Table 1.
Important aspects for in vivo dosimetry (IVD) and their main advantages
| Essential aspects for IVD | Aim | Existing developments | Further developments |
|---|---|---|---|
| Target/OAR dosimetry | Dose monitoring; error detection; QA of treatment plan; dose escalation control | Dose monitoring; gross error detection | Improvement of dosimetric accuracy of IVD in target/OAR |
| Sterilization | Eliminate risk for infection | In-house solutions for sterilization of catheters that contain dosemeter probes | Integrated IVD catheters in source applicators and IVD catheters dedicated for specific anatomical sites |
| Spatial accuracy | Fixate dosemeter with respect to target, OAR or source applicator; stabilize anatomical region; maximize dosimetric accuracy | Dosemeter probes embedded into endorectal balloons | Develop specialized equipment for specific anatomical sites |
| Identification of source position | Error detection; geometric feedback for brachytherapy source; facilitate independent catheter reconstruction | Multipoint dosemeters | Investigate full in vivo potential; optimize and adapt various existing algorithms (see Detector positioning technology section) |
| Identification of dosemeter position | Validate calculated reference dose rates; identify target, OAR or source applicator movements; geometric feedback for dosemeter; QA of treatment planning system reconstruction | Detector positioning technology; adaptive error detection algorithm | Further in vivo performance studies |
| Statistical error criterion | Improve sensitivity and specificity for error detection algorithms | Comparisons between measured and planned dose rates or source positions, considering all known sources of uncertainty | Thorough sensitivity and specificity assessments; further studies of uncertainties for IVD |
| Automation | Minimize resource requirements and interference with clinical workflow | None available | Afterloaded dosemeter; communication line between afterloader and IVD system |
OAR, organ at risk; QA, quality assurance.
Existing developments provided in this article are mentioned, and suggestions for further developments provided.