Review of methodology for Patient dose

from Cone Beam CT procedures in

Radiotherapy using TLD and PCXMC
software

Presented by
Ajay Thomas (UOW)
Background
• Image-guided radiation therapy (IGRT)
• Limitations of planar Imaging
• Use of kV CBCT – increased precision- accurate localization
• Consideration of Increased Dose due to kV CBCT
• Current project aims to measure CBCT doses in RT
• Dose evaluation Methodologies
• TLD
• PCXMC
Litterature
• 8th of Nov 1895 WH Roentgen –X Ray
• 1972 – CT by Godfrey Hounsfield and Allan Cormack
• 1982 first developed CBCT for Angiography
• During the 1990’s commercial systems for Dental uses
• Research for LINAC mounted CBCT started in 1992
• First LINAC mounted CBCT in 1999
Components of CBCT system
• Hard ware
• X- Ray source
• Imager
• Bow-tie filter
• Software
• Reconstruction Softwares
• FBP
• FDK ( Feldkamp, Davis and Kress )
Bow-tie Filter
Principle of CBCT
Why do we need to measure CBCT dose in RT
• CBCT dose is not included in Total treatment dose
• Critical organ doses
• Stochastic effects
Methodologies
• TLD
• Calculate calibration factor
• Load TLD’s in Rando Phantom
• Irradiate
• Read the TLD using Reader
 Standard Coefficient of
Deviatin variation

Organ Dose(mGy)
SPINAL CHORD(T) 0.66 0.04 5.2
SPINAL CHORD(M) 1.69 0.09 5.4
SPINAL CHORD(B) 4.66 0.15 3.1
BRAIN STEM(Top) 3.73 0.14 3.6
BRAIN STEM(M) 3.62 0.14 3.9
BRAIN STEM(B) 4.13 0.23 5.4
PAROTID(L) 4.89 0.1 2.3
PAROTID(R) 6.64 0.1 1.3
EYE (L) 0.85 0.12 14.0
EYE(R ) 0.96 0.0 2.0
Uterus 27.45 4.21 15.4
Femoral Head left 18.57 1.78 9.6
Femoral Head right 21.14 1.77 8.4
Prostate 27.46 3.77 13.7
Bladder 26.15 3.07 11.7
PCXMC
Distance Vs Detecor Reading

y = -0.0001x6 + 0.0002x5 + 0.0406x4 - 0.0472x3 - 5.1255x2 + 2.3768x + 231.34

• Step 1 : Plot Dose Profile vs Distance 250

200

150

100

50

0
-15 -10 -5 0 5 10 15

Chamber Reading Moniter Chamber Reading Detector

Poly. (Chamber Reading Detector)
Step2 120
Percentage vs HVL

• Draw Dose percentage vs HVL 100

• Get the trend line equation

• Using the trend line equation 80

generate table of HVL Vs % dose

60

• Find the HVL corresponding to 100%, 75%

40
50%, and 25% doses
• Abc 20

y = -19.299x + 206.75
R² = 0.9846
0
0 2 4 6 8 10 12
Step 3 HVL vs Distance

y = 1E-06x6 - 8E-06x5 - 0.0007x4 + 0.0014x3 + 0.0976x2 - 0.0398x + 5.7206

R² = 0.9876

• Draw HVL Vs Distance 12

• Get the trend line equation 10

• Generate table of HVL corresponding 8

to each distances 6

0
-15 -10 -5 0 5 10 15
• From the table generated in the step 2 find the HVL values corresponding
to 100%, 66%, and 33%
• Using the Xertex software or https://www.oem-xray-
components.siemens.com/x-ray-spectra-simulation calculate the
equivalent HVL’s
• Estimate the collimation width by considering the mid point each
percentage ie. for a 100% dose equivalent HVL use the collimation width of
around 83% dose. This is to include the missing out area
• Use this collimation width and equivalent HVL’s for the simulation using
PCXMC
• As per the percentage weighting from each step add the organ doses
obtained from each simulation to obtain the total organ dose
Thanks