An investigation into the INTRABEAM miniature x‐ray source dosimetry using ionization chamber and radiochromic film measurements

Watson, Peter; Bekerat, Hamed; Papaconstadopoulos, Pavlos; Davis, Stephen D.; Seuntjens, J

doi:10.1002/mp.13059

Cited by 30 publications

(36 citation statements)

References 40 publications

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“…Static-shielded applicators also include cup or D-shaped applicators, which are pressed up against the surface of the skin, as with Zeiss INTRABEAM (Carl Zeiss Meditec AG, Jena, Germany), [50][51][52] Leipzig, or Valencia applicators (Elekta Brachytherapy, Veenendaal, the Netherlands). 35,39,43,94 Static-shielded applicators can also be pressed against the breast, as with AccuBoost (Advanced Radiation Therapy, Inc, Billerica, MA), 37,41,42,44,47 or against colorectal tissue, as with Papillon devices (Ariane, Alfreton, UK).…”

Section: Static-shielded Applicatorsmentioning

confidence: 99%

“…94 Valencia applicators are essentially the same but with the addition of a flattening filter, [97][98][99][100] whereas Zeiss applicators (INTRABEAM) use electronic brachytherapy (eBT) sources. [50][51][52] Papillon devices are similar in concept but are clinically used for colorectal cancers or occasionally conjunctival malignancies. 83 Papillon devices also have a conical opening but use eBT sources generating, on average, 50-kVp low-energy photons, and they are introduced into the rectal cavity via proctoscope with a stainless-steel casing (Fig.…”

Section: Static-shielded Applicatorsmentioning

confidence: 99%

“…After 33 months of followup, there was a 7% incidence of cataracts, moderate dry eyes, and local recurrence, with no incidence of corneal ulcer. 83 Cutaneous malignancies have been treated with Leipzig applicators for contact BT 125 since at least 1987, and more recently with Valencia [97][98][99][100] and Zeiss [50][51][52] applicators. Surgical resection has historically demonstrated lower rates of local failuredradiation techniques are typically used in cases where the patient is older or cannot tolerate surgery, where the lesion has a midface location, and in consideration of cosmetic and functional outcomes by patient preference.…”

Section: Oculocutaneous Diseasementioning

confidence: 99%

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Systematic Review of Intensity-Modulated Brachytherapy (IMBT): Static and Dynamic Techniques

Callaghan

Adams

Flynn

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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Purpose: To systematically review scientific literature on the use of intensity-modulated brachytherapy (IMBT), including static and dynamic shielding approaches, to enhance therapeutic ratio. Studies were evaluated for technique, disease site, dosimetry, applicators, dosimetric calculations, and planning algorithms. Comparisons with standard-of-care brachytherapy techniques, alternative IMBT methods, or both were performed for dose-to-target volumes, organs at risk (OARs), and treatment planning or delivery times. Methods and Materials: Inclusion criteria were any peer-reviewed journal articles on IMBT published from January 1, 1980, to January 1, 2019, on PubMed, Google Scholar, Cochrane Library, and EBSCO databases. Two independent investigators reviewed each article for inclusion and exclusion criteria and scope. Data collected on each study included technique, source or shield material, disease site, n of study (n Z number of simulated plans/treated patients), doseto-target/OARs, and planning or delivery times. This review adhered to the Preferred Reporting Items for Systemic reviews and Meta Analyses (PRISMA). Results: Database queries yielded 1734 results, which were reduced to 436 after exclusion criteria and 78 peer-reviewed journal articles after evaluation of scope. Studies per disease site were 31 for cervical; 16 for rectal; 10 for oculocutaneous; 7 for breast; 6 for prostate; and 8 for other, multiple, or no specific disease site. Eighteen studies demonstrated a significant decrease in dose to OARs (5.1%-68.2%), 11 improved treatment planning or delivery times (7.6%-99.7%), and 6 increased target coverage (18.6%-71.6%) relative to standard-of-care or alternative IMBT technique. IMBT consistently decreased dose to OAR compared with the standard of care at the cost of increased planning or delivery times. Innovations in dose calculation or planning algorithms and applicators were capable of ameliorating prolonged treatment intervals.

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Section: Static-shielded Applicatorsmentioning

confidence: 99%

Section: Static-shielded Applicatorsmentioning

confidence: 99%

Section: Oculocutaneous Diseasementioning

confidence: 99%

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Systematic Review of Intensity-Modulated Brachytherapy (IMBT): Static and Dynamic Techniques

Callaghan

Adams

Flynn

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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“…Furthermore, measurements in the first millimeters are subject to uncertainties as a layer of separation can appear at the edge of the film [34]. Films must therefore be placed perpendicular to the beam axis [35].…”

