Broad beam transmission data for the shielding of brachytherapy facilities

2008

Dosimetry comparison between TG-43 and Monte Carlo calculations using the Freiburg flap for skin high-dose-rate brachytherapy

2012

Abstract Purpose The purpose of this work was to evaluate whether the delivered dose to the skin surface and at the prescription depth when using a Freiburg flap applicator is in agreement with the one predicted by the treatment planning system (TPS) using the TG-43 dose-calculation formalism. Methods and Materials Monte Carlo (MC) simulations and radiochromic film measurements have been performed to obtain dose distributions with the source located at the center of one of the spheres and between two spheres. Primary and scatter dose contributions were evaluated to understand the role played by the scatter component. A standard treatment plan was generated using MC- and TG-43-based TPS appl…

A dosimetric study of Leipzig applicators.

2005

Purpose: To obtain the absolute dose-rate distribution in liquid water for all six cup-shaped Leipzig applicators by means of an experimentally validated Monte Carlo (MC) code. These six applicators were used in high-dose-rate (HDR) afterloaders with the “classic” and v2 192Ir sources. The applicators have an inner diameter of 1, 2, and 3 cm, with the source traveling parallel or perpendicular to the contact surface. Methods and materials: The MC GEANT4 code was used to obtain the dose-rate distribution in liquid water for the six applicators and the two HDR source models. To normalize the applicator output factors, a MC simulation for the “classic” and v2 sources in air was performed to es…

Monte Carlo calculation of dose rate distributions around 192Ir wires.

1997

Monte Carlo calculations of absolute dose rate in liquid water are presented in the form of away-along tables for 1 and 5 cm 192 Ir wires of 0.3 mm diameter. Simulated absolute dose rate values can be used as benchmark data to verify the calculation results of treatment planning systems or directly as input data for treatment planning. Best fit value of attenuation coefficient suitable for use in Sievert-integrals-type calculations has been derived based on Monte Carlo calculation results. For the treatment planning systems that are based on TG43 formalism we have also calculated the required dosimetry parameters.

Exclusive MRI-based tandem and colpostats reconstruction in gynaecological brachytherapy treatment planning

2008

Purpose: According to the GYN GEC-ESTRO Recommendations, MRI is needed with the modality of T2 weighted. CT-MR compatible tandem Plus colpostats (T/C) (Nucletron) is widely used in cervical brachytherapy. The major challenge of MRI is the lack of dummy catheters. Therefore, an additional imaging modality is usually required. One disadvantage of sliced-based reconstruction is that resolution in longitudinal directions can be affected by the slice thickness. The aim of this study is to present a modified T/C applicator in which the catheter visibility is significantly improved. Methods and materials: A modification to the existing T/C applicator has been made available, increasing the cathete…

A program for the independent verification of brachytherapy planning system calculations

2010

Purpose: In this work a spreadsheet based program is presented that to a large extent independently verifies the calculations of individual plans of brachytherapy treatment planning systems for low dose rate, high dose rate and pulsed dose rate techniques.Material and methods: The verification program has been developed based on workbooks/spreadsheets. The treatment planning system output text files are automatically loaded into the new program, allowing the use of the source coordinates, the desired calculation point coordinates, and the dwell times of a patient plan. The source strength and the reference dates are entered by the user and then dose points calculations are independently per…

Design and evaluation of a HDR skin applicator with flattening filter

2008

The purposes of this study are: (i) to design field flattening filters for the Leipzig applicators of 2 and 3 cm of inner diameter with the source traveling parallel to the applicator contact surface, which are accessories of the microSelectron-HDR afterloader (Nucletron, Veenendaal, The Netherlands). These filters, made of tungsten, aim to flatten the heterogeneous dose distribution obtained with the Leipzig applicators. (ii) To estimate the dose rate distributions for these Leipzig+filter applicators by means of the Monte Carlo (MC) method. (iii) To experimentally verify these distributions for prototypes of these new applicators, and (iv) to obtain the correspondence factors to measure t…

Interobserver variability in rectum contouring in high-dose-rate brachytherapy for prostate cancer: A multi-institutional prospective analysis

2017

PURPOSE: The aim of this study was to evaluate the interobserver variability (KW) of rectum contouring, and its dosimetric consequences, for high-dose-rate brachytherapy in patients with prostate cancer across multiple institutions. METHODS AND MATERIALS: Five radiation oncologists contoured rectums in 10 patients on transperineal ultrasound image sets after establishing a delineation consensus. The D-0.1cc, D-1cc, and D-2cc rectum volume parameters were determined. The mean, standard deviation, and range of each dose-volume histogram parameter were evaluated for each patient. The JOY was determined using the coefficient of variation, and the dosimetric impacts on the total dose were analyz…

On the use of the absorbed depth-dose measurements in the beam calibration of a surface electronic high-dose-rate brachytherapy unit, a Monte Carlo-b…

2019

PURPOSE To evaluate the use of the absorbed depth-dose as a surrogate of the half-value layer in the calibration of a high-dose-rate electronic brachytherapy (eBT) equipment. The effect of the manufacturing tolerances and the absorbed depth-dose measurement uncertainties in the calibration process are also addressed. METHODS The eBT system Esteya® (Elekta Brachytherapy, Veenendaal, The Netherlands) has been chosen as a proof-of-concept to illustrate the feasibility of the proposed method, using its 10 mm diameter applicator. Two calibration protocols recommended by the AAPM (TG-61) and the IAEA (TRS-398) for low-energy photon beams were evaluated. The required Monte Carlo (MC) simulations w…

EP-1186: Accuracy of the TG-43 dose calculation formalism for HDR skin brachytherapy

2013

Backscatter and Transmission through a Lead Shield Used in Surface and Interstitial HDR Brachytherapy

2014

Phantom development for daily checks in electron intraoperative radiotherapy with a mobile linac.

