Tridimensional dosimetry for prostate IMRT treatments using MAGIC-f gel by MRI

Intensity-modulated radiation therapy is able to deliver complex dose distributions and a system able to determine tridimensional dose distribution during the quality assurance of the treatments would be of great interest. In this context polymeric gels can be a useful dosimeter. This work aims to apply this tridimensional dosimetry technique for two prostate IMRT treatments, using MAGIC-f as a gel dosimeter combined with the magnetic resonance imaging to determinate the dose distributions. Dose images obtained by the gel were compared with the treatment planning images and the gamma index was calculated as a quantitative comparison. In both plans a high pass rate was achieved in the gamma analyses (95.5% and 94.0% for plans 1 and 2 respectively) showing that they were approved in the tridimensional quality assurance.     

Gamma Knife® 3-D Dose Distribution Mapping by Magnetic Resonance Imaging

In medical processes where ionizing radiation is used, dose planning and dose delivery are the key elements to patient safety and treatment success, particularly, when the delivered dose in a single session of treatment can be an order of magnitude higher than the regular doses of radiotherapy. Therefore, the radiation dose should be well defined and precisely delivered to the target while minimizing radiation exposure to surrounding normal tissues [1]. Several methods have been proposed to obtain three-dimensional (3-D) dose distribution [2, 3]. In this paper, we propose an alternative method, which can be easily implemented in any stereotactic radiosurgery center with a magnetic resonance imaging (MRI) facility. A phantom with or without scattering centers filled with Fricke gel solution is irradiated with Gamma Knife^® system at a chosen spot. The phantom can be a replica of a human organ such as head, breast or any other organ. It can even be constructed from a real 3-D MR image of an organ of a patient using a computer-aided construction and irradiated at a specific region corresponding to the tumor position determined by MRI. The spin–lattice relaxation time T ₁ of different parts of the irradiated phantom is determined by localized spectroscopy. The T ₁-weighted phantom images are used to correlate the image pixels intensity to the absorbed dose and consequently a 3-D dose distribution with a high resolution is obtained.     

Comparison of TSE, TGSE, and CPMG measurement techniques for MR polymer gel dosimetry

A radiation dose distribution that optimally conforms to the target volume is of major interest for stereotactic radiotherapy. For this purpose treatment plans have to be verified experimentally before transferring to the patient. The requirements regarding dose accuracy and spatial resolution can be fulfilled with tissue equivalent polymer gel dosimeters which offer the possibility to visualize 3D dose distributions. Herewith, dosimetry can be performed by the spin-spin relaxation rate R2 which varies with the absorbed dose. In this work, different MR measurement techniques were evaluated: The standard Carr-Purcell-Meiboom-Gill (CPMG) method, a modified Turbo-Spin-Echo (TSE) sequence, and a modified Turbo-Gradient-Spin-Echo (TGSE) sequence. Experiments were performed both with a homogeneous water phantom and an irradiated polymer gel. The results show that TGSE and especially TSE are suited well for MR polymer gel dosimetry: The acquisition time of both techniques can be reduced in comparison to CPMG by a factor of 5. The accuracy of dose determination for doses between 2 Gy and 13 Gy lies between 5.6% and 2.0% (TSE), 9.0% and 3.2% (TGSE), and 7.9% and 2.7% (CPMG). These investigations show that especially TSE can be handled as a substitute or at least an alternative to CPMG for the verification of treatment plans in stereotactic radiotherapy.     

Development of high-radiation-sensitive polymer gel for magnetic resonance imaging in three-dimensional dosimetry

We developed a high radiation sensitive polymer gel by modifying the amounts of the gel components and the temperature for the gel preparation. We evaluated its relaxation time linearity against dose and compared the measured dose distribution with the calculated one. For the relaxation time-dose linearity, irradiations were carried out with a linear accelerator using 6 MV photons and doses ranging from 0-5.0 Gy. The relationship between dose and R(2) value (reciprocal of T(2) relaxation time) was measured and it had good linearity over a wide range (0.3-5 Gy). The measured dose distributions were in good agreement with calculated ones. Since the present gel has higher sensitivity and it is synthesized more easily at lower cost than conventional polymer gels, we expect to see improved three-dimensional (3D) dosimetry using it.     

