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Dosimetric feasibility of an anthropomorphic three-dimensional PRESAGE® dosimeter for verification of single entry hybrid catheter accelerated partial breast brachytherapy

  • Khalid Iqbal (a1) (a2) (a3), Geoffrey S. Ibbott (a1), Ryan G. Lafratta (a1), Kent A. Gifford (a1), Muhammad Akram (a2) and Saeed A. Buzdar (a2)...



To determine the feasibility of an anthropomorphic breast polyurethane-based three-dimensional (3D) dosimeter with cavity to measure dose distributions and skin dose for a commercial strut-based applicator strut-adjusted volume implant (SAVI™) 6–1.

Materials and methods

An anthropomorphic breast 3D dosimeter was created with a cavity to accommodate the SAVI™ strut-based device. 2 Gy was prescribed to the breast dosimeter having D95 to planning target volume evaluation (PTV_EVAL) while limiting 125% of the prescribed dose to the skin. Independent dose distribution verification was performed with GAFCHROMIC® EBT2 film. The dose distribution from the 3D dosimeter was compared to the distributions from commercial brachytherapy treatment planning system (TPS) and film. Point skin doses, line profiles and dose–volume histogram (DVHs) for the skin and PTV_EVAL were compared.


The maximum difference in skin dose for TPS and the 3D dosimeter was 4% whereas 41% between the TPS and EBT2 film. The maximum dose difference for line profiles between TPS, 3D dosimeter, and film was 4·1%. DVHs of skin and PTV_EVAL for TPS and 3D dosimeter differed by a maximum of 4% at 5 mm depth and skin differed by a maximum 1·5% between TPS and 3D dosimeter. The criterion for gamma analysis comparison was 92·5% at ±5%±3 mm criterion. The TPS demonstrated at least ±5% comparability in predicting dose to the skin, PTV_EVAL and normal breast tissue.


3D anthropomorphic polyurethane dosimeter with cavity gives comparable results to the TPS dose predictions and GAFCHROMIC® EBT2 film results in the context of HDR brachytherapy.


Corresponding author

Author for correspondence: Khalid Iqbal, Department Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Tel: +924235905000. Fax: +924235945206. E-mail:


