Vladimir Perevertaylo

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.

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.

The use of a silicon strip detector dose magnifying glass in stereotactic radiotherapy QA and dosimetry

PURPOSE Stereotactic radiosurgery/therapy (SRS/SRT) is the use of radiation ablation in place of conventional surgical excision to remove or create fibrous tissue in small target volumes. The target of the SRT/SRS treatment is often located in close proximity to critical organs, hence the requirement of high geometric precision including a tight margin on the planning target volume and a sharp dose fall off. One of the major problems with quality assurance (QA) of SRT/SRS is the availability of suitable detectors with the required spatial resolution. The authors present a novel detector that they refer to as the dose magnifying glass (DMG), which has a high spatial resolution (0.2 mm) and is capable of meeting the stringent requirements of QA and dosimetry in SRS/SRT therapy. METHODS The DMG is an array of 128 phosphor implanted n+ strips on a p-type Si wafer. The sensitive area defined by a single n+ strip is 20 x 2000 microm2. The Si wafer is 375 microm thick. It is mounted on a 0.12 mm thick Kapton substrate. The authors studied the dose per pulse (dpp) and angular response of the detector in a custom-made SRS phantom. The DMG was used to determine the centers of rotation and positioning errors for the linear accelerators gantry, couch, and collimator rotations. They also used the DMG to measure the profiles and the total scatter factor (S(cp)) of the SRS cones. Comparisons were made with the EBT2 film and standard S(cp) values. The DMG was also used for dosimetric verification of a typical SRS treatment with various noncoplanar fields and arc treatments when applied to the phantom. RESULTS The dose per pulse dependency of the DMG was found to be < 5% for a dpp change of 7.5 times. The angular response of the detector was investigated in the azimuthal and polar directions. The maximum polar angular response was 13.8% at the gantry angle of 320 degrees, which may be partly due to the phantom geometry. The maximum azimuthal angular response was 15.3% at gantry angles of 90 degrees and 270 degrees. The angular response at the gantry angle of 180 degrees was 6.3%. A correction function was derived to correct for the angular dependence of the detector, which takes into account the contribution of the azimuthal and polar angular response at different treatment couch positions. The maximum positioning errors due to collimator, gantry, and couch rotation were 0.2 +/- 0.1, 0.4 +/- 0.1, and 0.4 +/- 0.2 mm, respectively. The SRS cone S(cp) agrees very well with the standard data with an average difference of 1.2 +/- 1.1%. Comparison of the relative intensity profiles of the DMG and EBT2 measurements for a simulated SRS treatment shows a maximum difference of 2.5%. CONCLUSIONS The DMG was investigated for dose per pulse and angular dependency. Its application to SRS/SRT delivery verification was demonstrated. The DMG with its high spatial resolution and real time capability allows measurement of dose profiles for cone applicators down to 5 mm in diameter, both accurately and rapidly as required in typical SRS/SRT deliveries.

X-Tream: a novel dosimetry system for Synchrotron Microbeam Radiation Therapy

Microbeam Radiation Therapy (MRT) is a radiation treatment technique under development for inoperable brain tumors. MRT is based on the use of a synchrotron generated X-ray beam with an extremely high dose rate ( ~ 20 kGy/sec), striated into an array of X-ray micro-blades. In order to advance to clinical trials, a real-time dosimeter with excellent spatial resolution must be developed for absolute dosimetry. The design of a real-time dosimeter for such a radiation scenario represents a significant challenge due to the high photon flux and vertically striated radiation field, leading to very steep lateral dose gradients. This article analyses the striated radiation field in the context of the requirements for temporal dosimetric measurements and presents the architecture of a new dosimetry system based on the use of silicon detectors and fast data acquisition electronic interface. The combined system demonstrates micrometer spatial resolution and microsecond real time readout with accurate sensitivity and linearity over five orders of magnitude of input signal. The system will therefore be suitable patient treatment plan verification and may also be expanded for in-vivo beam monitoring for patient safety during the treatment.

