title: MAGAT gel and EBT2 film-based dosimetry for evaluating source plugging-based treatment plan in Gamma Knife stereotactic radiosurgery.
abstract: This work illustrates a procedure to assess the overall accuracy associated with Gamma Knife treatment planning using plugging. The main role of source plugging or blocking is to create dose falloff in the junction between a target and a critical structure. We report the use of MAGAT gel dosimeter for verification of an experimental treatment plan based on plugging. The polymer gel contained in a head-sized glass container simulated all major aspects of the treatment process of Gamma Knife radiosurgery. The 3D dose distribution recorded in the gel dosimeter was read using a 1.5T MRI scanner. Scanning protocol was: CPMG pulse sequence with 8 equidistant echoes, TR = 7 s, echo step = 14 ms, pixel size = 0.5mm × 0.5mm, and slice thickness of 2 mm. Using a calibration relationship between absorbed dose and spin-spin relaxation rate (R2), we converted R2 images to dose images. Volumetric dose comparison between treatment planning system (TPS) and gel measurement was accomplished using an in-house MATLAB-based program. The isodose overlay of the measured and computed dose distribution on axial planes was in close agreement. Gamma index analysis of 3D data showed more than 94% voxel pass rate for different tolerance criteria of 3%/2 mm, 3%/1 mm and 2%/2 mm. Film dosimetry with GAFCHROMIC EBT 2 film was also performed to compare the results with the calculated TPS dose. Gamma index analysis of film measurement for the same tolerance criteria used for gel measurement evaluation showed more than 95% voxel pass rate. Verification of gamma plan calculated dose on account of shield is not part of acceptance testing of Leksell Gamma Knife (LGK). Through this study we accomplished a volumetric comparison of dose distributions measured with a polymer gel dosimeter and Leksell GammaPlan (LGP) calculations for plans using plugging. We propose gel dosimeter as a quality assurance (QA) tool for verification of plug-based planning.
authors.affiliation: Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. gshankar1974@gmail.com
authors.forename: Gopishankar
authors.initials: G
authors.lastname: Natanasabapathi
authors.forename: Vivekanandhan
authors.initials: V
authors.lastname: Subbiah
authors.forename: Shashank Sharad
authors.initials: SS
authors.lastname: Kale
authors.forename: Goura Kishor
authors.initials: GK
authors.lastname: Rath
authors.forename: S
authors.initials: S
authors.lastname: Senthilkumaran
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thulkar
authors.forename: Vellaiyan
authors.initials: V
authors.lastname: Subramani
authors.forename: M A
authors.initials: MA
authors.lastname: Laviraj
authors.forename: Raj Kishor
authors.initials: RK
authors.lastname: Bisht
authors.forename: A K
authors.initials: AK
authors.lastname: Mahapatra
mesh_terms: D005373:Film Dosimetry; D005780:Gelatin / Q000737:chemistry*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009943:Organophosphorus Compounds / Q000737:chemistry*; D019047:Phantoms, Imaging; D011108:Polymers / Q000528:radiation effects*; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted
chemical_list: D009943:Organophosphorus Compounds; D011108:Polymers; D005780:Gelatin