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1 Manoharan, S R, Rodriguez, R R, Bobba, V S, Mukka, C. Dosimetry evaluation of SAVI-based HDR brachytherapy for partial breast irradiation. J Med Phys 2010; 35: 131136.
2 Guo, P Y, Adamovics, J A, Oldham, M. Characterization of a new radiochromic three-dimensional dosimeter. Med Phys 2006; 33 (5): 13381345.
3 Scanderbeg, D J, Yashar, C, Rice, R, Pawlicki, T. Clinical implementation of a new HDR brachytherapy device for partial breast irradiation. Radiother Oncol 2009; 90: 3642.
4 Low, D A, Dempsey, J F. Evaluation of the gamma dose distribution comparison method. Med Phys 2003; 30 (9): 24552464.
5 Palmer, A L, Di Pietro, P, Alobaidli, S et al. Comparison of methods for the measurement of radiation dose distributions in high dose rate (HDR) brachytherapy: Ge-doped optical fiber, EBT3 Gafchromic film, and PRESAGE® radiochromic plastic. Med Phys 2013; 40 (6): 061707.
6 Sakhalkar, H S, Adamovics, J, Ibbott, G, Oldham, M. A comprehensive evaluation of the PRESAGE/optical-CT 3D dosimetry system. Med Phys 2009; 36 (1): 7182.
7 Petrokokkinos, L, Zourari, K, Pantelis, E et al. Dosimetric accuracy of a deterministic radiation transport based I192r brachytherapy treatment planning system. Part II: Monte Carlo and experimental verification of a multiple source dwell position plan employing a shielded applicator. Med Phys 2011; 38 (4): 19811992.
8 Major, T, Polgár, C, Lövey, K, Fröhlich, G. Dosimetric characteristics of accelerated partial breast irradiation with CT image–based multicatheter interstitial brachytherapy: a single institution’s experience. Brachytherapy 2011; 10 (5): 421426.
9 Pantelis, E, Papagiannis, P, Karaiskos, P et al. The effect of finite patient dimensions and tissue inhomogeneities on dosimetry planning of 192 Ir HDR breast brachytherapy: a Monte Carlo dose verification study. Int J Radiat Oncol Biol Phys 2005; 61 (5): 15961602.
10 Poon, E, Verhaegen, F. Development of a scatter correction technique and its application to HDR 192Ir multicatheter breast brachytherapy. Med Phys 2009; 36 (8): 37033713.
11 Chung, H, Jin, H, Dempsey, J F et al. Evaluation of surface and build‐up region dose for intensity‐modulated radiation therapy in head and neck cancer. Med Phys 2005; 32 (8): 26822689.
12 Zourari, K, Major, T, Herein, A, Peppa, V, Polgár, C, Papagiannis, P. A retrospective dosimetric comparison of TG43 and a commercially available MBDCA for an APBI brachytherapy patient cohort. Phys Med 2015; 31 (7): 669676.
13 Awan, S B, Dini, S A, Hussain, M, Soleimani‐Meigooni, D, Meigooni, A S. Cylindrical coordinate based TG_43U1 parameters for dose calculation around elongated brachytherapy sources. J Appl Clin Med Phys 2008; 9: 123142.
14 Aland, T, Karin, T, Kenny, J. Evaluation of a Gafchromic EBT2 film dosimetry system for radiotherapy quality assurance. Australas Phys Eng Sci Med 2011; 34: 251260.
15 Patel, R R, Becker, S J, Das, R K, Mackie, T R. A dosimetric comparison of accelerated partial breast irradiation techniques: multicatheter Interstitital brachytherapy, three-dimensional conformal radiotherapy and supine versus prone helical tomotherapy. Int J Radiat Oncol Biol Phys 2007; 68: 935942.
16 Dickler, A, Kirk, M, Choo, J et al. Treatment volume and dose optimization of Mammosite breast brachytherapy applicator. Int J Radiat Oncol Biol Phys 2004; 59: 469472.
17 Hsu, I C, Lessard, E, Weinberg, V, Pouliot, J. Comparison of inverse planning simulated annealing and geometrical optimization for prostate high-dose-rate brachytherapy. Brachytherapy 2004; 3: 147152.
18 Lee, N, Chuang, C, Quivey, J M et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 2002; 53: 630637.
19 Hadley, S W, Kelly, R, Lam, K. Effects of immobilization mask material on surface dose. J Appl Clin Med Phys 2005; 6: 17.
20 Iqbal, K, Isa, M, Buzdar, S A, Gifford, K A, Afzal, M. Treatment planning evaluation of sliding window and multiple static segments technique in intensity modulated radiotherapy. Rep Pract Oncol Radiother 2013; 18 (2): 101106.
21 Court, L E, Tisher, R B. Experimental evaluation of the impact of different head-and-neck intensity-modulated radiation therapy planning techniques on doses to the skin and shallow targets. Int J Radiat Oncol Biol Phys 2007; 69: 607613.
22 Panettieri, V, Smith, R L, Mason, NJ, Millar, J L. Comparison of IPSA and HIPO inverse planning optimization algorithms for prostate HDR brachytherapy. J Appl Clin Med Phys 2014; 15 (6): 256266.
23 Chung, H, Jin, H, Dempsey, J F et al. Evaluation of surface and build-up region dose for intensity-modulated radiation therapy in head and neck cancer. Med Phys 2005; 32: 26822689.
24 Sakhalkar, H, Sterling, D, Adamovics, J, Ibbott, G, Oldham, M. Investigation of the feasibility of relative 3D dosimetry in the Radiologic Physics Center Head and Neck IMRT phantom using Presage/optical‐CT. Med Phys 2009; 36 (7): 33713377.
25 Vidovic, A K, Juang, T, Meltsner, S et al. An investigation of a PRESAGE® in vivo dosimeter for brachytherapy. Phys Med Biol 2014; 59 (14): 3893.
26 Susan, L R, Ramiro, P. Dosimetric effects of an air cavity for the SAVI™ partial breast irradiation applicator. Med Phys 2010; 37: 39193926.
27 Newton, J, Thomas, A, Ibbott, G, Oldham, M. Preliminary commissioning investigations with the DMOS-RPC optical-CT Scanner. J Phys Conf Ser 2010; 250: 012078.
28 Brady, S L, Brown, W E, Clift, C G, Yoo, S, Oldham, M. Investigation into the feasibility of using PRESAGE® /optical CT dosimetry for the verification of gating treatments. Phys Med Biol 2010; 55: 21872201.
29 Iqbal, K, Gillin, M, Summers, P A, Dhanesar, S, Gifford, K A, Buzdar, S A. Quality assurance evaluation of spot scanning beam proton therapy with an anthropomorphic prostate phantom. Br J Radiol 2013; 86 (1031): 20130390.
30 MacDougall, N D, Miquel, M E, Keevil, S F. Effects of phantom volume and shape on the accuracy of MRI BANG gel dosimetry using BANG3. Br J Radiol 2008; 81: 4650.
31 Sakhalkar, H, Oldham, M. Fast, high-resolution 3D dosimetry utilizing a novel optical-CT scanner incorporating tertiary telecentric collimation. Med Phys 2008; 35: 101111.
32 Iqbal, K, Gifford, K A, Ibbott, G, Grant, L R, Buzdar, S A. Comparison of an anthropomorphic PRESAGE® dosimeter and Radiochromic film with a commercial radiation treatment planning system for breast IMRT: a feasibility study. J Appl Clin Med Phys 2014; 15: 363374.
33 Guo, P, Adamovics, J, Oldham, M. A practical three-dimensional dosimetry system for radiation therapy. Med Phys 2006; 33: 39623972.
34 Iqbal, K, Iqbal, M M, Akram, M, Altaf, S, Buzdar, S A. Dosimetric verification and quality assurance for intensity-modulated radiation therapy using Gafchromic® EBT3 film. J Radiother Pract 2018; 17 (1): 8595.
35 Iqbal, K, Ibbott, G S, Lafratta, R G, Gifford, K A, Buzdar, S A. Dosimetric characterisation of anthropomorphic PRESAGE® dosimeter and EBT2 film for partial breast radiotherapy. J Radiother Pract 2018; 17 (1): 96103.
36 Gifford, K A, Iqbal, K, Grant, R L, Buzdar, S A, Ibbott, G S. Dosimetric verification of a commercial brachytherapy treatment planning system for a single Entry APBI Hybrid Catheter Device by PRESAGE® and Radiochromic Film. Brachytherapy 2013; 12: 1177.
37 RTOG/NSABP. NSABP Protocol B-39/RTOG Protocol 0413: a randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I, or II breast cancer. Philadelphia, PA: RTOG; 2009.


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Dosimetric feasibility of an anthropomorphic three-dimensional PRESAGE® dosimeter for verification of single entry hybrid catheter accelerated partial breast brachytherapy

  • Khalid Iqbal (a1) (a2) (a3), Geoffrey S. Ibbott (a1), Ryan G. Lafratta (a1), Kent A. Gifford (a1), Muhammad Akram (a2) and Saeed A. Buzdar (a2)...


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