Study of PRESAGE® dosimeter for end-to-end 3D radiotherapy verification using an anthropomorphic phantom with bespoke dosimeter insert

Modern radiotherapy techniques have advanced and become more sophisticated. End-to-end 3D verification of the complex radiotherapy dose distribution in an anthropomorphic phantom can ensure the accuracy of the treatment delivery. The phantoms commonly used for dosimetry are homogeneous solid water phantom which lacks the capability to measure the 3D dose distribution for heterogeneous tissues necessary for advanced radiotherapy techniques. Therefore, we developed an end-to-end 3D radiotherapy dose verification system based on MAX-HD anthropomorphic phantom (Integrated Medical Technologies Inc., Troy, New York) with bespoke intracranial insert for PRESAGE® dosimeter. In this study, several advanced radiotherapy treatment techniques of various levels of complexity; 3D-CRT, IMRT and VMAT treatment, were planned for a 20 mm diameter of a spherical target in the brain region and delivered to the phantom. The dosimeters were read out using an in-house developed optical computed tomography (OCT) imaging system known as 3DmicroHD-OCT. It was found that the measured dose distribution of the PRESAGE® when compared with the measured dose distribution of EBT film and Monaco TPS has a maximum difference of less than 3% for 3D-CRT, IMRT and VMAT treatment plans. The gamma analysis results of PRESAGE® in comparison to EBT film and Monaco TPS show pass rates of more than 95% for the criteria of 3% dose difference and 3 mm distance-to-agreement. This study proves the capability of PRESAGE® and bespoke MAX-HD phantom in conjunction with the 3DmicroHD-OCT system to measure 3D dose distribution for end-to-end dosimetry verification.