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Real‐time monitoring and verification of in vivo high dose rate brachytherapy using a pinhole camera
Author(s) -
Duan Jun,
Macey Daniel J.,
Pareek Prem N.,
Brezovich Ivan A.
Publication year - 2001
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.1339882
Subject(s) - pinhole (optics) , imaging phantom , brachytherapy , collimator , image resolution , materials science , optics , nuclear medicine , computer science , physics , radiology , medicine , radiation therapy
We investigated a pinhole imaging system for independent in vivo monitoring and verification of high dose rate (HDR) brachytherapy treatment. The system consists of a high‐resolution pinhole collimator, an x‐ray fluoroscope, and a standard radiographic screen‐film combination. Autofluoroscopy provides real‐time images of the in vivo Ir‐192 HDR source for monitoring the source location and movement, whereas autoradiography generates a permanent record of source positions on film. Dual‐pinhole autoradiographs render stereo‐shifted source images that can be used to reconstruct the source dwell positions in three dimensions. The dynamic range and spatial resolution of the system were studied with a polystyrene phantom using a range of source strengths and dwell times. For the range of source activity used in HDR brachytherapy, a 0.5 mm diameter pinhole produced sharp fluoroscopic images of the source within the dynamic range of the fluoroscope. With a source‐to‐film distance of 35 cm and a 400 speed screen‐film combination, the same pinhole yielded well recognizable images of a 281.2 GBq (7.60 Ci) Ir‐192 source for dwell times in the typical clinical range of 2 to 400 s. This 0.5 mm diameter pinhole could clearly resolve source positions separated by lateral displacements as small as 1 mm. Using a simple reconstruction algorithm, dwell positions in a phantom were derived from stereo‐shifted dual‐pinhole images and compared to the known positions. The agreement was better than 1 mm. A preliminary study of a patient undergoing HDR treatment for cervical cancer suggests that the imaging method is clinically feasible. Based on these studies we believe that the pinhole imaging method is capable of providing independent and reliable real‐time monitoring and verification for HDR brachytherapy.