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Correlation analysis of CT-based rectal planning dosimetric parameters with in vivo dosimetry of MOSkin and PTW 9112 detectors in Co-60 source HDR intracavitary cervix brachytherapy

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Abstract

Intracavitary cervical brachytherapy delivers high doses of radiation to the target tissue and a portion of these doses will also hit the rectal organs due to their close proximity. Rectal dose can be evaluated from dosimetric parameters in the treatment planning system (TPS) and in vivo (IV) dose measurement. This study analyzed the correlation between IV rectal dose with selected volume and point dose parameters from TPS. A total of 48 insertions were performed and IV dose was measured using the commercial PTW 9112 semiconductor diode probe. In 18 of 48 insertions, a single MOSkin detector was attached on the probe surface at 50 mm from the tip. Four rectal dosimetric parameters were retrospectively collected from TPS; (a) PTW 9112 diode maximum reported dose (RPmax) and MOSkin detector, (b) minimum dose to 2 cc (D2cc), (c) ICRU reference point (ICRUr), and (d) maximum dose from additional points (Rmax). The IV doses from both detectors were analyzed for correlation with these dosimetric parameters. This study found a significantly high correlation between IV measured dose from RPmax (r = 0.916) and MOSkin (r = 0.959) with TPS planned dose. The correlation between measured RPmax with both D2cc and Rmax revealed high correlation of r > 0.7, whereas moderate correlation (r = 0.525) was observed with ICRUr. There was no significant correlation between MOSkin IV measured dose with D2cc, ICRUr and Rmax. The non-significant correlation between parameters was ascribable to differences in both detector position within patients, and dosimetric volume and point location determined on TPS, rather than detector uncertainties.

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References

  1. Pötter R, Dimopoulos J, Georg P et al (2007) Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer. Radiother Oncol 83:148–155. https://doi.org/10.1016/j.radonc.2007.04.012

    Article  PubMed  Google Scholar 

  2. ICRU, GEC-ESTRO (2016) Prescribing, recording, and reporting brachytherapy for. J ICRU 13

  3. Georg P, Kirisits C, Goldner G et al (2009) Correlation of dose-volume parameters, endoscopic and clinical rectal side effects in cervix cancer patients treated with definitive radiotherapy including MRI-based brachytherapy. Radiother Oncol 91:173–180. https://doi.org/10.1016/j.radonc.2009.01.006

    Article  PubMed  Google Scholar 

  4. Koom WS, Sohn DK, Kim J-Y et al (2007) Computed tomography-based high-dose-rate intracavitary brachytherapy for uterine cervical cancer: preliminary demonstration of correlation between dose-volume parameters and rectal mucosal changes observed by flexible sigmoidoscopy. Int J Radiat Oncol Biol Phys 68:1446–1454. https://doi.org/10.1016/j.ijrobp.2007.02.009

    Article  PubMed  Google Scholar 

  5. Ogino I, Kitamura T, Okamoto N et al (1995) Late rectal complication following high dose rate intracavitary brachytherapy in cancer of the cervix. Int J Radiat Oncol Biol Phys 31:725–734. https://doi.org/10.1016/0360-3016(94)00547-8

    Article  CAS  PubMed  Google Scholar 

  6. Pötter R, Van Limbergen E, Gerstner N, Wambersie A (2001) Survey of the use of the ICRU 38 in recording and reporting cervical cancer brachytherapy. Radiother Oncol 58:11–18. https://doi.org/10.1016/S0167-8140(00)00266-8

    Article  PubMed  Google Scholar 

  7. Huh SJ, Lim DH, Ahn YC et al (2003) Comparison between in vivo dosimetry and barium contrast technique for prediction of rectal complications in high-dose-rate intracavitary radiotherapy in cervix cancer patients. Strahlentherapie und Onkol 179:191–196. https://doi.org/10.1007/s00066-003-1015-2

