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Title: SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning

Abstract

Purpose: Accuracy of positioning, timing and activity is of critical importance for High Dose Rate (HDR) brachytherapy delivery. Respective measurements via film autoradiography, stop-watches and well chambers can be cumbersome, crude or lack dynamic source evaluation capabilities. To address such limitations, a single device radioluminescent detection system enabling automated real-time quantification of activity, position and timing accuracy is presented and experimentally evaluated. Methods: A radioluminescent sheet was fabricated by mixing Gd?O?S:Tb with PDMS and incorporated into a 3D printed device where it was fixated below a CMOS digital camera. An Ir-192 HDR source (VS2000, VariSource iX) with an effective active length of 5 mm was introduced using a 17-gauge stainless steel needle below the sheet. Pixel intensity values for determining activity were taken from an ROI centered on the source location. A calibration curve relating intensity values to activity was generated and used to evaluate automated activity determination with data gathered over 6 weeks. Positioning measurements were performed by integrating images for an entire delivery and fitting peaks to the resulting profile. Timing measurements were performed by evaluating source location and timestamps from individual images. Results: Average predicted activity error over 6 weeks was .35 ± .5%. The distance betweenmore » four dwell positions was determined by the automated system to be 1.99 ± .02 cm. The result from autoradiography was 2.00 ± .03 cm. The system achieved a time resolution of 10 msec and determined the dwell time to be 1.01 sec ± .02 sec. Conclusion: The system was able to successfully perform automated detection of activity, positioning and timing concurrently under a single setup. Relative to radiochromic and radiographic film-based autoradiography, which can only provide a static evaluation positioning, optical detection of temporary radiation induced luminescence enables dynamic detection of position enabling automated quantification of timing with millisecond accuracy.« less

Authors:
; ;  [1]
  1. Stanford University, Stanford, CA (United States)
Publication Date:
OSTI Identifier:
22649245
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:
61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; ACCURACY; AUTORADIOGRAPHY; BRACHYTHERAPY; DOSE RATES; EQUIPMENT; EVALUATION; IMAGES; IRIDIUM 192; POSITIONING; QUALITY ASSURANCE; RADIOLUMINESCENCE; TIME RESOLUTION

