Bloemen-van Gurp Esther J, Murrer Lars H P, Haanstra Björk K C, van Gils Francis C J M, Dekker Andre L A J, Mijnheer Ben J, Lambin Philippe
Department of Radiation Oncology, Maastro Clinic, Research Institute Growth and Development (GROW), University Hospital Maastricht, Maastricht, The Netherlands.
Int J Radiat Oncol Biol Phys. 2009 Jan 1;73(1):314-21. doi: 10.1016/j.ijrobp.2008.08.040.
In vivo dosimetry during brachytherapy of the prostate with (125)I seeds is challenging because of the high dose gradients and low photon energies involved. We present the results of a study using metal-oxide-semiconductor field-effect transistor (MOSFET) dosimeters to evaluate the dose in the urethra after a permanent prostate implantation procedure.
Phantom measurements were made to validate the measurement technique, determine the measurement accuracy, and define action levels for clinical measurements. Patient measurements were performed with a MOSFET array in the urinary catheter immediately after the implantation procedure. A CT scan was performed, and dose values, calculated by the treatment planning system, were compared to in vivo dose values measured with MOSFET dosimeters.
Corrections for temperature dependence of the MOSFET array response and photon attenuation in the catheter on the in vivo dose values are necessary. The overall uncertainty in the measurement procedure, determined in a simulation experiment, is 8.0% (1 SD). In vivo dose values were obtained for 17 patients. In the high-dose region (> 100 Gy), calculated and measured dose values agreed within 1.7% +/- 10.7% (1 SD). In the low-dose region outside the prostate (< 100 Gy), larger deviations occurred.
MOSFET detectors are suitable for in vivo dosimetry during (125)I brachytherapy of prostate cancer. An action level of +/- 16% (2 SD) for detection of errors in the implantation procedure is achievable after validation of the detector system and measurement conditions.
由于近距离放射治疗前列腺癌时使用碘-125种子源存在高剂量梯度和低光子能量问题,因此进行体内剂量测定具有挑战性。我们展示了一项使用金属氧化物半导体场效应晶体管(MOSFET)剂量计评估永久性前列腺植入术后尿道剂量的研究结果。
进行模体测量以验证测量技术、确定测量准确性并定义临床测量的行动水平。在植入手术后立即使用MOSFET阵列在导尿管中对患者进行测量。进行CT扫描,并将治疗计划系统计算的剂量值与使用MOSFET剂量计测量的体内剂量值进行比较。
有必要对MOSFET阵列响应的温度依赖性和导尿管中光子衰减对体内剂量值进行校正。在模拟实验中确定的测量过程总体不确定度为8.0%(1标准差)。获得了17名患者的体内剂量值。在高剂量区域(>100 Gy),计算剂量值和测量剂量值在1.7%±10.7%(1标准差)范围内一致。在前列腺外的低剂量区域(<100 Gy),出现了较大偏差。
MOSFET探测器适用于前列腺癌碘-125近距离放射治疗期间的体内剂量测定。在验证探测器系统和测量条件后,可实现用于检测植入过程中误差的±16%(2标准差)行动水平。