2020

Abstract Purpose IORT with mobile linear accelerators is a well-established modality where the dose rate and, therefore, the dose per pulse are very high. The constancy of the dosimetric parameters of the accelerator has to be checked daily. The aim of this work is to develop a phantom with embedded detectors to improve both accuracy and efficiency in the daily test of an IORT linac at the surgery room. Methods The developed phantom is manufactured with transparent polymethyl methacrylate (PMMA), allocating 6 parallel-plate chambers: a central one to evaluate the on-axis beam output, another on-axis one placed at a fixed depth under the previous one to evaluate the energy constancy and four…

Dosimetric characteristics of backscattered electrons in lead.

2000

In electron beam therapy, tissue overdose due to electrons backscattered from lead has been profusely studied. To quantify this dose enhancement effect, an electron backscatter factor (EBF) was defined as the ratio of dose at the tissue-inhomogeneity interface with and without the scatterer present. The dependence of the EBF on energy at the scatterer surface is not well known for energies lower than 3 MeV which is the most frequent clinical situation. In this work, we have done Monte Carlo calculations with the GEANT code to study EBF in lead at this energy range. The applicability of this code and the developed procedure for dose estimation has been experimentally verified. The dependence…

Novel simple templates for reproducible positioning of skin applicators in brachytherapy.

2016

Purpose : Esteya and Valencia surface applicators are designed to treat skin tumors using brachytherapy. In clinical practice, in order to avoid errors that may affect the treatment outcome, there are two issues that need to be carefully addressed. First, the selected applicator for the treatment should provide adequate margin for the target, and second, the applicator has to be precisely positioned before each treatment fraction. In this work, we describe the development and use of a new acrylic templates named Template La Fe-ITIC. They have been designed specifically to help the clinical user in the selection of the correct applicator, and to assist the medical staff in reproducing the po…

Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

2013

Purpose : The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using60Co or 192 Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Methods : Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference…

SU-GG-T-70: A Dosimetric Study of the MicroSelectron HDR Ir-192 Brachytherapy Source

2010

Purpose: Recently the manufacturer of the mHDR‐v2 HDR Ir‐192 brachytherapy source clarified design changes that may alter the existing dosimetric data for this source. The object of this study was to obtain new dose rate tables following the TG‐43 formalism and to provide these data in close proximity to the source with high spatial resolution including the electron dosimetric contributions from Ir‐192 disintegration. Methods and Material: To study the source we used three different Monte Carlo codes: MCNP5, GEANT4, and Penelope. The source was located inside a 40 cm radius water phantom. Dose and kerma were obtained using 0.1 mm thick voxels to provide high‐resolution dosimetry near the so…

Physics Contributions Evaluation of interpolation methods for TG-43 dosimetric parameters based on comparison with Monte Carlo data for high-energy b…

2010

Purpose: The aim of this work was to determine dose distributions for high-energy brachytherapy sources at spa- tial locations not included in the radial dose function gL(r) and 2D anisotropy function F(r,θ) table entries for radial dis- tance r and polar angle θ. The objectives of this study are as follows: 1) to evaluate interpolation methods in order to accurately derive gL(r) and F(r,θ) from the reported data; 2) to determine the minimum number of entries in gL(r) and F(r,θ) that allow reproduction of dose distributions with sufficient accuracy. Material and methods: Four high-energy photon-emitting brachytherapy sources were studied: 60Co model Co0.A86, 137Cs model CSM-3, 192Ir model I…

Dosimetric evaluation of internal shielding in a high dose rate skin applicator

2011

Purpose: The Valencia HDR applicators are accessories of the microSelectron HDR afterloading system (Nucletron) shaped as truncated cones. The base of the cone is either 2 or 3 cm diameter. They are intended to treat skin lesions, being the typical prescription depth 3 mm. In patients with eyelid lesions, an internal shielding is very useful to reduce the dose to the ocular globe. The purpose of this work was to evaluate the dose enhancement from potential backscatter and electron contamination due to the shielding. Material and methods: Two methods were used: a) Monte Carlo simulation, performed with the GEANT4 code, 2 cm Valencia applicator was placed on the surface of a water phantom in …

Radiation leakage study for the Valencia applicators

2011

Abstract Introduction and purpose The Valencia applicators which are accessories of the microSelectron-HDR afterloader (Nucletron, Veenendaal, The Netherlands) are designed to treat skin lesions. These cup-shaped applicators are an alternative to superficial/orthovoltage x-ray treatment units. They limit the irradiation to the required area using tungsten-alloy shielding, and are equipped with a tungsten-alloy flattering filter allowing the treatment of skin tumors, the oral cavity, vaginal cuff, etc. The tungsten-alloy thickness to shield radiation is not the same in all parts of the applicators. This fact led us to question whether the leakage radiation differs depending on where it is me…

SU-F-T-248: FMEA Risk Analysis Implementation (AAPM TG-100) in Total Skin Electron Irradiation Technique

2016

Purpose: Total Skin Electron Irradiation (TSEI) is a radiotherapy treatment which involves irradiating the entire body surface as homogeneously as possible. It is composed of an extensive multi-step technique in which quality management requires high consumption of resources and a fluid communication between the involved staff, necessary to improve the safety of treatment. The TG-100 proposes a new perspective of quality management in radiotherapy, presenting a systematic method of risk analysis throughout the global flow of the stages through the patient. The purpose of this work has been to apply TG-100 approach to the TSEI procedure in our institution. Methods: A multidisciplinary team s…

Monte Carlo calculation of dose rate distributions around 0.5 and 0.6 mm in diameter 192Ir wires

1999

Monte Carlo simulations of absolute dose rate in liquid water are presented in the form of away-along tables for 1 and 5 cm 192 Ir wires of 0.5 and 0.6 mm diameter. Simulated absolute dose rate values can be used as benchmark data to verify the calculation results of treatment planning systems or directly as input data for treatment planning. Best fit value of an attenuation coefficient suitable for use in Sievert integral-type calculations has been derived based on Monte Carlo simulation results. For the treatment planning systems that are based on the TG43 formalism we have also computed the required dosimetry parameters.

