Multi-Institutional Study of End-to-End Dose Delivery Quality Assurance Testing for Image-Guided Brachytherapy Using a Gel Dosimeter

Tachibana, Hideki; Watanabe, Yusuke; Kurokawa, Shogo; Maeyama, Takashige; Hiroki, Tomoyuki; Ikoma, Hideaki; Hirashima, Hideaki; Kojima, Hironori; Shiinoki, Takehiro; Tanimoto, Yuuki; Shimizu, Hidetoshi; Shishido, Hajime; Oka, Yoshitaka; Hirose, Taka aki; Kinjo, Masashi; Morozumi, Takuya; Kurooka, Masahiko; Suzuki, Hidekazu; Saito, Takeyasu; Fujita, Kazuo; Shirata, Ryosuke; Inada, Ryuji; Yada, Ryuichi; Yamashita, Mikiko; Kondo, Kazuto; Hanada, Takashi; Takenaka, Tadashi; Usui, Keisuke; Okamoto, Hiroyuki; Asakura, Hiroshi; Notake, Ryoichi; Kojima, Toru; Kumazaki, Yu; Hatanaka, Shin–ichi; Nakajima, Masatoshi; Nakada, Ryosei; Suzuki, Ryusuke; Mizuno, Hideyuki; Kawamura, Shinji; Nakamura, Mistuhiro; Akimoto, Tetsuo

doi:10.1016/j.brachy.2022.06.006

Cited by 12 publications

(3 citation statements)

References 33 publications

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“…Polymer gel dosimetry was applied for treatment verification around intravascular sources [ 299 , 300 , 301 , 302 , 303 ], intracavitary brachytherapy [ 242 , 304 , 305 , 306 , 307 , 308 ] and interstitial brachytherapy [ 309 , 310 ]. As with external radiotherapy, polymer gel dosimetry was found of particular importance in end-to-end delivery quality assurance [ 311 , 312 ].…”

Section: Polymer Gel Dosimetersmentioning

confidence: 99%

Radiation Dosimetry by Use of Radiosensitive Hydrogels and Polymers: Mechanisms, State-of-the-Art and Perspective from 3D to 4D

Deene

2022

Gels

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Gel dosimetry was developed in the 1990s in response to a growing need for methods to validate the radiation dose distribution delivered to cancer patients receiving high-precision radiotherapy. Three different classes of gel dosimeters were developed and extensively studied. The first class of gel dosimeters is the Fricke gel dosimeters, which consist of a hydrogel with dissolved ferrous ions that oxidize upon exposure to ionizing radiation. The oxidation results in a change in the nuclear magnetic resonance (NMR) relaxation, which makes it possible to read out Fricke gel dosimeters by use of quantitative magnetic resonance imaging (MRI). The radiation-induced oxidation in Fricke gel dosimeters can also be visualized by adding an indicator such as xylenol orange. The second class of gel dosimeters is the radiochromic gel dosimeters, which also exhibit a color change upon irradiation but do not use a metal ion. These radiochromic gel dosimeters do not demonstrate a significant radiation-induced change in NMR properties. The third class is the polymer gel dosimeters, which contain vinyl monomers that polymerize upon irradiation. Polymer gel dosimeters are predominantly read out by quantitative MRI or X-ray CT. The accuracy of the dosimeters depends on both the physico-chemical properties of the gel dosimeters and on the readout technique. Many different gel formulations have been proposed and discussed in the scientific literature in the last three decades, and scanning methods have been optimized to achieve an acceptable accuracy for clinical dosimetry. More recently, with the introduction of the MR-Linac, which combines an MRI-scanner and a clinical linear accelerator in one, it was shown possible to acquire dose maps during radiation, but new challenges arise.

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Section: Polymer Gel Dosimetersmentioning

confidence: 99%

Radiation Dosimetry by Use of Radiosensitive Hydrogels and Polymers: Mechanisms, State-of-the-Art and Perspective from 3D to 4D

Deene

2022

Gels

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“…Since all the previous studies are largely single institution research initiatives, in this study, our goal is to provide a dual-institution validation of the PGD based on Linac integrated CBCT readout (Adamson et al 2019, Shih et al 2019, Jirasek et al 2020, Pant et al 2020, Maras and Kozicki 2022. In a broader context, few multi-institutional gel studies have been accomplished previously (Kozicki et al 2020, Tachibana et al 2022. However, there are currently no collaborative studies in the context of NIPAM gel dosimetry workflow with Linac-integrated CBCT readout technique.…”

Section: Introductionmentioning

confidence: 99%

Clinical applicability of Linac-integrated CBCT based NIPAM 3D dosimetry: a dual-institutional investigation

Kunkyab,

Lakrad,

Jirasek

et al. 2024

Phys. Med. Biol.

