[en] Radiation therapy dosimetry software now frequently incorporates biological predictions of the probability of normal tissue complications. This study investigates whether the length of normal structure outlined affects a normal tissue complication probability (NTCP) for that structure. It also researches the effect of any change in the dose parameter used to produce a 50% probability of a complication (the TD⁵⁰) on the calculated NTCP, as this is related to the clinical observations. An NTCP was calculated for rectum and bladder on a sample of prostate cases receiving external beam radiation therapy. The length of the organs at risk was varied and the NTCP recalculated for each different length using the same treatment plan. Large variations of up to 80% in NTCP for different delineated lengths of organ for a given TD⁵⁰ were observed. Changing the TD⁵⁰ dose altered the calculated NTCP and the relative size of the variation in the values. This parameter will need further investigation; a standardized delineated length of 2 cm beyond the beam edge for normal structures is recommended. Interpatient and interinstitution plan comparison using dose volume histograms and/or normal tissue complication probabilities will be compromised until such standardization occurs

[en] The effective use of near water equivalent organic plastic scintillators (OPS) for radiation dosimetry with high-energy sources under laboratory conditions is recognized. In this work, an OPS-based dosimeter using a photodiode combined with improved solid state detection and signal processing techniques has been developed; it offers the potential for the construction of a stable and fully portable dosimeter which will extend the useful range of measurement beyond the usual MeV area and provide reliable readings down to sub-100 keV X-ray energy levels. In these experiments, the instrument described has been used for the dosimetry of INTRABEAM intraoperative radiotherapy (IORT) equipment at distances as low as 1.8 mm from the effective source, i.e., 0.2 mm from the X-ray probe surface. Comparison is shown with dosimetry measurements made using the calibrated reference ion chamber supplied by the IORT equipment manufacturer. (author)

[en] In vivo dosimetry is recommended as a defence-in-depth strategy in radiotherapy treatments and is currently employed by clinics around the world. The characteristics of a new optically stimulated luminescence dosimetry system were investigated for the purpose of replacing an aging thermoluminescence dosimetry system for in vivo dosimetry. The stability of the system was not sufficient to satisfy commissioning requirements and therefore it has not been released into clinical service at this time.

[en] Stereotactic radiotherapy (SRT) requires tight margins around the tumor, thus producing a steep dose gradient between the tumor and the surrounding healthy tissue. Any setup errors might become clinically significant. To date, no study has been performed to evaluate the dosimetric variations caused by setup errors with a 3-dimensional dosimeter, the PRESAGE. This research aimed to evaluate the potential effect that setup errors have on the dose distribution of intracranial SRT. Computed tomography (CT) simulation of a CIRS radiosurgery head phantom was performed with 1.25-mm slice thickness. An ideal treatment plan was generated using Brainlab iPlan. A PRESAGE was made for every treatment with and without errors. A prescan using the optical CT scanner was carried out. Before treatment, the phantom was imaged using Brainlab ExacTrac. Actual radiotherapy treatments with and without errors were carried out with the Novalis treatment machine. Postscan was performed with an optical CT scanner to analyze the dose irradiation. The dose variation between treatments with and without errors was determined using a 3-dimensional gamma analysis. Errors are clinically insignificant when the passing ratio of the gamma analysis is 95% and above. Errors were clinically significant when the setup errors exceeded a 0.7-mm translation and a 0.5° rotation. The results showed that a 3-mm translation shift in the superior-inferior (SI), right-left (RL), and anterior-posterior (AP) directions and 2° couch rotation produced a passing ratio of 53.1%. Translational and rotational errors of 1.5 mm and 1°, respectively, generated a passing ratio of 62.2%. Translation shift of 0.7 mm in the directions of SI, RL, and AP and a 0.5° couch rotation produced a passing ratio of 96.2%. Preventing the occurrences of setup errors in intracranial SRT treatment is extremely important as errors greater than 0.7 mm and 0.5° alter the dose distribution. The geometrical displacements affect dose delivery to the tumor and the surrounding normal tissues

