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Suitability of microDiamond detectors for the determination of absorbed dose to water around high-dose-rate Ir-192 brachytherapy sources
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-1257-2383
Karolinska Univ Hosp, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics.ORCID iD: 0000-0003-0209-498X
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2018 (English)In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 45, no 1, p. 429-437Article in journal (Refereed) Published
Abstract [en]

Purpose: Experimental dosimetry of high-dose-rate (HDR) Ir-192 brachytherapy (BT) sources is complicated due to high dose and dose-rate gradients, and softening of photon energy spectrum with depth. A single crystal synthetic diamond detector microDiamond (PTW 60019, Freiburg, Germany) has a small active volume, high sensitivity, direct readout, and nearly water-equivalent active volume. The purpose of this study was to evaluate the suitability of microDiamond detectors for the determination of absorbed dose to water around HDR Ir-192 BT sources. Three microDiamond detectors were used, allowing for the comparison of their properties. Methods: In-phantom measurements were performed using microSelectron and VariSource iX HDR Ir-192 BT treatment units. Their treatment planning systems (TPSs), Oncentra (v. 4.3) and BrachyVision (v. 13.6), respectively, were used to create irradiation plans for a cubic PMMA phantom with the microDiamond positioned at one of three source-to-detector distances (SDDs) (1.5, 2.5, and 5.5 cm) at a time. The source was stepped in increments of 0.5 cm over a total length of 6 cm to yield absorbed dose of 2 Gy at the nominal reference-point of the detector. Detectors were calibrated in Co-60 beam in terms of absorbed dose to water, and Monte Carlo (MC) calculated beam quality correction factors were applied to account for absorbed-dose energy dependence. Phantom correction factors were applied to account for differences in dimensions between the measurement phantom and a water phantom used for absorbed dose calculations made with a TPS. The same measurements were made with all three of the detectors. Additionally, dose-rate dependence and stability of the detectors were evaluated in Co-60 beam. Results: The percentage differences between experimentally determined and TPS-calculated absorbed doses to water were from -1.3% to +2.9%. The values agreed to within experimental uncertainties, which were from 1.9% to 4.3% (k = 2) depending on the detector, SDD and treatment delivery unit. No dose-rate or intrinsic energy dependence corrections were applied. All microDiamonds were comparable in terms of preirradiation dose, stability of the readings and energy response, and showed a good agreement. Conclusions: The results indicate that the microDiamond is potentially suitable for the determination of absorbed dose to water around HDR Ir-192 BT sources and may be used for independent verification of TPSs calculations, as well as for QA measurements of HDR Ir-192 BT treatment delivery units at clinical sites. (C) 2017 American Association of Physicists in Medicine

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 45, no 1, p. 429-437
Keywords [en]
brachytherapy; dosimetry; Iridium-192; microDiamond detector; radiation detectors
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-144894DOI: 10.1002/mp.12694ISI: 000419961400041PubMedID: 29171060OAI: oai:DiVA.org:liu-144894DiVA, id: diva2:1181663
Note

Funding Agencies|Swedish Radiation Safety Authority [SSM 2013-1253]; Swedish Cancer Society (Cancer-fonden) [CAN 2015/618]

Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2021-10-13
In thesis
1. Development of Experimental Brachytherapy Dosimetry Using Monte Carlo Simulations for Detector Characterization
Open this publication in new window or tab >>Development of Experimental Brachytherapy Dosimetry Using Monte Carlo Simulations for Detector Characterization
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Brachytherapy (BT) is a type of interventional radiotherapy that is advantageous due to high absorbed dose conformity and possibility to deliver high dose in few fractions. It is often used for prostate and gynecological tumors as monotherapy or a boost alongside external beam radiotherapy (EBRT). However, there is a number of things that can compromise treatment delivery, starting from incorrect source data in a treatment planning system to malfunctioning of a treatment delivery unit. None of the established quality assurance (QA) procedures emulate treatment delivery where the planned dose could be compared with the experimentally determined value. While such practices are employed in EBRT, BT suffers from the lack of detectors that would be water-equivalent and convenient to use for regular measurements. First-choice thermoluminescence dosimeters are water-equivalent but have passive readout. Sporadic attempts to use other detectors have not led to any established practices at clinical sites. Stepping ahead, the safety of treatment delivery could be further evaluated using real-time in vivo dosimetry. If detectors were characterized with high-accuracy, a reliable error detection level could be set to terminate treatments if needed. Contrary to in-phantom QA, there are detectors suitable for such applications but their characterization is incomplete. In this thesis we address both problems.

Focusing on high-dose-rate 192Ir remote afterloading treatments, which are among the most common in BT, we investigate and propose a direct readout synthetic diamond detector for in-phantom QA of treatment units. The detector was designed for small-field high-energy EBRT dosimetry but our findings demonstrate its suitability for BT dosimetry. Additionally, due to detector calibration with traceability to absorbed dose to water primary standards of high-energy photon beams and combined experimental and Monte Carlo (MC) characterization, the uncertainties in absorbed dose to water were comparable to passive readout detectors and lower than for other direct readout detectors. We complemented detector investigation with a theoretical study on diamond material properties and which values (mass density, mean excitation energy, number of conduction electrons per atom) shall be used for the most faithful description of ionizing radiation interactions in diamond for MC simulations and calculations of mass electronic stopping power. The findings improve diamond dosimetry accuracy, and subsequently, experimental dosimetry of not only BT but all radiotherapy beam qualities where the detectors are used.

Aiming to further contribute to experimental BT dosimetry, we focused on high atomic number inorganic scintillators used for in vivo dosimetry: ZnSe, CsI, and Al2O3. These are already existing dosimeters exhibiting promising luminescence properties, but until now, their investigation has been solely experimental. MC simulations are not subject to detector positioning uncertainties which are high due to steep dose gradients and other detector response artifacts, thus we used the method to investigate the absorbed-dose energy response of detectors, its dependence on radial distance and polar angles, scatter conditions, as well as detector design. We clarified how error-prone high atomic number detector characterization might be if experimental and MC methods are not combined. Both have certain limitations and have to complement each other.

Though the thesis addresses two different types of detectors for two different applications, the underlying theme is to understand the detector at hand. The use of MC simulations allowed introducing a new synthetic diamond detector into BT field and improving accuracy of in vivo dosimetry systems using inorganic scintillators. We also raised awareness to the lack of unified detector calibration and characterization practice in BT dosimetry.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2021. p. 49
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1775
Keywords
Dosimetry, brachytherapy, solid-state detectors, Monte Carlo
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-175192 (URN)10.3384/diss.diva-175192 (DOI)9789179296766 (ISBN)
Public defence
2021-06-10, Belladonna, Building 511, Campus US, Linköping, 14:00 (English)
Opponent
Supervisors
Available from: 2021-04-26 Created: 2021-04-26 Last updated: 2021-10-13Bibliographically approved

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