Purpose This study is devoted to optimizing and characterizing the response of a multipoint plastic scintillator detector (mPSD) for application to in vivo dosimetry in high dose rate (HDR) brachytherapy. Methods An exhaustive analysis was carried out in order to obtain an optimized mPSD design that maximizes the scintillation light collection produced by the interaction of ionizing photons. More than 20 prototypes of mPSD were built and tested in order to determine the appropriate order of scintillators relative to the photodetector (distal, center, or proximal) as well as their length as a function of the scintillation light emitted. The available detecting elements are the BCF‐60, BCF‐12, and BCF‐10 scintillators (Saint Gobain Crystals, Hiram, OH, USA), separated from each other by segments of Eska GH‐4001 clear optical fibers (Mitsubishi Rayon Co., Ltd., Tokyo, Japan). The contribution of each scintillator to the total spectrum was determined by irradiations in the low energy range (<120 keV). For the best mPSD design, a numerical optimization was done in order to select the optical components [dichroic mirrors, filters, and photomultipliers tubes (PMTs)] that best match the light emission profile. Calculations were performed taking into account the measured scintillation spectrum and light yield, the manufacturer‐reported transmission and attenuation of the optical components, and the experimentally characterized PMT noise. The optimized dosimetric system was used for HDR brachytherapy measurements. The system was independently controlled from the 192Ir source via LabVIEW and read simultaneously using an NI‐DAQ board. Dose measurements as a function of distance from the source were carried out according to TG‐43U1 recommendations. The system performance was quantified in terms of signal to noise ratio (SNR) and signal to background ratio (SBR). Results For best overall light‐yield emission, it was determined that BCF‐60 should be placed at the distal position, BCF‐12 in the center, and BCF‐10 at the proximal position with respect to the photodetector. This configuration allowed for optimized light transmission through the collecting fiber and avoided inter‐scintillator excitation and self‐absorption effects. The optimal scintillator length found was of 3, 6, and 7 mm for BCF‐10, BCF‐ 12, and BCF‐60, respectively. The optimized luminescence system allowed for signal deconvolution using a multispectral approach, extracting the dose to each element while taking into account the Cerenkov stem effect. Differences between the mPSD measurements and TG‐43U1 remain below 5% in the range of 0.5 to 6.5 cm from the source. The dosimetric system can properly differentiate the scintillation signal from the background for a wide range of dose rate conditions; the SNR was found to be above 5 for dose rates above 22 mGy/s while the minimum SBR measured was 1.8 at 6 mGy/s. Conclusion Based on the spectral response at different conditions, an mPSD was constructed and optimized for HDR brachytherapy dosimetry. It is sensitive e...

Purpose High‐dose rate (HDR) and pulsed‐dose rate (PDR) brachytherapy would benefit from an independent treatment verification system to monitor treatment delivery and to detect errors in real time. This paper characterizes and provides an uncertainty budget for a detector based on a fiber‐coupled high‐Z inorganic scintillator capable of performing time‐resolved in vivo dosimetry during HDR and PDR brachytherapy. Method The detector was composed of a detector probe and an optical reader. The detector probe consisted of either a 0.5 × 0.4 × 0.4 mm3 (HDR) or a 1.0 × 0.4 × 0.4 mm3 (PDR) cuboid ZnSe:O crystal glued onto an optical‐fiber cable. The outer diameter of the detector probes was 1 mm, and fit inside standard brachytherapy catheters. The signal from the detector probe was read out at 20 Hz by a photodiode and a data acquisition device inside the optical reader. In order to construct an uncertainty budget for the detector, six characteristics were determined: (1) temperature dependence of the detector probe, (2) energy dependence as a function of the probe‐to‐source position in 2D (determined with 2 mm resolution using a robotic arm), (3) the signal‐to‐noise ratio (SNR), (4) short‐term stability over 8 h, and (5) long‐term stability of three optical readers and four probes used for in vivo monitoring in HDR and PDR treatments over 21 months (196 treatments and 189 detector calibrations, and (6) dose‐rate dependence. Results The total uncertainty of the detector at a 20 mm probe‐to‐source distance was < 5.1% and < 5.8% for the HDR and PDR versions, respectively. Regarding the above characteristics, (1) the sensitivity of the detector decreased by an average of 1.4%/°C for detector probe temperatures varying from 22 to 37°C; (2) the energy dependence of the detector was nonlinear and depended on both probe‐to‐source distance and the angle between the probe and the brachytherapy source; (3) the median SNRs were 187 and 34 at a 20 mm probe‐to‐source distance for the HDR and PDR versions, respectively (corresponding median source activities of 4.8 and 0.56 Ci, respectively); (4) the detector response varied by 0.6% in 11 identical irradiations over 8 h; (5) the sensitivity of the four detector probes decreased systematically by 0–1.2%/100 Gy of dose delivered to the probes, and random fluctuations of 4.8% in the sensitivity were observed for the three probes used in PDR and 1.9% for the probe used in HDR; and (6) the detector response was linear with dose rate. Conclusion ZnSe:O detectors can be used effectively for in vivo dosimetry and with high accuracy for HDR and PDR brachytherapy applications.