[en] The main advantage of radiochromic-film dosimeters is the coupling of rapid full planar-acquisition, high-spatial resolution and dose linearity. Their main limitation, however, is their low radiation sensitivity. This precludes their application to measuring doses below a few Gy. Radiochromic films are sensitive to ultraviolet radiation. In this note the results of exposing radiochromic films to x rays through an UV imaging cassette, which converts and amplifies x rays to UV radiation, are presented. These results indicate a clear increase (around 50%) in radiochromic film's sensitivity to MV x rays (6, 10, and 18 MV) when exposed through the UV phosphor

[en] Normoxic type polyacrylamide gel (nPAG) dosimeters are established for dose quantification in three-dimensions for radiotherapy and hence represent an adequate dosimeter for quantification of the dose variation due to the existence of the gold nanoparticles (AuNPs) in the target during irradiation. This work compared the degree of polymerisation in gel doped with nanoparticles (nPAG–AuNP) with control gel samples when irradiated by various sources. Samples were irradiated with a synchrotron radiation source of mean energy 125 keV, 80 kV X-ray beams from superficial therapy machine (SXRT), 6 MV X-rays and 6 MeV electron beams from linear accelerator. Analysis of the dose–response relation was used to determine a dose enhancement factor (DEF) of 1.76 ± 0.34 and 1.64 ± 0.44 obtained for samples irradiated with kilovoltage X-rays energy from synchrotron source and SXRT respectively. Similarly, including AuNPs in gel results in a DEF of approximately 1.37 ± 0.35 when irradiated by an electron beam and 1.14 ± 0.28 for high energy X-ray beams. The results demonstrate the use of AuNPs embedded in polymer gels for measuring the enhancement of radiation caused by metallic nanoparticles.

[en] Purpose: To identify the benefits in image contrast enhancement using gold nanoparticles (AuNPs) compared to conventional iodinated contrast media. Materials and methods: Gold nanoparticles and iodinated contrast media were evaluated for contrast enhancement at various X-ray tube potentials in an imaging phantom. Iopromide and AuNP suspension were equalized according to molar concentration of radiopaque element (0.5077 Mol/L). Contrast-to-noise ratio is used to quantify contrast enhancement. Both projectional radiographic (40-80 kVp) and computed tomography (CT) (80-140kVp) imaging modalities were examined. Results and conclusions: Findings indicate 89% improvement in CNR at low energies near the mammographic range (40 kVp). However, as expected no significant difference in enhancement was observed at potentials commonly used for angiography (around 80 kVp) probably due to the k-edge influence for iodine. At the highest energies typically available in computed tomography, significant improvement in contrast enhancement using gold nanoparticles is obtained, 114% greater CNR than that produced by iodine at 140 kVp. Experimental findings for 70-120 kVp spectra correlate well with the theoretical calculations based on linear attenuation coefficients. Superior attenuation of gold nanoparticles at low and high kVp potentials support their further (pre)clinical evaluation.

[en] Highlights: • Dosimeters were ‘spiked’ with large radiation doses then smaller doses; 0.5–10 Gy. • Subtraction of the ^spike signal gave reliable measurements for doses below 2 Gy. • Spiking is easy to perform and requires no complex EPR signal analysis. • The method is not susceptible to EPR signal baseline distortions at doses • Spiking can extend the use of alanine/ other epr dosimeters in radiotherapy. - Abstract: Alanine dosimeters are limited in radiotherapy by poor sensitivity at low doses (< 5 Gy). A set of alanine dosimeters were ‘spiked’ with a large dose of radiation, (~30 Gy, 6 MV X-rays) and additional doses ranging between 0.5 and 10 Gy. The radical yield was measured by Electron Paramagnetic Resonance (EPR) spectroscopy, and after subtraction of the contribution from the ^spike dose, a linear correlation between the radiation dose and the area of the central EPR signal was obtained for doses between 0.5 and 10 Gy (regression value of 0.9890), and for the central peak's amplitude (regression value of 0.9895). Overall, this method is easy to perform, requires no complex EPR signal analysis, and offers much potential to extend the current usage of alanine dosimeters in radiotherapy.

