Dosimetric Impact of Contrast Medium on Different Photon Energies Using Conformal & IMRT Techniques in the Treatment of Carcinoma Cervix and Its Validation with Indigenous Phantom

  • سال انتشار: 1401
  • محل انتشار: مجله فیزیک پزشکی ایران، دوره: 19، شماره: 2
  • کد COI اختصاصی: JR_IJMP-19-2_008
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 125
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نویسندگان

Deepak Tripathi

Amity School of Applied Sciences, Amity University (AUUP), NOIDA, India

Manindra Bhushan

Amity School of Applied Sciences, Amity University (AUUP), NOIDA, India Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Girigesh Yadav

Medical Physics Division, Elekta Medical Systems, India

Lalit Kumar

Medical Physics Division & Radiation Oncology Department, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India

Soumitra Barik

Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Sarthak Tandon

Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Pawan Kumar

Amity School of Applied Sciences, Amity University (AUUP), NOIDA, India Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Swarupa Mitra

Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Munish Gairola

Division of Medical Physics & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

چکیده

Introduction: Considering the unwanted exposure to organs in the path of the beam, ۴-field (۴F) and subsequently, Intensity-modulated-radiation-therapy (IMRT), is known as the standard mode of treatment of carcinoma cervix. It is routine practice to inject intravenous contrast during simulation scan which elopes after that from the patient body. Therefore, the impact of contrast media should be investigated for radiation dose calculations. Material and Methods: An indigenously made phantom, named as ‘original contrast (OC)’, was used with dimensions ۱۵ x ۱۵ x ۳۰ cm۳. A sleeve was given to place the ionization chamber at the isocentre of the planning target volume (PTV) inside the cylindrical vial of iodinized contrast. Similarly, a virtual phantom was created with similar dimensions in the presence and absence of contrast media, called as ‘virtual contrast (VC)’ and ‘virtual without contrast (VWC)’ phantom. Plans were generated with photon energies (۶MV/۱۰MV/۱۵MV/۶FFF/۱۰FFF) using ۴F and IMRT technique. Plans were evaluated for PTV (D۹۹%, D۱۰%, Dmean) and Bladder & Rectum (V۳۰Gy, V۱۰Gy). Normal-tissue-integral-dose (NTID) and total-monitor-units (TMU) were also evaluated. Results: D۹۹% of the PTV was comparable in VC and VWC phantoms but was decreased for OC phantom. Similarly, D۱۰% was reportedly higher as ۵۴.۰۳ Gy (۴F, ۶ MV), ۵۴.۷۱ Gy (۴F, ۱۵ MV), ۵۵.۷۸ Gy (۴F, ۶ FFF) and ۵۷.۶۴ Gy (۴F, ۱۰ FFF) for OC phantom. D۳۰% of the bladder and also the NTID was lesser for IMRT cases in all the selected phantoms. Additionally, ۴F has shown lesser spillage with ۶MV/۱۵ MV photon beam energies in OC phantom. The ‘total monitor units (TMU)’ required for IMRT plans were significantly higher. Conclusion: The contrast material under-estimates the planned dose yet has an insignificant influence on the dose calculation. Therefore, unnecessary exposure of dual scans should be avoided the use of ۶MV and IMRT technique should be continued in the clinics.

کلیدواژه ها

Contrast, Enhanced Intensity, Modulated Box, Technique Photon Beam Carcinoma Cervix

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