Evaluation of two calibration methods for MRI-based polymer gel dosimetry.

Polymer gel dosimetry (PGD) can provide three-dimensional (3D) dose data for evaluation of the dose calculation algorithms used by treatment planning systems (TPS). Although the PGD technique, particularly with MRI, is now ready for clinical applications, an accurate calibration method is vital for treatment validation in 3D. This study evaluated the single-phantom electron beam (SPE) method that used the depth-dose data of a 9 MeV electron beam. This technique was compared with the multi-vial x-ray (MVX) method that used nine small vials irradiated with various doses. We tested two regression equations, i.e., third-order polynomial and tangent functions, and two dose-normalization methods, i.e., one-point and two-point methods. These methods were evaluated using a dose distribution generated by a 3 cm × 3 cm open arc beam. We used MAGAT polymer gel manufactured in-house. We found that the SPE method required a smaller dose scaling for the dose comparison. The tangent function showed better data fitting than the polynomial function with smaller uncertainty of the estimated coefficients. We did not observe a distinct advantage of the SPE method over the MVX method for the 3D dose comparison with the test case. From this study, we infer that the SPE method with the tangent function as the regression equation and one-point dose normalization is a good calibration option for the MRI-based polymer gel dosimetry.

Three-dimensional radiation dosimetry using polymer gel and solid radiochromic polymer: From basics to clinical applications.

Accurate dose measurement tools are needed to evaluate the radiation dose delivered to patients by using modern and sophisticated radiation therapy techniques. However, the adequate tools which enable us to directly measure the dose distributions in three-dimensional (3D) space are not commonly available. One such 3D dose measurement device is the polymer-based dosimeter, which changes the material property in response to radiation. These are available in the gel form as polymer gel dosimeter (PGD) and ferrous gel dosimeter (FGD) and in the solid form as solid plastic dosimeter (SPD). Those are made of a continuous uniform medium which polymerizes upon irradiation. Hence, the intrinsic spatial resolution of those dosimeters is very high, and it is only limited by the method by which one converts the dose information recorded by the medium to the absorbed dose. The current standard methods of the dose quantification are magnetic resonance imaging, optical computed tomography, and X-ray computed tomography. In particular, magnetic resonance imaging is well established as a method for obtaining clinically relevant dosimetric data by PGD and FGD. Despite the likely possibility of doing 3D dosimetry by PGD, FGD or SPD, the tools are still lacking wider usages for clinical applications. In this review article, we summarize the current status of PGD, FGD, and SPD and discuss the issue faced by these for wider acceptance in radiation oncology clinic and propose some directions for future development.

Three-dimensional assessment of the effects of high-density embolization material on the absorbed dose in the target for Gamma Knife radiosurgery of arteriovenous malformations.

OBJECTIVE Arteriovenous malformation (AVM) is an intracranial vascular disorder. Gamma Knife radiosurgery (GKRS) is used in conjunction with intraarterial embolization to eradicate the nidus of AVMs. Clinical results indicate that patients with prior embolization tend to gain less benefit from GKRS. The authors hypothesized that this was partly caused by dosimetric deficiency. The actual dose delivered to the target may be smaller than the intended dose because of increased photon attenuation by high-density embolic materials. The authors performed a phantom-based study to quantitatively evaluate the 3D dosimetric effect of embolic material on GKRS. METHODS A 16-cm-diameter and 12-cm-long cylindrical phantom with a 16-cm-diameter hemispherical dome was printed by a 3D printer. The phantom was filled with radiologically tissue-equivalent polymer gel. To simulate AVM treatment with embolization, phantoms contained Onyx 18. The material was injected into an AVM model, which was suspended in the polymer gel. The phantom was attached to a Leksell frame by standard GK fixation method, using aluminum screws, for imaging. The phantom was scanned by a Phillips CT scanner with the standard axial-scanning protocol (120 kV and 1.5-mm slice thickness). CT-based treatment planning was performed with the GammaPlan treatment planning system (version 10.1.1). The plan was created to cover a fictitious AVM target volume near the embolization areas with eleven 8-mm shots and a prescription dose of 20 Gy to 50% isodose level. Dose distributions were computed using both tissue maximum ratio (TMR) 10 and convolution dose-calculation algorithms. These two 3D dose distributions were compared using an in-house program. Additionally, the same analysis method was applied to evaluate the dosimetric effects for 2 patients previously treated by GKRS. RESULTS The phantom-based analyses showed that the mean dose difference between TMR 10 and convolution doses of the AVM target was no larger than 6%. The difference for GKRS cases was 5%. There were small areas where a large dose difference was observed on the isodose line plots, and those differences were mostly at or in the vicinity of the embolization materials. CONCLUSIONS The results of both the phantom and patient studies showed a dose reduction no larger than 5% due to the embolization material placed near the target. Although the comparison of 3D dose distributions indicated small local effects of the embolic material, the clinical impact on the obliteration rate is expected to be small.

Polymer gel dosimetry for measuring the dose near thin high-Z materials irradiated with high energy photon beams.

PURPOSE: To investigate the feasibility of three-dimensional (3D) dose measurements near thin high-Z materials placed in a water-like medium by using a polymer gel dosimeter (PGD) when the medium was irradiated with high energy photon beams. METHODS: PGD is potentially a useful tool for this application because it can record the dose around a small object made of a high-Z material in a continuous 3D medium. In this study, the authors manufactured a methacrylic acid-based normoxic PGD, nMAG. Two 0.5 mm thick lead foils (1 × 1 cm) were placed in foil supports with 0.7 cm separation in a 1000 ml polystyrene container filled with nMAG. The authors used two foil configurations, i.e., orthogonal and parallel. In the orthogonal configuration, two foils were placed in the direction orthogonal to the beam axis. The parallel configuration had two foils arranged in parallel to the beam axis. The phantom was irradiated with an 18 MV photon beam of 5 × 5 cm field size. It was imaged with a three-Tesla (3 T) magnetic resonance imaging (MRI) scanned using the Car-Purcell-Meiboom-Gill pulse sequence. The spin-spin relaxation time (R2) to-dose calibration data were obtained by using small vials filled with nMAG and exposing to known doses. The DOSXYZnrc Monte Carlo (MC) code was used to get the expected dose distributions. More than 35 × 106 of histories were simulated so that the average error was less than 1%. An in-house matlab-based software was used to obtain the dose distributions from the measured R2 data as well as to compare the measurements and the MC predictions. The dose change due to the presence of the foils was studied by comparing the dose distributions with and without foils (or the reference). RESULTS: For the orthogonal configuration, the measured dose along the beam axis showed an increase in the upstream side of the first foil, between the foils, and on the downstream side of the second foil. The range of increased dose area was 1.1 cm in the upstream of the first foil. However, in the downstream of the second foil, it was 0.2 cm, beyond which the dose fell below the reference dose by 10%. The dose profile between the foils showed a well-like shape with the minimum dose still larger than the reference dose by 1.8%. The minimum dose point was closer to the first foil than to the second foil. For the parallel configuration, the dose between foils was the largest at the center. The increased dose area opposite to the gap between foils extended outward to 1 cm. The spatial dose distributions of PGD and MC showed the same geometrical patterns except for the points inside the foils for both orthogonal and parallel foil arrangements. CONCLUSIONS: The authors demonstrated that the nMAG PGD with MRI could be used to measure the 3D dosimetric structures at the mm-scale in the vicinity of the foil. The current study provided more accurate 3D spatial dose distribution than the previous studies. Furthermore, the measurements were validated by the MC simulation.