Determination of Radiation Dose Distribution by Magnetic Resonance Imaging in the New Tissue Equivalent Gel

Abstract

A new tissue-equivalent substance for the MR dosimetry has been developed. It is composed of water, bovine serum albumin, acrylamide with N,N′-methylene-bis-acrylamide, ammonium ferrous sulphate and sulphuric acid. The elemental composition, mass density, and electron density of the PIRA gel are closer to real tissue than those of dosimeter gels previously investigated. Irradiation causes the changes in the NMR properties of the gel. The dose dependence of NMR longitudinal relaxation rate, R1, is reproducible (less than 2% variation) and is linear up to about 30 Gy, with a slope of 0.023 s^?1Gy^?1 at 0.48 T. The gel, referred to as PIRA, can be used to obtain accurate radiation dose distribution with conventional magnetic resonance imaging devices.     

Characterization of ferric ions diffusion in Fricke gel dosimeters by using inverse problem techniques

Diffusion of ferric ions in ferrous sulfate (Fricke) gels represents one of the main drawbacks of some radiation detectors, such as Fricke gel dosimeters. In practice, this disadvantage can be overcome by prompt dosimeter analysis, and constraining strongly the time between irradiation and analysis, implementing special dedicated protocols aimed at minimizing signal blurring due to diffusion effects. This work presents a novel analytic modeling and numerical calculation approach of diffusion coefficients in Fricke gel radiation sensitive materials. Samples are optically analyzed by means of visible light transmission measurements by capturing images with a charge-coupled device camera provided with a monochromatic filter corresponding to the XO-infused Fricke solution absorbance peak. Dose distributions in Fricke gels are suitably delivered by assessing specific initial conditions further studied by periodical sample image acquisitions. Diffusion coefficient calculations were performed using a set of computational algorithms based on inverse problem formulation. Although 1D approaches to the diffusion equation might provide estimations of the diffusion coefficient, it should be calculated in the 2D framework due to the intrinsic bi-dimensional characteristics of Fricke gel layers here considered as radiation dosimeters. Thus a suitable 2D diffusion model capable of determining diffusion coefficients was developed by fitting the obtained algorithm numerical solutions with the corresponding experimental data. Comparisons were performed by introducing an appropriate functional in order to analyze both experimental and numerical values. Solutions to the second-order diffusion equation are calculated in the framework of a dedicated method that incorporates finite element method. Moreover, optimized solutions can be attained by gradient-type minimization algorithms. Knowledge about diffusion coefficient for a Fricke gel radiation detector is helpful in accounting for effects regarding elapsed time between dosimeter irradiation and further analysis. Hence, corrections might be included in standard dependence of optical density differences and actual, non-diffused, absorbed dose distributions. The obtained values for ferric ion diffusion coefficient are around 0.65 mm² h^?1, being in good agreement with previous works corresponding to similar Fricke gel dosimeter compositions. Therefore, more accurate 2D and 3D dose mapping might be attained, thus constituting valuable improvements in Fricke gel dosimetry, and parallely a high precision method of diffusion modeling and calculation has been developed.     

The role of dose distribution gradient in the observed ferric ion diffusion time scale in MRI-Fricke-infused gel dosimetry

Ferric ion diffusion is a detrimental factor in MRI-Fricke-infused gel dosimetry. In this study, a novel approach involving MR image subtraction and a fast image-based dosimetry technique to study ferric ion diffusion effects is presented. The fast image-based approach allows studying dose profile degradation within minutes post-irradiation. The relationship between the rate of dose profile deterioration and dose distribution gradients can be elucidated with the improved imaging temporal resolution also. Our results showed that for a dose distribution with gradient 4 Gy/mm or higher, ferric ion diffusion causes apparent dose profile degradation in 0.5-1 h post-irradiation. For a gradual dose gradient change of 2.1 Gy/mm or smaller, dose profile degradation appears insignificant for a two-hour elapsed diffusion time. These observations agree well with the theoretical analysis of a square dependence between dose profile degradation and dose distribution gradient. Because all stereotactic radiosurgery procedures produce steep dose distributions and because the ideal "snapshot" of MR scanning cannot be achieved, knowledge of the ferric ion diffusion time scale is important in experimental designs in order to avoid potential measurement errors in MRI-Fricke-agarose gel dosimetry.     

