1. Dose perturbation due to dental amalgam in the head and neck radiotherapy: A phantom study
- Author
-
Iraj Abedi, Alireza Amouheidari, Pegah Saadatmand, and Ahmad Shanei
- Subjects
Dose perturbation ,medicine.medical_treatment ,Dose distribution ,Dental Amalgam ,Imaging phantom ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Head and neck radiotherapy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiation treatment planning ,Head and neck ,Radiological and Ultrasound Technology ,Phantoms, Imaging ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Nasopharyngeal Neoplasms ,Radiotherapy Dosage ,Radiation therapy ,stomatognathic diseases ,Oncology ,030220 oncology & carcinogenesis ,Thermoluminescent Dosimetry ,Radiotherapy, Intensity-Modulated ,Thermoluminescent dosimeter ,Nuclear medicine ,business - Abstract
Dental amalgam, causes perturbation in photon dose distribution of head and neck (H&N) radiotherapy. The aim of this study was to evaluate the effects of dental amalgam on dose distribution of H&N radiotherapy and accuracy of dose calculations algorithm of commercial treatment planning system (TPS). In this study, the measurements were performed using a constructed H&N anthropomorphic. The sample of healthy teeth and teeth filled by amalgam inserted in the desired segment of the phantom in turn. After scanning and organs segmentation of phantom, intensity-modulated radiation therapy (IMRT) plan including 7 fields in the absence (plan 1) and presence (plan 2) of dental amalgam were created separately. Phantom was irradiated using 6 MV linear accelerator (SIMENS-ARTISTE, 5918). Assessment of the effects of dental amalgam on dose distribution and the accuracy of dose calculation algorithm of TPS was done by measurement and comparing of organ's received dose using thermoluminescent dosimeter (TLDs), placed on a phantom and TPS calculations. The scattering and attenuation due to the presence of dental amalgam led to an increase in parotid glands received dose (up to 24.38%) and a decrease in mean dose (up to -6.25%) PTV70. Results of this study revealed that discrepancies between the collapsed cone convolution (CCC) algorithm calculations Prowess Panther TPS and TLD measurements were -19.77% to 27.49% in presence of amalgam and -1.09% to 5.03% in presence of healthy teeth in phantoms. Attenuation and scattering due to amalgam in IMRT of H&N cancer may lead to a significant dose perturbation which is not predictable by dose calculation of TPS.
- Published
- 2020
- Full Text
- View/download PDF