Fakultät Physik, Technische Universität Dortmund, D 44221 Dortmund, Germany.
Med Phys. 2009 Oct;36(10):4634-43. doi: 10.1118/1.3218762.
The therapeutic outcome of the therapy with ophthalmic applicators is highly dependent on the application of a sufficient dose to the tumor, whereas the dose applied to the surrounding tissue needs to be minimized. The goal for the newly developed apparatus described in this work is the determination of the individual applicator surface dose rate distribution with a high spatial resolution and a high precision in dose rate with respect to time and budget constraints especially important for clinical procedures. Inhomogeneities of the dose rate distribution can be detected and taken into consideration for the treatment planning.
In order to achieve this, a dose rate profile as well as a surface profile of the applicator are measured and correlated with each other. An instrumental setup has been developed consisting of a plastic scintillator detector system and a newly designed apparatus for guiding the detector across the applicator surface at a constant small distance. It performs an angular movement of detector and applicator with high precision.
The measurements of surface dose rate distributions discussed in this work demonstrate the successful operation of the measuring setup. Measuring the surface dose rate distribution with a small distance between applicator and detector and with a high density of measuring points results in a complete and gapless coverage of the applicator surface, being capable of distinguishing small sized spots with high activities. The dosimetrical accuracy of the measurements and its analysis is sufficient (uncertainty in the dose rate in terms of absorbed dose to water is <7%), especially when taking the surgical techniques in positioning of the applicator on the eyeball into account.
The method developed so far allows a fully automated quality assurance of eye applicators even under clinical conditions. These measurements provide the basis for future calculation of a full 3D dose rate distribution, which then can be used as input for a refined clinical treatment planning system. The improved dose rate measurements will facilitate a clinical study, which could correlate the therapeutic outcome of a brachytherapy treatment with an applicator and its individual dose rate distribution.
眼科施源器治疗的疗效高度依赖于将足够剂量施用于肿瘤,同时需要将施用于周围组织的剂量最小化。本工作中所描述的新开发设备的目标是,在时间和预算限制的情况下,以高空间分辨率和高精度确定施源器表面剂量率分布,这对于临床程序尤为重要。可以检测剂量率分布的不均匀性,并将其纳入治疗计划中。
为了实现这一目标,测量了剂量率曲线和施源器的表面轮廓,并将它们相互关联。开发了一种仪器设置,由塑料闪烁体探测器系统和新设计的装置组成,用于在施源器表面以恒定的小距离引导探测器。它可以高精度地执行探测器和施源器的角运动。
本工作中讨论的表面剂量率分布的测量结果证明了测量设置的成功运行。在施源器和探测器之间保持小距离,并以高测量点密度测量表面剂量率分布,可实现施源器表面的完全无间隙覆盖,能够区分具有高活性的小尺寸点。测量的剂量学准确性及其分析是足够的(水吸收剂量的剂量率不确定度<7%),尤其是考虑到在眼球上定位施源器的手术技术时。
迄今为止开发的方法甚至可以在临床条件下实现眼科施源器的全自动质量保证。这些测量结果为未来计算完整的 3D 剂量率分布提供了基础,然后可以将其用作精细临床治疗计划系统的输入。改进的剂量率测量将促进一项临床研究,该研究可以将近距离放射治疗的疗效与施源器及其个体剂量率分布相关联。