3D-Mesa “Bridge” Silicon Microdosimeter: Charge Collection Study and Application to RBE Studies in

Microdosimetry is an extremely useful technique, used for dosimetry in unknown mixed radiation fields typical of space and aviation, as well as in hadron therapy. A new silicon microdosimeter with 3D sensitive volumes has been proposed to overcome the shortcomings of the conventional Tissue Equivalent Proportional Counter. In this article, the charge collection characteristics of a new 3D mesa microdosimeter were investigated using the ANSTO heavy ion microprobe utilizing 5.5 MeV He2+ and 2 MeV H+ ions. Measurement of the microdosimetric characteristics allowed for the determination of the Relative Biological Effectiveness of the 12C heavy ion therapy beam at the Heavy Ion Medical Accelerator in Chiba (HIMAC), Japan. Well-defined sensitive volumes of the 3D mesa microdosimeter have been observed and the microdosimetric RBE obtained showed good agreement with the TEPC. The new 3D mesa “bridge” microdosimeter is a step forward towards a microdosimeter with fully free-standing 3D sensitive volumes.

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Silicon microdosimeters for the characterisation of mixed radiation fields relevant to the space radiation environment have been under continual development at the Centre for Medical Radiation Physics for over a decade. These devices are useful for the prediction of single event upsets in microelectronics and for radiation protection of spacecraft crew. The latest development in silicon microdosimetry is a family of large-area n-SOI microdosimeters for real-time dosimetry in space radiation environments. The response of n-SOI microdosimeters to 2 MeV H and 5.5 MeV He ions has been studied to investigate their charge collection characteristics. The studies have confirmed 100% yield of functioning cells, but have also revealed a charge sharing effect due to diffusion of charge from events occurring outside the sensitive volume and an enhanced energy response due to the collection of charge created beneath the insulating layer. The use of a veto electrode aims to reduce collection of diffused charge. The effectiveness of the veto electrode has been studied via a coincidence analysis using IBIC. It has been shown that suppression of the shared events allows results in a better defined sensitive volume corresponding to the region under the core electrode where the electric field is strongest.

Radiation Therapy

This paper reports on the development of an interactive, intraoperative dose planning system for seed implant brachytherapy in cancer treatment. This system involves in-vivo dosimetry and the ability to determine implanted seed positions. The first stage of this project is the development of a urethral alarm probe to measure the dose along the urethra during a prostate brachytherapy treatment procedure. Ultimately the system will be used to advise the physicians upon reaching a preset dose rate or dose after total seed decay in urethra during the seed placement. The second stage is the development of a method and instrumentation for in-vivo measurements of the location of implanted seeds in the same frame as for dose planning, and using these in intraoperative treatment planning. We have developed a silicon mini-detector and preamplifier/amplifier system to satisfy the spectroscopic requirements of the urethral probe. This technique will avoid complications related to overdosing the urethra and the rectum.

Large Area Silicon Microdosimeter for Dosimetry in High LET Space Radiation Fields: Charge Collection Study

Due to the ever-increasing complexity of treatment modalities in radiation therapy, there has been a greater need for detectors to perform quality assurance to ensure patients are treated correctly and safely. Modern radiation therapy techniques involve small field sizes, high dose gradients, and varying intensity of energy and rate. The ideal dosimeter for this treatment should display high spatial resolution, high linearity, accuracy, and radiation hardness. Silicon detectors have been widely used for radiotherapy measurements and have many attractive qualities as a dosimeter; weaknesses of silicon detectors are, however, decreases in sensitivity with accumulated dose. The Centre for Medical Radiation Physics has developed a new technology with an unusual charge collection efficiency variation with accumulated dose which stabilizes the response of the detector within ±5% after 120 kGy photon irradiation. The sensor has been also characterized by irradiation by an 18 MV medical LINAC with sensitivity to a photoneutron-induced damage of less than 0.5%/100 Gy. The radiation damage mechanism has been validated by TCAD simulations which confirmed the mechanism behind the CCE increase as a function of the accumulated dose.

