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Optical stimulated luminescence (OSL) combines reusability, sub-mm resolution, and a linear dose response in a single radiation detection technology. Such a combination is currently lacking in radiotherapy dosimetry. But OSL-films have a strong energy dependent response to keV photons due to a relative high effective atomic number (Z eff). The current work studied the applicability of a 2D OSL-film with a reduced Z eff as (IMRT/VMAT) dosimeter. Based on their commercial OSL-film experience, Agfa Healthcare N.V. produced a new experimental OSL-film for RT dosimetry. This film had a lower effective atomic number compared to the films used in radiology. Typical 2D dosimeter requirements such as uniformity, dose response, signal stability with time, and angular dependence were evaluated. Additionally, the impact of a possible residual energy dependence was assessed for the infield as well as the out-of-field region of both static beams and standard intensity modulated patterns (chair and pyramid). The OSL-film's reusable nature allowed for a film specific absolute and linear calibration including a flood-field uniformity correction. The OSL-film was scanned with a CR-15X engine based reader using a strict timing (i.e. 4 min after 'beam on' or as soon as possible) to account for spontaneous recombination. The OSL-film had good basic response properties: non-uniformities ≤2.6%, a linear dose response (0–32 Gy), a linear signal decay (0.5% min−1) over the 20 min measured, and limited angular dependence ≤2.6%. Due to variations of the energy spectrum, larger dose differences were noted outside the central region of the homogenous phantom and outside both static and IMRT fields. However, the OSL-film's measured dose differences of the IMRT patterns were lower than those of Gafchromic EBT measurements ([−1.6%, 2.1%] versus [−2.9%, 3.6%]). The current OSL-film could be used as a reusable high resolution dosimeter with read-out immediately after irradiation. Inside the (IMRT) treatment fields residual energy dependent effects were not observed. Novelty and significance: Implementing a reusable optical stimulated luminescence (OSL) film for radiotherapy dosimetry would enable user-friendly, sub(mm) resolution 2D dosimetry with instantaneous read-out. Radiology OSL-films have a strong energy dependent response which hampers accurate dosimetry. The current work reports measurements with a first 2D OSL-film tailored to the radiotherapy needs: including an improved water equivalent composition. The dosimeter adds the ability for sub-mm resolution repeated measurements to the portfolio of radiotherapy dosimetry.

PURPOSE: 3D printing technology is investigated for the purpose of patient immobilization during proton therapy. It potentially enables a merge of patient immobilization, bolus range shifting, and other functions into one single patient-specific structure. In this first step, a set of 3D printed materials is characterized in detail, in terms of structural and radiological properties, elemental composition, directional dependence, and structural changes induced by radiation damage. These data will serve as inputs for the design of 3D printed immobilization structure prototypes. METHODS: Using four different 3D printing techniques, in total eight materials were subjected to testing. Samples with a nominal dimension of 20 × 20 × 80 mm3 were 3D printed. The geometrical printing accuracy of each test sample was measured with a dial gage. To assess the mechanical response of the samples, standardized compression tests were performed to determine the Young's modulus. To investigate the effect of radiation on the mechanical response, the mechanical tests were performed both prior and after the administration of clinically relevant dose levels (70 Gy), multiplied with a safety factor of 1.4. Dual energy computed tomography (DECT) methods were used to calculate the relative electron density to water ρe, the effective atomic number Zeff, and the proton stopping power ratio (SPR) to water SPR. In order to validate the DECT based calculation of radiological properties, beam measurements were performed on the 3D printed samples as well. Photon irradiations were performed to measure the photon linear attenuation coefficients, while proton irradiations were performed to measure the proton range shift of the samples. The directional dependence of these properties was investigated by performing the irradiations for different orientations of the samples. RESULTS: The printed test objects showed reduced geometric printing accuracy for 2 materials (deviation > 0.25 mm). Compression tests yielded Young's moduli ranging from 0.6 to 2940 MPa. No deterioration in the mechanical response was observed after exposure of the samples to 100 Gy in a therapeutic MV photon beam. The DECT-based characterization yielded Zeff ranging from 5.91 to 10.43. The SPR and ρe both ranged from 0.6 to 1.22. The measured photon attenuation coefficients at clinical energies scaled linearly with ρe. Good agreement was seen between the DECT estimated SPR and the measured range shift, except for the higher Zeff. As opposed to the photon attenuation, the proton range shifting appeared to be printing orientation dependent for certain materials. CONCLUSIONS: In this study, the first step toward 3D printed, multifunctional immobilization was performed, by going through a candidate clinical workflow for the first time: from the material printing to DECT characterization with a verification through beam measurements. Besides a proof of concept for beam modification, the mechanical response of printed materials was also investigated to assess their capabilities for positioning functionality. For the studied set of printing techniques and materials, a wide variety of mechanical and radiological properties can be selected from for the intended purpose. Moreover the elaborated hybrid DECT methods aid in performing in-house quality assurance of 3D printed components, as these methods enable the estimation of the radiological properties relevant for use in radiation therapy. received: 2016-04-24 revised: 2016-08-12 accepted: 2016-08-21 published: 2016-09-07 ispartof: Medical Physics vol:43 issue:10 pages:5392-5403 ispartof: location:United States status: published