Depth determination of skin cancers treated with superficial brachytherapy: ultrasound vs. histopathology

2014

Purpose: The purpose of this study is to compare high frequency ultrasonography (HFUS) and histpathologic assessment done by punch biopsy in order to determine depth of basal cell carcinoma (BCC), in both superficial and nodular BCCs prior to brachytherapy treatment. Material and methods: This study includes 20 patients with 10 superficial and 10 nodular BCCs. First, punch biopsy was done to confirm the diagnosis and to measure tumour depth (Breslow rate). Subsequently, HFUS was done to measure tumour depth to search for correlation of these two techniques. Results: Neither clear tendency nor significance of the punch biopsy vs. HFUS depth determination is observed. Depth value differences …

SU-E-J-64: Evaluation of a Commercial EPID-Based in Vivo Dosimetric System in the Presence of Lung Tissue Heterogeneity

2014

Purpose: To study the performance of Dosimetry Check (DC), an EPID-based dosimetry software, which allows performing transit dosimetry, in low density medium, by comparing calculations in-phantom, and analysing results for 15 lung patients. Methods: DC software (v.3.8, pencil beam-based algorithm) has been tested, for plans (Eclipse v.10.0 TPS) delivered in two Varian Clinac iX equipped with aS1000 EPIDs.In the CIRS lung phantom, comparisons between DC and Eclipse (Acuros) were performed for several plans: (1) four field box; (2) square field delivered in arc mode; (3) RapidArc lung patient plan medially centred; (4) RapidArc lung patient plan centred in one lung. Reference points analysed:…

MO-D-AUD B-08: Treatment Planning for Complex Brachytherapy Dose Distributions Using High-Z Shields and Conventional Software

2008

Purpose: Certain brachytherapydose distributions, like for LDR prostate implants, are readily modeled by treatment planningsoftware using the superposition principle of individual seeds to replicate the total dose distribution. However, dose distributions for brachytherapy treatments using high‐Z shields are currently not well‐modeled using conventional software.Method and Materials:Dose distributions from complex brachytherapy plaques determined using Monte Carlo methods were used as input data, and included COMS‐based eye plaques using 125 I , 103 Pd , and 131 Cs ; 4–8cm diameter AccuBoost peripheral breast brachytherapy applicators from Advanced Radiation Therapy; and the 2 and 3cm diame…

Influence of photon energy spectra from brachytherapy sources on Monte Carlo simulations of kerma and dose rates in water and air

2010

Purpose: For a given radionuclide, there are several photonspectrum choices available to dosimetry investigators for simulating the radiation emissions from brachytherapy sources. This study examines the dosimetric influence of selecting the spectra for I 192 r , I 125 , and P 103 d on the final estimations of kerma and dose. Methods: For I 192 r , I 125 , and P 103 d , the authors considered from two to five published spectra. Spherical sources approximating common brachytherapy sources were assessed. Kerma and dose results from GEANT4, MCNP5, and PENELOPE-2008 were compared for water and air. The dosimetric influence of I 192 r , I 125 , and P 103 d spectral choice was determined. Results…

The necessity of systematic verification of applicator position in brachytherapy treatment of the vaginal cuff

2009

Prescription Depth in Surface Skin Brachytherapy

2017

Technique for routine output verification of Leipzig applicators with a well chamber

2005

The H-type Leipzig applicators are accessories of the microSelectron-HDR system (Nucletron, Veenendaal, The Netherlands) for treatment of superficial malignancies. Recently, the dose rate distributions in liquid water for the whole set of applicators using both source models available for the microSelectron-HDR afterloaders have been obtained by means of the experimentally validated Monte Carlo (MC) code GEANT4. Also an output table (cGy/hU) at 3 mm depth on the applicator central axis was provided. The output verification of these applicators by the user, prior to their clinical use, present practical problems: small detectors such as thermoluminescent dosimeters or parallel-plate ionizati…

Electronic Design for a Bleeding Detector to be Used in Intraoperative Radiotherapy Applications

2021

An electronic design for a bleeding detector used with mobile linac during intraoperative radiotherapy (IORT) is presented. It consists on a readout circuit based on a De Sauty Bridge and a wireless power supply using a supercapacitor. The goal is the measurement of the height of fluid present in the applicator in order to avoid a misadministration dose during the irradiation process. A minimum measurement height of 5 mm is required by clinic to be confident with the selected radiation dose. The measurement circuit uses a capacitive sensor which detects variations lower than 0.1 pF. The readout circuit converts dynamic capacitance variation from the bleeding detector into an analog voltage …

Urethral Dose Limit in Boost Permanent Prostate 125I Seed Implants Based on Biologically Effective Dose Values

2010

Dose Escalation in Permanent Brachytherapy for Prostate Cancer: Preliminary Results

2010

EP-1168: RapidArc independent monitor unit calculations with Diamond. Practical considerations

2013

SU-G-201-02: Application of RayStretch in Clinical Cases: A Calculation for Heterogeneity Corrections in LDR Permanent I-125 Prostate Brachytherapy

