Marco Zaider

Purpose: This paper presents initial experimental results from a prototype of high dose rate (HDR) BrachyView, a novel in‐body source tracking system for HDR brachytherapy based on a multipinhole tungsten collimator and a high resolution pixellated silicon detector array. The probe and its associated position estimation algorithms are validated and a comprehensive evaluation of the accuracy of its position estimation capabilities is presented.Methods: The HDR brachytherapy source is moved through a sequence of positions in a prostate phantom, for various displacements in x, y, and z. For each position, multiple image acquisitions are performed, and source positions are reconstructed. Error estimates in each dimension are calculated at each source position and combined to calculate overall positioning errors. Gafchromic film is used to validate the accuracy of source placement within the phantom.Results: More than 90% of evaluated source positions were estimated with an error of less than one millimeter, with the worst‐case error being 1.3 mm. Experimental results were in close agreement with previously published Monte Carlo simulation results.Conclusions: The prototype of HDR BrachyView demonstrates a satisfactory level of accuracy in its source position estimation, and additional improvements are achievable with further refinement of HDR BrachyView's image processing algorithms.

Microdosimetry is an extremely useful technique, used for dosimetry in unknown mixed radiation fields typical of space and aviation, as well as in hadron therapy. A new silicon microdosimeter with 3D sensitive volumes has been proposed to overcome the shortcomings of the conventional Tissue Equivalent Proportional Counter. In this article, the charge collection characteristics of a new 3D mesa microdosimeter were investigated using the ANSTO heavy ion microprobe utilizing 5.5 MeV He ²⁺ and 2 MeV H ⁺ ions. Measurement of the microdosimetric characteristics allowed for the determination of the Relative Biological Effectiveness of the ¹² C heavy ion therapy beam at the Heavy Ion Medical Accelerator in Chiba (HIMAC), Japan. Well-defined sensitive volumes of the 3D mesa microdosimeter have been observed and the microdosimetric RBE obtained showed good agreement with the TEPC. The new 3D mesa “bridge” microdosimeter is a step forward towards a microdosimeter with fully free-standing 3D sensitive volumes.

HDR BrachyView is a novel in-body dosimetric imaging system for real-time monitoring and verification of the source position in high dose rate (HDR) prostate brachytherapy treatment. It is based on a high-resolution pixelated detector array with a semi-cylindrical multi-pinhole tungsten collimator and is designed to fit inside a compact rectal probe, and is able to resolve the 3D position of the source with a maximum error of 1.5 mm. This paper presents an evaluation of the additional dose that will be delivered to the patient as a result of backscatter radiation from the collimator. Monte Carlo simulations of planar and cylindrical collimators embedded in a tissue-equivalent phantom were performed using Geant4, with an (192)Ir source placed at two different source-collimator distances. The planar configuration was replicated experimentally to validate the simulations, with a MOSkin dosimetry probe used to measure dose at three distances from the collimator. For the cylindrical collimator simulation, backscatter dose enhancement was calculated as a function of axial and azimuthal displacement, and dose distribution maps were generated at three distances from the collimator surface. Although significant backscatter dose enhancement was observed for both geometries immediately adjacent to the collimator, simulations and experiments indicate that backscatter dose is negligible at distances beyond 1 mm from the collimator. Since HDR BrachyView is enclosed within a 1 mm thick tissue-equivalent plastic shell, all backscatter radiation resulting from its use will therefore be absorbed before reaching the rectal wall or other tissues. dosimetry, brachytherapy, HDR.

We revisit a long-standing problem of optimization of fractionated radiotherapy and solve it in considerable generality under the following three assumptions only: (1) repopulation of clonogenic cancer cells between radiation exposures follows linear birth-and-death Markov process; (2) clonogenic cancer cells do not interact with each other; and (3) the dose response function s(D) is decreasing and logarithmically concave. Optimal schedules of fractionated radiation identified in this work can be described by the following 'greedy' principle: give the maximum possible dose as soon as possible. This means that upper bounds on the total dose and the dose per fraction reflecting limitations on the damage to normal tissue, along with a lower bound on the time between successive fractions of radiation, determine the optimal radiation schedules completely. Results of this work lead to a new paradigm of dose delivery which we term optimal biologically-based adaptive boosting (OBBAB). It amounts to (a) subdividing the target into regions that are homogeneous with respect to the maximum total dose and maximum dose per fraction allowed by the anatomy and biological properties of the normal tissue within (or adjacent to) the region in question and (b) treating each region with an individual optimal schedule determined by these constraints. The fact that different regions may be treated to different total dose and dose per fraction mean that the number of fractions may also vary between regions. Numerical evidence suggests that OBBAB produces significantly larger tumor control probability than the corresponding conventional treatments.

The probability of a cure in radiation therapy (RT)-viewed as the probability of eventual extinction of all cancer cells-is unobservable, and the only way to compute it is through modeling the dynamics of cancer cell population during and post-treatment. The conundrum at the heart of biophysical models aimed at such prospective calculations is the absence of information on the initial size of the subpopulation of clonogenic cancer cells (also called stem-like cancer cells), that largely determines the outcome of RT, both in an individual and population settings. Other relevant parameters (e. g. potential doubling time, cell loss factor and survival probability as a function of dose) are, at least in principle, amenable to empirical determination. In this article we demonstrate that, for heavy-ion RT, microdosimetric considerations (justifiably ignored in conventional RT) combined with an expression for the clone extinction probability obtained from a mechanistic model of radiation cell survival lead to useful upper bounds on the size of the pre-treatment population of clonogenic cancer cells as well as upper and lower bounds on the cure probability. The main practical impact of these limiting values is the ability to make predictions about the probability of a cure for a given population of patients treated to newer, still unexplored treatment modalities from the empirically determined probability of a cure for the same or similar population resulting from conventional low linear energy transfer (typically photon/electron) RT. We also propose that the current trend to deliver a lower total dose in a smaller number of fractions with larger-than-conventional doses per fraction has physical limits that must be understood before embarking on a particular treatment schedule.

A 4th generation silicon microdosimeter has been designed by the Centre for Medical Radiation Physics (CMRP) at the University of Wollongong using three dimensional (3D) Sensitive Volumes (SVs). This new microdosimeter design has the advantage of well-defined 3D SVs as well as the elimination of lateral charge diffusion by removal of silicon laterally adjacent to the 3D SVs. The gaps between the sensitive volumes are to be backfilled with PolyMethyl MethAcrylate (PMMA) to produce a surrounding tissue equivalent medium. The advantage of this design avoids the generation of secondary particles from inactive silicon lateral to SVs. The response of the microdosimeter to the neutron field from ²⁵² Cf, Pu-Be sources and an avionic radiation environment were simulated using the Geant4 Monte Carlo toolkit for design optimisation. The simulated energy deposition in the SVs from the neutron fields and microdosimetric spectra is presented. The simulation study shows a significant reduction in silicon nuclear recoil contribution to the energy deposition for the novel microdosimeter design. The reduction of silicon recoil events from outside of the SV's will consequently reduce the uncertainty in the calculated dose equivalent. The simulations have demonstrated that a 3D silicon microdosimeter surrounded by PMMA can produce microdosimetric spectra similar to those of a tissue equivalent microdosimeter.