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Glucose, sucrose, starch, and locust bean gum have been used as additives to the ferrous-agarose-xylenol orange (FAX) gel dosimeter. The saccharide enhanced dosimeters were found to have a higher dose sensitivity over a standard FAX gel as measured by both optical density change and magnetic resonance imaging (MRI). With optical density measurement, OD-dose sensitivity increases were up to 55% for glucose, 122% for sucrose and 43% for starch, while locust bean gum did not give a consistent response. With MRI, R1-dose sensitivity increases were up to 178% with sucrose addition. The FAX gel with sucrose was studied in greatest detail. The OD-dose sensitivity dependence on cooling rate was reduced for the sucrose FAX gel over the standard FAX gel, which has significant implications for uniform dose sensitivity in large gel phantoms. The thermal oxidation rate in the sucrose FAX gel was up to 2.3 times higher than in the standard gel. The OD-dose sensitivity of oxygenated sucrose FAX gels was 4.3 times greater than standard FAX gels, while continued enhancement in OD-dose sensitivity with increased sucrose concentrations beyond 2.0 g/l was found only for the oxygenated sucrose FAX gels. Both the molar absorption coefficient of the ferric ion-xylenol orange complex at 543 nm and gel pH were not affected by the presence of sucrose, with the implication that the higher OD-dose sensitivity of gels with saccharides is due to increased chain reaction production of ferric ions.

The spatial accuracy of magnetic resonance imaging (MRI) Fricke-gel dosimetry is limited by diffusion of ferric ions. This paper describes a honeycomb structure to limit diffusion of Fe3+ ions in a three-dimensional phantom. Such a phantom containing the dosimeter gel was irradiated to a known dose distribution. Maps of dose distributions were produced from the MR images acquired at 2 and 24 hours after the dose was given. The dose distribution maps verified that the honeycomb structure precludes ion diffusion from one honeycomb cell to another, thus improving the usefulness of MRI Fricke-gel dosimetry.

The purpose of this work is to undertake a critical appraisal of the evidence in the published literature concerning the basic parameters of accuracy and precision associated with the use of Fricke and polymer gels (in conjunction with MR imaging) as radiation dosimeters in photon radiotherapy, condensing and analysing the body of published information (to the end of April 2002). A systematic review was undertaken addressing specific issues of precision and accuracy asking defined questions of the published literature. Accuracy and precision in relation to gel dosimetry were defined. Information was obtained from published, peer-reviewed journals. A defined search strategy utilizing MeSH headings and keywords, with extensive use of cross-referencing, identified 115 references dealing with gel dosimetry. Exclusion criteria were used to select only data from publications which would give unequivocal evidence. For accuracy, results had to be compared with an ionization chamber as gold standard and all gel samples had to be manufactured in the same batch. For precision, in addition to gels being from the same batch, samples must all have been irradiated at the same time and scanned simultaneously (or within a short time frame). Many results were found demonstrating 'dose mapping' examples using gels. However, there were very few publications containing firm evidence of precision and accuracy. There was no evidence which fulfilled our criteria about accuracy or precision using Fricke gels. For polymer gels only one paper was found for accuracy (4% (Low et al 1999 Med. Phys. 26 1542-51)) and precision (1.7% (Baldock et al 1998 Phys. Med. Biol. 43695-702)); however, both were carried out at only one dose level. If the exclusion criteria were relaxed to include accuracy results comparing gel to a non gold standard dosimeter (e.g. TLD), results give a median accuracy of 10% (range 8-23.5%) for polymer gel (Cosgrove et al 2000 Phys. Med. Biol. 45 1195-210, De Deene et al 1998 Radiother: Oncol. 48 283-91, Farajollahi et al 2000 Br. J. Radiol. 72 1085-92, McJury et al 1999b Phys. Med. Biol. 44 2431-44, Murphy et al 2000b Phys. Med. Biol. 45 835-45, Oldham et al 2001 Med. Phys. 28 1436-45) and 5% for Fricke gel (Chan and Ayyangar 1995b Med. Phys. 22 1171-5). Evidence also points to accuracy worsening at lower dose levels for both gels. The precision data should be viewed with caution as repeated MR measurements were not performed with the same samples. The only precision data for Fricke gels was 1.5% (Johansson Back et al 1998 Phys. Med. Biol. 43 261-76), but for zero dose. In conclusion, despite the amount of published data, sparse research has been undertaken which provides clear evidence of the accuracy and precision for both gels. That which has been published has used higher doses than would be routine in radiotherapy. The basic radiation dosimeter qualities of accuracy and precision have yet to be fully quantified for polymer and Fricke gels at clinically relevant dose levels.