2016

Purpose: Tissue heterogeneities and calcifications have significant impact on the dosimetry of low energy brachytherapy (BT). RayStretch is an analytical algorithm developed in our institution to incorporate heterogeneity corrections in LDR prostate brachytherapy. The aim of this work is to study its application in clinical cases by comparing its predictions with the results obtained with TG-43 and Monte Carlo (MC) simulations. Methods: A clinical implant (71 I-125 seeds, 15 needles) from a real patient was considered. On this patient, different volumes with calcifications were considered. Its properties were evaluated in three ways by i) the Treatment planning system (TPS) (TG-43), ii) a M…

EP-1613: Depth determination of skin cancers treated with superficial barchytherapy: ultrasound vs. histopathology

2015

HDR Valencia skin applicators: A proposed commissioning procedure

2008

SU-E-T-516: Limitations and Clinical Implications of the TG-43 Formalism for High-Dose-Rate Skin Brachytherapy

2013

Purpose: In high‐dose‐rate (HDR) skin brachytherapy, sources are located outside, in contact with, or implanted at some depth below the skin surface. Nowadays, most TPS use the TG‐43 formalism that is based on sources within an infinite water medium, without accounting for the scatter defect due to surrounding air. The purpose of the present study is to evaluate the limitations of the TG‐43 formalism in HDR skin brachytherapy. Methods: This study examined two HDR sources (Ir‐192 and Co‐60) together with a hypothetical Yb‐169 source. Dose distributions were obtained using Monte Carlo methods (i.e., GEANT4). The following configurations were investigated: 1)A typical clinical case consisting …

EP-1590: Shielding design and fetal dose evaluation of a breast cancer pregnant patient undergoing HDR Ir-192 brachytherapy

2015

TH-C-AUD A-08: Evaluation of Electronic Equilibrium Conditions Near Brachytherapy Sources

2008

Purpose: For high‐energy photon‐emitting brachytherapysources such as 60 Co , 137 Cs , 192 Ir , and 169 Yb , the main contribution of the systematic uncertainty in the dose distributions near the sources is understanding of electronic equilibrium and the contribution of β‐rays due to radioactive disintegration. Thus, it is important to study these effects in detail to accurately depict dose distributions near these brachytherapysources. This work studies the relative importance of β‐ray contributions to total dose (β + γ + x‐ray), and feasibility of using the approximation “collision kerma equals dose in electronic equilibrium conditions.” Method and Materials:Characteristics of kerma and d…

Evaluation of methods of interpolation-extrapolation of g L (r) and F(r,θ) for high-energy brachytherapy sources

2009

Limitations of the TG-43 formalism for skin high-dose-rate brachytherapy dose calculations

2014

Purpose: In skin high-dose-rate (HDR) brachytherapy, sources are located outside, in contact with, or implanted at some depth below the skin surface. Most treatment planning systems use the TG-43 formalism, which is based on single-source dose superposition within an infinite water medium without accounting for the true geometry in which conditions for scattered radiation are altered by the presence of air. The purpose of this study is to evaluate the dosimetric limitations of the TG-43 formalism in HDR skin brachytherapy and the potential clinical impact. Methods: Dose rate distributions of typical configurations used in skin brachytherapy were obtained: a 5 cm × 5 cm superficial mould; a …

SU-E-T-237: Monte Carlo Dosimetric Characterization of the Mobetron Mobile Linac

2014

Purpose: The aim of this work is to characterize dosimetrically a clinical intraoperative electron beam accelerator, Mobetron (IntraOp Medical, Inc.) in clinical use in our Hospital. Once this first step is completed our purpose is to evaluate shielding requirements for such a device by preparing adequate phase space files. Methods: It is known that electron beam simulation parameters required for state-of-the-art Monte Carlo codes to obtain a good match with measured data, like the mean energy or the FWHM, may not be code-independent due to the different set of process simulated and formalisms involved. Then, to cross-check our results against any issue in the simulation we have compared e…

SU-FF-T-15: Comparison of Various Monte Carlo Codes for Brachytherapy Source Dosimetry

2009

Purpose: Monte Carlo simulations are used for dosimetric evaluation of brachytherapysources. Various investigators had demonstrated good agreement between the measured and simulated data while some others have shown discrepancies between the two methods. These discrepancies were attributed to the errors in cross section data, differences in phantom and source geometry and composition. However, the exact causes of these differences have not yet fully explored. The goal of this project is to verify the differences among the widely available Monte Carlo codes for brachytherapysourcedosimetry.Material and method: These investigations are based on VariSource 192 Ir , Model VS2000, IsoAid Advanta…

Monte Carlo Application in Brachytherapy Dosimetry

2009

This paper devoted to Monte-Carlo Applications in BT Dosimetry is organized in four parts: 1. Motivation of the use of Monte Carlo in brachytherapy 2. The use of Monte Carlo to obtain dose distribution around brachytherapy sources 3. Experimental dosimetry versus Monte Carlo 4. Others Monte Carlo applications in brachytherapy

Dosimetric characteristics of the CDC-type miniature cylindrical 137Cs brachytherapy sources

2002

The low dose rate CDC-type miniature cylindrical 137 Cs sources are available, with one or three active beads, for use in source trains in automatic and manual afterloading systems for gynecological brachytherapy. Absolute dose rate distributions in water have been calculated around these sources using the Monte CarloGEANT3 code and they are presented as conventional two-dimensional Cartesian lookup tables. The AAPM Task Group 43 formalism for dose calculation has been also applied. The dose rate constant obtained for the one bead source is Λ=1.113±0.003 cGyh −1 U −1 , and the value for the three bead source is Λ=1.103±0.003 cGyh −1 U −1 . Finally, for the treatment planning systems based o…

