In vivo dosimetry in intraoperative electron radiotherapy

López-Tarjuelo, Juan; Bouché-Babiloni, Ana; Morillo-Macías, Virginia; Marco-Blancas, N. de; Santos-Serra, Agustín; Quirós-Higueras, Juan David; Ferrer-Albiach, Carlos

doi:10.1007/s00066-014-0689-y

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…MOSFET or microMOSFET dosimeters have been proposed for online in vivo dosimetry in IOERT procedures for different tumor types [ 13 – 15 ]. Gafchromic and radiochromic films wrapped in sterile envelopes for offline in vivo breast or rectal dosimetry [ 34 , 35 ] were also used.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the very high planned dose in an IOERT treatment, in vivo dosimetry is highly recommended in order to: verify the correct delivery of irradiation; apply possible monitor units corrections and record the dose received by patients [ 12 ]. Dosimeters like MOSFETs and radiochromic films have been routinely used for this purpose [ 13 – 15 ]. Although thermoluminescent dosimeters (TLDs) are well-established for in vivo dose verification, their response to IOERT beams has not been yet investigated.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of LiF:Mg,Ti (TLD-100) for Intraoperative Electron Radiation Therapy Quality Assurance

et al. 2015

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BackgroundPurpose of the present work was to investigate thermoluminescent dosimeters (TLDs) response to intraoperative electron radiation therapy (IOERT) beams. In an IOERT treatment, a large single radiation dose is delivered with a high dose-per-pulse electron beam (2–12 cGy/pulse) during surgery. To verify and to record the delivered dose, in vivo dosimetry is a mandatory procedure for quality assurance. The TLDs feature many advantages such as a small detector size and close tissue equivalence that make them attractive for IOERT as in vivo dosimeters.MethodsLiF:Mg,Ti dosimeters (TLD-100) were irradiated with different IOERT electron beam energies (5, 7 and 9 MeV) and with a 6 MV conventional photon beam. For each energy, the TLDs were irradiated in the dose range of 0–10 Gy in step of 2Gy. Regression analysis was performed to establish the response variation of thermoluminescent signals with dose and energy.ResultsThe TLD-100 dose-response curves were obtained. In the dose range of 0–10 Gy, the calibration curve was confirmed to be linear for the conventional photon beam. In the same dose region, the quadratic model performs better than the linear model when high dose-per-pulse electron beams were used (F test; p<0.05).ConclusionsThis study demonstrates that the TLD dose response, for doses ≤10Gy, has a parabolic behavior in high dose-per-pulse electron beams. TLD-100 can be useful detectors for IOERT patient dosimetry if a proper calibration is provided.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of LiF:Mg,Ti (TLD-100) for Intraoperative Electron Radiation Therapy Quality Assurance

et al. 2015

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“…The difficulty of inserting more than one MOSFET has also been identified elsewhere [ 24 ]. In addition, it has been pointed out that MOSFETs are presumably more difficult for the surgeon to initially handle because they have to be inserted with sterile components and attached onto the surgical bed [ 15 ]. Moreover, the compression placed on the MOSFET by the applicator can also move it [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fruitful experiences based either on metal oxide semiconductor field effect transistors (MOSFETs) [ 10 – 12 ], radiochromic films [ 13 , 14 ], or both [ 15 ] have been reported. However, information about in vivo dosimetry in intraoperative radiotherapy is somewhat scarce.…”

Section: Introductionmentioning

confidence: 99%

Implementation of an intraoperative electron radiotherapy in vivo dosimetry program

et al. 2016

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BackgroundIntraoperative electron radiotherapy (IOERT) is a highly selective radiotherapy technique which aims to treat restricted anatomic volumes during oncological surgery and is now the subject of intense re-evaluation. In vivo dosimetry has been recommended for IOERT and has been identified as a risk-reduction intervention in the context of an IOERT risk analysis. Despite reports of fruitful experiences, information about in vivo dosimetry in intraoperative radiotherapy is somewhat scarce. Therefore, the aim of this paper is to report our experience in developing a program of in vivo dosimetry for IOERT, from both multidisciplinary and practical approaches, in a consistent patient series. We also report several current weaknesses.MethodsReinforced TN-502RDM-H mobile metal oxide semiconductor field effect transistors (MOSFETs) and Gafchromic MD-55-2 films were used as a redundant in vivo treatment verification system with an Elekta Precise fixed linear accelerator for calibrations and treatments. In vivo dosimetry was performed in 45 patients in cases involving primary tumors or relapses. The most frequent primary tumors were breast (37 %) and colorectal (29 %), and local recurrences among relapses was 83 %. We made 50 attempts to measure with MOSFETs and 48 attempts to measure with films in the treatment zones. The surgical team placed both detectors with supervision from the radiation oncologist and following their instructions.ResultsThe program was considered an overall success by the different professionals involved. The absorbed doses measured with MOSFETs and films were 93.8 ± 6.7 % and 97.9 ± 9.0 % (mean ± SD) respectively using a scale in which 90 % is the prescribed dose and 100 % is the maximum absorbed dose delivered by the beam. However, in 10 % of cases we experienced dosimetric problems due to detector misalignment, a situation which might be avoided with additional checks. The useful MOSFET lifetime length and the film sterilization procedure should also be controlled.ConclusionsIt is feasible to establish an in vivo dosimetry program for a wide set of locations treated with IOERT using a multidisciplinary approach according to the skills of the professionals present and the detectors used; oncological surgeons’ commitment is key to success in this context. Films are more unstable and show higher uncertainty than MOSFETs but are cheaper and are useful and convenient if real-time treatment monitoring is not necessary.

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“…On the other hand, publications on IOERT for applications outside the breast mostly report clinical results and do not describe dosimetric aspects (e.g [10,28]). Besides the work of Costa et al [29], who reported in vivo dosimetry for pelvis IOERT on a limited series of 32 patients, very few studies [4,30] report results of in vivo dosimetry outside the breast.…”

Section: Introductionmentioning

confidence: 99%

Electron radiotherapy (IOERT) for applications outside of the breast: Dosimetry and influence of tissue inhomogeneities

et al. 2020

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In vivo dosimetry in intraoperative electron radiotherapy

Abstract: In vivo dosimetry can produce satisfactory results at every studied location with a general-purpose linac. Detector choice should depend on user factors, not on the detector performance itself. Surgical team collaboration is crucial to success.

Cited by 10 publications

References 20 publications

Evaluation of LiF:Mg,Ti (TLD-100) for Intraoperative Electron Radiation Therapy Quality Assurance

Evaluation of LiF:Mg,Ti (TLD-100) for Intraoperative Electron Radiation Therapy Quality Assurance

Implementation of an intraoperative electron radiotherapy in vivo dosimetry program

Electron radiotherapy (IOERT) for applications outside of the breast: Dosimetry and influence of tissue inhomogeneities

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