Study on energy dependence of PAGAT polymer gel dosimeter evaluated using X-Ray CT

The normoxic polymer gel dosimeter evaluated with X-Ray computed tomography has emerged as a promising tool for measuring the dose delivered during radiotherapy in three dimensions. This study presents the dependence of PAGAT normoxic polymer gel sensitivity to different photon and electron energies. PAGAT polymer gel was prepared under normal atmospheric condition and irradiated with different photon energies of 1.25 MeV from Co-60 and 6 MV and 15 MV from linear accelerator and electron energies of 6, 9, 12, 15, 18 and 21 MeV from linear accelerator. Evaluation of dosimeter was performed with an X-Ray CT scanner. Images were acquired with optimum scanning protocols to reduce the signal-to-noise ratio. The averaged image was subtracted from the unirradiated polymer gel image for background. Central axis depth dose (PDD) curves obtained for each energy and polymer gel dosimeter measurements were in good agreement with diode and film measurements. Hounsfield (HU) – dose response curve for each photon and electron energy were derived from the PDD curve obtained from the gel dosimeter measurements. From the study it was clear that the HU-dose response curve was linear in the region 1–10 Gy. The dosimeter sensitivity was defined as a slope of these linear HU-dose response curves and found that the sensitivity of polymer gel decreases with increase in both photon and electron energies. This trend in dependence of PAGAT gel dosimeter sensitivity to different photon and electron energies was not dosimetrically significant. However, to evaluate the test phantom exposed with one energy using the calibration curve derived at another energy can produce clinically significant error.     

Determination of Very Slow Diffusion of Paramagnetic Ions by NMR Spectroscopy

In this paper, we propose a new method of measuring the very slow paramagnetic ion diffusion coefficient using a commercial high-resolution spectrometer. If there are distinct paramagnetic ions influencing the hydrogen nuclear magnetic relaxation time differently, their diffusion coefficients can be measured separately. A cylindrical phantom filled with Fricke xylenol gel solution and irradiated with gamma rays was used to validate the method. The Fricke xylenol gel solution was prepared with 270 Bloom porcine gelatin, the phantom was irradiated with gamma rays originated from a ⁶⁰Co source and a high-resolution 200 MHz nuclear magnetic resonance (NMR) spectrometer was used to obtain the phantom ¹H profile in the presence of a linear magnetic field gradient. By observing the temporal evolution of the phantom NMR profile, an apparent ferric ion diffusion coefficient of 0.50 μm²/ms due to ferric ions diffusion was obtained. In any medical process where the ionizing radiation is used, the dose planning and the dose delivery are the key elements for the patient safety and success of treatment. These points become even more important in modern conformal radio therapy techniques, such as stereotactic radiosurgery, where the delivered dose in a single session of treatment can be an order of magnitude higher than the regular doses of radiotherapy. Several methods have been proposed to obtain the three-dimensional (3-D) dose distribution. Recently, we proposed an alternative method for the 3-D radiation dose mapping, where the ionizing radiation modifies the local relative concentration of Fe²⁺/Fe³⁺ in a phantom containing Fricke gel and this variation is associated to the MR image intensity. The smearing of the intensity gradient is proportional to the diffusion coefficient of the Fe³⁺ and Fe²⁺ in the phantom. There are several methods for measurement of the ionic diffusion using NMR, however, they are applicable when the diffusion is not very slow.     

新型辐射变色凝胶的紫外辐照研究

将类丁二炔化合物自组装成纳米囊泡后,均匀分散于凝胶载体中,研制出一种新型的辐射变色凝胶剂量计。用电镜观测了囊泡形貌,采用CL-1000型紫外交联仪对凝胶进行辐照,测试并研究了凝胶对紫外辐照的变色响应、辐射后效应、扩散效应等剂量学性能。结果表明:该辐射变色凝胶在5~150mJ/cm2能量密度范围内对紫外线辐照具有良好的响应线性,同时克服了扩散效应、辐射后效应、成型能力差等现有凝胶剂量计的不足。该辐射变色凝胶剂量计适于光学扫描方式测量剂量分布。     

Ionic conductivity study on electron beam irradiated polyacrylonitrileben polyethylene oxide gel

Different mass percent polyacrylonitrile (PAN)—polyethylene oxide (PEO) gels were prepared and irradiated by an electron beam (EB) with energy of 1.0 MeV to the dose ranging from 13 kGy to 260 kGy. The gels were analysed by using Fourier transform infrared spectrum, gel fraction and ionic conductivity (IC) measurement. The results show that the gel is crosslinked by EB irradiation, the crosslinking degree rises with the increasing EB irradiation dose (ID) and the mass percents of both PAN and PEO contribute a lot to the crosslinking; in addition, EB irradiation can promote the IC of PAN—PEO gels. There exists an optimum irradiation dose, at which the IC can increase dramatically. The IC changes of the PAN—PEO gels along with ID are divided into three regions: IC rapidly increasing region, IC decreasing region and IC balanced region. The cause of the change can be ascribed to two aspects, gel capturing electron degree and crosslinking degree. By comparing the IC—ID curves of different mass percents of PAN and PEO in gel, we found that PAN plays a more important role for gel IC promotion than PEO, since addition of PAN in gel causes the IC—ID curve sharper, while addition of PEO in gel causes the curve milder.     