Section: Introductionmentioning

confidence: 99%

Determination of paramagnetic ferrous gel sensitivity in low energy x-ray beam produced by a miniature accelerator

et al. 2020

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The INTRABEAM Carl Zeiss Surgical system (Oberkochen, Germany) is a miniature accelerator producing low energy photons (50 keV maximum). The published dosimetric characterization of the INTRABEAM was based on detectors (radiochromic films or ionization chambers) not allowing measuring the absorbed dose in the first millimeters of the irradiated medium, where the dose is actually prescribed. This study aims at determining with Magnetic Resonance Imaging (MRI) the sensitivity of a paramagnetic gel in order to measure the dose deposit produced with the INTRABEAM from 0 to 20 mm. Although spherical applicators are mostly used with the INTRABEAM system for breast applications, this study focuses on surface applicators that are of interest for cutaneous carcinomas. The irradiations at 12 different dose levels (between 2 Gy and 50 Gy at the gel surface) were performed with the INTRA-BEAM and a 4 cm surface applicator. The gel used in this study is a new « sensitive » material. In order to compare gel sensitivity at low energy with high energy, gels were irradiated by an 18 MV photon beam produced by a Varian Clinac 2100 CD. T 2 weighted multi echo MRI sequences were performed with 16 echo times. The T 2 signal versus echo times was fitted with a mono-exponential function with 95% confidence interval. The calibration curve determined at low energy is a linear function (r 2 = 0.9893) with a sensitivity of 0.0381 s-1 .Gy-1 , a similar linear function was obtained at high energy (0.0372 s-1 .Gy-1 with r 2 = 0.9662). The calibration curve at low energy was used to draw isodose maps from the MR images. The PDD (Percent Depth Dose) determined in the gel is within 5%-1mm of the ionization chamber PDD except for one point. The dosimetric sensitivity of this new paramagnetic ferrous gel was determined with MRI measurements. It allowed measuring the dose distribution specifically in the first millimeters for an irradiation with the INTRABEAM miniature accelerator equipped with a surface applicator.

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“…Although each INTRABEAM XRS has the same design, the output and the shape of the depth–dose curve (DDC) for each XRS can vary because of manufacturing variances in the thickness of the gold x‐ray target and electron source . INTRABEAM system users commented on source‐to‐source variations using sample sizes of 2–4 XRSs, but no report has estimated the dosimetric impact to the patient resulting from these variations. Armoogun et al presented a functional inter‐source comparison of four photon radiosurgery system XRSs, the predecessor design to the current INTRABEAM 500.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the dosimetric impact of manufacturing variations for the INTRABEAM x‐ray source

Shaikh¹,

Joiner

Nalichowski

et al. 2020

J Applied Clin Med Phys

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Introduction INTRABEAM x‐ray sources (XRSs) have distinct output characteristics due to subtle variations between the ideal and manufactured products. The objective of this study is to intercompare 15 XRSs and to dosimetrically quantify the impact of manufacturing variations on the delivered dose. Methods and Materials The normality of the XRS datasets was evaluated with the Shapiro–Wilk test, the accuracy of the calibrated depth–dose curves (DDCs) was validated with ionization chamber measurements, and the shape of each DDC was evaluated using depth–dose ratios (DDRs). For 20 Gy prescribed to the spherical applicator surface, the dose was computed at 5‐mm and 10‐mm depths from the spherical applicator surface for all XRSs. Results At 5‐, 10‐, 20‐, and 30‐mm depths from the source, the coefficient of variation (CV) of the XRS output for 40 kVp was 4.4%, 2.8%, 2.0%, and 3.1% and for 50 kVp was 4.2%, 3.8%, 3.8%, and 3.4%, respectively. At a 20‐mm depth from the source, the 40‐kVp energy had a mean output in Gy/Minute = 0.36, standard deviation (SD) = 0.0072, minimum output = 0.34, and maximum output = 0.37 and a 50‐kVp energy had a mean output = 0.56, SD = 0.021, minimum output = 0.52, and maximum output = 0.60. We noted the maximum DRR values of 2.8% and 2.5% for 40 kVp and 50 kVp, respectively. For all XRSs, the maximum dosimetric effect of these variations within a 10‐mm depth of the applicator surface is ≤ 2.5%. The CV increased as depth increased and as applicator size decreased. Conclusion The American Association of Physicist in Medicine Task Group‐167 requires that the impurities in radionuclides used for brachytherapy produce ≤ 5.0% dosimetric variations. Because of differences in an XRS output and DDC, we have demonstrated the dosimetric variations within a 10‐mm depth of the applicator surface to be ≤ 2.5%.

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An investigation into the INTRABEAM miniature x‐ray source dosimetry using ionization chamber and radiochromic film measurements

Cited by 30 publications

References 40 publications

Systematic Review of Intensity-Modulated Brachytherapy (IMBT): Static and Dynamic Techniques

Systematic Review of Intensity-Modulated Brachytherapy (IMBT): Static and Dynamic Techniques

Determination of paramagnetic ferrous gel sensitivity in low energy x-ray beam produced by a miniature accelerator

Evaluation of the dosimetric impact of manufacturing variations for the INTRABEAM x‐ray source

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