Citation Formats

Jenkins, C, Xing, L, and Fahimian, B. SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning. United States: N. p., 2016. Web. doi:10.1118/1.4956876.
Jenkins, C, Xing, L, & Fahimian, B. SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning. United States. doi:10.1118/1.4956876.
Jenkins, C, Xing, L, and Fahimian, B. 2016. "SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning". United States. doi:10.1118/1.4956876.
@article{osti_22649245,
title = {SU-G-201-03: Automation of High Dose Rate Brachytherapy Quality Assurance: Development of a Radioluminescent Detection System for Simultaneous Detection of Activity, Timing, and Positioning},
author = {Jenkins, C and Xing, L and Fahimian, B},
abstractNote = {Purpose: Accuracy of positioning, timing and activity is of critical importance for High Dose Rate (HDR) brachytherapy delivery. Respective measurements via film autoradiography, stop-watches and well chambers can be cumbersome, crude or lack dynamic source evaluation capabilities. To address such limitations, a single device radioluminescent detection system enabling automated real-time quantification of activity, position and timing accuracy is presented and experimentally evaluated. Methods: A radioluminescent sheet was fabricated by mixing Gd?O?S:Tb with PDMS and incorporated into a 3D printed device where it was fixated below a CMOS digital camera. An Ir-192 HDR source (VS2000, VariSource iX) with an effective active length of 5 mm was introduced using a 17-gauge stainless steel needle below the sheet. Pixel intensity values for determining activity were taken from an ROI centered on the source location. A calibration curve relating intensity values to activity was generated and used to evaluate automated activity determination with data gathered over 6 weeks. Positioning measurements were performed by integrating images for an entire delivery and fitting peaks to the resulting profile. Timing measurements were performed by evaluating source location and timestamps from individual images. Results: Average predicted activity error over 6 weeks was .35 ± .5%. The distance between four dwell positions was determined by the automated system to be 1.99 ± .02 cm. The result from autoradiography was 2.00 ± .03 cm. The system achieved a time resolution of 10 msec and determined the dwell time to be 1.01 sec ± .02 sec. Conclusion: The system was able to successfully perform automated detection of activity, positioning and timing concurrently under a single setup. Relative to radiochromic and radiographic film-based autoradiography, which can only provide a static evaluation positioning, optical detection of temporary radiation induced luminescence enables dynamic detection of position enabling automated quantification of timing with millisecond accuracy.},
doi = {10.1118/1.4956876},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: The purpose of this work was to develop a quality assurance (QA) system for high dose rate (HDR) brachytherapy to verify the absolute position of an 192Ir source in real time and to measure dwell time and position of the source simultaneously with a movie recorded by a web camera. Methods: A web camera was fixed 15 cm above a source position check ruler to monitor and record 30 samples of the source position per second over a range of 8.0 cm, from 1425 mm to 1505 mm. Each frame had a matrix size of 480×640 in the movie.more » The source position was automatically quantified from the movie using in-house software (built with LabVIEW) that applied a template-matching technique. The source edge detected by the software on each frame was corrected to reduce position errors induced by incident light from an oblique direction. The dwell time was calculated by differential processing to displacement of the source. The performance of this QA system was illustrated by recording simple plans and comparing the measured dwell positions and time with the planned parameters. Results: This QA system allowed verification of the absolute position of the source in real time. The mean difference between automatic and manual detection of the source edge was 0.04 ± 0.04 mm. Absolute position error can be determined within an accuracy of 1.0 mm at dwell points of 1430, 1440, 1450, 1460, 1470, 1480, 1490, and 1500 mm, in three step sizes and dwell time errors, with an accuracy of 0.1% in more than 10.0 sec of planned time. The mean step size error was 0.1 ± 0.1 mm for a step size of 10.0 mm. Conclusion: This QA system provides quick verifications of the dwell position and time, with high accuracy, for HDR brachytherapy. This work was supported by the Japan Society for the Promotion of Science Core-to-Core program (No. 23003)« less
  • This article describes apparatus for quickly checking the positioning and dwell times of a high-dose-rate (HDR) afterloader as part of daily quality assurance (QA). A groove was milled into an aluminum plate to align an HDR applicator, and fluorescent screens were placed on either side of the groove. Lines were drawn at the fluorescent screen corresponding to distances to which the radioactive source should travel in our daily QA treatment protocol. By dimming the room lights, the fluorescence from the source was seen with a closed-circuit video camera, and the positioning accuracy and dwell time of the source could bemore » efficiently verified. Not only is this an excellent QA tool, but it also provides good training for radiation therapists and other HDR professionals.« less
  • Traditionally, radiographic film has been used to verify high-dose-rate brachytherapy source position accuracy by co-registering autoradiographic and diagnostic images of the associated applicator. Filmless PACS-based clinics that do not have access to radiographic film and wet developers may have trouble performing this quality assurance test in a simple and practical manner. We describe an alternative method for quality assurance using radiochromic-type film. In addition to being easy and practical to use, radiochromic film has some advantages in comparison with traditional radiographic film when used for HDR brachytherapy quality assurance.
  • Purpose: High dose rate (HDR) brachytherapy is a radiation treatment technique capable of delivering large dose rates to the tumor. Radiation is delivered using remote afterloaders to drive highly active sources (commonly {sup 192}Ir with an air KERMA strength range between 20 000 and 40 000 U, where 1 U = 1 μGy m{sup 2}/h in air) through applicators directly into the patient's prescribed region of treatment. Due to the obvious ramifications of incorrect treatment while using such an active source, it is essential that there are methods for quality assurance (QA) that can directly and accurately verify the treatmentmore » plan and the functionality of the remote afterloader. This paper describes the feasibility study of a QA system for HDR brachytherapy using a phantom based two-dimensional 11 × 11 epitaxial diode array, named “magic phantom.”Methods: The HDR brachytherapy treatment plan is translated to the phantom with two rows of 10 (20 in total) HDR source flexible catheters, arranged above and below the diode array “magic plate” (MP). Four-dimensional source tracking in each catheter is based upon a developed fast iterative algorithm, utilizing the response of the diodes in close proximity to the {sup 192}Ir source, sampled at 100 ms intervals by a fast data acquisition (DAQ) system. Using a {sup 192}Ir source in a solid water phantom, the angular response of the developed epitaxial diodes utilized in the MP and also the variation of the MP response as a function of the source-to-detector distance (SDD) were investigated. These response data are then used by an iterative algorithm for source dwelling position determination. A measurement of the average transit speed between dwell positions was performed using the diodes and a fast DAQ.Results: The angular response of the epitaxial diode showed a variation of 15% within 360°, with two flat regions above and below the detector face with less than 5% variation. For SDD distances of between 5 and 30 mm the relative response of the epitaxial diodes used in the MP is in good agreement (within 8%) with radial dose function measurements found within the TG-43 protocol, with SDD of up to 70 mm showing a 40% over response. A method for four-dimensional localization of the HDR source was developed, allowing the source dwell position to be derived within 0.50 mm of the expected position. An estimation of the average transit speed for varying step sizes was determined and was found to increase from (12.8 ± 0.3) up to (38.6 ± 0.4) cm/s for a step size of 2.5 and 50 mm, respectively.Conclusions: Our characterization of the designed QA “magic phantom” with MP in realistic HDR photon fields demonstrates the promising performance for real-time source position tracking in four dimensions and measurements of transit times. Further development of this system will allow a full suite for QA in HDR brachytherapy and analysis, and for future in vivo tracking.« less
  • High dose rate (HDR) remote afterloading brachytherapy involves sending a small, high-activity radioactive source attached to a cable to different positions within a hollow applicator implanted in the patient. It is critical that the source position within the applicator and the dwell time of the source are accurate. Daily quality assurance (QA) tests of the positional and dwell time accuracy are essential to ensure that the accuracy of the remote afterloader is not compromised prior to patient treatment. Our centre has developed an automated, video-based QA system for HDR brachytherapy that is dramatically superior to existing diode or film QAmore » solutions in terms of cost, objectivity, positional accuracy, with additional functionalities such as being able to determine source dwell time and transit time of the source. In our system, a video is taken of the brachytherapy source as it is sent out through a position check ruler, with the source visible through a clear window. Using a proprietary image analysis algorithm, the source position is determined with respect to time as it moves to different positions along the check ruler. The total material cost of the video-based system was under $20, consisting of a commercial webcam and adjustable stand. The accuracy of the position measurement is ±0.2 mm, and the time resolution is 30 msec. Additionally, our system is capable of robustly verifying the source transit time and velocity (a test required by the AAPM and CPQR recommendations), which is currently difficult to perform accurately.« less