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      Characterization of EBT3 radiochromic films for dosimetry of proton beams in the presence of magnetic fields

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          Abstract

          Purpose

          Radiochromic film dosimetry is extensively used for quality assurance in photon and proton beam therapy. So far, GafchromicTM EBT3 film appears as a strong candidate to be used in future magnetic resonance (MR) based therapy systems. The response of Gafchromic EBT3 films in the presence of magnetic fields has already been addressed for different MR‐linacs systems. However, a detailed evaluation of the influence of external magnetic fields on the film response and calibration curves for proton therapy has not yet been reported. This study aims to determine the dose responses of EBT3 films for clinical proton beams exposed to magnetic field strengths up to 1 T in order to investigate the feasibility of EBT3 film as an accurate dosimetric tool for a future MR particle therapy system (MRPT).

          Methods

          The dosimetric characteristics of EBT3 films were studied for a proton beam passing through magnetic field strengths of B = 0, 0.5, and 1 T. Absorbed dose calibration and measurements were performed using clinical proton beams in the nominal energy range of 62.4–252.6 MeV. Irradiations were done using an in‐house developed PMMA slab phantom placed in the center of a dipole research magnet. Monte Carlo (MC) simulations using the GATE/Geant4 toolkit were performed to predict the effect of magnetic fields on the energy deposited by proton beams in the phantom. Planned and measured doses from 3D box cube irradiations were compared to assess the accuracy of the dosimetric method using EBT3 films with/without the external magnetic field.

          Results

          Neither for the mean pixel value nor for the net optical density, any significant deviations were observed due to the presence of an external magnetic field (B ≤ 1T) for doses up to 10 Gy. Dose‐response curves for the red channel were fitted by a three‐parameter function for the field‐free case and for B = 1T, showing for both cases an R‐square coefficient of unity and almost identical fitting parameters. Independently of the magnetic field, EBT3 films showed an under‐response as high as 8% in the Bragg peak region, similarly to previously reported effects for particle therapy. No noticeable influence of the magnetic field strength was observed on the quenching effect of the EBT3 films.

          Conclusions

          For the first time detailed absorbed dose calibrations of EBT3 films for proton beams in magnetic field regions were performed. Results showed that EBT3 films represent an attractive solution for the dosimetry of a future MRPT system. As film response functions for protons are not affected by the magnetic field strenght, they can be used for further investigations to evaluate the dosimetric effects induced due to particle beams bending in magnetic fields regions.

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          Most cited references30

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          Future of Medical Physics: Real-time MRI guided Proton Therapy.

          With the recent clinical implementation of real-time MRI guided x-ray beam therapy (MRXT), attention is therapy (MRPT). MRI guidance for proton beam therapy is expected to offer a compelling improvement to the turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI guided proton beam current treatment workflow which is warranted arguably more than for x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomes are similar to that of the most advanced IMRT treatments, despite being a fundamentally superior particle for cancer treatment. In this Future of Medical Physics article we describe the various software and hardware aspects of potential MRPT systems and the corresponding treatment workflow. Significant software developments, particularly focused around adaptive MRI based planning will be required. The magnetic interaction between the MRI and the proton beamline components will be a key area of focus. For example, the modeling and potential redesign of a magnetically compatible gantry to allow for beam delivery from multiple angles towards a patient located within the bore of an MRI scanner. Further to this, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringe field will require modeling, testing, and potential further development to ensure that the highly targeted radiotherapy is maintained. Looking forward we envisage a clear and accelerated path for hardware development, leveraging from lessons learnt from MRXT development. Within a few years simple prototype systems will likely exist, and in a decade we could envisage coupled systems with integrated gantries. Such milestones will be key in the development of a more efficient, more accurate, and more successful form of proton beam therapy for many common cancer sites. This article is protected by copyright. All rights reserved.
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            Radiochromic film dosimetry: considerations on precision and accuracy for EBT2 and EBT3 type films.