[en] The main aims of this research was to employ alanine doped with gold-nanoparticles “AuNPs” to determine the levels of dose enhancement caused by these particles when irradiated with proton beams, low and high energy X-rays and electrons. DL-alanine was impregnated with 5 nm gold-nanoparticles (3% by weight) and added as a uniform layer within a wax pellet of dimensions 10 × 5 × 5 mm. Control pellets, containing DL-Alanine were also produced, and placed within a phantom, and exposed to various types of radiations: low energy (kV ranges) X-rays were obtained from a superficial machine, high energy (MV) X-rays and electrons derived from a linear accelerator, and protons were produced by the Hyogo Ion Beam Centre in Japan. Nominal doses received ranged from 2 to 20 Gy (within clinical range). The Electron Paramagnetic Resonance (EPR) spectra of the irradiated samples were recorded on a BRUKER Elexsys 9.5 MHz. The dose enhancement caused by gold nanoparticles for 80 kV x-rays was found to be more than 60% at about 5 Gy. Smaller dose enhancements (under the same measurement conditions) were observed for megavoltage x-ray beams (up to 10%). Dose enhancement caused by charged particles indicated minimal values for 6 MeV electrons (approximately 5%) whilst less than that is obtained with protons of 150 MeV. The proton results validate the latest simulation results based on Monte Carlo calculations but the dose enhancement is significantly less than that reported in cell and animal model systems, (about 20%). We attribute this difference to the fact that alanine only measures the levels of free radicals generated by the inclusion of nanoparticles and not the redox type radicals (such as reactive oxygen species) generated from aqueous media in cells. Dose enhancement caused by 5 nm gold-nanoparticles with radiotherapy type proton beams has been found to be less than 5% as determined when using alanine/wax as both a phantom and dosimeter. This agrees well with the latest Monte Carlo simulation results for similar sized gold-nanoparticles. Furthermore, our results for both low and high energy x-rays are validated against published data for in vitro studies. - Highlights: • Dose enhancement by 5 nm AuNPs (3% within alanine) determined for various beam types • Alanine/3% AuNPs composites show potential as low dose radiotherapy dosimeters (kV) • Alanine doped with AuNPs gave ∼60% dose enhancement for kV and ∼10% for MV X-rays • Alanine doped with AuNPs gave ≤5% dose enhancement for electron and proton beams • Good agreement with results for dose enhancement in cell and simulation studies

[en] Background and purpose: This prospective study sought to determine how the use of combined PET/CT for radiotherapy treatment planning of oesophageal cancer would alter the delineation of tumour volumes compared to CT alone if PET/CT is assumed to more accurately represent true disease extent. Patients and methods: All patients underwent FDG-PET/CT scanning in the radiotherapy treatment position. For each patient, two separate gross tumour volumes (GTV) were defined, one based on CT images alone (GTV-CT) and another based on combined PET/CT data (GTV-PET). Corresponding planning target volumes (PTV) were generated, and separate treatment plans were then produced. For each patient, volumetric analysis of GTV-CT, PTV-CT and GTV-PET was performed to quantify the proportion of PET-avid disease that was not included in the GTV and PTV (geographic miss) if CT data alone were used for radiotherapy planning. Assessment of the cranial and caudal extent of the primary oesophageal tumour as defined by CT alone vs PET/CT was also compared. Results: The addition of PET information altered the clinical stage in 8 of 21 eligible patients enrolled on the study (38%); 4 patients had distant metastatic disease and 4 had unsuspected regional nodal disease. Sixteen patients proceeded to the radiotherapy planning phase of the study and received definitive chemoradiation planned with the PET/CT data set. The GTV based on CT information alone excluded PET-avid disease in 11 patients (69%), and in five patients (31%) this would have resulted in a geographic miss of gross tumour. The discordance between CT and PET/CT was due mainly to differences in defining the longitudinal extent of disease in the oesophagus. The cranial extent of the primary tumour as defined by CT vs PET/CT differed in 75% of cases, while the caudal extent differed in 81%. Conclusions: This study demonstrates that if combined PET/CT is used for radiotherapy treatment planning, there may be alterations to the delineation of tumour volumes when compared to CT alone, with the potential to avoid a geographic miss of tumour