Multi-center trial with protocols and prototype test objects for the assessment of MRI equipment. EEC Concerted Research Project

A trial was carried out in which the protocols and prototype test objects developed under a European Economic Community concerted research project for the assessment of MR imaging equipment were tested in a series of commercial imaging systems situated throughout Europe. In general, many imperfections were discovered in the imaging performance of the scanners and, in particular, the accuracy and precision with which the relaxation times T1 and T2 could be measured from the images were found to be rather disappointing.     

Simulation and measurement of air generated electron contamination in radiotherapy

Monte Carlo simulations using MCNP4A and experimental work have been performed to evaluate the contribution of electrons that are produced in air from a 6 MV x-ray beam produced by a medical linear accelerator. Results show that up to 9% of applied dose is delivered to a patient’s skin surface from electrons excited in the irradiated air column. For most field sizes this constitutes approximately 30% of dose delivered to this region. This study gives clinically relevant information on the origins and quantity of electrons at the skin of patients undergoing radiation therapy.     

Investigation of the dose rate dependency of the PAGAT gel dosimeter at low dose rates

Medical physicists need dosimeters such as gel dosimeters capable of determining three-dimensional dose distributions with high spatial resolution. To date, in combination with magnetic resonance imaging (MRI), polyacrylamide gel (PAG) polymers are the most promising gel dosimetry systems. The purpose of this work was to investigate the dose rate dependency of the PAGAT gel dosimeter at low dose rates. The gel dosimeter was used for measurement of the dose distribution around a Cs-137 source from a brachytherapy LDR source to have a range of dose rates from 0.97 Gy h^?1 to 0.06 Gy h^?1. After irradiation of the PAGAT gel, it was observed that the dose measured by gel dosimetry was almost the same at different distances (different dose rates) from the source, although the points nearer the source had been expected to receive greater doses. Therefore, it was suspected that the PAGAT gel is dose rate dependent at low dose rates. To test this further, three other sets of measurements were performed by placing vials containing gel at different distances from a Cs-137 source. In the first two measurements, several plastic vials were exposed to equal doses at different dose rates. An ionization chamber was used to measure the dose rate at each distance. In addition, three TLD chips were simultaneously irradiated in order to verify the dose to each vial. In the third measurement, to test the oxygen diffusion through plastic vials, the experiment was repeated again using plastic vials in a nitrogen box and glass vials. The study indicates that oxygen diffusion through plastic vials for dose rates lower than 2 Gy h^?1 would affect the gel dosimeter response and it is suggested that the plastic vials or (phantoms) in an oxygen free environment or glass vials should be used for the dosimetry of low dose rate sources using PAGAT gel to avoid oxygen diffusion through the vials.     

Oxygen-sensitive 19F NMR imaging of the vascular system in vivo

The fluorine nuclear magnetic resonance spin-lattice relaxation rate (1/T1) of the perfluorochemical blood substitute perfluorotripropylamine (FTPA) is very sensitive to oxygen tension. This presents the possibility of measuring blood oxygen tension by 19F MR imaging. We obtained oxygen-sensitive 19F NMR images of the circulatory system of rats infused with emulsified FTPA. Blood oxygenation was assessed under conditions of both air- and 100% O2-breathing. T1 relaxation times were derived from MR images using a partial saturation pulse sequence. The T1 times were compared with a phantom calibration curve to calculate average blood pO2 values in the lung, liver, and spleen. The results showed marked, organ-specific increases in blood oxygen tension when the rat breathed 100% O2 instead of air.     

Quantitative mapping of transverse relaxivity (1/T(2)) in hepatic iron overload: a single spin-echo imaging methodology

Recent research into the non-invasive assessment of hepatic iron concentrations using magnetic resonance imaging has shown that the proton transverse relaxivity (1/T(2)) varies linearly with liver iron concentration. However, the development of an image-based system for the assessment of hepatic iron distribution has been confounded by the presence of motion induced artifacts in the T(2)-weighted images. We report on the development of a single spin-echo imaging methodology that enables the generation of transverse relaxivity maps over the liver. A simple smoothing technique is used to accommodate the image intensity perturbations caused by abdominal motion. The relaxivity maps are consistent with the variation of iron concentration throughout the liver. A Parzen density estimate and histogram of the relaxivity distribution are generated to assist in the visual assessment of the degree and variability of T(2) shortening with liver iron loading. It was found that one or two Gaussian functions could be used to characterize the relaxivity distributions with a small number of parameters. We propose that this methodology may be used in the clinical setting to monitor hepatic iron concentrations in the advent of an accurate transverse relaxivity calibration curve.     