SU-E-T-530: Comparison of Analytical and Monte Carlo Calculations for Heterogeneity Corrections in LDR Prostate Brachytherapy

2013

Purpose: It is well‐known that tissue heterogeneities and calcifications have significant influence on low energy brachytherapy. The aim of this work is to study the application of a simplified analytic algorithm that could be compatible with commercial Treatment Planning System (TPS) based on TG‐43. The algorithm, based on the classic equivalent path length method, has been compared with Monte Carlo (MC) computations using Penelope2009. Methods: The analytical model scales the distance from the seed to the calculation point according to the electronic density of the medium relative to water. Then, the dose is calculated from TG‐43 consensus data (stored on a TPS) by scaling the radial dose…

New HDR Valencia Applicator for Treating Skin Lesions Larger Than 3 cm Size with Either a Co-60 or Ir-192 Source

2016

A Monte Carlo investigation of the dosimetric characteristics of the CSM11 137Cs source from CIS

2000

The purpose of this study is to calculate basic dosimetry data for a CSM11 low dose rate 137Cs source in water. This source is widely used in afterloadable dome cylinders designed to homogeneously irradiate the vaginal cuff alone or additional areas of the vagina in hysterectomized patients. In this study, the Monte Carlo simulation code GEANT, incorporating in detail source geometry, is used to investigate the dosimetric characteristics of the source. The calculated data were analyzed using a fitting procedure that is described in detail. Absolute dose rate distributions in water were calculated around this source and are presented as conventional 2D Cartesian lookup tables (classically al…

Erratum: “Technical note: Monte-Carlo dosimetry of the HDR 12i and Plus 192Ir sources” [Med. Phys. 28 , 2586-2591 (2001)]

2004

Impact of the Tiloop Bra mesh in CT images and dose delivery in breast radiotherapy

2012

A new titanized breast mesh, TiLOOP Bra, is currently available for implantation in patients who require radiotherapy. The purpose of this work is to study the dosimetric effect of the presence of a TiLOOP Bra mesh on breast radiation treatment and radiographic imaging. The dosimetric effects have been measured for three X‐ray energies: 1.25 MeV, 6 MV and 18 MV, using radiochromic films placed at three different depths. These depths are representative of mesh location in breast during the radiotherapy treatment and hence, are of interest in this study. In order to assess the disturbance in a radiographic image, different computed tomographic (CT) studies of the mesh have been performed. The…

SU-F-T-63: Dosimetric Relevance of the Valencia and Leipzig HDR Applicators Plastic Cap

2016

Purpose: Utilization of HDR brachytherapy treatment of skin lesions using collimated applicators, such as the Valencia or Leipzig is increasing. These applicators are made of cup-shaped tungsten material in order to focalize the radiation into the lesion and to protect nearby tissues. These applicators have an attachable plastic cap that removes secondary electrons generated in the applicator and flattens the treatment surface. The purpose of this study is to examine the dosimetric impact of this cap, and the effect if the cap is not placed during the HDR fraction delivery. Methods: Monte Carlo simulations have been done using the code Geant4 for the Valencia and Leipzig applicators. Dose r…

SU-E-T-508: Monte Carlo Dosimetric Study of the CSM40 Low Dose Rate Source

2013

Purpose: There is a LDR 137Cs brachytherapy source, CSM40, developed by Eckert & Ziegler BEBIG. Fundamental dosimetric datasets to be used on treatment planning systems do not exist for this source. This study aims to obtain quality dosimetric data for this source for its use in clinical practice as required by AAPM and ESTRO. Methods: Penelope2008 and GEANT4 Monte Carlo codes were used to characterize this source dosimetry. Water composition and mass density was that recommended by AAPM. Due to the typical energies of the 137 Cs, dose for small distances can be approximated by collisional kerma. Therefore, we have considered collisional kerma for r<20 cm. To provide adequate spatial resolu…

A dosimetric study on the Ir-192 high dose rate Flexisource

2006

In this work, the dose rate distribution of a new Ir-192 high dose rate source (Flexisource used in the afterloading Flexitron system, Isodose Control, Veenendaal, The Netherlands) is studied by means of Monte Carlo techniques using the GEANT4 code. The dosimetric parameters of the Task Group No. 43 Report (TG43) formalism and two-dimensional rectangular look-up tables have been obtained.

SU-FF-T-365: Practical Reconstruction Method for 3D CT-Based Brachytherapy with Shielded Colpostats

2006

Introduction and purpose.‐ The most extended worldwide HDR and PDR afterloading machines are from Nucletron, using the Plato Treatment Planning System (TPS) to perform the clinical dosimetry. The Fletcher‐Williamson (FW) vaginal colpostat applicators are widely used with these machines, they are made of a very dense material (densimet‐17) which allows shielding up to 50% of the dose. Almost all the TPS have incorporated the CT‐Based Brachytherapy (BT), in which the CT catheters and applicators reconstruction is based on contiguous CT transverse slices where the user points the catheter position. The problem with these applicators is the production of artefacts that makes the reconstruction …

MRI based treatment planning in gynaecological brachytherapy

2008

Interobserver study of countouringbased on ultrasound image in real-time interactive prostate brachytherapy

2009

Assessing the Relationship Between Dose-Volume Histogram Parameters and Late Rectal Toxicity in HDR Brachytherapy for Prostate Cancer

