Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Saturday
May 07
10:30 - 11:30
Auditorium 11
Physics
Danique Barten, The Netherlands;
Victor Gonzalez-Perez, Spain
Proffered Papers
Brachytherapy
11:00 - 11:10
Online treatment verification during brachytherapy using an inorganic scintillator – a phantom study
Jacob Johansen, Denmark
OC-0116

Abstract

Online treatment verification during brachytherapy using an inorganic scintillator – a phantom study
Authors:

Jacob Johansen1,2, Erik B Jørgensen1,2, Peter Georgi1,2, Kari Tanderup1,2

1Aarhus University Hospital, Department of Oncology, Aarhus, Denmark; 2Aarhus University, Department of Clinical Medicine, Aarhus, Denmark

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Purpose or Objective

Currently, in vivo dosimetry (IVD) treatment verification is mainly based on evaluation of accumulated absorbed dose. The purpose of this study is to demonstrate online brachytherapy treatment verification based on real-time IVD and source tracking.

Material and Methods

A brachytherapy treatment was simulated in a water phantom while real-time IVD was performed (phantom size: 25x30x30 cm3, water temperature: 37.5±1oC). A ZnSe:O-based scintillation detector [1] with an in-house developed treatment verification software was used for IVD, and the procedure resembled a clinical routine. Prior to irradiation, a calibration of the scintillator was performed in a plastic phantom. For the simulated treatment, six needles were used for irradiation and the dosimeter was placed in a dedicated needle (distances to the other needles, 1, 1, 2, 2, 3 and 4 cm). A treatment plan (exported from Oncentra Prostate) was loaded into the treatment verification software to generate the expected dose rates, fig. 1. The treatment plan consisted of 5-12 dwell positions in each needle with dwell times in the range of 0.7-2 s.

During irradiation, the software recorded and converted the signal into dose rate including a correction of the energy-dependency based on the signal height. A graphical user interface provided a direct comparison of the measured and expected dose rates every 50 ms, fig. 1. After the irradiation of each needle, an IVD-based source tracking methodology was used to determine the position of the needle. The discrepancy between expected and tracked position of the given needle was displayed.

The irradiation was repeated ten times while the treatment verification software was giving real-time feedback. Furthermore, two irradiations with induced errors were performed: A swap of guide tubes for channel 5 and 6, and a 5 mm radial shift of channel 3.

Results

The procedures related to IVD, including detector calibration, exporting and loading the treatment plans, were performed in <20 minutes. The mean±1SD deviation between measured and expected dose were -3.28±1.13% for the total dose and -0.66±8.21% for the dose pr. needle. The needle positions were tracked within 5 s, which is significantly shorter than the period between the irradiation of two subsequent needles (~25 s). The tracked position of each needle differed from the expected with 0.72±0.46 mm (mean±1SD) across the ten irradiations. The swap of guide tubes resulted in positional differences of +10.22/-9.32 mm for channel 5/6. The 5 mm radial shift of a single channel was determined to -4.88 mm, fig. 1.


Conclusion

Real time IVD can be performed and provide online comparison of dose rates and tracking of the source. This can be provided to the users in an easy-to-interpret way and with <20 min additional workload. The next step is to utilise the real-time IVD monitoring in patients.

 [1] Jorgensen EB et al. Med. Phys. 2021:1-17, http://doi.org/10.1002/mp.15257