In vivo skin dose measurement using MOSkin detectors in tangential breast radiotherapy

•Patients’ skin dose during tangential breast radiotherapy have been determined.•EBT2 film and PBC overestimated the skin dose.•The skin dose is approached and exceeded the dose toxicity level for skin erythema.•The use of suitable metrological device is necessary to determine actual skin dose. The...

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Veröffentlicht in:Physica medica 2016-11, Vol.32 (11), p.1466-1474
Hauptverfasser: Jong, W.L., Ung, N.M., Wong, J.H.D., Ng, K.H., Wan Ishak, W.Z., Abdul Malik, R., Phua, V.C.E., Cutajar, D.L., Metcalfe, P.E., Rosenfeld, A.B., Ho, G.F.
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container_end_page 1474
container_issue 11
container_start_page 1466
container_title Physica medica
container_volume 32
creator Jong, W.L.
Ung, N.M.
Wong, J.H.D.
Ng, K.H.
Wan Ishak, W.Z.
Abdul Malik, R.
Phua, V.C.E.
Cutajar, D.L.
Metcalfe, P.E.
Rosenfeld, A.B.
Ho, G.F.
description •Patients’ skin dose during tangential breast radiotherapy have been determined.•EBT2 film and PBC overestimated the skin dose.•The skin dose is approached and exceeded the dose toxicity level for skin erythema.•The use of suitable metrological device is necessary to determine actual skin dose. The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies (“bolus” and “no bolus”) were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during “no bolus radiotherapy”. The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for “bolus radiotherapy”. In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. Hence, a suitable device for in vivo dosimetry is necessary to accurately determine skin dose.
doi_str_mv 10.1016/j.ejmp.2016.10.022
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The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies (“bolus” and “no bolus”) were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p&lt;0.05) in the “no bolus radiotherapy”. No significant differences were observed in the “bolus radiotherapy” (p&gt;0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during “no bolus radiotherapy”. The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for “bolus radiotherapy”. In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. 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The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies (“bolus” and “no bolus”) were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p&lt;0.05) in the “no bolus radiotherapy”. No significant differences were observed in the “bolus radiotherapy” (p&gt;0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during “no bolus radiotherapy”. The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for “bolus radiotherapy”. In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. 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Ung, N.M. ; Wong, J.H.D. ; Ng, K.H. ; Wan Ishak, W.Z. ; Abdul Malik, R. ; Phua, V.C.E. ; Cutajar, D.L. ; Metcalfe, P.E. ; Rosenfeld, A.B. ; Ho, G.F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-db8b16bca305c7145aa5e691a0809cbea03089908076013e726142bfa46be2e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Algorithms</topic><topic>Breast conserving radiotherapy</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Chest wall irradiation</topic><topic>Humans</topic><topic>In vivo dosimetry</topic><topic>MOSFET</topic><topic>Organs at Risk - radiation effects</topic><topic>Phantoms, Imaging</topic><topic>Radiometry - instrumentation</topic><topic>Radiotherapy Planning, Computer-Assisted</topic><topic>Rotation</topic><topic>Skin - radiation effects</topic><topic>Superficial dose</topic><topic>Surface dose</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jong, W.L.</creatorcontrib><creatorcontrib>Ung, N.M.</creatorcontrib><creatorcontrib>Wong, J.H.D.</creatorcontrib><creatorcontrib>Ng, K.H.</creatorcontrib><creatorcontrib>Wan Ishak, W.Z.</creatorcontrib><creatorcontrib>Abdul Malik, R.</creatorcontrib><creatorcontrib>Phua, V.C.E.</creatorcontrib><creatorcontrib>Cutajar, D.L.</creatorcontrib><creatorcontrib>Metcalfe, P.E.</creatorcontrib><creatorcontrib>Rosenfeld, A.B.</creatorcontrib><creatorcontrib>Ho, G.F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Physica medica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jong, W.L.</au><au>Ung, N.M.</au><au>Wong, J.H.D.</au><au>Ng, K.H.</au><au>Wan Ishak, W.Z.</au><au>Abdul Malik, R.</au><au>Phua, V.C.E.</au><au>Cutajar, D.L.</au><au>Metcalfe, P.E.</au><au>Rosenfeld, A.B.</au><au>Ho, G.F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In vivo skin dose measurement using MOSkin detectors in tangential breast radiotherapy</atitle><jtitle>Physica medica</jtitle><addtitle>Phys Med</addtitle><date>2016-11</date><risdate>2016</risdate><volume>32</volume><issue>11</issue><spage>1466</spage><epage>1474</epage><pages>1466-1474</pages><issn>1120-1797</issn><eissn>1724-191X</eissn><abstract>•Patients’ skin dose during tangential breast radiotherapy have been determined.•EBT2 film and PBC overestimated the skin dose.•The skin dose is approached and exceeded the dose toxicity level for skin erythema.•The use of suitable metrological device is necessary to determine actual skin dose. The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies (“bolus” and “no bolus”) were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p&lt;0.05) in the “no bolus radiotherapy”. No significant differences were observed in the “bolus radiotherapy” (p&gt;0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during “no bolus radiotherapy”. The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for “bolus radiotherapy”. In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. Hence, a suitable device for in vivo dosimetry is necessary to accurately determine skin dose.</abstract><cop>Italy</cop><pub>Elsevier Ltd</pub><pmid>27842982</pmid><doi>10.1016/j.ejmp.2016.10.022</doi><tpages>9</tpages></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Algorithms
Breast conserving radiotherapy
Breast Neoplasms - radiotherapy
Chest wall irradiation
Humans
In vivo dosimetry
MOSFET
Organs at Risk - radiation effects
Phantoms, Imaging
Radiometry - instrumentation
Radiotherapy Planning, Computer-Assisted
Rotation
Skin - radiation effects
Superficial dose
Surface dose
title In vivo skin dose measurement using MOSkin detectors in tangential breast radiotherapy
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