Hannah J. Lee

Investigation of magnetic field effects on the dose–response of 3D dosimeters for magnetic resonance – image guided radiation therapy applications

BACKGROUND AND PURPOSE The strong magnetic field of integrated magnetic resonance imaging (MRI) and radiation treatment systems influences secondary electrons resulting in changes in dose deposition in three dimensions. To fill the need for volumetric dose quality assurance, we investigated the effects of strong magnetic fields on 3D dosimeters for MR-image-guided radiation therapy (MR-IGRT) applications. MATERIAL AND METHODS There are currently three main categories of 3D dosimeters, and the following were used in this study: radiochromic plastic (PRESAGE®), radiochromic gel (FOX), and polymer gel (BANG™). For the purposes of batch consistency, an electromagnet was used for same-day irradiations with and without a strong magnetic field (B0, 1.5T for PRESAGE® and FOX and 1.0T for BANG™). RESULTS For PRESAGE®, the percent difference in optical signal with and without B0 was 1.5% at the spectral peak of 632nm. For FOX, the optical signal percent difference was 1.6% at 440nm and 0.5% at 585nm. For BANG™, the percent difference in R2 MR signal was 0.7%. CONCLUSIONS The percent differences in responses with and without strong magnetic fields were minimal for all three 3D dosimeter systems. These 3D dosimeters therefore can be applied to MR-IGRT without requiring a correction factor.

Using 3D dosimetry to quantify the Electron Return Effect (ERE) for MR-image-guided radiation therapy (MR-IGRT) applications

Image-guided radiation therapy (IGRT) using computed tomography (CT), cone-beam CT, MV on-board imager (OBI), and kV OBI systems have allowed for more accurate patient positioning prior to each treatment fraction. While these imaging modalities provide excellent bony anatomy image quality, MRI surpasses them in soft tissue image contrast for better visualization and tracking of soft tissue tumors with no additional radiation dose to the patient. A pre-clinical integrated 1.5 T magnetic resonance imaging and 7 MV linear accelerator system (MR-linac) allows for real-time tracking of soft tissues and adaptive treatment planning prior to each treatment fraction. However, due to the presence of a strong magnetic field from the MR component, there is a three dimensional (3D) change in dose deposited by the secondary electrons. Especially at nonhomogeneous anatomical sites with tissues of very different densities, dose enhancements and reductions can occur due to the Lorentz force influencing the trajectories of secondary electrons. These dose changes at tissue interfaces are called the electron return effect or ERE. This study investigated the ERE using 3D dosimeters.

PO-0800: Fricke-type dosimetry for “real-time” 3D dose measurements using MR-guided RT: a feasibility study

S377 ________________________________________________________________________________ Purpose or Objective: The emergence of MRI-guided radiotherapy has led to the development of new radiotherapy treatment machines with integrated MR-imaging systems. Several designs have emerged such as the 60Co ViewRay system and the different MRI-linac systems developed independently by Utrecht/Elekta, the Cross Cancer Institute in Canada and the Ingham Research Institute in Australia. Magnetic (B-)fields do not alter the photon energy fluence of the beam but they do change the dose distribution in water. Therefore the quantity that is used to specify the beam quality of an MRI-RT device must ideally be insensitive to these changes. The purpose of this study was to investigate the sensitivity of the two most standard beam quality specifiers (%dd(10)x and TPR20,10) to the presence of the Bfield.

SU-G-JeP2-04: Comparison Between Fricke-Type 3D Radiochromic Dosimeters for Real-Time Dose Distribution Measurements in MR-Guided Radiation Therapy.

PURPOSE To assess MR signal contrast for different ferrous ion compounds used in Fricke-type gel dosimeters for real-time dose measurements for MR-guided radiation therapy applications. METHODS Fricke-type gel dosimeters were prepared in 4% w/w gelatin prior to irradiation in an integrated 1.5 T MRI and 7 MV linear accelerator system (MR-Linac). 4 different ferrous ion (Fe2?) compounds (referred to as A, B, C, and D) were investigated for this study. Dosimeter D consisted of ferrous ammonium sulfate (FAS), which is conventionally used for Fricke dosimeters. Approximately half of each cylindrical dosimeter (45 mm diameter, 80 mm length) was irradiated to ∼17 Gy. MR imaging during irradiation was performed with the MR-Linac using a balanced-FFE sequence of TR/TE = 5/2.4 ms. An approximate uncertainty of 5% in our dose delivery was anticipated since the MR-Linac had not yet been fully commissioned. RESULTS The signal intensities (SI) increased between the un-irradiated and irradiated regions by approximately 8.6%, 4.4%, 3.2%, and 4.3% after delivery of ∼2.8 Gy for dosimeters A, B, C, and D, respectively. After delivery of ∼17 Gy, the SI had increased by 24.4%, 21.0%, 3.1%, and 22.2% compared to the un-irradiated regions. The increase in SI with respect to dose was linear for dosimeters A, B, and D with slopes of 0.0164, 0.0251, and 0.0236 Gy-1 (R2 = 0.92, 0.97, and 0.96), respectively. Visually, dosimeter A had the greatest optical contrast from yellow to purple in the irradiated region. CONCLUSION This study demonstrated the feasibility of using Fricke-type dosimeters for real-time dose measurements with the greatest optical and MR contrast for dosimeter A. We also demonstrated the need to investigate Fe2+ compounds beyond the conventionally utilized FAS compound in order to improve the MR signal contrast in 3D dosimeters used for MR-guided radiation therapy. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. LH- 102SPS.