3D printing is investigated for application in patient immobilization during proton therapy (PT). It potentially enables a merge of immobilization, range shifting and other functionality into one patient-specific structure. Beside minimizing the lateral beam spread due to the removal of air gap it could also reduce the collision risk and the treatment time compared to movable nozzle snouts. In this first study, 9 different 3D printed materials were characterized in detail. The resulting data (Table 1) will serve as input for the design of a printed immobilization structure. The printed test objects showed reduced geometric printing accuracy for 3 materials. Compression testing yielded Young’s moduli from 0.6 MPa to 3445 MPa, without deterioration after exposure to 100 Gy in a MV photon beam. Dual-energy CT methods were used to estimate the effective atomic number Zeff, the relative electron density e and the stopping power ratio SPR. Zeff ranged from 5.91 to 10.43. The SPR and e both ranged from 0.6 to 1.22. The measured photon attenuation coefficients at therapeutic energies scaled linearly with e. In a 62 MeV proton beam, good agreement was seen between the DECT estimated SPR and the measured range shift, except for the higher Zeff. As opposed to the photon attenuation, the proton range shifting was printing orientation dependent for certain materials. In conclusion printed materials exhibit a wide variation in structural and radiological properties. The quantification of these characteristics enables optimal material selection for the design of a multifunctional 3D printed immobilization structure for PT.

Van Herck H., Crijns W., Slagmolen P., Depuydt T., Haustermans K., Maes F., ''Investigating the need for additional kV imaging in marker based prostate motion tracking using the MV treatment beam'', Technical report KUL/ESAT/PSI/1504, KU Leuven, ESAT, December 2015, Leuven, Belgium. ispartof: Technical report KUL/ESAT/PSI/1504, KU Leuven, ESAT, Leuven, Belgium status: published

