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SU‐G‐201‐11: Exploring the Upper Limits of Dose Sculpting Capacity of the Novel Direction Modulated Brachytherapy (DMBT) Tandem Applicator
Author(s) -
Han D,
Safigholi H,
Soliman A,
Song W
Publication year - 2016
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 - 10.1118/1.4956884
Subject(s) - brachytherapy , tandem , dosimetry , nuclear medicine , materials science , optics , physics , radiation therapy , medicine , radiology , composite material
Purpose: To explore and quantify the upper limits in dose sculpting capacity of the novel direction modulated brachytherapy (DMBT) tandem applicator compared with conventional tandem design for 192 Ir‐based HDR planning. Methods: The proposed DMBT tandem applicator is designed for image‐guided adaptive brachytherapy (IGABT), especially MRI, of cervical cancer. It has 6 peripheral holes of 1.3‐mm width, grooved along a 5.4‐mm diameter nonmagnetic tungsten alloy rod of density 18.0 g/cc, capable of generating directional dose profiles – leading to enhanced dose sculpting capacity through inverse planning. The external dimensions are identical to that of conventional tandem design to ensure clinical compatibility. To explore the expansive dose sculpting capacity, we constructed a hypothetical circular target with 20‐mm radius and positioned the DMBT and conventional tandems at the center. We then incrementally shifted the positions laterally away from the center of up to 15 mm, at 1‐mm steps. The in‐house coded gradient projection‐based inverse planning system was then used to generate inverse optimized plans ensuring identical V100=100% coverage. Conformity index (CI) was calculated for all plans. Results: Overall, the DMBT tandem generates more conformal dose distributions than conventional tandem for all lateral positional shifts of 0‐15 mm (CI=0.91–0.52 and 0.99–0.34, respectively), with an exception at the central position due to the ideal circular dose distribution, generated by the 192 Ir, fitting tightly around the circular target (CI = 0.91 and 0.99, respectively). The DMBT tandem is able to generate dose conformity of CI>0.8 at up to 6‐mm positional shift while the conventional tandem violates this past 2‐mm shift. Also, the CI ratio (=DMBT/conv.) increases rapidly until about 8 mm and then stabilizes beyond. Conclusion: A substantial enhancement in the dose sculpting capacity has been demonstrated for the novel DMBT tandem applicator. While further studies are warranted, the concept is promising for potential clinical translation.