Verification of radiotherapy doses by EPR dosimetry in patients' teeth

The aim of this work was to verify applicability of electron paramagnetic resonance (EPR) ex vivo dosimetry in teeth enamel for determination of doses absorbed by patients during radiotherapy with radiation fields covering head regions and to examine with what accuracy the doses predicted by radiotherapy treatment plan (RTP) can be confirmed by doses measured ex post by the EPR method. The doses were determined in 22 enamel samples obtained from 11 patients who, after their radiotherapy treatment underwent extraction of teeth due to medical reasons. The delivered doses were determined by measuring EPR signals in enamel samples from the extracted teeth; magnitude of these signals is proportional to concentration of stable free radicals induced by radiation in the hydroxyapatite content of enamel. The measured doses were compared with doses planned in the teeth locations by RTP systems. The relation between the measured (Dm) and the planned (Dp) doses can be described as a linear function: Dm = s·Dp + b, with the slope s = 0.93 ± 0.03 and the intercept b = 0.67 ± 1.26. The deviations between the measured and calculated doses were in the (−12.6%, +1.9%) range with the average deviation of - 4.6%. It is concluded, than more accurate measurements, achievable when using a higher calibration dose than in the present study, are necessary to confirm or to deny the observed bias between the measured and planned doses.