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Title: SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy

Abstract

Purpose: Optically-stimulated luminescent dosimeters (OSLDs) are increasingly utilized for in vivo dosimetry of complex radiation delivery techniques. Measured doses, however, underestimate planned doses for plans that utilize thermoplastic mask immobilization. The purpose of this work was to quantify the effect of beam obliquity and air gap span between the mask and backscatter material, on measured-to-planned OSLD dose agreement. Methods: A previously-used thermoplastic mask was cut, reheated, and flattened to form a 33 by 9 cm{sup 2} stage approximately 2 mm thick. Two OSLDs were placed on the stage on 5 cm of solid water, covered with 50 by 50 by 5 mm{sup 3} square of bolus, and scanned in the CT simulator. Plans were created with 10 by 10 cm{sup 2} open fields using 4, 6, 10, and 15 MV photon beams at 0°, 45°, and 90° incidence. The isocenter was placed between the OSLDs at 5 mm depth. Dose was calculated and averaged for two OSLDs. Artificial air gaps of 3, 5, 10, and 20 mm were introduced in the plan and dose was recalculated for each energy/angle/gap combination. The experimental setup was replicated on a linear accelerator and air gaps were introduced by “bridging” the thermoplastic stage acrossmore » solid water plastic of varying thickness. Fields were delivered as planned. OSLDs were read 12–15 hours after irradiation. Results: Measured-toplanned percent differences were constant with increasing gap thickness for 0° and 45° beam angles. At 90° and 0 cm gap, planned dose underestimated measured dose by 10–23% for all energies. This discrepancy decreased linearly to 0% with a 20 mm gap. OSLD signal did not decrease more than 6% for any gap span and energy. Conclusion: With the exception of parallel beam incidence, beam obliquity and air gap thickness did not have a substantial effect on measured-to-planned dose agreement.« less

Authors:
;  [1];  [2]
  1. Northwell Health, Lake Success, NY (United States)
  2. Hofstra University, Hempstead, NY (United States)
Publication Date:
OSTI Identifier:
22648925
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
07 ISOTOPES AND RADIATION SOURCES; AIR; DOSIMETRY; LINEAR ACCELERATORS; LUMINESCENCE; PHOTON BEAMS; THERMOPLASTICS; THICKNESS

