Six-probe scintillator dosimeter for treatment verification in HDR-brachytherapy.

Background: In vivo dosimetry (IVD) is gaining interest for treatment delivery verification in HDR-brachytherapy. Time resolved methods, including source tracking, have the ability both to detect treatment errors in real time and to minimize experimental uncertainties. Multiprobe IVD architectures holds promise for simultaneous dose determinations at the targeted tumor and surrounding healthy tissues while enhancing measurement accuracy. However, most of the multiprobe dosimeters developed so far either suffer from compactness issues or rely on complex data post-treatment.

Purpose: We introduce a novel concept of a compact multiprobe scintillator detector and demonstrate its applicability in HDR-brachytherapy. Our fabricated seven-fiber probing system is sufficiently narrow to be inserted in a brachytherapy needle or in a catheter.

Methods: Our multiprobe detection system results from the parallel implementation of six miniaturized inorganic Gd O S:Tb scintillator detectors at the end of a bundle of seven fibers, one fiber is kept bare to assess the stem effect. The resulting system, which is narrower than 320 microns, is tested with a MicroSelectron 9.14 Ci Ir-192 HDR afterloader, in a water phantom. The detection signals from all six probes are simultaneously read with a sCMOS camera (at a rate of 0.06 s). The camera is coupled to a chromatic filter to cancel Cerenkov signal induced within the fibers upon exposure. By implementing an aperiodic array of six scintillating cells along the bundle axis, we first determine the range of inter-probe spacings leading to optimal source tracking accuracy (first tracking method). Then, three different source tracking algorithms involving all the scintillating probes are tested and compared. In each of these four methods, dwell positions are assessed from dose measurements and compared to the treatment plan. Dwell time is also determined and compared to the treatment plan.

Results: The optimum inter-probe spacing for an accurate source tracking ranges from 15 to 35 mm. The optimum detection algorithm consists of adding the readout signals from all detector probes. In that case, the error to the planned dwell positions is of 0.01 ± 0.14 mm and 0.02 ± 0.29 mm at spacings between the source and detector axes of 5.5 and 40 mm, respectively. Using this approach, the average deviations to the expected dwell time are of s and s, at spacings between source and probe axes of 5.5 and 20 mm, respectively.

Conclusions: Our six-probe Gd O S:Tb dosimeter coupled to a sCMOS camera can perform time-resolved treatment verification in HDR brachytherapy. This detection system of high spatial and temporal resolutions (0.25 mm and 0.06 s, respectively) provides a precise information on the treatment delivery via a dwell time and position verification of unmatched accuracy.