    Article  Google Scholar 

  8. Kirchheiner K, Nout RA, Lindegaard JC et al (2016) Dose—effect relationship and risk factors for vaginal stenosis after definitive radio (chemo) therapy with image-guided brachytherapy for locally advanced cervical cancer in the EMBRACE study. Radiother Oncol 118:160–166. https://doi.org/10.1016/j.radonc.2015.12.025

    Article  PubMed  Google Scholar 

  9. Choi P, Teo P, Foo W et al (1992) High-dose-rate remote afterloading irradiation of carcinoma of the cervix in Hong Kong: unexpectedly high complication rate. Clin Oncol 4:186–191. https://doi.org/10.1016/S0936-6555(05)81087-8

    Article  CAS  Google Scholar 

  10. Teshima T, Chatani M, Hata K, Inoue T (1988) High-dose rate intracavitary therapy for carcinoma of the uterine cervix: II. Risk factors for rectal complication. Int J Radiat Oncol 14:281–286

    Article  CAS  Google Scholar 

  11. Waldhäusl C, Wambersie A, Pötter R, Georg D (2005) In-vivo dosimetry for gynaecological brachytherapy: physical and clinical considerations. Radiother Oncol 77:310–317. https://doi.org/10.1016/j.radonc.2005.09.004

    Article  PubMed  Google Scholar 

  12. Hassouna AH, Bahadur YA, Constantinescu C et al (2011) In vivo diode dosimetry vs. computerized tomography and digitally reconstructed radiographs for critical organ dose calculation in high-dose-rate brachytherapy of cervical cancer. Brachytherapy 10:498–502. https://doi.org/10.1016/j.brachy.2011.03.004

    Article  PubMed  Google Scholar 

  13. Ghahramani F, Allahverdi M, Jaberi R (2008) Dependency of semiconductor dosimeter responses, used in MDR/LDR brachytherapy, on factors which are important in clinical conditions. Rep Pract Oncol Radiother 13:29–33. https://doi.org/10.1016/S1507-1367(10)60079-X

    Article  Google Scholar 

  14. Allahverdi M, Jaberi R, Aghili M et al (2013) In vivo dosimetry with semiconductors in medium dose rate (MDR) brachytherapy for cervical cancer. Jpn J Radiol 31:160–165. https://doi.org/10.1007/s11604-012-0160-x

    Article  PubMed  Google Scholar 

  15. Zaman ZK, Ung NM, Malik RA et al (2014) Comparison of planned and measured rectal dose in-vivo during high dose rate Cobalt-60 brachytherapy of cervical cancer. Phys Medica 30:980–984. https://doi.org/10.1016/j.ejmp.2014.07.002

    Article  CAS  Google Scholar 

  16. Carrara M, Cutajar D, Alnaghy S et al (2018) Semiconductor real-time quality assurance dosimetry in brachytherapy. Brachytherapy 17:133–145. https://doi.org/10.1016/j.brachy.2017.08.013

    Article  PubMed  Google Scholar 

  17. Legge K, Greer PB, O’Connor DJ et al (2017) Real-time in vivo rectal wall dosimetry using MOSkin detectors during linac based stereotactic radiotherapy with rectal displacement. Radiat Oncol 12:1–9. https://doi.org/10.1186/s13014-017-0781-4

    Article  Google Scholar 

  18. Jong WL, Ung NM, Vannyat A et al (2017) “Edge-on” MOSkin detector for stereotactic beam measurement and verification. Phys Medica 33:127–135. https://doi.org/10.1016/j.ejmp.2016.12.020

    Article  Google Scholar 

  19. Jamalludin Z, Jong WL, Ho GF et al (2019) In vivo dosimetry using MOSkin detector during Cobalt-60 high-dose-rate (HDR) brachytherapy of skin cancer. Australas Phys Eng Sci Med 42:1099–1107. https://doi.org/10.1007/s13246-019-00809-7

    Article  CAS  PubMed  Google Scholar 

  20. Jong WL, Wong JHD, Ung NM et al (2014) Characterization of MOSkin detector for in vivo skin dose measurement during megavoltage radiotherapy. J Appl Clin Med Phys 15:120–132. https://doi.org/10.1120/jacmp.v15i5.4869