Citation Formats

Riegel, A, Klein, E, and Sea, P. SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy. United States: N. p., 2016. Web. doi:10.1118/1.4956504.
Riegel, A, Klein, E, & Sea, P. SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy. United States. doi:10.1118/1.4956504.
Riegel, A, Klein, E, and Sea, P. Wed . "SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy". United States. doi:10.1118/1.4956504.
@article{osti_22648925,
title = {SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy},
author = {Riegel, A and Klein, E and Sea, P},
abstractNote = {Purpose: Optically-stimulated luminescent dosimeters (OSLDs) are increasingly utilized for in vivo dosimetry of complex radiation delivery techniques. Measured doses, however, underestimate planned doses for plans that utilize thermoplastic mask immobilization. The purpose of this work was to quantify the effect of beam obliquity and air gap span between the mask and backscatter material, on measured-to-planned OSLD dose agreement. Methods: A previously-used thermoplastic mask was cut, reheated, and flattened to form a 33 by 9 cm{sup 2} stage approximately 2 mm thick. Two OSLDs were placed on the stage on 5 cm of solid water, covered with 50 by 50 by 5 mm{sup 3} square of bolus, and scanned in the CT simulator. Plans were created with 10 by 10 cm{sup 2} open fields using 4, 6, 10, and 15 MV photon beams at 0°, 45°, and 90° incidence. The isocenter was placed between the OSLDs at 5 mm depth. Dose was calculated and averaged for two OSLDs. Artificial air gaps of 3, 5, 10, and 20 mm were introduced in the plan and dose was recalculated for each energy/angle/gap combination. The experimental setup was replicated on a linear accelerator and air gaps were introduced by “bridging” the thermoplastic stage across solid water plastic of varying thickness. Fields were delivered as planned. OSLDs were read 12–15 hours after irradiation. Results: Measured-toplanned percent differences were constant with increasing gap thickness for 0° and 45° beam angles. At 90° and 0 cm gap, planned dose underestimated measured dose by 10–23% for all energies. This discrepancy decreased linearly to 0% with a 20 mm gap. OSLD signal did not decrease more than 6% for any gap span and energy. Conclusion: With the exception of parallel beam incidence, beam obliquity and air gap thickness did not have a substantial effect on measured-to-planned dose agreement.},
doi = {10.1118/1.4956504},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: Optically-stimulated luminescent dosimeters (OSLDs) are increasingly utilized for in vivo dosimetry of complex radiation delivery techniques such as intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). Evaluation of clinical uncertainties such as placement error has not been performed. This work retrospectively investigates the magnitude of placement error using conebeam computed tomography (CBCT) and its effect on measured/planned dose agreement. Methods: Each OSLD was placed at a physicist-designated location on the patient surface on a weekly basis. The location was given in terms of a gantry angle and two-dimensional offset from central axis. The OSLDs were placed before dailymore » image guidance. We identified 77 CBCTs from 25 head-and-neck patients who received IMRT or VMAT, where OSLDs were visible on the CT image. Grossly misplaced OSLDs were excluded (e.g. wrong laterality). CBCTs were registered with the treatment plan and the distance between the planned and actual OSLD location was calculated in two dimensions in the beam’s eye view. Distances were correlated with measured/planned dose percent differences. Results: OSLDs were grossly misplaced for 5 CBCTs (6.4%). For the remaining 72 CBCTs, average placement error was 7.0±6.0 mm. These errors were not correlated with measured/planned dose percent differences (R{sup 2}=0.0153). Generalizing the dosimetric effect of placement errors may be unreliable. Conclusion: Correct placement of OSLDs for IMRT and VMAT treatments is critical to accurate and precise in vivo dosimetry. Small placement errors could produce large disagreement between measured and planned dose. Further work includes expansion to other treatment sites, examination of planned dose at the actual point of OSLD placement, and the influence of imageguided shifts on measured/planned dose agreement.« less
  • Purpose: To assess and report the in vivo dose for a patient with a pacemaker being treated in left breast intraoperative radiation therapy (IORT). The ZEISS Intrabeam 50 kVp X-ray beam with a spherical applicator was used. Methods: The optically stimulated luminescent dosimeters (OSLDs) (Landauer nanoDots) were employed and calibrated under the conditions of the Intrabeam 50 kVp X-rays. The nanoDots were placed on the patient at approximately 15 cm away from the lumpectomy cavity both under and above a shield of lead equivalence 0.25 mm (RayShield X-Drape D-110) covering the pacemaker area during IORT with a 5 cm sphericalmore » applicator. Results: The skin surface dose near the pacemaker during the IORT with a prescription of 20 Gy was measured as 4.0±0.8 cGy. The dose behind the shield was 0.06±0.01 Gy, demonstrating more than 98% dose reduction. The in vivo skin surface doses during a typical breast IORT at a 4.5 cm spherical applicator surface were further measured at 5, 10, 15, and 20 cm away to be 159±11 cGy, 15±1 cGy, 6.6±0.5 cGy, and 1.8±0.1 cGy, respectively. A power law fit to the dose versus the distance z from the applicator surface yields the dose fall off at the skin surface following z^-2.5, which can be used to estimate skin doses in future cases. The comparison to an extrapolation of depth dose in water reveals an underestimate of far field dose using the manufactory provided data. Conclusion: The study suggests the appropriateness of OSLD as an in vivo skin dosimeter in IORT using the Intrabeam system in a wide dose range. The pacemaker dose measured during the left breast IORT was within a safe limit.« less
