Investigating the dosimetric impact of seed location uncertainties in Collaborative Ocular Melanoma Study-based eye...

To quantify the dosimetric effects of random and systematic seed position uncertainties in Collaborative Ocular Melanoma Study-based eye plaques.

An eye plaque dose calculation routine was created using Task Group 43 formalism. A variety of clinical configurations were simulated, including two seed models: (125)I and (103)Pd, three eye plaque sizes, and eight plaque/eye orientations. Dose was calculated at four ocular anatomic sites and three central axis plaque depths. Random seed positional uncertainty was modeled by adding Gaussian random displacements, in one of three seed-motion degrees of freedom, to each seed's nominal coordinate. Distributions of dosimetric outcomes were obtained and fitted after 10(6) randomizations. Similar analysis was performed for deterministic, systematic shifts of the plaque along the eye surface and radially from the globe center.

Random seed placement uncertainties of 0.2-mm root mean square (RMS) (amplitude) produce dose changes that are typically <4% for each degree of freedom (95% confidence interval). Systematic seed placement uncertainties are generally greater than random uncertainty 95% confidence intervals (factor of 0.72-2.15), with the relative magnitudes depending on plaque size and location of interest. Eye plaque dosimetry is most sensitive to seed movement toward the center of the eye. Dosimetric uncertainty also increases with increasing dose gradients, which are typically greatest near the inner sclera, with smaller plaques, and with lower energy radionuclides (e.g., (103)Pd).

Dosimetric uncertainties due to the random seed positional displacements anticipated in the clinic are expected to be <4% for each degree of freedom in most circumstances.