            Gafchromic® EBT2 film is a widely used dosimetric tool for quality assurance in radiation therapy. In 2012 EBT3 was presented as a replacement for EBT2 films. The symmetric structure of EBT3 films to reduce face-up/down dependency as well as the inclusion of a matte film surface to frustrate Newton Ring artifacts present the most prominent improvements of EBT3 films. The aim of this study was to investigate the characteristics of EBT3 films, to benchmark the films against the known EBT2-features and to evaluate the dosimetric behavior over a time period greater than 6 months. All films were irradiated to clinical photon beams (6 MV, 10 MV and 18 MV) on an Elekta Synergy Linac equipped with a Beam Modulator MLC in solid water phantom slabs. Film digitalization was done with a flatbed transparency scanner (Type Epson Expression 1680 Pro). MATLAB® was used for further statistical calculations and image processing. The investigations on post-irradiation darkening, film orientation, film uniformity and energy dependency resulted in negligible differences between EBT2 and EBT3 film. A minimal improvement in face-up/down dependence was found for EBT3. The matte film surface of EBT3 films turned out to be a practical feature as Newton rings could be eliminated completely. Considering long-term behavior (> 6 months) a shift of the calibration curve for EBT2 and EBT3 films due to changes in the dynamic response of the active component was observed. In conclusion, the new EBT3 film yields comparable results to its predecessor EBT2. The general advantages of radiochromic film dosimeters are completed by high film homogeneity, low energy dependence for the observed energy range and a minimized face-up/down dependence. EBT2 dosimetry-protocols can also be used for EBT3 films, but the inclusion of periodical recalibration-interval (e.g. once a quarter) is recommended for protocols of both film generations. Copyright © 2013. Published by Elsevier GmbH.
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              Feasibility of MRI guided proton therapy: magnetic field dose effects.

              Many methods exist to improve treatment outcome in radiotherapy. Two of these are image-guided radiotherapy (IGRT) and proton therapy. IGRT aims at a more precise delivery of the radiation, while proton therapy is able to achieve more conformal dose distributions. In order to maximally exploit the sharp dose gradients from proton therapy it has to be combined with soft-tissue based IGRT. MRI-guided photon therapy (currently under development) offers unequalled soft-tissue contrast and real-time image guidance. A hybrid MRI proton therapy system would combine these advantages with the advantageous dose steering capacity of proton therapy. This paper addresses a first technical feasibility issue of this concept, namely the impact of a 0.5 T magnetic field on the dose distribution from a 90 MeV proton beam. In contrast to photon therapy, for MR-guided proton therapy the impact of the magnetic field on the dose distribution is very small. At tissue-air interfaces no effect of the magnetic field on the dose distribution can be detected. This is due to the low-energy of the secondary electrons released by the heavy protons.
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                Author and article information

                Contributors
                fatima.padillacabal@meduniwien.ac.at
                Journal
                Med Phys
                Med Phys
                10.1002/(ISSN)2473-4209
                MP
                Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                0094-2405
                2473-4209
                31 May 2019
                July 2019
                : 46
                : 7 ( doiID: 10.1002/mp.2019.46.issue-7 )
                : 3278-3284
                Affiliations
                [ 1 ] Department of Radiotherapy Medical University of Vienna/AKH Vienna Austria
                [ 2 ] Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology Medical University of Vienna Vienna Austria
                [ 3 ] EBG MedAustron GmbH Wiener Neustadt Austria
                [ 4 ] National Physical Laboratory Teddington TW 11 0LW UK
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Electronic mail: fatima.padillacabal@ 123456meduniwien.ac.at .

                Article
                MP13567
                10.1002/mp.13567
                6852248
                31055847
                014daa14-9c93-4c0b-a2f8-4f664661c8a4
                © 2019 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 April 2019
                : 04 April 2019
                : 20 April 2019
                Page count
                Figures: 5, Tables: 1, Pages: 7, Words: 5168
                Categories
                Research Article
                COMPUTATIONAL AND EXPERIMENTAL DOSIMETRY
                Research Articles
                Custom metadata
                2.0
                July 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:13.11.2019

                ebt3 films dosimetry,magnetic fields,proton therapy
                ebt3 films dosimetry, magnetic fields, proton therapy

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