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Comparison of TLD calibration methods for 192Ir dosimetry.

ABSTRACT: For the purpose of dose measurement using a high-dose rate (192)Ir source, four methods of thermoluminescent dosimeter (TLD) calibration were investigated. Three of the four calibration methods used the (192)Ir source. Dwell times were calculated to deliver 1 Gy to the TLDs irradiated either in air or water. Dwell time calculations were confirmed by direct measurement using an ionization chamber. The fourth method of calibration used 6 MV photons from a medical linear accelerator, and an energy correction factor was applied to account for the difference in sensitivity of the TLDs in (192)Ir and 6 MV. The results of the four TLD calibration methods are presented in terms of the results of a brachytherapy audit where seven Australian centers irradiated three sets of TLDs in a water phantom. The results were in agreement within estimated uncertainties when the TLDs were calibrated with the (192)Ir source. Calibrating TLDs in a phantom similar to that used for the audit proved to be the most practical method and provided the greatest confidence in measured dose. When calibrated using 6 MV photons, the TLD results were consistently higher than the (192)Ir-calibrated TLDs, suggesting this method does not fully correct for the response of the TLDs when irradiated in the audit phantom.

SUBMITTER: Haworth A

PROVIDER: S-EPMC5714053 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Comparison of TLD calibration methods for 192Ir dosimetry.

Haworth Annette A Butler Duncan J DJ Wilfert Lisa L Ebert Martin A MA Todd Stephen P SP Hayton Anna J M AJ Kron Tomas T

Journal of applied clinical medical physics 20130107 1

For the purpose of dose measurement using a high-dose rate (192)Ir source, four methods of thermoluminescent dosimeter (TLD) calibration were investigated. Three of the four calibration methods used the (192)Ir source. Dwell times were calculated to deliver 1 Gy to the TLDs irradiated either in air or water. Dwell time calculations were confirmed by direct measurement using an ionization chamber. The fourth method of calibration used 6 MV photons from a medical linear accelerator, and an energy ...[more]

PMID: 23318392

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Project description:BACKGROUND:Red bone marrow (RBM) toxicity is dose-limiting in (pretargeted) radioimmunotherapy (RIT). Previous blood-based and two-dimensional (2D) image-based methods have failed to show a clear dose-response relationship. We developed a three-dimensional (3D) image-based RBM dosimetry approach using the Monte Carlo-based 3D radiobiological dosimetry (3D-RD) software and determined its additional value for predicting RBM toxicity. METHODS:RBM doses were calculated for 13 colorectal cancer patients after pretargeted RIT with the two-step administration of an anti-CEA × anti-HSG bispecific monoclonal antibody and a (177)Lu-labeled di-HSG-peptide. 3D-RD RBM dosimetry was based on the lumbar vertebrae, delineated on single photon emission computed tomography (SPECT) scans acquired directly, 3, 24, and 72 h after (177)Lu administration. RBM doses were correlated to hematologic effects, according to NCI-CTC v3 and compared with conventional 2D cranium-based and blood-based dosimetry results. Tumor doses were calculated with 3D-RD, which has not been possible with 2D dosimetry. Tumor-to-RBM dose ratios were calculated and compared for (177)Lu-based pretargeted RIT and simulated pretargeted RIT with (90)Y. RESULTS:3D-RD RBM doses of all seven patients who developed thrombocytopenia were higher (range 0.43 to 0.97 Gy) than that of the six patients without thrombocytopenia (range 0.12 to 0.39 Gy), except in one patient (0.47 Gy) without thrombocytopenia but with grade 2 leucopenia. Blood and 2D image-based RBM doses for patients with grade 1 to 2 thrombocytopenia were in the same range as in patients without thrombocytopenia (0.14 to 0.29 and 0.11 to 0.26 Gy, respectively). Blood-based RBM doses for two grade 3 to 4 patients were higher (0.66 and 0.51 Gy, respectively) than the others, and the cranium-based dose of only the grade 4 patient was higher (0.34 Gy). Tumor-to-RBM dose ratios would increase by 25% on average when treating with (90)Y instead of (177)Lu. CONCLUSIONS:3D dosimetry identifies patients at risk of developing any grade of RBM toxicity more accurately than blood- or 2D image-based methods. It has the added value to enable calculation of tumor-to-RBM dose ratios.

Project description:PurposeInvestigate reproducibility of two segmentation methods for multicompartment dosimetry, including normal tissue absorbed dose (NTAD) and tumour absorbed dose (TAD), in hepatocellular carcinoma patients treated with yttrium-90 (90Y) glass microspheres.MethodsTARGET was a retrospective investigation in 209 patients with < 10 tumours per lobe and at least one tumour ≥ 3 cm ± portal vein thrombosis. Dosimetry was compared using two distinct segmentation methods: anatomic (CT/MRI-based) and count threshold-based on pre-procedural 99mTc-MAA SPECT. In a round robin substudy in 20 patients with ≤ 5 unilobar tumours, the inter-observer reproducibility of eight reviewers was evaluated by computing reproducibility coefficient (RDC) of volume and absorbed dose for whole liver, whole liver normal tissue, perfused normal tissue, perfused liver, total perfused tumour, and target lesion. Intra-observer reproducibility was based on second assessments in 10 patients ≥ 2 weeks later.Results99mTc-MAA segmentation calculated higher absorbed doses compared to anatomic segmentation (n = 209), 43.9% higher for TAD (95% limits of agreement [LoA]: - 49.0%, 306.2%) and 21.3% for NTAD (95% LoA: - 67.6%, 354.0%). For the round robin substudy (n = 20), inter-observer reproducibility was better for anatomic (RDC range: 1.17 to 3.53) than 99mTc-MAA SPECT segmentation (1.29 to 7.00) and similar between anatomic imaging modalities (CT: 1.09 to 3.56; MRI: 1.24 to 3.50). Inter-observer reproducibility was better for larger volumes. Perfused normal tissue volume RDC was 1.95 by anatomic and 3.19 by 99mTc-MAA SPECT, with corresponding absorbed dose RDC 1.46 and 1.75. Total perfused tumour volume RDC was higher, 2.92 for anatomic and 7.0 by 99mTc-MAA SPECT with corresponding absorbed dose RDC of 1.84 and 2.78. Intra-observer variability was lower for perfused NTAD (range: 14.3 to 19.7 Gy) than total perfused TAD (range: 42.8 to 121.4 Gy).ConclusionAnatomic segmentation-based dosimetry, versus 99mTc-MAA segmentation, results in lower absorbed doses with superior reproducibility. Higher volume compartments, such as normal tissue versus tumour, exhibit improved reproducibility.Trial registrationNCT03295006.

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Comparison of TLD calibration methods for 192Ir dosimetry.

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Comparison of TLD calibration methods for 192Ir dosimetry.

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