In vivo dosimetry and seed localization in prostate brachytherapy with permanent implants

Electrical characteristics and neutron dosimetry properties of silicon based p-i-n diodes are presented in support of the applications in the sensors for beam monitoring and medical physics. Both the current-voltage (I-V) and capacitance-voltage (C-V) characteristics of silicon planar p-i-n diode sensors with cylindrical geometry have been theoretically modeled and experimentally measured. The shifts of the forward and reverse diode characteristics of the sensors versus the neutron dose have been obtained. It is shown that the neutron irradiation caused shift of the forward voltage of the p-i-n diodes is proportional to the current at which it is measured in the case of the low level injection or to the square root of the current in the case of the high level injection. The C-V characteristics and the full depletion voltages of the diodes have been estimated and experimentally verified. It is shown that the sensitivity of planar cylindrical structures as neutron sensors can be optimized by the selection of the device geometry and the current at which the measurement is performed.

Characterization of an Innovative p-type Epitaxial Diode for Dosimetry in Modern External Beam Radiotherapy

Purpose: Nowadays, there are many different applications that use small fields in radiotherapy treatments. The dosimetry of small radiation fields is not trivial due to the problems associated with lateral disequilibrium and source occlusion and requires reliable quality assurance (QA). Ideally such a QA tool should provide high spatial resolution, minimal beam perturbation and real time fast measurements. Many different types of silicon diode arrays are used for QA in radiotherapy; however, their application in small filed dosimetry is limited, in part, due to a lack of spatial resolution. The Center of Medical Radiation Physics (CMRP) has developed a new generation of a monolithic silicon diode array detector that will be useful for small field dosimetry in SRS/SRT. The objective of this study is to characterize a monolithic silicon diode array designed for dosimetry QA in SRS/SRT named DUO that is arranged as two orthogonal 1D arrays with 0.2 mm pitch. Methods: DUO is two orthogonal 1D silicon detector arrays in a monolithic crystal. Each orthogonal array contains 253 small pixels with size 0.04 × 0.8 mm2 and three central pixels are with a size of 0.18 × 0.18 mm2 each. The detector pitch is 0.2 mm and total active area is 52 × 52 mm2. The response of the DUO silicon detector was characterized in terms of dose per pulse, percentage depth dose, and spatial resolution in a radiation field incorporating high gradients. Beam profile of small fields and output factors measured on a Varian 2100EX LINAC in a 6 MV radiation fields of square dimensions and sized from 0.5 × 0.5 cm2 to 5 × 5 cm2. The DUO response was compared under the same conditions with EBT3 films and an ionization chamber. Results: The DUO detector shows a dose per pulse dependence of 5% for a range of dose rates from 2.7 × 10−4 to 1.2 × 10−4 Gy/pulse and 23% when the rate is further reduced to 2.8 × 10−5 Gy/pulse. The percentage depth dose measured to 25 cm depth in solid water phantom beyond the surface and for a field size of 10 × 10 cm2 agrees with that measured using a Markus IC within 1.5%. The beam profiles in both X and Y orthogonal directions showed a good match with EBT3 film, where the FWHM agreed within 1% and penumbra widths within 0.5 mm. The effect of an air gap above the DUO detector has also been studied. The output factor for field sizes ranging from 0.5 × 0.5 cm2 to 5 × 5 cm2 measured by the DUO detector with a 0.5 mm air gap above silicon surface agrees with EBT3 film and MOSkin detectors within 1.8%. Conclusions: The CMRPs monolithic silicon detector array, DUO, is suitable for SRS/SRT dosimetry and QA because of its very high spatial resolution (0.2 mm) and real time operation.