  • Purpose: The objective of this work is to test the premise that luminescence materials with less under-response to proton beams can be identified by testing their dose response to low-LET radiation. The goal is to develop new Optically Stimulated Luminescence (OSL) materials with improved response for proton therapy dosimetry. Methods: We first measured the dose response of new OSL materials, synthesized in our laboratory, to low-LET radiation (beta rays from a {sup 90}Sr/{sup 90}Y source) and selected two materials having different OSL saturation characteristics and good dosimetric properties, namely MgB4O7:Ce,Li and MgO:Li. Commercial Al2O3:C was also used for comparison. Thesemore » materials were then irradiated at several depths along a pristine proton beam. The luminescence responses of the materials, relative to the entrance response, were compared with the depth dose profile measured by a multiple-layer ion chamber. Results: The OSL signals of MgB4O7:Ce,Li and MgO:Li were characterized for signal stability, dose response, and response to a clinical proton beam. The materials were also compared with the commercial Al2O3:C. The signals from both MgB4O7:Ce,Li and MgO:Li were relatively stable after a one day delay following irradiation. The low-LET dose response of the materials showed that, over the dose range investigated (up to ∼800 Gy), MgB4O7:Ce,Li did not saturate, whereas MgO:Li and Al2O3:C saturated at doses of ∼100 Gy. MgB4O7:Ce,Li showed less underresponse to proton beams than MgO:Li and Al2O3:C. Conclusion: In general the material with the highest saturation doses for low-LET radiation (MgB4O7:Ce,Li) showed the least under-response to proton beams, which suggests that it may be possible to develop better OSL materials for proton dosimetry if the dose response can be controlled during synthesis. Nevertheless, the degree in which the response to proton beams can be controlled remains to be determined. The research is funded by the Oklahoma Center for the Advancement of Science and Technology (OCAST), project number HR12-055.« less
  • Purpose: A sufficient amount of ionizing radiation can cause failure to components of pacemakers. Studies have shown that permanent damage can occur after a dose of 10 Gy and minor damage to functionality occurs at doses as low as 2 Gy. Optically stimulated thermoluminescent dosimeters (OSLDs) can be used as in vivo dosimeters to predict dose to be deposited throughout the treatment. The purpose of this work is to determine the effectiveness of using OSLDs for in vivo dosimetry of pacemaker dose. Methods: As part of a clinical in vivo dosimetry experience, OSLDs were placed at the site of themore » pacemaker by the therapist for one fraction of the radiation treatment. OSLD measurements were extrapolated to the total dose to be received by the pacemaker during treatment. A total of 79 measurements were collected from November 2011 to December 2013 on six linacs. Sixty-six (66) patients treated in various anatomical sites had the dose of their pacemakers monitored. Results: Of the 79 measurements recorded, 76 measurements (96 %) were below 2 Gy. The mean and standard deviation were 50.12 ± 76.41 cGy. Of the 3 measurements that exceeded 2 Gy, 2 measurements matched the dose predicted in the treatment plan and 1 was repeated after an unexpectedly high Result. The repeated measurement yielded a total dose less than 2 Gy. Conclusion: This analysis suggests OSLDs may be used for in vivo monitoring of pacemaker dose. Further research should be performed to assess the effect of increased backscatter from the pacemaker device.« less
  • Purpose: For external beam in vivo measurements, the dosimeter is normally placed on the patient's skin, and the dose to a point of interest inside the patient is derived from surface measurements. In order to obtain accurate and reliable measurements, which correlate with the dose values predicted by a treatment planning system, a dosimeter needs to be at a point of electronic equilibrium. This equilibrium is accomplished by adding material (buildup) above the detector. This paper examines the use of buildup caps in a clinical setting for two common detector types: OSLDs and diodes. Clinically built buildup-caps and commercially availablemore » hemispherical caps are investigated. The effects of buildup cap thickness and fabrication material on field-size correction factors, C{sub FS}, are reported, and differences between the effects of thickness and fabrication material are explained based on physical parameters. Methods: Measurements are made on solid water phantoms for 6 and 15 MV x-ray beams. Two types of dosimeters are used: OSLDs, InLight/OSL Nanodot dosimeters (Landauer, Inc., Glenwood, IL) and a P-type surface diode (Standard Imaging, Madison, WI). Buildup caps for these detectors were fabricated out of M3, a water-equivalent material, and sheet-metal stock of Al, Cu, and Pb. Also, commercially available hemispherical buildup caps made of plastic water and brass (Landauer, Inc., Glenwood, IL) were used with Nanodots. OSLDs were read with an InLight microStar reader (Landauer, Inc., Glenwood, IL). Dose calculations were carried out with the XiO treatment planning system (CMS/Elekta, Stockholm) with tissue heterogeneity corrections. Results: For OSLDs and diodes, when measurements are made with no buildup cap a change in C{sub FS} of 200% occurs for a field-size change from 3 cm x 3 cm to 30 cm x 30 cm. The change in C{sub FS} is reduced to about 4% when a buildup cap with wall thickness equal to the depth of maximum dose is used. Buildup caps with larger wall thickness do not cause further reduction in C{sub FS}. The buildup cap fabrication material has little or no effect on C{sub FS}. The perturbation to the delivered dose caused by placing a detector with a buildup cap on the surface of a patient is measured to be 4%-7%. A comparison between calculated dose and dose measured with a Nanodot and a diode for 6 and 15 MV x-rays is made. When C{sub FS} factors are carefully determined and applied to measurements made on a phantom, the differences between measured and calculated doses were found to be between {+-}1.3%. Conclusions: OSLDs and diodes with appropriate buildup caps can be used to measure dose on the surface of a patient and predict the delivered dose to depth dmax in a range of {+-}1.3% for 100 cGy. The buildup cap: can be fabricated from any material examined in this work, is best with wall thickness dmax, and causes a perturbation to the delivered dose of 4%-7% when the wall thickness is dmax. OSLDs and diodes with buildup caps can both give accurate measurements of delivered dose.« less