Michael L. F Lerch

Verification of the plan dosimetry for high dose rate brachytherapy using metal–oxide–semiconductor field effect transistor detectors

The feasibility of a recently designed metal-oxide-semiconductor field effect transistor (MOSFET) dosimetry system for dose verification of high dose rate (HDR) brachytherapy treatment planning was investigated. MOSFET detectors were calibrated with a 0.6 cm3 NE-2571 Farmer-type ionization chamber in water. Key characteristics of the MOSFET detectors, such as the energy dependence, that will affect phantom measurements with HDR 192Ir sources were measured. The MOS-FET detector was then applied to verify the dosimetric accuracy of HDR brachytherapy treatments in a custom-made water phantom. Three MOSFET detectors were calibrated independently, with the calibration factors ranging from 0.187 to 0.215 cGy/mV. A distance dependent energy response was observed, significant within 2 cm from the source. The new MOSFET detector has a good reproducibility (<3%), small angular effect (<2%), and good dose linearity (R2=1). It was observed that the MOSFET detectors had a linear response to dose until the threshold voltage reached approximately 24 V for 192Ir source measurements. Further comparison of phantom measurements using MOSFET detectors with dose calculations by a commercial treatment planning system for computed tomography-based brachytherapy treatment plans showed that the mean relative deviation was 2.2 +/- 0.2% for dose points 1 cm away from the source and 2.0 +/- 0.1% for dose points located 2 cm away. The percentage deviations between the measured doses and the planned doses were below 5% for all the measurements. The MOSFET detector, with its advantages of small physical size and ease of use, is a reliable tool for quality assurance of HDR brachytherapy. The phantom verification method described here is universal and can be applied to other HDR brachytherapy treatments.

In vivo verification of superficial dose for head and neck treatments using intensity-modulated techniques

Skin dose is one of the key issues for clinical dosimetry in radiation therapy. Currently planning computer systems are unable to accurately predict dose in the buildup region, leaving ambiguity as to the dose levels actually received by the patients skin during radiotherapy. This is one of the prime reasons why in vivo measurements are necessary to estimate the dose in the buildup region. A newly developed metal-oxide-semiconductor-field-effect-transistor (MOSFET) detector designed specifically for dose measurements in rapidly changing dose gradients was introduced for accurate in vivo skin dosimetry. The feasibility of this detector for skin dose measurements was verified in comparison with plane parallel ionization chamber and radiochromic films. The accuracy of a commercial treatment planning system (TPS) in skin dose calculations for intensity-modulated radiation therapy treatment of nasopharyngeal carcinoma was evaluated using MOSFET detectors in an anthropomorphic phantom as well as on the patients. Results show that this newly developed MOSFET detector can provide a minimal but highly reproducible intrinsic buildup of 7 mg cm(-2) corresponding to the requirements of personal surface dose equivalent Hp (0.07). The reproducibility of the MOSFET response, in high sensitivity mode, is found to be better than 2% at the phantom surface for the doses normally delivered to the patients. The MOSFET detector agrees well with the Attix chamber and the EBT Gafchromic film in terms of surface and buildup region dose measurements, even for oblique incident beams. While the dose difference between MOSFET measurements and TPS calculations is within measurement uncertainty for the depths equal to or greater than 0.5 cm, an overestimation of up to 8.5% was found for the surface dose calculations in the anthropomorphic phantom study. In vivo skin dose measurements reveal that the dose difference between the MOSFET results and the TPS calculations was on average -7.2%, ranging from -4.3% to -9.2%. The newly designed MOSFET detector encapsulated into a thin water protective film has a minimal reproducible intrinsic buildup recommended for skin dosimetry. This feature makes it very suitable for routine IMRT QA and accurate in vivo skin dosimetry.

In vivo real-time rectal wall dosimetry for prostate radiotherapy

Rectal balloons are used in external beam prostate radiotherapy to provide reproducible anatomy and rectal dose reductions. This is an investigation into the combination of a MOSFET radiation detector with a rectal balloon for realtime in vivo rectal wall dosimetry. The MOSFET used in the study is a radiation detector that provides a water equivalent depth of measurement of 70 microm. Two MOSFETs were combined in a face-to-face orientation. The reproducibility, sensitivity and angular dependence were measured for the dual MOSFET in a 6 MV photon beam. The dual MOSFET was combined with a rectal balloon and irradiated with hypothetical prostate treatments in a phantom. The anterior rectal wall dose was measured in real time and compared with the planning system calculated dose. The dual MOSFET showed angular dependence within +/-2.5% in the azimuth and +2.5%/-4% in the polar axes. When compared with an ion chamber measurement in a phantom, the dual MOSFET agreed within 2.5% for a range of radiation path lengths and incident angles. The dual MOSFET had reproducible sensitivity for fraction sizes of 2-10 Gy. For the hypothetical prostate treatments the measured anterior rectal wall dose was 2.6 and 3.2% lower than the calculated dose for 3DCRT and IMRT plans. This was expected due to limitations of the dose calculation method used at the balloon cavity interface. A dual MOSFET combined with a commercial rectal balloon was shown to provide reproducible measurements of the anterior rectal wall dose in real time. The measured anterior rectal wall dose agreed with the expected dose from the treatment plan for 3DCRT and IMRT plans. The dual MOSFET could be read out in real time during the irradiation, providing the capability for real-time dose monitoring of the rectal wall dose during treatment.

