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Définition d'un système de dosimétrie tridimensionnelle en curiethérapie à débit de dose pulsé :

Abstract : CT -based brachytherapy and the pulsed dose rate irradiation allowed anatomy-based dose optimisation and dose evaluation. The principal interest of dose optimisation is to obtain an homogenous target volume coverage and a protection of the normal tissues and the organs at risk. The object of our work was to define a CT -based dosimetry system for pulsed dose rate brachytherapy. We defined, in this work, the necessary components to having 3D dosimetry system. We studied the possibility of having a 3D dosimetry system in phantoms of regular and irregular implant, and in clinical gynaecological and oropharyngeal implants. We showed that the ruIe of Paris system for the implantation is the easiest way to obtain a good implant which cover fully the target volume with an homogenous dose distribution, nevertheless, this ruIe is sometimes difficult to get. For that, dose distribution optimisation is needed. We studied the different optimisation methods, and showed the necessary specific factors for the application of each method. We studied the capacity and the limitation of the geometry-based optimisation methods (direct optimisation). The needed of anatomy-based optimisation method take the lead to define a fully 3D dosimetry system. The inverse planning by IPSA method was studied to having a dosimetry system available for aIl clinical implants. We completed the dosimetry system with the de finition of dose distribution evaluation process. The dose evaluation process includes the information about the anatomy and about the dose distribution homogeneity. This work showed the possibility to obtain a conformaI dose distribution to the target volume with normal tissues and organs at risk protection. Anatomy-based dosimetry system could be applicable for aIl clinical cases and adapt to each anatomy. A high precision for target volume and organs at risk delineation is indispensable for clinical use of anatomy-based dose calculation method
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Submitted on : Thursday, March 29, 2018 - 1:50:40 PM
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Faten Al Ahmad. Définition d'un système de dosimétrie tridimensionnelle en curiethérapie à débit de dose pulsé :. Autre. Institut National Polytechnique de Lorraine, 2005. Français. ⟨NNT : 2005INPL061N⟩. ⟨tel-01752542⟩

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