True 3D chemical dosimetry (gels, plastics): Development and clinical role

Since the introduction of volumetric chemical dosimetry with Fricke gel dosimeters in the 1980s, three-dimensional (3D) dosimetry has been a promising technique for the clinic, since it provides a unique methodology for 3D dose measurement of the complex conformal dose distributions achieved by modern techniques such as Intensity Modulated and Volumetric Arc Radiation Therapy. In the last decade, the potential for improved clinical applicability has been advanced by the development of improved 3D dosimeters such as normoxic polymer gel systems, radiochromic plastics (such as PRESAGE) and, recently, newer radiochromic gel dosimeters. Some of these new 3D dosimetry systems were enabled by the availability of optical computed tomography imaging systems for fast dose readout. However, despite its promise, true 3D dosimetry is still not widely practiced in the community. Its use has been confined primarily to select centres of expertise and to specialised quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. In this paper I review some of the current 3D chemical dosimeters available, discuss the requirements for their use and briefly review the roles that these systems can provide to complement the other dose delivery validation approaches available in the clinic. I conclude by describing two roles that may be uniquely served by 3D chemical dosimetry in end-to-end process testing and validation in the complex environment coming into play with the development of Image Guided Adaptive Radiation Therapy.