Observation of intrinsic tristability in a resonant tunneling structure

A new technique has been developed to probe the region of apparent bistability due to a tunneling resonance in the characteristic of a semiconductor asymmetric double‐barrier structure. The measuring circuit uses a voltage supply designed to have a load line with positive slope, equivalent to a voltage source and negative series resistance. The appearance of bistability and hysteresis in the characteristic is an artifact of the conventional measuring technique, which employs a load line with negative slope. The complete characteristic is found to be a continuous Z‐shaped curve between 50 and 150 K, corresponding to tristability. Equivalent circuit models for the device and voltage supply predict a narrow range of circuit parameters for which a static operating point exists inside the tristable region.

Medical physics aspects of the synchrotron radiation therapies: Microbeam radiation therapy (MRT) and synchrotron stereotactic radiotherapy (SSRT)

Stereotactic Synchrotron Radiotherapy (SSRT) and Microbeam Radiation Therapy (MRT) are both novel approaches to treat brain tumor and potentially other tumors using synchrotron radiation. Although the techniques differ by their principles, SSRT and MRT share certain common aspects with the possibility of combining their advantages in the future. For MRT, the technique uses highly collimated, quasi-parallel arrays of X-ray microbeams between 50 and 600 keV. Important features of highly brilliant Synchrotron sources are a very small beam divergence and an extremely high dose rate. The minimal beam divergence allows the insertion of so called Multi Slit Collimators (MSC) to produce spatially fractionated beams of typically ∼25-75 micron-wide microplanar beams separated by wider (100-400 microns center-to-center(ctc)) spaces with a very sharp penumbra. Peak entrance doses of several hundreds of Gy are extremely well tolerated by normal tissues and at the same time provide a higher therapeutic index for various tumor models in rodents. The hypothesis of a selective radio-vulnerability of the tumor vasculature versus normal blood vessels by MRT was recently more solidified. SSRT (Synchrotron Stereotactic Radiotherapy) is based on a local drug uptake of high-Z elements in tumors followed by stereotactic irradiation with 80 keV photons to enhance the dose deposition only within the tumor. With SSRT already in its clinical trial stage at the ESRF, most medical physics problems are already solved and the implemented solutions are briefly described, while the medical physics aspects in MRT will be discussed in more detail in this paper.

Neutron dosimetry with planar silicon p-i-n diodes

New nonionizing energy losses (NIEL) sensors based on silicon planar p-i-n diodes of different geometry have been investigated and their response to fast neutron field compared with bulk diodes. The possibility of obtaining a wide range of sensitivities in these NIEL sensors simultaneously with measurements of IEL has been demonstrated.

MOSFET dosimetry with high spatial resolution in intense synchrotron-generated x-ray microbeams

Various dosimeters have been tested for assessing absorbed doses with microscopic spatial resolution in targets irradiated by high-flux, synchrotron-generated, low-energy (approximately 30-300 keV) x-ray microbeams. A MOSFET detector has been used for this study since its radio sensitive element, which is extraordinarily narrow (approximately 1 microm), suits the main applications of interest, microbeam radiation biology and microbeam radiation therapy (MRT). In MRT, micrometer-wide, centimeter-high, and vertically oriented swaths of tissue are irradiated by arrays of rectangular x-ray microbeams produced by a multislit collimator (MSC). We used MOSFETs to measure the dose distribution, produced by arrays of x-ray microbeams shaped by two different MSCs, in a tissue-equivalent phantom. Doses were measured near the center of the arrays and maximum/minimum (peak/valley) dose ratios (PVDRs) were calculated to determine how variations in heights and in widths of the microbeams influenced this for the therapy, potentially important parameter. Monte Carlo (MC) simulations of the absorbed dose distribution in the phantom were also performed. The results show that when the heights of the irradiated swaths were below those applicable to clinical therapy (< 1 mm) the MC simulations produce estimates of PVDRs that are up to a factor of 3 higher than the measured values. For arrays of higher microbeams (i.e., 25 microm x 1 cm instead of 25 x 500 microm2), this difference between measured and simulated PVDRs becomes less than 50%. Closer agreement was observed between the measured and simulated PVDRs for the Tecomet MSC (current collimator design) than for the Archer MSC. Sources of discrepancies between measured and simulated doses are discussed, of which the energy dependent response of the MOSFET was shown to be among the most important.