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Purpose: Because frame rates on current clinical available electronic portal imaging devices (EPID's) are limited to 7.5 Hz, a new commercially available PerkinElmer EPID (XRD 1642 AP19) with a maximum frame rate of 30 Hz and a new scintillator (Kyokko PI200) with improved sensitivity (light output) for megavolt (MV) irradiation was evaluated. In this work, the influence of MV pulse artifacts and pulsing artifact suppression techniques on fiducial marker and marker-less detection of a lung lesion was investigated, because target localization is an important component of uncertainty in geometrical verification of real-time tumor tracking. Methods: Visicoil (TM) markers with a diameter of 0.05 and 0.075 cm were used for MV marker tracking with a frame rate of, respectively, 7.5, 15, and 30 Hz. A 30 Hz readout of the detector was obtained by a 2x2 pixel binning, reducing spatial resolution. Static marker detection was conducted in function of increasing phantom thickness. Additionally, marker-less tracking was conducted and compared with the ground-truth fiducial marker motion. Performance of MV target detection was investigated by comparing the least-square sine wave fit of the detected marker positions with the predefined sine wave motion. For fiducial marker detection, a Laplacian-of-Gaussian enhancement was applied after which normalized cross correlation was used to find the most probable marker position. Marker-less detection was performed by using the scale and orientation adaptive mean shift tracking algorithm. For each MV fluoroscopy, a free running (FR-nF) (ignoring MV pulsing during readout) acquisition mode was compared with two acquisition modes intending to reduce MV pulsing artifacts, i.e., combined wavelet-FFT filtering (FR-wF) and electronic readout synchronized with respect to MV pulses. Results: A 0.05 cm Visicoil marker resulted in an unacceptable root-mean square error (RMSE) > 0.2 cm with a maximum frame rate of 30 Hz during FR-nF readout. With a 30 Hz synchronized readout (S-nF) and during 15 Hz readout (independent of readout mode), RMSE was submillimeter for a static 0.05 cm Visicoil. A dynamic 0.05 cm Visicoil was not detectable on the XRD 1642 AP19, despite a fast synchronized readout. For a 0.075 cm Visicoil, deviations of sine wave motion were submillimeter (RMSE < 0.08 cm), independent of the acquisition mode (FR, S). For marker-less tumor detection, FR-nF images resulted in RMSE > 0.3 cm, while for MV fluoroscopy in S-mode RMSE < 0.1 cm for 15 Hz and RMSE < 0.16 cm for 30 Hz. Largest consistency in target localization was experienced during 15 Hz S-nF readout. Conclusions: In general, marker contrast decreased in function of higher frame rates, which was detrimental for marker detection success. In this work, Visicoils with a thickness of 0.075 cm were showing best results for a 15 Hz frame rate, while non-MV compatible 0.05 cm Visicoil markers were not visible on the new EPID with improved sensitivity compared to EPID models based on a Kodak Lanex Fast scintillator. No noticeable influence of pulsing artifacts on the detection of a 0.075 cm Visicoil was observed, while a synchronized readout provided most reliable detection of a marker-less soft-tissue structure. (C) 2014 American Association of Physicists in Medicine.

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Background and purpose: To report the feasibility and clinical validation of an in-house developed MOSFET dosimetry system and describing an integrated non-destructive reset procedure. Material and Methods: Off-the-shelf MOSFETs are connected to a common PC using an 18bit/analogueinput and 16bit/output data acquisition card. A reading algorithm was developed defining the Zero- Temperature-Coefficient point to determine the threshold voltage. A wireless interface was established for ease-of-use. The reset procedure consists of an internal circuit generating a local heating induced by an electrical current. Sensitivity has been investigated as a function of bias voltage (0V-9V) to the gate. Dosimetric properties have been evaluated for 6MV and 15MV clinical photon beams and in vivo benchmarking was performed against TLD for conventional treatments (2 groups of 10 patients for each energy) and TBI. Results: MOSFETS were pre-irradiated with 20Gy. Sensitivity of 0.08mV/cGy can be obtained for 200cGy irradiations at 5V bias voltage. Ten consecutive measurements at 200cGy yield a SD of 2.08cGy (1.05%). Increasing dose in steps from 5cGy to 1000cGy yields a 1.00 Pearson correlation coefficient and agreement within 2.0%. Dose rate dependence (160-800cGy/min) was within 2.5%, temperature dependence within 2.0% (25-37ºC). A strong angular dependence has been observed for gantry incidences exceeding ±30º. Dose response is stable up to 50Gy (saturation occurs at approximately 90Gy), which is used as threshold dose before resetting the MOSFET. An average measured-overcalculated dose ratio within 1.05 (SD: 0.04) has been obtained in vivo. TBI midplane-dose assessed by entrance and exit dose measurements agreed within 1.9% with ionisation chamber in phantom, and within 1.0% with TLD in vivo. Conclusions: An in-house developed resettable MOSFET-based dosimetry system is proposed. The system has been validated and is currently used for in vivo entrance dose measurement in clinical routine for simple (open field) treatment configurations.

nrpages: 193 status: published