Dosimetric performance of a multipoint plastic scintillator dosimeter as a tool for real-time source tracking in high dose rate192Ir brachytherapy

Purpose This study aims to present the performance of a multipoint plastic scintillation detector (mPSD) as a tool for real-time dose measurements (covering three orders of magnitude in dose rate), source-position triangulation, and dwell time assessment in high dose rate (HDR) brachytherapy. Methods A previously characterized and optimized three-point sensor system was used for HDR brachytherapy measurements. The detector was composed of three scintillators: BCF60, BCF12, and BCF10. Scintillation light was transmitted through a single 1-mm-diameter clear optical fiber and read by a compact assembly of photomultiplier tubes (PMTs). Each component was numerically optimized to allow for signal deconvolution using a multispectral approach, taking care of the Cerenkov stem effect as well as extracting the dose from each scintillator. The PMTs were read simultaneously using a data acquisition board at a rate of 100 KHz and controlled with in-house software based on Python. An192Irsource (Flexitron, Elekta-Brachy) was remotely controlled and sent to various positions in a in-house PMMA holder, ensuring 0.1 mm positional accuracy. Dose measurements covering a range of 10 cm of source movement were carried out according to TG-43 U1 recommendations. Water measurements were performed in order to: (a) characterize the system's response in terms of angular dependence; (b) obtain the relative contribution of positioning and measurement uncertainties to the total system uncertainty; (c) assess the system's temporal resolution; and (d) track the source position in real time. The triangulation principle was applied to report the source position in three-dimensional space. Results As expected, the positioning uncertainty dominated close to the source, whereas the measurement uncertainty dominated at larger distances. A maximum measurement uncertainty of 17 % was observed for the BCF60 scintillator at 10 cm from the source. Based on the uncertainty chain, the best compromises between positioning and measurement uncertainties were reached at 17.2, 17.4, and 17.5 mm for the BCF10, BCF12, and BCF60 scintillators, respectively, which also corresponded to the recommended optimal distances to the source for calibration purposes. The detector further exhibited no angular dependence. All dose values were found to be within 2% of the dose value at90 circle. In the experiments performed for source-position determination, the system provided an average location with a standard deviation under 1.7 mm. The maximum observed differences between measured and expected values were 1.82 and 1.8 mm in the x- and z-directions, respectively. Deviations between the mPSD measurements and expected TG-43 values were below 5% in all the explored measurement conditions. With regard to dwell time measurement accuracy, the maximum deviation observed at all distances was 0.56 +/- 0.25 s, with a weighted average of the three scintillators below 0.33 +/- 0.37 s at all distances covered in this study. Conclusions Real-time HDR brachytherapy measurements were performed with an optimized mPSD system. The performance of the system demonstrated that it could be used for simultaneous, in vivo, real-time reporting of dose, dwell time, and source position during HDR brachytherapy.