Radiation Monitoring in Mixed Environments at CERN: From the IRRAD6 Facility to the LHC Experiments

RadFET and p-i-n diode semiconductor dosimeters from different manufacturers will be used for radiation monitoring at the Experiments of the CERN LHC accelerator. In this work these sensors were exposed over three months in the CERN-IRRAD6 facility that provides mixed high-energy particles at low rates. The aim was to validate the operation of such sensors in a radiation field where the conditions are close to the ones expected inside full working LHC particle detectors. The results of this long-term irradiation campaign are presented, discussed and compared with measurements by other dosimetric means as well as Monte Carlo simulations. Finally, the integration of several dosimetric devices in one sensor carrier is also presented.

Microbeam radiation therapy: a Monte Carlo study of the influence of the source, multislit collimator, and beam divergence on microbeams.

Microbeam radiation therapy (MRT) is a new oncology method currently under development for the treatment of inoperable pediatric brain tumors. Monte Carlo simulation, or the computational study of radiation transport in matter, is often used in radiotherapy to theoretically estimate the dose required for treatment. However, its potential use in MRT dose planning systems is currently hindered by the significant discrepancies that have been observed between measured and theoretical dose and the PVDR (peak to valley dose ratio). The need to resolve these discrepancies is driven by the desirability of making MRT available to humans in the next few years. This article aims to resolve some of the discrepancies by examining the simplifications adopted in previous MRT Monte Carlo studies, such as the common practice of commencing microbeam transport on the surface of the target which neglects the influence of the distributed synchrotron source, multislit collimator, and the beam divergence between them. This article uses PENELOPE Monte Carlo simulation to investigate the influence of these beamline components upstream of the target on the lateral dose profiles and PVDRs of an array of 25 microbeams. It also compares the dose profiles and PVDRs of a microbeam array produced from a single simulation (full array) to those produced from the superposition of a single microbeam profile (sup array). The effect of modeling the distributed source and the beam divergence was an increase in the absorbed dose in the penumbral and valley regions of the microbeam profiles. Inclusion of the multislit collimator resulted in differences of up to 5 microm in the FWHM of microbeam profiles across the array, which led to minor variations in the corresponding PVDR yields.

A silicon strip detector dose magnifying glass for IMRT dosimetry

PURPOSE Intensity modulated radiation therapy (IMRT) allows the delivery of escalated radiation dose to tumor while sparing adjacent critical organs. In doing so, IMRT plans tend to incorporate steep dose gradients at interfaces between the target and the organs at risk. Current quality assurance (QA) verification tools such as 2D diode arrays, are limited by their spatial resolution and conventional films are nonreal time. In this article, the authors describe a novel silicon strip detector (CMRP DMG) of high spatial resolution (200 microm) suitable for measuring the high dose gradients in an IMRT delivery. METHODS A full characterization of the detector was performed, including dose per pulse effect, percent depth dose comparison with Farmer ion chamber measurements, stem effect, dose linearity, uniformity, energy response, angular response, and penumbra measurements. They also present the application of the CMRP DMG in the dosimetric verification of a clinical IMRT plan. RESULTS The detector response changed by 23% for a 390-fold change in the dose per pulse. A correction function is derived to correct for this effect. The strip detector depth dose curve agrees with the Farmer ion chamber within 0.8%. The stem effect was negligible (0.2%). The dose linearity was excellent for the dose range of 3-300 cGy. A uniformity correction method is described to correct for variations in the individual detector pixel responses. The detector showed an over-response relative to tissue dose at lower photon energies with the maximum dose response at 75 kVp nominal photon energy. Penumbra studies using a Varian Clinac 21EX at 1.5 and 10.0 cm depths were measured to be 2.77 and 3.94 mm for the secondary collimators, 3.52 and 5.60 mm for the multileaf collimator rounded leaf ends, respectively. Point doses measured with the strip detector were compared to doses measured with EBT film and doses predicted by the Philips Pinnacle treatment planning system. The differences were 1.1% +/- 1.8% and 1.0% +/- 1.6%, respectively. They demonstrated the high temporal resolution capability of the detector readout system, which will allow one to investigate the temporal dose pattern of IMRT and volumetric modulated are therapy (VMAT) deliveries. CONCLUSIONS The CMRP silicon strip detector dose magnifying glass interfaced to a TERA ASIC DAQ system has high spatial and temporal resolution. It is a novel and valuable tool for QA in IMRT dose delivery and for VMAT dose delivery.