Real-time volumetric relative dosimetry for magnetic resonance?image-guided radiation therapy (MR-IGRT)

The integration of magnetic resonance imaging (MRI) with linear accelerators (linac) has enabled the use of 3D MR-visible gel dosimeters for real-time verification of volumetric dose distributions. Several iron-based radiochromic 3D gels were created in-house then imaged and irradiated in a pre-clinical 1.5 T-7 MV MR-Linac. MR images were acquired using a range of balanced-fast field echo (b-FFE) sequences during irradiation to assess the contrast and dose response in irradiated regions and to minimize the presence of MR artifacts. Out of four radiochromic 3D gel formulations, the FOX 3D gel was found to provide superior MR contrast in the irradiated regions. The FOX gels responded linearly with respect to real-time dose and the signal remained stable post-irradiation for at least 20 min. The response of the FOX gel also was found to be unaffected by the radiofrequency and gradient fields created by the b-FFE sequence during irradiation. A reusable version of the FOX gel was used for b-FFE sequence optimization to reduce artifacts by increasing the number of averages at the expense of temporal resolution. Regardless of the real-time MR sequence used, the FOX 3D gels responded linearly to dose with minimal magnetic field effects due to the strong 1.5 T field or gradient fields present during imaging. These gels can easily be made in-house using non-reusable and reusable formulations depending on the needs of the clinic, and the results of this study encourage further applications of 3D gels for MR-IGRT applications.

Iron-based radiochromic systems for UV dosimetry applications

Phototherapy treatment using ultraviolet (UV) A and B light sources has long existed as a treatment option for various skin conditions. Quality control for phototherapy treatment recommended by the British Association of Dermatologists and British Photodermatology Group generally focused on instrumentation-based dosimetry measurements. The purpose of this study was to present an alternative, easily prepared dosimeter system for the measurement of UV dose and as a simple quality assurance technique for phototherapy treatments. Five different UVA-sensitive radiochromic dosimeter formulations were investigated and responded with a measurable and visible optical change both in solution and in gel form. Iron(III) reduction reaction formulations were found to be more sensitive to UVA compared to iron(II) oxidation formulations. One iron(III) reduction formulation was found to be especially promising due to its sensitivity to UVA dose, ease of production, and linear response up to a saturation point.

SU-G-TeP2-06: Development of Novel Radiochromic Films for Radiotherapy Dosimetry

PURPOSE To develop and evaluate novel radiochromic films for quality assurance in radiotherapy dosimetry. MATERIALS AND METHODS Novel radiochromic film compositions were formulated using leuco crystal violet (LCV) as a reporting system and tetrabromoethane as a free radical source. The film matrix used consisted of polyurethane polymer mixed with dibutyl phthalate plasticizer (20 wt%). The concentration of the radical initiator was kept constant at 10 wt% and the concentration of the LCV dye varied (1 and 2 wt%). To ensure uniform thickness of the film, its precursors were sandwiched between two pieces of glass separated by a 1 mm gap between during the curing process. The films were cut into pieces and were irradiated with a 6 MV X-ray beam to selected doses. The change in optical density was measured using a flatbed scanner and a spectrophotometer. RESULTS The results showed that all film formulations exhibited a linear response with dose and an absorption maximum at ∼ 590 nm. The formulation with 2 wt% LCV was ∼ 30% more sensitive to dose than the formulation with 1 wt% LCV. Both films were very deformable. In addition, the radiochromic response of the film was found to bleach over a short period of time (few weeks) allowing the film to be reused for dose verification measurements. CONCLUSION Both film formulations displayed excellent sensitivity and linearity to radiation dose and thus can be used for the 2D dosimetry of clinical megavoltage and kilovoltage X-ray beams. In addition, the thickness of the film could easily be increased allowing for their potential use as a deformable bolus material. However, thicker films would need more optimization of the manufacturing procedure to ensure consistent material uniformity and sensitivity are recommended.