2017

Improving bleeding detector features for electron intraoperative radiotherapy

2019

Abstract Purpose The aim of this work is to improve the potential bleeding detection during intraoperative radiotherapy with linac polymethyl methacrylate applicators (PMMA), based on one previously developed. The improvements carried out have been focused on: i) minimizing the impact of the detector on the visual through the plastic applicators and ii) avoiding the asymmetry in the detection capability when the applicator is tilted. Methods Simulations have been made to select the geometry that provides a reduced visual impact on the applicator as well as allowing an independent response with the tilting angle of the applicator. A low-noise circuit for signal conditioning has been develope…

Study of encapsulated T170m sources for their potential use in brachytherapy

2010

Purpose: High dose-rate (HDR) brachytherapy is currently performed with {sup 192}Ir sources, and {sup 60}Co has returned recently into clinical use as a source for this kind of cancer treatment. Both radionuclides have mean photon energies high enough to require specific shielded treatment rooms. In recent years, {sup 169}Yb has been explored as an alternative for HDR-brachytherapy implants. Although it has mean photon energy lower than {sup 192}Ir, it still requires extensive shielding to deliver treatment. An alternative radionuclide for brachytherapy is {sup 170}Tm (Z=69) because it has three physical properties adequate for clinical practice: (a) 128.6 day half-life, (b) high specific a…

Erratum: “Technique for routine output verification of Leipzig applicators with a well chamber” [Med. Phys. 33, 16-20 (2006)]

2006

A Monte Carlo study of intersource effects in dome-type applicators loaded with LDR Cs-137 sources

2005

In this study, the dose rate distributions produced by low dose rate Cs-137 sources loaded in afterloadable dome applicators are studied using the Monte Carlo method. Dose differences between Monte Carlo results and calculations done using the superposition principle are within 1-3% in front of the applicator and between 3 and 10% near and along the longitudinal source axis. Consequently, the real doses to lateral vaginal wall, rectum and bladder are very close to the doses estimated applying the superposition principle, while the dose to the vaginal cuff has been overestimated by up to 10%.

The use of nomograms in LDR-HDR prostate brachytherapy

2011

Purpose: The common use of nomograms in Low Dose Rate (LDR) permanent prostate brachytherapy (BT) allows to estimate the number of seeds required for an implant. Independent dosimetry verification is recommended for each clinical dosimetry in BT. Also, nomograms can be useful for dose calculation quality assurance and they could be adapt ed to High Dose Rate (HDR). This work sets nomograms for LDR and HDR prostate-BT implants, which are applied to three different institutions that use different implant techniques. Material and methods: Patients treated throughout 2010 till April 2011 were considered for this study. This exam ple was chosen to be the representative of the latest implant tech…

Depth-dose measurement corrections for the surface electronic brachytherapy beams of an Esteya® unit: a Monte Carlo study

2020

Abstract Three different correction factors for measurements with the parallel-plate ionization chamber PTW T34013 on the Esteya electronic brachytherapy unit have been investigated. This chamber type is recommended by AAPM TG-253 for depth-dose measurements in the 69.5 kV x-ray beam generated by the Esteya unit. Monte Carlo simulations using the PENELOPE-2018 system were performed to determine the absorbed dose deposited in water and in the chamber sensitive volume at different depths with a Type A uncertainty smaller than 0.1%. Chamber-to-chamber differences have been explored performing measurements using three different chambers. The range of conical applicators available, from 10 to 30…

Design and characterization of a new high-dose-rate brachytherapy Valencia applicator for larger skin lesions

2016

Purpose: The aims of this study were (i) to design a new high-dose-rate (HDR) brachytherapy applicator for treating surface lesions with planning target volumes larger than 3 cm in diameter and up to 5 cm in size, using the microSelectron-HDR or Flexitron afterloader (Elekta Brachytherapy) with a 192Ir source; (ii) to calculate by means of the Monte Carlo(MC) method the dose distribution for the new applicator when it is placed against a water phantom; and (iii) to validate experimentally the dose distributions in water. Methods: The penelope2008MC code was used to optimize dwell positions and dwell times. Next, the dose distribution in a water phantom and the leakage dose distribution arou…

WE-C-108-08: Organ Doses in a Male Phantom Undergoing High-Dose-Rate Brachytherapy Applied to the Prostate

2013

Purpose: The aim of this study was to obtain equivalent doses to radiosensitive organs when applying high‐dose‐rate (HDR) brachytherapy to the prostate using60 Co or 192 Ir sources, and in comparison to external‐beam radiotherapy (EBRT) modalities. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized adult reference man described in Publication 110 by the International Commission on Radiological Protection (ICRP). Point sources of 60Co or 192Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate. Equivalent doses per therapeutic absorbed dose to the prostate were obtained in several radiosensitive organs. …

SU-FF-T-14: Monte Carlo Derivation of TG-43 Dosimetric Parameters for Radiation Therapy Resources and 3M Cs-137 Sources

2005

Purpose: In clinical brachytherapydosimetry a detailed dose rate distribution of the radioactive source in water is needed to make a quality treatment planning. Two Cs‐137 sources are considered in this study the Radiation Therapy Resources 67–800 source(Radiation Therapy Resources Inc., Valencia, CA) and the 3M model 6500/6D6C source.Material and methods: A complete dosimetric dataset for both sources has been obtained by means of the Monte Carlo GEANT4 code. Results:Dose rate distributions are presented in two different ways, following the TG43 formalism and in a 2D rectangular dose rate table. Conclusion: This 2D dose rate table is helpful for the TPS quality control and it is fully cons…

SU-FF-T-41: Monte Carlo Dosimetric Study of the New BEBIG Co-60 HDR Source

2005

Purpose: The use of high dose rate brachytherapy (HDR) is a highly extended practice today, being the Ir‐192 the most widely extended isotope used for this type of practice although Co‐60 is also available for HDR. The purpose of this study is to obtain the dosimetric parameters of the Co‐60 source used by the BEBIG MultiSource remote afterloader (BEBIG GmbH, Germany) for which there is no dosimetric data available in the literature. It is recommended that accurate dose distribution data, based on a realistic geometry and on the mechanical characteristics of the source, should be obtained by an appropriate method, experimental or Monte Carlo, to be used as input in the HDR Treatment Plannin…

Dosimetric perturbations of a lead shield for surface and interstitial high-dose-rate brachytherapy.