This study aims to present the performance of a multipoint plastic scintillation detector (mPSD) as a tool for real-time dose measurements (covering three orders of magnitude in dose rate), source-position triangulation, and dwell time assessment in high dose rate (HDR) brachytherapy. Methods: A previously characterized and optimized three-point sensor system was used for HDR brachytherapy measurements. The detector was composed of three scintillators: BCF60, BCF12, and BCF10. Scintillation light was transmitted through a single 1-mm-diameter clear optical fiber and read by a compact assembly of photomultiplier tubes (PMTs). Each component was numerically optimized to allow for signal deconvolution using a multispectral approach, taking care of the Cerenkov stem effect as well as extracting the dose from each scintillator. The PMTs were read simultaneously using a data acquisition board at a rate of 100 KHz and controlled with in-house software based on Python. An 192 Ir source (Flexitron, Elekta-Brachy) was remotely controlled and sent to various positions in a in-house PMMA holder, ensuring 0.1 mm positional accuracy. Dose measurements covering a range of 10 cm of source movement were carried out according to TG-43 U1 recommendations. Water measurements were performed in order to: (a) characterize the system's response in terms of angular dependence; (b) obtain the relative contribution of positioning and measurement uncertainties to the total system uncertainty; (c) assess the system's temporal resolution; and (d) track the source position in real time. The triangulation principle was applied to report the source position in three-dimensional space. Results: As expected, the positioning uncertainty dominated close to the source, whereas the measurement uncertainty dominated at larger distances. A maximum measurement uncertainty of 17 % was observed for the BCF60 scintillator at 10 cm from the source. Based on the uncertainty chain, the best compromises between positioning and measurement uncertainties were reached at 17.2, 17.4, and 17.5 mm for the BCF10, BCF12, and BCF60 scintillators, respectively, which also corresponded to the recommended optimal distances to the source for calibration purposes. The detector further exhibited no angular dependence. All dose values were found to be within 2% of the dose value at 90. In the experiments performed for source-position determination, the system provided an average location with a standard deviation under 1.7 mm. The maximum observed differences between measured and expected values were 1.82 and 1.8 mm in the x-and z-directions, respectively. Deviations between the mPSD measurements and expected TG-43 values were below 5% in all the explored measurement conditions. With regard to dwell time measurement accuracy, the maximum deviation observed at all distances was 0.56 AE 0.25 s, with a weighted average of the three scintillators below 0.33 AE 0.37 s at all distances covered in this study. Conclusions: Real-time HDR brachytherapy measurements were performed with a...

The aim of this study is to perform three-dimensional (3D) source position reconstruction by combining in vivo dosimetry measurements from two independent detector systems. Methods: Time-resolved dosimetry was performed in a water phantom during HDR brachytherapy irradiation with 192 Ir source using two detector systems. The first was based on three plastic scintillator detectors and the second on a single inorganic crystal (CsI:Tl). Brachytherapy treatments were simulated in water under TG-43U1 conditions, including a HDR prostate plan. Treatment needles were placed in distances covering a range of source movement of 120 mm around the detectors. The distance from each dwell position to each scintillator was determined based on the measured dose rates. The three distances given by the mPSD were recalculated to a position along the catheter (z) and a distance radially away from the mPSD (xy) for each dwell position (a circumference around the mPSD). The source x, y, and z coordinates were derived from the intersection of the mPSD's circumference with the sphere around the ISD based on the distance to this detector. We evaluated the accuracy of the source position reconstruction as a function of the distance to the source, the most likely location for detector positioning within a prostate volume, as well as the capacity to detect positioning errors.Results: Approximately 4000 source dwell positions were tracked for eight different HDR plans. An intersection of the mPSD torus and the ISD sphere was observed in 77.2% of the dwell positions, assuming no uncertainty in the dose rate determined distance. This increased to 100% if 1σ search regions were added. However, only 73(96)% of the expected dwell positions were found within the intersection band for 1(2) σ uncertainties. The agreement between the source's reconstructed and expected positions was within 3 mm for a range of distances to the source up to 50 mm. The experiments on a HDR prostate plan, showed that by having at least one of the detectors located in the middle of the prostate volume, reduces the measurement deviations considerably compared to scenarios where the detectors were located outside of the prostate volume. The analysis showed a detection probability that, in most cases, is far from the random detection threshold. Errors of 1(2) mm can be detected in ranges of 5-25 (25-50) mm from the source, with a true detection probability rate higher than 80%, while the false probability rate is kept below 20%. Conclusions: By combining two detector responses, we enabled the determination of the absolute source coordinates. The combination of the mPSD and the ISD in vivo dosimetry constitutes a promising alternative for real-time 3D source tracking in HDR brachytherapy.

Purpose: A prototype 169 Yb source was developed in combination with a dynamic rotating platinum shield system (AIM-Brachy) to deliver intensity modulated brachytherapy (IMBT). The purpose of this study was to evaluate the dosimetric characteristics of the bare/shielded 169 Yb source using Monte Carlo (MC) simulations and perform an independent dose verification using a dosimetry platform based on a multipoint plastic scintillator detector (mPSD). Methods: The TG-43U1 dosimetric parameters were calculated for the source model using Rapid-BrachyMCTPS. Real-time dose rate measurements were performed in a water tank for both the bare/ shielded source using a custom remote afterloader. For each dwell position, the dose rate was independently measured by the three scintillators (BCF-10, BCF-12, and BCF-60). For the bare source, dose rate was measured at distances up to 3 cm away from the source over a range of 7 cm along the catheter. For the shielded source, measurements were performed with the mPSD placed at 1 cm from the source at four different azimuthal angles (0 , 90 , 180 , and 270). Results: The dosimetric parameters were tabulated for the source model. For the bare source, differences between measured and calculated along-away dose rates were generally below 5-10%. Along the transverse axis, deviations were, on average (range), 3.3% (0.6-6.2%) for BCF-10, 1.7% (0.9-2.9%) for BCF-12, and 2.2% (0.3-4.4%) for BCF-60. The maximum dose rate reduction due to shielding at a radial distance of 1 cm was 88.8 AE 1.2%, compared to 83.5 AE 0.5% as calculated by MC. Conclusions: The dose distribution for the bare/shielded 169 Yb source was independently verified using mPSD with good agreement in regions close to the source. The 169 Yb source coupled with the partial-shielding system is an effective technique to deliver IMBT.