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Dosimetric assessment of the exposure of radiotherapy patients due to cone-beam CT procedures

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Abstract

Cone-beam computed tomography (CBCT) is widely used for pre-treatment verification and patient setup in image-guided radiation therapy (IGRT). CBCT imaging is employed daily and several times per patient, resulting in potentially high cumulative imaging doses to healthy tissues that surround exposed target organs. Computed tomography dose index (CTDI) is the parameter used by CBCT equipment as indication of the radiation output to patients. This study aimed to increase the knowledge on the relation between CBCT organ doses and weighted CTDI (CTDIW) for a thorax scanning protocol. A CBCT system was modelled using the Monte Carlo (MC) radiation transport program MCNPX2.7.0. Simulation results were validated against half-value layer (HVL), axial beam profile, patient skin dose (PSD) and CTDI measurements. For organ dose calculations, a male voxel phantom (“Golem”) was implemented with the CBCT scanner computational model. After a successful MC model validation with measurements, a systematic comparison was performed between organ doses (and their distribution) and CTDI dosimetry concepts [CTDIW and cumulative dose quantities f100(150) and \({\text{CTD}}{{\text{I}}_\infty }\)]. The results obtained show that CBCT organ doses vary between 1.2 ± 0.1 mGy and 3.3 ± 0.2 mGy for organs located within the primary beam. It was also verified that CTDIW allows prediction of absorbed doses to tissues at distances of about 5 cm from the isocentre of the CBCT system, whereas f100(150) allows prediction of organ doses at distances of about 10 cm from the isocentre, independently from its location. This study demonstrates that these dosimetric concepts are suitable methods that easily allow a good approximation of the additional CBCT imaging doses during a typical lung cancer IGRT treatment.

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Acknowledgements

The authors from Centro de Ciências e Tecnologias Nucleares (C2TN) would like to acknowledge the Fundação para a Ciência e Tecnologia (FCT) support through the UID/Multi/04349/2013 project. Mariana Baptista wants to thank C2TN, Instituto Superior Técnico and Universidade de Lisboa for the scholarship (BD2015). The authors thank the support of Champalimaud Center for the Unknown, for allowing the use of the CBCT system to perform the experimental measurements. The authors would like to acknowledge Debora António for the support given during the CTDI measurements.

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Authors and Affiliations

  1. Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal

    Mariana Baptista, Salvatore Di Maria, Joana Santos, Joana Pereira, Miguel Pereira & Pedro Vaz

  2. Fundação Champalimaud, Centro Clínico Champalimaud, Avenida de Brasília, 1400-038, Lisbon, Portugal

    Sandra Vieira

  3. Instituto Politécnico de Coimbra, ESTESC, DIMR, Rua 5 de Outubro, 3046-854, Coimbra, Portugal

    Joana Santos

  4. Laboratório de Protecção e Segurança Radiológica, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal

    Joana Pereira & Miguel Pereira

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  1. Mariana Baptista
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  2. Salvatore Di Maria
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Correspondence to Mariana Baptista.

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Baptista, M., Di Maria, S., Vieira, S. et al. Dosimetric assessment of the exposure of radiotherapy patients due to cone-beam CT procedures. Radiat Environ Biophys 58, 21–37 (2019). https://doi.org/10.1007/s00411-018-0760-7

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