IGRT induced dose burden for a variety of imaging protocols at two different anatomical sites

Radiochromic film based dosimetry of image‐guidance procedures on different radiotherapy modalities

“…However, the increased imaging sessions associated with IGRT posed questions about the amount of concomitant dose burden 4 , 5 . The American Association of Physicists in Medicine (AAPM) Task Group 75 has differentiated between the management of imaging dose from IGRT and doses received from diagnostic radiology exams because IGRT doses could be optimized within treatment regimen 6 , 7 .…”

“…The American Association of Physicists in Medicine (AAPM) Task Group 75 has differentiated between the management of imaging dose from IGRT and doses received from diagnostic radiology exams because IGRT doses could be optimized within treatment regimen 6 , 7 . The importance of imaging dose management in IGRT stems not only from concepts such as ALARA (as low as reasonably achievable), but it also constitutes a risk of stochastic effects outside the primary treatment area which is in parallel to risks arising from linear accelerator head leakage and scatter (4) . Furthermore, realization of this risk becomes especially important in the course of whole treatment when one considers possibility of approaching deterministic effects borderlines from increased dose to organs at risk 4 , 8 …”

“…The importance of imaging dose management in IGRT stems not only from concepts such as ALARA (as low as reasonably achievable), but it also constitutes a risk of stochastic effects outside the primary treatment area which is in parallel to risks arising from linear accelerator head leakage and scatter (4) . Furthermore, realization of this risk becomes especially important in the course of whole treatment when one considers possibility of approaching deterministic effects borderlines from increased dose to organs at risk 4 , 8 …”

“…This includes point dosimeters such as ionization chambers, 9 , 10 , 11 thermoluminscent detectors (TLD), 4 , 7 , 12 MOSFETs, (9) optically stimulated luminescence dosimeters (OSLD), (13) radiochromic films used as either point dosimeters 13 , 14 or as 2D dosimeters, 15 , 16 as well as Monte Carlo (MC) simulations 5 , 8 , 17 . Most of the aforementioned studies reported doses measured to the head, chest, and pelvic regions in phantoms, 4 , 5 , 8 , 9 , 10 , 13 , 15 , 17 , 18 , 19 , 20 and only few in selected patients 9 , 11 , 18 …”

“…To the best of our knowledge, all studies found in the literature reported either point doses using a single imaging tool 8 , 9 , 10 , 14 , 17 (or different imaging tools 4 , 5 , 11 , 13 ), or 2D profiles of a single imaging tool 12 , 15 , 16 . The only study that compared different patient profiles from multiple imaging tools using the same dosimetry method was the recent MC simulations by Ding and Munro (5) where they compared imaging doses from kV CBCT, orthogonal kV radiographs, and MV portal images.…”