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Present state and issues in IORT Physics
1Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. frank.hensley@gmx.de.
Radiation Oncology (London, England)
|February 15, 2017
Summary
This review assesses physical aspects of intraoperative radiation therapy (IORT) technologies, including electrons, kV X-rays, and electronic brachytherapy. Key challenges in calibration, dosimetry, and dose distribution for IORT require further investigation to improve accuracy.
Area of Science:
- Medical Physics
- Radiation Oncology
Background:
- Intraoperative radiation therapy (IORT) offers targeted radiation delivery during surgery.
- Emerging technologies complement established methods, necessitating a review of their physical underpinnings.
Purpose of the Study:
- To review and compare the physical aspects of electron, kV X-ray, and electronic brachytherapy for IORT.
- To identify challenges in calibration, dosimetry, quality assurance, and dose distribution for these IORT technologies.
Main Methods:
- Systematic literature review focusing on physical aspects of IORT technologies.
- Comparison of dose distribution adaptation for breast IORT.
- Review of radiation protection, commissioning, calibration, QA, and dosimetry literature.
Main Results:
- Identified three major IORT technologies: electrons, kV X-rays, and electronic brachytherapy.
- Highlighted issues in calibration and dosimetry for low-energy X-rays.
- Estimated total uncertainty in IORT dose determination at 10-15%.
Conclusions:
- Further investigation is needed for calibration and dosimetry of low-energy X-ray IORT.
- Dose inhomogeneity from electron prescription and kV X-ray gradients impact IORT accuracy.
- Understanding physical constraints is crucial for optimizing IORT dose response.