Gel dosimetry based on magnetic resonance imaging (MRI) has previously been shown to provide verification of calculated dose distributions in soft tissue equivalent homogeneous phantoms. This study demonstrates how measurements of dose distribution can also be achieved in a phantom containing porous, lung-equivalent, Fricke gel. A phantom was made of Fe2+ infused low-density gel and conventional ferrous sulphate gel, filled in separate compartments in a Perspex container. Absorbed dose measurements were accomplished by MR imaging and by calibrating the proton spin-lattice relaxation rate (R1) versus absorbed dose by means of TLD measurements. This study shows that the production of lung-equivalent low-density (LD) dosimeter gel (mean CT number of -610 HU) is feasible. The MR signal detected in the LD gel dosimeter was substantially more noisy (i.e. displayed larger random fluctuations) than the signal from conventional gel, as expected. A deviation between calculated (TPS) and measured dose of about 3% (6 MV) and 4-7% (15 MV) was found in the LD region of the phantom. These results correspond well with data from other studies of dose distribution in lung-equivalent phantoms. The Fe2+ infused LD gel therefore seems suitable for measurement of absorbed dose distribution in phantoms that contain lung tissue compartments.

Ferrous sulphate gel dosimetry has the potential for measurement of absorbed dose distributions in proton therapy. The chemical properties of the gel are altered according to the radiation dose and these changes can be evaluated in three dimensions using MRI. The purpose of this work was to investigate the properties of a ferrous gel used with clinical proton beams. The gel was irradiated with both monoenergetic and range-modulated proton beams. It was then evaluated using MRI. The depth dose by means of the 1/T1 distribution was studied and compared with data from a plane-parallel plate ionization chamber. 1/T1 was shown to be proportional to the dose at a mean proton energy of approximately 90 MeV. The dose response was no different from that obtained using photon beams. However, on normalization at the entrance, the relative 1/T1 at the Bragg peak was 15-20% lower than the corresponding ionization chamber data for the monoenergetic proton beam. Better agreement was found for the modulated beam, but with significant differences close to the distal edge of the 1/T1 distribution. The change in sensitivity with depth was explained by means of a linear energy transfer dependence. This property was further studied using Monte Carlo methods.

Background and Purpose: MRI ferrous sulphate gel dosimetry has proven to be a valuable method for assessment of dose delivered in teletherapy. The intention of this study was to investigate ferrous sulphate gel as a possible dosimeter for intracavitary brachytherapy applications., Materials and Methods: A plastic duplicate of a cervix ring applicator set was submerged in Fe2(+)-infused gelatin gel. The gel was subsequently irradiated by a stepwise moving 192Ir source, using automatic afterloading equipment (Microselectron, Nucletron-Oldelft International BV, Veenendaal, The Netherlands). A 3D dose distribution was reconstructed from MR images of the gel., Results: The gel dose measurements were found to be of the same accuracy as TLD measurements. Isodose curves based on gel dosimetry and isodose curves computed by a dose planning system were generally less than 2 mm apart. MR images showing the position of the applicator set in a patient during treatment were used to obtain images describing patient anatomy in the sagittal and ring planes of the applicator set. Isodose curves computed from the gel measurements were then superimposed on these images, illustrating one possible way of linking dosimetrical and anatomical data., Conclusions: Our study shows that MRI ferrous sulphate gel dosimetry is a useful tool for studies of dose distributions in brachytherapy and their relation to critical organs. Possible improvements of the gel dosimeter lie in reducing the diffusion of ferric ions and increasing the radiation sensitivity of the gel.

The radiation-response characteristics of agarose gels prepared with Fricke dosemeter solution have been studied. The response mechanism is an increase in the NMR longitudinal relaxation rate of protons caused by ferric ions. It has been observed that: (i) oxygen saturation assures consistent and maximum sensitivity; (ii) agarose concentrations in the range 1.0-2.0% have no effect upon sensitivity; (iii) the initial G value is 150 Fe3+/100 eV for gels containing 0.5 mM Fe2+ ions; (iv) increasing NMR frequencies only causes a moderate increase in sensitivity; (v) the gel dosemeters are dose rate independent in the range 4.7-24.2 Gy min-1; (vi) sensitivity is pH dependent, being zero at pH 7; (vii) freshly prepared gels are slightly more sensitive than those more than 24 h old; and (ix) the diffusion coefficient for ferric ions in a 1.0% agarose gel containing 0.0125 M H2SO4 is 1.83 x 10(-2) cm2 h-1, and this will require consideration for the NMR imaging of dose distributions.

The measurement of absorbed dose distributions using dosemeter gel and magnetic resonance imaging (MRI) in a standard geometry has been investigated. Absorbed depth-dose curves and profiles measured with this new technique show good agreement with corresponding measurements using diodes. This was proven in a 60Co beam as well as an electron beam. The dosemeter gel is made of agarose and ferrous sulphate solution. The dose response is linear (r = 0.9996) in the investigated dose interval, 0-40 Gy. The sensitivity is a factor of about six higher compared to ordinary ferrous sulphate solution, known as 'Fricke'. This is a true 3D dose measurement technique which will have a number of applications in radiation therapy, since it is possible to mould the gel to arbitrary geometries, mix different radiation qualities and integrate the absorbed dose from different kinds of fields.