<i>In vivo</i> dosimetry for gynaecological brachytherapy using a novel position sensitive radiation detector: Feasibility study
Notice bibliographique
Résumé
PURPOSE: In gynecological radiotherapy with high dose rate (HDR)(192)Ir brachytherapy, the treatment complexity has increased due to improved optimization techniques and dose constraints. As a consequence, it has become more important to verify the dose delivery to the target and also to the organs at risk (e.g., the bladder). In vivo dosimetry, where dosimeters are placed in or on the patient, is one way of verifying the dose but until recently this was hampered by motion of the radiation detectors with respect to the source. The authors present a novel dosimetry method using a position sensitive radiation detector. METHODS: The prototype RADPOS system (Best Medical Canada) consists of a metal oxide field effect transistor (MOSFET) dosimeter coupled to a position-sensor, which deduces its 3D position in a magnetic field. To assess the feasibility of in vivo dosimetry based on the RADPOS system, different characteristics of the detector need to be investigated. Using a PMMA phantom, the positioning accuracy of the RADPOS system was quantified by comparing position readouts with the known position of the detector along the x and y-axes. RADPOS dose measurements were performed at various distances from a Nucletron(192)Ir source in a PMMA phantom to evaluate the energy dependence of the MOSFET. A sensitivity analysis was performed by calculating the dose after varying (1) the position of the RADPOS detector to simulate organ motion and (2) the position of the first dwell position to simulate errors in delivery. The authors also performed an uncertainty analysis to determine the action level (AL) that should be used during in vivo dosimetry. RESULTS: Positioning accuracy is found to be within 1 mm in the 1-10 cm range from the origin along the x-axis (away from the transmitter), meeting the requirements for in vivo dosimetry. Similar results are obtained for the other axes. The ALs are chosen to take into account the total uncertainty on the measurements. As a consequence for in vivo dosimetry, it is determined that the RADPOS sensor, if placed, for example, in the bladder Foley balloon, would detect a 2 mm motion of the bladder, at a 5% chance of a false positive, with an AL limit of 9% of the dose delivered. The authors found that source position errors, caused by, e.g., a wrong first dwell position, are more difficult to detect; indeed, with our single RADPOS detector, positioned in the bladder, dwell position errors below 5 mm and resulting in a dose error within 10%, could be detected in the tandem but not in the colpostats. A possible solution to improve error detection is to use multiple MOSFETs to obtain multiple dose values. CONCLUSIONS: In this study, the authors proposed a dosimetry procedure, based on the novel RADPOS system, to accurately determine the position of the radiation dosimeter with respect to the applicator. The authors found that it is possible to monitor the delivered dose in a point and compare it to the predetermined dose. This allows in principle the detection of problems such as bladder motion/filling or source mispositioning. Further clinical investigation is warranted.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».