On zero-field anisotropic static Kubo-Toyabe relaxation functions

For muons which have thermalized in the allowed stopping sites of a given crystal, zero-field static Kubo-Toyabe spin dynamics is expressed in terms of the crystal frame spherical harmonic coefficients of the local classical random magnetic field distributions associated with each stopping site. The resulting muon spin polarization involves nine observable relaxation functions which are the counter frame spherical tensor expansion coefficients of the second-rank dynamic motion tensor. These relaxation functions can be measured simultaneously using the skewed field technique for the same experimental conditions, that is, with a single apparatus and with a single crystal-counter frame orientation. The local field distributions of, in general, arbitrary symmetry are classical approximations to the magnetic field interactions between the spin of the muon and the spins of the nuclei associated with each site at which the muon has stopped. They are characterized by equating their moments with the quantal moments generated by the quantal magnetic fields. The observable consequences of the anisotropic second-order moments associated with the planar sites of hexagonal crystals are used as an illustration.     

TRUS-probe integrated MOSkin detectors for rectal wall in vivo dosimetry in HDR brachytherapy: In phantom feasibility study

The increasing complexity and high amount of dose per fraction delivered in prostate high dose rate (HDR) brachytherapy treatments call for the implementation of accurate and effective methods for the systematic and independent quality control of the overall treatment procedure. In this study, MOSkin detectors were placed on a trans-rectal ultrasound (TRUS) probe with the aim of performing both imaging and real time rectal wall in vivo dosimetry with the use of just one single instrument. After an adequate calibration of the detectors, which was carried out in a solid water phantom, the use of MOSkins integrated to the TRUS probe was studied in a gel phantom with a typical (simplified) prostate implant. Measured and calculated doses from the treatment planning system were compared, with a resulting very low average discrepancy of −0.6 ± 2.6%. The results are very promising and of particular clinical importance, however, further in vivo investigation is planned to validate the proposed method.     

Absolute metabolite quantification by in vivo NMR spectroscopy: I. introduction,objectives and activities of a concerted action in biomedical research

By utilizing achievements and results of two previous concerted research projects on magnetic resonance imaging and spectroscopy (MRS), the EU BIOMED 1 Concerted Action on “Cancer and brain disease characterization and therapy assessment by quantitative MRS” was specifically aimed at: 1) developing at a multicentre level harmonized methodologies and protocols for quantitative and reproducible MRS measurements, as a basis for validating these procedures in well controlled clinical and experimental conditions; and 2) providing multicentre critical reviews on the present understanding of the significance of MRS parameters as possible new markers of diagnosis, prognosis and response to therapy. The programme comprised the following main areas of collaborative research and multicentre evaluation: a) development of methods and protocols for quality assessment, calibration and absolute metabolite quantification in in vivo localized, volume-selective MRS; b) design and validation of a new method for assessing localization performance in spectroscopic imaging (MRSI); c) interlaboratory comparison of different methods of signal processing and data analysis, for improving signal quantification in vivo and in vitro MRS spectra; d) quality assessment of high resolution MRS analyses of biological fluids; e) protocol for assembling a pilot data base of MR spectra of tumour extracts for pattern recognition analysis; f) multicentre review on evaluation of the significance of MRS parameters in monitoring lipid metabolism and function in cancer; and g) multicentre review on evaluation of drug pharmacokinetics and metabolism using MRS. The main results and conclusions of four multi-centre trials on items (a), (b) and (c), which involved 24 teams, are reported in the accompanying papers of this series.     

碳离子束混合LET辐照的EBT3辐射变色胶片剂量修正方法

针对EBT3辐射变色胶片对碳离子束混合LET辐照的剂量欠响应比较了两种剂量修正方法。利用260MeV/u的碳离子束通过被动降能得到多种剂量平均LET的碳离子束,利用这些碳离子束进行了胶片剂量响应刻度辐照,选择最佳的拟合公式得到了胶片剂量刻度曲线。使用RE(Relative Efficiency)量化了EBT3胶片随LET的剂量欠响应,并使用RE剂量修正法修正了混合LET辐照胶片的剂量。此外,根据剂量刻度曲线公式中拟合参数随不同LET所占剂量比例的变化规律,提出了拟合参数剂量修正法并修正了混合LET辐照胶片的剂量。最后比较了这两种方法的结果,表明拟合参数方法得到的剂量偏差在5%以内,优于RE方法10%以内的剂量偏差。