Effects on skin dose from unwanted air gaps under bolus in an MR-guided linear accelerator (MR-linac) system. 2021

Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
Medical Physics and Research Department, Hong Kong Sanatorium and Hospital, Hong Kong SAR, People's Republic of China.

Bolus is commonly used in MV photon radiotherapy to increase superficial dose and improve dose uniformity for treating shallow lesions. However, irregular patient body contours can cause unwanted air gaps between a bolus and patient skin. The resulting dosimetric errors could be exacerbated in MR-Linac treatments, as secondary electrons generated by photons are affected by the magnetic field. This study aimed to quantify the dosimetric effect of unwanted gaps between bolus and skin surface in an MR-Linac. A parallel-plate ionization chamber and EBT3 films were utilized to evaluate the surface dose under bolus with various gantry angles, field sizes, and different air gaps. The results of surface dose measurements were then compared to Monaco 5.40 Treatment Planning System (TPS) calculations. The suitability of using a parallel-plate chamber in MR-Linac measurement was validated by benchmarking the percentage depth dose and output factors with the microDiamond detector and air-filled ionization chamber measurements in water. A non-symmetric response of the parallel-plate chamber to oblique beams in the magnetic field was characterized. Unwanted air gaps significantly reduced the skin dose. For a frontal beam, skin dose was halved when there was a 5 mm gap, a much larger difference than in a conventional linac. Skin dose manifested a non-symmetric pattern in terms of gantry angle and gap size. The TPS overestimated skin dose in general, but shared the same trend with measurement when there was no air gap, or the gap size was larger than 5 mm. However, the calculated and measured results had a large discrepancy when the bolus-skin gap was below 5 mm. When treating superficial lesions, unwanted air gaps under the bolus will compromise the dosimetric goals. Our results highlight the importance of avoiding air gaps between bolus and skin when treating superficial lesions using an MR-Linac system.

UI MeSH Term Description Entries
D007477 Ions An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as CATIONS; those with a negative charge are ANIONS.
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D010315 Particle Accelerators Devices which accelerate electrically charged atomic or subatomic particles, such as electrons, protons or ions, to high velocities so they have high kinetic energy. Betatrons,Linear Accelerators,Accelerator, Linear,Accelerator, Particle,Accelerators, Linear,Accelerators, Particle,Betatron,Linear Accelerator,Particle Accelerator
D011874 Radiometry The measurement of radiation by photography, as in x-ray film and film badge, by Geiger-Mueller tube, and by SCINTILLATION COUNTING. Geiger-Mueller Counters,Nuclear Track Detection,Radiation Dosimetry,Dosimetry, Radiation,Geiger Counter,Geiger-Mueller Counter Tube,Geiger-Mueller Probe,Geiger-Mueller Tube,Radiation Counter,Counter Tube, Geiger-Mueller,Counter Tubes, Geiger-Mueller,Counter, Geiger,Counter, Radiation,Counters, Geiger,Counters, Geiger-Mueller,Counters, Radiation,Detection, Nuclear Track,Dosimetries, Radiation,Geiger Counters,Geiger Mueller Counter Tube,Geiger Mueller Counters,Geiger Mueller Probe,Geiger Mueller Tube,Geiger-Mueller Counter Tubes,Geiger-Mueller Probes,Geiger-Mueller Tubes,Probe, Geiger-Mueller,Probes, Geiger-Mueller,Radiation Counters,Radiation Dosimetries,Tube, Geiger-Mueller,Tube, Geiger-Mueller Counter,Tubes, Geiger-Mueller,Tubes, Geiger-Mueller Counter
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011880 Radiotherapy Planning, Computer-Assisted Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy. Computer-Assisted Radiotherapy Planning,Dosimetry Calculations, Computer-Assisted,Planning, Computer-Assisted Radiotherapy,Calculation, Computer-Assisted Dosimetry,Calculations, Computer-Assisted Dosimetry,Computer Assisted Radiotherapy Planning,Computer-Assisted Dosimetry Calculation,Computer-Assisted Dosimetry Calculations,Dosimetry Calculation, Computer-Assisted,Dosimetry Calculations, Computer Assisted,Planning, Computer Assisted Radiotherapy,Radiotherapy Planning, Computer Assisted
D004583 Electrons Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called CATHODE RAYS. Fast Electrons,Negatrons,Positrons,Electron,Electron, Fast,Electrons, Fast,Fast Electron,Negatron,Positron
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000388 Air The mixture of gases present in the earth's atmosphere consisting of oxygen, nitrogen, carbon dioxide, and small amounts of other gases.
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.

Related Publications

Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
January 2022, Technology in cancer research & treatment,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
September 2022, Asian Pacific journal of cancer prevention : APJCP,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
August 2011, Physics in medicine and biology,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
October 2021, Journal of applied clinical medical physics,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
November 1969, Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
July 2017, Medical physics,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
January 2024, Practical radiation oncology,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
February 2021, Journal of biomedical physics & engineering,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
February 2022, Journal of applied clinical medical physics,
Chen-Yu Huang, and Bin Yang, and Wai Wang Lam, and Ka Keung Tang, and Ting Chuan Li, and Wai Kong Law, and Kin Yin Cheung, and Siu Ki Yu
May 2012, Medical physics,
Copied contents to your clipboard!