A scintillation dosimeter with real‐time positional tracking information for in vivo dosimetry error detection in HDR brachytherapy

PURPOSE: To evaluate the performance of an electromagnetic (EM)‐tracked scintillation dosimeter in detecting source positional errors of IVD in HDR brachytherapy treatment. MATERIALS AND METHODS: Two different scintillator dosimeter prototypes were coupled to 5 degrees‐of‐freedom (DOF) EM sensors read by an Aurora V3 system. The scintillators used were a 0.3 × 0.4 × 0.4 mm(3) ZnSe:O and a BCF‐60 plastic scintillator of 0.5 mm diameter and 2.0 mm in length (Saint‐Gobain Crystals). The sensors were placed at the dosimeter's tip at 20.0 mm from the scintillator. The EM sampling rate was 40/s while the scintillator signal was sampled at 100 000/s using two photomultiplier tubes from Hamamatsu (series H10722) connected to a data acquisition board. A high‐pass filter and a low‐pass filter were used to separate the light signal into two different channels. All measurements were performed with an afterloader unit (Flexitron‐Elekta AB, Sweden) in full‐scattered (TG43) conditions. EM tracking was further used to provide distance/angle‐dependent energy correction for the ZnSe:O inorganic scintillator. For the error detection part, lateral shifts of 0.5 to 3 mm were induced by moving the source away from its planned position. Indexer length (longitudinal) errors between 0.5 to 10 mm were also introduced. The measured dose rate difference was converted to a shift distance, with and without using the positional information from the EM sensor. RESULTS: The inorganic scintillator had both a signal‐to‐noise‐ratio (SNR) and signal‐to‐background‐ratio (SBR) close to 70 times higher than those of the plastic scintillator. The mean absolute difference from the dose measurement to the dose calculated with TG‐43U1 was 1.5% ±0.7%. The mean absolute error for BCF‐60 detector was 1.7% [Formula: see text] when compared to TG‐43 calculations formalism. With the inorganic scintillator and EM tracking, a maximum area under the curve (AUC) gain of 24.0% was obtained for a 0.5‐mm lateral shift when using the EMT data with the ZnSe:O. Lower AUC gains were obtained for a 3‐mm lateral shifts with both scintillators. For the plastic scintillator, the highest gain from using EM tracking information occurred for a 0.5‐mm lateral shift at 20 mm from the source. The maximal gain (17.4%) for longitudinal errors was found at the smallest shifts (0.5 mm). CONCLUSIONS: This work demonstrates that integrating EM tracking to in vivo scintillation dosimeters enables the detection of smaller shifts, by decreasing the dosimeter positioning uncertainty. It also serves to perform position‐dependent energy correction for the inorganic scintillator,providing better SNR and SBR, allowing detection of errors at greater distances from the source.