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Objective: To develop and benchmark a novel 3D dose verification technique consisting of polymer-gel-dosimeter (PGD) with cone-beam-CT (CBCT) readout through a two-institution study. The technique has potential for wide and robust applicability through reliance on CBCT readout.Approach: Three treatment plans (3-Field, TG119-C-shape spine, 4-target SRS) were created by two independent institutions (Institution A and B). A Varian Truebeam LINAC was used to deliver the plans to NIPAM polymer gel dosimeters produced at both institutions using an identical approach. For readout, a slow CBCT scan mode was used to acquire pre- and post-irradiation images of the gel (1 mm slice thickness). Independent gel analysis tools were used to process the PGD images (A: VistaAce software, B: in-house MATLAB code). Comparing planned and measured doses, the analysis involved a combination of 1D line profiles, 2D contour plots, and 3D global gamma maps (criteria ranging between 2%1mm and 5%2mm, with a 10% dose threshold). Main Results: For all gamma criteria tested, the 3D gamma pass rates were all above 90% for 3-field and 88% for the SRS plan. For the C-shape spine plan, we benchmarked our 2% 2mm result against previously published work using film analysis (93.4%). For 2%2mm, 99.4% (Institution A data), and 89.7% (Institution B data) were obtained based on VistaAce software analysis, 83.7% (Institution A data), and 82.9% (Institution B data) based on MATLAB. Significance: The benchmark data demonstrate that when two institutions follow the same rigorous procedures gamma passing rates up to 99%, for 2%2mm criteria can be achieved for substantively different treatment plans. The use of different software and calibration techniques may have contributed to the variation in the 3D gamma results. By sharing the data across institutions, we observe the gamma passing rate is more consistent within each pipeline, indicating the need for standardized analysis methods.

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“…To compare the actual delivered dose with the planned dose, the end-to-end (E2E) dosimetry was verified by undertaking the whole RT procedure with a polymer gel dosimeter [ 21 , 22 , 23 ]. E2E QA was investigated for intensity-modulated radiotherapy with a PAGAT gel dosimeter [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

End-to-End QA with Polymer Gel Dosimeter for Photon Beam Radiation Therapy

Zhu

Peng

et al. 2023

Gels

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With the complexity and high demands on quality assurance (QA) of photon beam radiation therapy, end-to-end (E2E) QA is necessary to validate the entire treatment workflow from pre-treatment imaging to beam delivery. A polymer gel dosimeter is a promising tool for three-dimensional (3D) dose distribution measurement. The purpose of this study is to design a fast “one delivery” polymethyl methacrylate (PMMA) phantom with a polymer gel dosimeter for the E2E QA test of the photon beam. The one delivery phantom is composed of ten calibration cuvettes for the calibration curve measurement, two 10 cm gel dosimeter inserts for the dose distribution measurement, and three 5.5 cm gel dosimeters for the square field measurement. The one delivery phantom holder is comparable in size and shape to that of a human thorax and abdomen. In addition, an anthropomorphic head phantom was employed to measure the patient-specific dose distribution of a VMAT plan. The E2E dosimetry was verified by undertaking the whole RT procedure (immobilization, CT simulation, treatment planning, phantom set-up, imaged-guided registration, and beam delivery). The calibration curve, field size, and patient-specific dose were measured with a polymer gel dosimeter. The positioning error can be mitigated with the one-delivery PMMA phantom holder. The delivered dose measured with a polymer gel dosimeter was compared with the planned dose. The gamma passing rate is 86.64% with the MAGAT-f gel dosimeter. The results ascertain the feasibility of the one delivery phantom with a polymer gel dosimeter for a photon beam in E2E QA. The QA time can be reduced with the designed one delivery phantom.

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Multi-Institutional Study of End-to-End Dose Delivery Quality Assurance Testing for Image-Guided Brachytherapy Using a Gel Dosimeter

Cited by 12 publications

References 33 publications

Radiation Dosimetry by Use of Radiosensitive Hydrogels and Polymers: Mechanisms, State-of-the-Art and Perspective from 3D to 4D

Radiation Dosimetry by Use of Radiosensitive Hydrogels and Polymers: Mechanisms, State-of-the-Art and Perspective from 3D to 4D

Clinical applicability of Linac-integrated CBCT based NIPAM 3D dosimetry: a dual-institutional investigation

End-to-End QA with Polymer Gel Dosimeter for Photon Beam Radiation Therapy

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