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Title: Measuring pacemaker dose: A clinical perspective

Abstract

Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimetermore » to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.« less

Authors:
 [1]; ;  [1]
  1. Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
22130399
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 37; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; CARDIAC PACEMAKERS; COMPUTERIZED TOMOGRAPHY; DOSEMETERS; DOSIMETRY; EFFICIENCY; ENERGY DEPENDENCE; IMAGES; IONIZATION CHAMBERS; LUMINESCENCE; MOSFET; PATIENTS; PHANTOMS; RADIATION DOSES

Citation Formats

Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org, Xiao Ying, and Harrison, Amy S.. Measuring pacemaker dose: A clinical perspective. United States: N. p., 2012. Web. doi:10.1016/J.MEDDOS.2011.06.007.
Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org, Xiao Ying, & Harrison, Amy S.. Measuring pacemaker dose: A clinical perspective. United States. doi:10.1016/J.MEDDOS.2011.06.007.
Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org, Xiao Ying, and Harrison, Amy S.. Sun . "Measuring pacemaker dose: A clinical perspective". United States. doi:10.1016/J.MEDDOS.2011.06.007.
@article{osti_22130399,
title = {Measuring pacemaker dose: A clinical perspective},
author = {Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org and Xiao Ying and Harrison, Amy S.},
abstractNote = {Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.},
doi = {10.1016/J.MEDDOS.2011.06.007},
journal = {Medical Dosimetry},
number = 2,
volume = 37,
place = {United States},
year = {Sun Jul 01 00:00:00 EDT 2012},
month = {Sun Jul 01 00:00:00 EDT 2012}
}