Experimental Validation of Small-field Dosimetry in Radiotherapy Using Ionization Chamber and Edge Detector

Document Type : Original Paper

Authors

1 Department of Engineering, Shahrood Branch, Islamic Azad University, Shahrood, Iran

2 Department of Radiotherapy and Oncology, Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction:To study the impact of 6 MV and 10 MV flattened beam (FB) and flattening filter free (FFF) beam in whole brain radiotherapy (WBRT) by using volumetric modulated arc therapy (VMAT).
Material and Methods: Twenty WBRTpatients were selected randomly. The dose prescription was 30 Gy, which was delivered in ten fractions. The planning target volume (PTV) and organs at risk (OARs) were contoured. Four VMAT plans, including 6 MV FB, 6 MV FFF, 10 MV FB, and 10 MV FFF beam plans, were generated.
Results: The 6MV FB and FFF beam plans were statistically significant (p <0.05) in terms of the dose received by 98% of the PTV (D98%) (26.86 Gy vs. 27.31 Gy, P=0.006), the dose received by 95% of the PTV (D95%) (28.28 Gy vs. 28.52 Gy, P=0.038), 107% isodose (V107%) of the PTV (2.43% vs. 3.74%, P=0.001), D100% of the hippocampus (9.31 Gy vs. 9.16 Gy, P=0.009), and the Dmean scalp (16.7 Gy vs. 16.8 Gy, p=0.035). The 10 MV FB and FFF beam plans showed significant differences in the conformity index (0.9 vs. 0.85, P=0.01), V107% of the PTV (1.68% vs. 4.54%, P=0.001), D100% (10.08 Gy vs. 9.81 Gy, P=0.036), and Dmean of the hippocampus (12.78 Gy vs. 12.57 Gy, P=0.018). The 6 MV and 10 MV FFF beams showed homogeneous conformal plans, which required 18-19% more MUs, compared to the FB plans.
Conclusion: The 6 MV and 10 MV FB and FFFB spared the hippocampus and the scalp with acceptable target coverage in WBRT cases.

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  1. Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence‐based clinical guidelines. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2005; 104(6): 1129-37.
  2. Kaderka R, Schardt D, Durante M, Berger T, Ramm U, Licher J, et al. Out-of-field dose measurements in a water phantom using different radiotherapy modalities. Phys Med Biol. 2012; 57(16): 5059.
  3. Alagar AG, Mani GK, Karunakaran K. Percentage depth dose calculation accuracy of model based algorithms in high energy photon small fields through heterogeneous media and comparison with plastic scintillator dosimetry. J Appl Clin Med Phys. 2016; 17: 132–42.
  4. Das IJ, Francescon P, Ahnesjö A, Aspradakis MM, Cheng CW, Ding GX, et al. Small fields and non-equilibrium condition photon beam dosimetry: AAPM Task Group Report 155. Med Phys. 2014; 41.
  5. Moreno AC, Frank SJ, Garden AS, Rosenthal DI, Fuller CD, Gunn GB, et al. Intensity modulated proton therapy (IMPT)–The future of IMRT for head and neck cancer. Oral oncol. 2019; 1(88): 66-74.
  6. Bagheri H, Soleimani A, Gharehaghaji N, Mesbahi A, Manouchehri F, Shekarchi B, et al. An overview on small-field dosimetry in photon beam radiotherapy: developments and challenges. J Cancer Res Ther. 2017; 13(2): 175.
  7. Aznar MC, Andersen CE, Bøtter-Jensen L, Bäck SÅJ, Mattsson S, Kjær-Kristoffersen F, et al. Real-time optical-fibre luminescence dosimetry for radiotherapy: physical characteristics and applications in photon beams. Phys Med Biol. 2004; 49(9): 1655.
  8. Attix FH. Introduction to radiological physics and radiation dosimetry. John Wiley & Sons; 2008.
  9. Chang KH, Lee BR, Kim YH, Choi KS, Lee JS, Park BM, et al. Dosimetric characteristics of Edge detector (TM) in small beam dosimetry. Korean J Med Phys. 2009; 20(4): 191-8.
  10. Dieterich S, Sherouse GW. Experimental comparison of seven commercial dosimetry diodes for measurement of stereotactic radiosurgery cone factors. Med phys. 2011; 38(7): 4166-73.
  11. Vicoroski N, Espinoza A, Duncan M, Oborn BM, Carolan M, Metcalfe P, et al. Development of a silicon diode detector for skin dosimetry in radiotherapy. Medical physics. 2017; 44(10): 5402-12.
  12. Shin HJ, Kim MH, Choi IB, Kang YN, Kim DH, Chio BO, et al. Evaluation of the EDGE detector in small-field dosimetry. J Korean Phys Soc. 2013; 63(1): 128-34.
  13. Looe HK, Büsing I, Tekin T, Brant A, Delfs B, Poppinga D, et al. The polarity effect of compact ionization chambers used for small field dosimetry. Med phys. 2018; 45(12): 5608-21.
  14. Groppo, D.P., Saraiva, C.W. and Caldas, L.V. Determination of the penumbra width of Elekta SRS cone collimator for 6 MV FF and 6 MV FFF energies using gradient-based edge detection. Rad Phys Chem, 2020; 167, 108319.
  15. Mancosu, P., Pasquino, M., Reggiori, G., Masi, L., Russo, S. and Stasi, M. Dosimetric characterization of small fields using a plastic scintillator detector: a large multicenter study. Phys Med. 2017; 41: 33-38.
  16. Ade, N. and Nam, T.L. The influence of detector size relative to field size in small-field photon-beam dosimetry using synthetic diamond crystals as sensors. Rad Phys Chem, 2015; 113: 6-13.
  17. Yarahmadi M, Wegener S, Sauer OA. Energy and field size dependence of a silicon diode designed for small‐field dosimetry. Med phys. 2017; 44(5): 1958-64.
  18. Khan FM, Gibbons JP. Khan's the physics of radiation therapy. Lippincott Williams & Wilkins; 2014.
  19. Parwaie W, Refahi S, Ardekani MA, Farhood B. Different Dosimeters/Detectors Used in Small-Field Dosimetry: Pros and Cons. J med signals sens. 2018; 8(3): 195–203.