In vivo dosimetry in low-voltage IORT breast treatments with XR-RV3 radiochromic film

Lozares, S.; Font, José A.; Gandía, A.; Campos, Arantxa; Flamarique, S.; Ibáñez, Reyes; Villa, D.; Alba, V.; Jiménez, S.; Hernández, Mónica; Casamayor, Carmen; Vicente, Isabel Martínez de San; Hernando, E. Molina; Rubio, Pedro Luis Sorribas

doi:10.1016/j.ejmp.2020.12.011

Cited by 10 publications

(10 citation statements)

References 50 publications

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“…Gafchromic films in kV energy beams often give rise to the question of energy dependence, both with respect to the megavoltage beams (e.g., 6 MV–15 MV photon beam) and the beam hardening effect. 15 , 19 , 20 , 30 , 31 Monte Carlo simulations by Moradi et al had shown that the 50 kV beam hardens with the use of spherical applicators and distance from the tip of the XRS source. 32 …”

Section: Discussionmentioning

confidence: 99%

“…Gafchromic films in kV energy beams often give rise to the question of energy dependence, both with respect to the megavoltage beams (e.g., 6 MV-15 MV photon beam) and the beam hardening effect. 15,19,20,30,31 Monte Carlo simulations by Moradi et al had shown that the 50 kV beam hardens with the use of spherical applicators and distance from the tip of the XRS source. 32 The energy dependence of Gafchromic films also varied with different types, generally categorized by the radiology films (XR-series) and the radiotherapy films (EBT-series).…”

Section: Ebt3 Film Dosimetrymentioning

confidence: 99%

“…32 The energy dependence of Gafchromic films also varied with different types, generally categorized by the radiology films (XR-series) and the radiotherapy films (EBT-series). 15,19,20,30,31 Most studies compared the energy dependence of the film at kV beams to megavoltage beams, reporting a large energy dependence of up to 11%-20%. 19,20 In radiotherapy, calibration was typically carried out using megavoltage beams, whereby Compton scattering dominates the photon interaction.…”

Section: Ebt3 Film Dosimetrymentioning

confidence: 99%

“…Several groups have attempted to measure in vivo skin dose using different radiation dosimeters, such as thermoluminescent dosimeters (TLD), radiochromic film, and optically stimulated luminescent dosimeter (OSLD). 12 , 13 , 14 , 15 However, due to variability in the type of dosimeter used and measured positions, a direct comparison between studies was difficult to evaluate. Radiochromic films such as Gafchromic EBT3 films are tissue equivalent and is the only dosimeter that can provide 2D dosimetric information.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Wong

Zaili

Malik

et al. 2021

J Applied Clin Med Phys

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This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation-induced skin toxicity.Methodology: A total of 21 breast cancer patients who underwent breastconserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid-term skin toxicities were evaluated at 3 and 6 months post-IORT. Results:The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post-IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post-IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose. Conclusion:EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient-specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.

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Section: Discussionmentioning

confidence: 99%

Section: Ebt3 Film Dosimetrymentioning

confidence: 99%

Section: Ebt3 Film Dosimetrymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Wong

Zaili

Malik

et al. 2021

J Applied Clin Med Phys

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“…However, they under-respond to photon energies lower than 100 keV 8 , and exhibit LET dependence for protons. 10 In kV X-rays applications, such as dose measurements in interventional radiology or IORT 11 , XR-RV3 films should be used instead. In the energy range of these applications, films are strongly energy dependent and should be calibrated for each energy in use.…”

Section: Radiochr Omic Filmsmentioning

confidence: 99%

A protocol for accurate radiochromic film dosimetry using Radiochromic.com

Méndez

Rovira-Escutia²,

Casar

2021

Radiology and Oncology

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Background Radiochromic films have many applications in radiology and radiation therapy. Generally, the dosimetry system for radiochromic film dosimetry is composed of radiochromic films, flatbed scanner, and film analysis software. The purpose of this work is to present the effectiveness of a protocol for accurate radiochromic film dosimetry using Radiochromic.com as software for film analysis. Materials and methods Procedures for image acquisition, lot calibration, and dose calculation are explained and analyzed. Radiochromic.com enables state-of-the-art models and corrections for radiochromic film dosimetry, such as the Multigaussian model for multichannel film dosimetry, and lateral, inter-scan, and re-calibration corrections of the response. Results The protocol presented here provides accurate dose results by mitigating the sources of uncertainty that affect radiochromic film dosimetry. Conclusions Appropriate procedures for film and scanner handling in combination with Radiochromic.com as software for film analysis make easy and accurate radiochromic film dosimetry feasible.

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Intraoperative radiation therapy with 50 kV x‐rays: A multi‐institutional review

Sethi,

Gros,

Brodin

et al. 2024

J Applied Clin Med Phys

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This report covers clinical implementation of a low kV intraoperative radiation therapy (IORT) program with the INTRABEAM® System (Carl Zeiss Meditec AG, Jena, Germany). Based on collective user experience from eight institutions, we discuss best methods of INTRABEAM quality assurance (QA) tests, commissioning measurements, clinical workflow, treatment planning, and potential avenues for research. The guide provides pertinent background information and clinical justification for IORT. It describes the INTRABEAM system and commissioning measurements along with a TG100 risk management analysis to ensure safety and accuracy of the IORT program. Following safety checks, dosimetry measurements are performed for verification of field flatness and symmetry, x‐ray output, and depth dose. Also discussed are dose linearity checks, beam isotropy, ion chamber measurements, calibration protocols, and in‐vivo dosimetry with optically stimulated luminescence dosimeters OSLDs, and radiochromic film. Emphasis is placed on the importance of routine QA procedures (daily, monthly, and annual) performed at regular intervals for a successful IORT program. For safe and accurate dose delivery, tests of important components of IORT clinical workflow are emphasized, such as, dose prescription, pre‐treatment QA, treatment setup, safety checks, radiation surveys, and independent checks of delivered dose. Challenges associated with in‐vivo dose measurements are discussed, along with special treatment procedures and shielding requirements. The importance of treatment planning in IORT is reviewed with reference to a Monte Carlo‐based commercial treatment planning system highlighting its main features and limitations. The report concludes with suggested topics for research including CT‐based image‐guided treatment planning and improved prescription dose accuracy. We hope that this multi‐institutional report will serve as a guidance document on the clinical implementation and use of INTRABEAM IORT.

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In vivo dosimetry in low-voltage IORT breast treatments with XR-RV3 radiochromic film

Cited by 10 publications

References 50 publications

Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

A protocol for accurate radiochromic film dosimetry using Radiochromic.com

Intraoperative radiation therapy with 50 kV x‐rays: A multi‐institutional review

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