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Strahlentherapie und Onkologie

, Volume 190, Issue 11, pp 1060–1065 | Cite as

In vivo dosimetry in intraoperative electron radiotherapy

microMOSFETs, radiochromic films and a general-purpose linac
  • Juan López-TarjueloEmail author
  • Ana Bouché-Babiloni
  • Virginia Morillo-Macías
  • Noelia de Marco-Blancas
  • Agustín Santos-Serra
  • Juan David Quirós-Higueras
  • Carlos Ferrer-Albiach
Original article

Abstract

Introduction

In vivo dosimetry is desirable for the verification, recording, and eventual correction of treatment in intraoperative electron radiotherapy (IOERT). Our aim is to share our experience of metal oxide semiconductor field–effect transistors (MOSFETs) and radiochromic films with patients undergoing IOERT using a general-purpose linac.

Materials and methods

We used MOSFETs inserted into sterile bronchus catheters and radiochromic films that were cut, digitized, and sterilized by means of gas plasma. In all, 59 measurements were taken from 27 patients involving 15 primary tumors (seven breast and eight non-breast tumors) and 12 relapses. Data were subjected to an outliers’ analysis and classified according to their compatibility with the relevant doses. Associations were sought regarding the type of detector, breast and non-breast irradiation, and the radiation oncologist’s assessment of the difficulty of detector placement. At the same time, 19 measurements were carried out at the tumor bed with both detectors.

Results

MOSFET measurements (\(\overline{D}\)  = 93.5 %, sD  =  6.5 %) were not significantly shifted from film measurements (\(\overline{D}\)  =  96.0 %, sD  =  5.5 %; p  =  0.109), and no associations were found (p = 0.526, p = 0.295,  and p = 0.501, respectively). As regards measurements performed at the tumor bed with both detectors, MOSFET measurements (\(\overline{D}\)  =  95.0 %, sD  =  5.4 % were not significantly shifted from film measurements (\(\overline{D}\)  =  96.4 %, sD  =  5.0 %; p  =  0.363).

Conclusion

In vivo dosimetry can produce satisfactory results at every studied location with a general-purpose linac. Detector choice should depend on user factors, not on the detector performance itself. Surgical team collaboration is crucial to success.

Keywords

IOERT In vivo dosimetry Radiochromic film MOSFET Surgical bed 

In-vivo-Dosimetrie für Intraoperative Elektron-Strahlentherapie

microMOSFETs, Radiochromfilme und ein Allzweck-Linac

Zusammenfassung

Hintergrund und Ziel

Die In-vivo-Dosimetrie ist wünschenswert für die Überprüfung, Registrierung und die eventuelle Korrektur der Behandlungen in der IOERT („Intraoperative Electron Radiation Therapy“). Unser Ziel ist die Veröffentlichung unserer Erfahrungen beim Gebrauch von MOSFETs und Radiochromfilmen bei den Patienten, die sich einer IOERT-Behandlung mit einem Allzweck-Linac unterzogen.

Material und Methoden

Es wurden in sterile Bronchialkatheter eingeführte MOSFETs sowie zerschnittene und digitalisierte Radiochromfilme, die durch Gasplasma sterilisiert wurden, verwendet. Insgesamt wurden 59 Messungen bei 27 Patienten durchgeführt. Dazu zählten 15 Primärtumore (7 Brust- und 8 anderweitige Tumore) und 12 erneut aufgetretene Tumore. Die Daten wurden einer Analyse mit atypischen Werten unterzogen und entsprechend ihrer Kompatibilität mit den relevanten Dosen klassifiziert. Gesucht wurden Assoziationen bezüglich der Art des Detektors, Brust- und Nichtbrustbestrahlung und der Bewertung durch den Radioonkologen hinsichtlich des Schwierigkeitsgrads der Detektorplatzierung. Außerdem wurden 19 Messungen im Tumorbett mit beiden Detektoren durchgeführt.

Ergebnisse

Es ergaben sich keine bedeutenden Unterschiede bei den Messergebnissen mit MOSFET (\(\overline{D}\) =  93,5 %, sD  =  6,5 %) und den Messergebnissen mit Radiochromfilmen (\(\overline{D}\)  =  96,0 %, sD  =  5,5 %; p  =  0,109). Assoziationen wurden nicht gefunden (p = 0,526; p = 0,295; p = 0,501). Auch die im Tumorbett durchgeführten Messungen mit den beiden Detektoren ergaben, dass die Messergebnisse mit MOSFET (\(\overline{D}\)  =  95,0 %, sD  =  5,4 %) nicht wesentlich von den Messergebnissen mit Radiochromfilmen abwichen (\(\overline{D}\)  =  96,4 %, sD  =  5,0 %; p  =  0,363).

Schlussfolgerung

Die In-vivo-Dosimetrie mit einem Allzweck-Linac kann an jeder untersuchten Stelle zu zufriedenstellenden Ergebnissen führen. Ausschlaggebend für die Wahl des Detektors sollten Benutzerfaktoren und nicht das Verhalten des Detektors selbst sein. Die Zusammenarbeit mit dem chirurgischen Team ist entscheidend für den Erfolg.

Schlüsselwörter

IOERT In-vivo-Dosimetrie Radiochromfilm MOSFET Chirurgisches Bett 

Notes

Acknowledgments

Authors would like to thank Ms. Kavita Gandhi and Mrs. Sonja Behler for the linguistic assessment of this document in English and German, respectively, Mr. Juan Carlos Ruiz for the choice and the acceptance of the dosimetric equipment, Dr. Irene Torres for her documentation tasks and Prof. Dr. Felipe Calvo for his useful comments.

Compliance with ethical guidelines

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

Funding

This work has been supported by grant IPT-300000-2010-3. Spanish Government and ERDF funds.

Conflict of interest

J. López-Tarjuelo, A. Bouché-Babiloni, V. Morillo-Macías, N. de Marco-Blancas, A. Santos-Serra, J.D. Quirós-Higueras, and C. Ferrer-Albiach state that there are no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Juan López-Tarjuelo
    • 1
    Email author
  • Ana Bouché-Babiloni
    • 2
  • Virginia Morillo-Macías
    • 2
  • Noelia de Marco-Blancas
    • 1
  • Agustín Santos-Serra
    • 1
  • Juan David Quirós-Higueras
    • 1
  • Carlos Ferrer-Albiach
    • 2
  1. 1.Servicio de Radiofísica y Protección RadiológicaConsorcio Hospitalario Provincial de CastellónCastellón de la PlanaSpain
  2. 2.Servicio de Oncología RadioterápicaConsorcio Hospitalario Provincial de CastellónCastellón de la PlanaSpain

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