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Dose Perturbation Due to Dental Amalgam in the Head and Neck Radiotherapy: A Phantom Study Publisher Pubmed



Saadatmand P1 ; Amouheidari A2 ; Shanei A1 ; Abedi I1
Authors

Source: Medical Dosimetry Published:2020


Abstract

Dental amalgam, causes perturbation in photon dose distribution of head and neck (H&N) radiotherapy. The aim of this study was to evaluate the effects of dental amalgam on dose distribution of H&N radiotherapy and accuracy of dose calculations algorithm of commercial treatment planning system (TPS). In this study, the measurements were performed using a constructed H&N anthropomorphic. The sample of healthy teeth and teeth filled by amalgam inserted in the desired segment of the phantom in turn. After scanning and organs segmentation of phantom, intensity-modulated radiation therapy (IMRT) plan including 7 fields in the absence (plan 1) and presence (plan 2) of dental amalgam were created separately. Phantom was irradiated using 6 MV linear accelerator (SIMENS-ARTISTE, 5918). Assessment of the effects of dental amalgam on dose distribution and the accuracy of dose calculation algorithm of TPS was done by measurement and comparing of organ's received dose using thermoluminescent dosimeter (TLDs), placed on a phantom and TPS calculations. The scattering and attenuation due to the presence of dental amalgam led to an increase in parotid glands received dose (up to 24.38%) and a decrease in mean dose (up to −6.25%) PTV70. Results of this study revealed that discrepancies between the collapsed cone convolution (CCC) algorithm calculations Prowess Panther TPS and TLD measurements were −19.77% to 27.49% in presence of amalgam and −1.09% to 5.03% in presence of healthy teeth in phantoms. Attenuation and scattering due to amalgam in IMRT of H&N cancer may lead to a significant dose perturbation which is not predictable by dose calculation of TPS. © 2019 American Association of Medical Dosimetrists
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