2014

In surface and interstitial high-dose-rate brachytherapy with either (60)Co, (192)Ir, or (169)Yb sources, some radiosensitive organs near the surface may be exposed to high absorbed doses. This may be reduced by covering the implants with a lead shield on the body surface, which results in dosimetric perturbations. Monte Carlo simulations in Geant4 were performed for the three radionuclides placed at a single dwell position. Four different shield thicknesses (0, 3, 6, and 10 mm) and three different source depths (0, 5, and 10 mm) in water were considered, with the lead shield placed at the phantom surface. Backscatter dose enhancement and transmission data were obtained for the lead shields…

Dosimetry characteristics of the Plus and 12i Gammamed PDR 192Ir sources.

2001

In this study a complete set of dosimetric data for the Plus and 12i Gammamed PDR (pulsed dose rate) 192 Ir sources is presented. These data have been calculated using the Monte Carlo simulation code GEANT3. Absolute dose rate distributions in water around these sources were calculated and are presented in form of conventional two dimensional (2D) Cartesian look-up tables. All dosimetric quantities recommended by the AAPM Task Group 43 report have been also calculated. These quantities are dose rate constant, radial dose function, anisotropy function and anisotropy factor. The dose rate distribution of the 12i source was compared with the corresponding data for the microselectron PDR source…

SU-E-T-176: Commissiong and Initial Clinical Experience with Dosimetry Check, a Commercial Software for in Vivo Volumetric Dosimetry

2013

Purpose: The aim of this work is to study the differences of reference point doses between the commercial EPID based dosimetry software Dosimetry Check (DC) and TPS to establish an accuracy level of the system, to evaluate its use in clinical routine and to obtain results for the first patients. Methods: We used DC v.3.8 (Math Resolutions), two Varian Clinac iX accelerators equipped with EPID aS1000 and Eclipse v.10.0 with AAA algorithm. Several plans with and without air gap were generated over the phantoms: MP1 Water Tank and Solid Octavius 4D (PTW). 5 head and neck, 3 lung and 4 prostate cases were selected for clinical evaluation. We compared the calculated dose at the isocenter and in …

Collision-kerma conversion between dose-to-tissue and dose-to-water by photon energy-fluence corrections in low-energy brachytherapy

2016

The AAPM TG-43 brachytherapy dosimetry formalism, introduced in 1995, has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations, except in the vicinity of the source capsule. Subsequent dosimetry developments, based on Monte Carlo calculations or analytical solutions of transport equations, do not rely on the CPE assumption and determine directly the dose to different tissues. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so tha…

Technical note: Monte-Carlo dosimetry of the HDR 12i and Plus 192Ir sources.

2001

In this study a complete set of dosimetric data for the GammaMed high dose rate (HDR) 12i and Plus 192 Ir sources are presented. These data have been calculated by means of the Monte Carlo simulation code GEANT3. Absolute dose rate distributions in water are presented as conventional two dimensional (2D) Cartesian look-up tables, and in the TG43 formalism.

SU-FF-T-62: Dosimetric Evaluation of An Internal Shielding Used with a HDR Skin Applicator

2009

Purpose: The Valencia HDR skin applicators are accessories of the microSelectron HDR afterloading system (Nucletron) cup shaped to limit the dose to the irradiation area. Applicators sizes are: diameter 2 and 3 cm. The typical prescription depth is 3 mm. This work aims to evaluate the backscatter and electron contamination of an internal shielding used to reduce the dose to the ocular globe when the lesion is located at the eyelid. Monte Carlo(MC) and experimental methods have been used. Method and Materials: The geometry has been: the Valencia applicator (2 cm diameter) on the surface of a solid polystyrene slab phantom; inside, a 2 mm lead slab located at 3 mm depth. MC simulation charact…

SU-FF-T-13: Monte Carlo Calculation of the TG-43 Dosimetric Parameters of a New BEBIG Ir-192 HDR Source

2005

Purpose: High dose rate (HDR) brachytherapy is a highly extended practice in clinical brachytherapy today. Quality dose rate distribution datasets of the HDR sources used in a clinical treatment are required. Because of the different source designs, a specific dosimetry dataset is required for each source model. In the recently published BRAPHYQS-ESTRO Report, an overview of available dosimetric data for all HDR Ir-192 sources is given, pointing out the lack of data for one of the sources, the used by the BEBIG MultiSource afterloading system (BEBIG GmbH, Germany). The purpose of this study is to obtain detailed dose rate distributions in liquid water media around this source. Material and …

Detector for monitoring potential bleeding during electron intraoperative radiotherapy

2018

Purpose: The aim of this work is to develop a bleeding detector integrated into the acrylic circular applicators for specific mobile linacs. Thus, a bleeding detector has been developed based on a capacitive sensor to be used with plastic applicators, as in the case of LIAC HWL from Sordina IORT Technologies SpA. According to the clinical impact, we have selected 0.5 cm as the minimum depth of fluid that should be detected. Methods: An experiment was developed using water-simulating blood. Two setups were considered: non-beveled applicators with 7 cm and 10 cm diameter. Measurements were done for applicators 0 degrees and 45 degrees tilted, both with respect to the horizontal surface, in or…

