded with time for different gel formulations. In addition to this R2-dose-response stability study, the dose edge of a half-blocked field was recorded with time. Three different PAG type polymer gels, a hydroxyethyl acrylate (HEA) gel and two different normoxic polymer gels were investigated. In the PAG type polymer gels, the relative concentration of gelatin and comonomers was varied in order to study the influence of the different components, that constitute the dosimeter, on the stability. It is shown that the R2-dose-response stability is largely determined by the chemical composition of the gel dosimeters. All the PAG gel dosimeters and the normoxic gel dosimeters are found to preserve the integrity of the dose distribution up to 22 days after irradiation. The half-life of the change in dose sensitivity of a MAGIC gel is found to be 18 h compared to 5.7 h for a (6%T, 50%C) PAG gel. A maximum relative decrease in dose sensitivity of 21% was noted for the MAGIC gel compared to an increase of 50% for a (6%T, 50%C) PAG gel. A loss of integrity of the dose distribution was found in the HEA gel.