    Article  PubMed Central  Google Scholar 

  21. Jamalludin Z, Jong WL, Abdul Malik R et al (2019) Characterization of MOSkin detector for in vivo dose verification during Cobalt-60 high dose-rate intracavitary brachytherapy. Phys Medica 58:1–7. https://doi.org/10.1016/j.ejmp.2019.01.010

    Article  Google Scholar 

  22. Jamalludin Z, Jong WL, Malik RA et al (2020) Evaluation of rectal dose discrepancies between planned and in vivo dosimetry using MO Skin detector and PTW 9112 semiconductor probe during 60 Co HDR CT-based intracavitary cervix brachytherapy. Phys Medica 69:52–60. https://doi.org/10.1016/j.ejmp.2019.11.025

    Article  CAS  Google Scholar 

  23. Jamalludin Z, Min UN, Ishak WZW, Malik RA (2016) Preliminary experience on the implementation of computed tomography (CT)-based image guided brachytherapy (IGBT) of cervical cancer using high-dose-rate (HDR) Cobalt-60 source in University of Malaya Medical Centre (UMMC). J Phys Conf Ser. https://doi.org/10.1088/1742-6596/694/1/012016

    Article  Google Scholar 

  24. Alecu R, Alecu M (1999) In-vivo rectal dose measurements with diodes to avoid misadministrations during intracavitary high dose rate brachytherapy for carcinoma of the cervix. Med Phys 26:768–770. https://doi.org/10.1118/1.598598

    Article  CAS  PubMed  Google Scholar 

  25. Carrara M, Romanyukha A, Tenconi C et al (2017) Clinical application of MOSkin dosimeters to rectal wall in vivo dosimetry in gynecological HDR brachytherapy. Phys Medica 41:5–12. https://doi.org/10.1016/j.ejmp.2017.05.003

    Article  CAS  Google Scholar 

  26. Cheng JCH, Peng LC, Chen YH et al (2003) Unique role of proximal rectal dose in late rectal complications for patients with cervical cancer undergoing high-dose-rate intracavitary brachytherapy. Int J Radiat Oncol Biol Phys 57:1010–1018. https://doi.org/10.1016/S0360-3016(03)00721-1

    Article  PubMed  Google Scholar 

  27. Gudmundsdóttir TS, Myrdal G, Sastre Padro MV (2013) PO-0962: correlation between DVHs and in-vivo dosimetry measurements in OARs for brachytherapy cervix cancer patients. Radiother Oncol 106:S371. https://doi.org/10.1016/s0167-8140(15)33268-0

    Article  Google Scholar 

  28. Cheng G, Zhao Z, He M, Zhao H (2015) Comparison study of the measured rectal point dose by detector in vivo and the recommended point dose of rectum in brachytherapy of cervical cancer. Int J Radiat Oncol 93:E253–E254. https://doi.org/10.1016/j.ijrobp.2015.07.1185

    Article  Google Scholar 

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Acknowledgements

The authors like to thank all the radiographers, technicians, medical officers and nurses in the Department of Clinical Oncology, University of Malaya Medical Centre, for their assistance. This study was supported by Postgraduate Research Grant (PPP) Project No. PG211-2015B at the Faculty of Medicine, University of Malaya, Malaysia.

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Authors and Affiliations

  1. Medical Physics Unit, University of Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia

    Z. Jamalludin

  2. Department of Clinical Oncology, University of Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia

    Z. Jamalludin, R. A. Malik & N. M. Ung

  3. Clinical Oncology Unit, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Z. Jamalludin, R. A. Malik & N. M. Ung

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  1. Z. Jamalludin
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  3. N. M. Ung
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Correspondence to N. M. Ung.

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Jamalludin, Z., Malik, R.A. & Ung, N.M. Correlation analysis of CT-based rectal planning dosimetric parameters with in vivo dosimetry of MOSkin and PTW 9112 detectors in Co-60 source HDR intracavitary cervix brachytherapy. Phys Eng Sci Med 44, 773–783 (2021). https://doi.org/10.1007/s13246-021-01026-x

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