SU-E-J-69: Evaluation of the Lens Dose On the Cone Beam IGRT Procedures

2014

Purpose: With the establishment of the IGRT as a standard technique, the extra dose that is given to the patients should be taken into account. Furthermore, it has been a recent decrease of the dose threshold in the lens, reduced to 0.5 Gy (ICRP ref 4825-3093-1464 on 21st April, 2011).The purpose of this work was to evaluate the extra dose that the lens is receive due to the Cone-Beam (CBCT) location systems in Head-and-Neck treatments. Methods: The On-Board Imaging (OBI) v 1.5 of the two Varian accelerators, one Clinac iX and one True Beam, were used to obtain the dose that this OBI version give to the lens in the Head-and-Neck location treatments. All CBCT scans were acquired with the Sta…

SU-FF-T-329: Monte Carlo Dosimetric Study of the Flexisource Ir-192 HDR Source

2006

Purpose:Brachytherapy with high dose rate (HDR) sources of 192 Ir is a usual practice in clinical brachytherapy today. The TG43 U1 update report recommends that accurate dose distribution data of the brachytherapysource in use should be obtained experimentally or by Monte Carlo (MC), to be used as input in the HDR Treatment Planning System (TPS). The purpose of this study is to obtain the dose rate distribution in liquid water media for the Flexisource HDR 192 Ir source (Isodose Control GmbH, Germany) using the Monte Carlo method to obtain the TG43 U1 parameters and the 2‐D rectangular dose rate table. Material and methods: The MC code GEANT4 (7.1 version) was used to estimate dose rate in …

Erratum: “Fitted dosimetric parameters of high dose-rate 192Ir sources according to the AAPM TG43 formalism” [Med. Phys. 28 (4), 654-660 (2001)]

2001

Response to “Comment on ‘Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brac…

2016

SU-FF-T-180: Dosimetric Characteristics of Tm-170 as a Radionuclide for Its Possible Use in Brachytherapy

2006

In clinical brachytherapy several types of photon sources are used, mainly Cs‐137, Ir‐192, I‐125, and Pd‐103. The Tm‐170 is a promising radionuclide for use in brachytherapy because of the low mean‐energy (46.75 keV or 66.39 keV if the lines below 10 keV are removed) and the possible high specific activity (2.21×1014 Bq/g for a half life of 128.6 days). Tm‐170 is produced in a nuclear reactor by neutron absorption of the natural Tm‐169 and decays mainly via β‐emission. The maximum energies of the β‐rays are 0.290 and 0.323 MeV. These β particles are thus absorbed in the source core and in the encapsulation cover producing bremsstrahlung that contributes significantly to the dose. These fact…

Influence of Photon Energy Spectra from 192Ir and 125I Brachytherapy Sources on Kerma and Dose Rates in Water and Air

2010

SU-E-T-218: Octavius 4D: Commissioning and Clinical Implementation of a New Device for VMAT Verifications

2013

Purpose: To commission a new device for pre‐treatment patient specific verification of VMAT plans, which is capable of reconstructing 3D dose with high resolution. Methods: Octavius 4D system (PTW) consists of an ion chamber array embedded in a cylindrical phantom which, assisted by an inclinometer, rotates synchronously with the gantry. For VMAT plans, it measures planar dose distributions as a function of gantry angle in order to compute the resulting 3D dose distribution. There are two options for the ion chamber array: Octavius 729 (general purpose) and Octavius 1000 SRS (small field size, high resolution). We have used three linacs: two Varian Clinac iX and one TrueBeam with MLC HD 120…

Reply to “Comment on ‘Correspondence factor for Nucletron surface applicators'” [Med. Phys. 39, 2947-2948 (2012)]

2012

Monte Carlo dosimetric study of the medium dose rate CSM40 source

2013

Abstract The 137Cs medium dose rate (MDR) CSM40 source model (Eckert & Ziegler BEBIG, Germany) is in clinical use but no dosimetric dataset has been published. This study aims to obtain dosimetric data for the CSM40 source for its use in clinical practice as required by the American Association of Physicists in Medicine (AAPM) and the European Society for Radiotherapy and Oncology (ESTRO). Penelope2008 and Geant4 Monte Carlo codes were used to characterize this source dosimetrically. It was located in an unbounded water phantom with composition and mass density as recommended by AAPM and ESTRO. Due to the low photon energies of 137Cs, absorbed dose was approximated by collisional kerma. Add…

Equivalent phantom sizes in Ir-192 source brachytherapy dosimetric studies

2008

Erratum: “TG-43 U1 based dosimetric characterization of model 67-6520 Cs-137 brachytherapy source”

2012

Purpose: Brachytherapy treatment has been a cornerstone for management of various cancer sites, particularly for the treatment of gynecological malignancies. In low dose rate brachytherapy treatments,C137s sources have been used for several decades. A new C137s source design has been introduced (model 67-6520, source B3-561) by Isotope Products Laboratories (IPL) for clinical application. The goal of the present work is to implement the TG-43 U1 protocol in the characterization of the aforementioned C137s source. Methods: The dosimetriccharacteristics of the IPLC137s source are measured using LiF thermoluminescent dosimeters in a Solid Water™ phantom material and calculated using Monte Carl…

Source strength determination in iridium-192 and cobalt-60 brachytherapy : A European survey on the level of agreement between clinical measurements …

2021

Background and purpose: Brachytherapy treatment outcomes depend on the accuracy of the delivered dose distribution, which is proportional to the reference air-kerma rate (RAKR). Current societal recommendations require the medical physicist to compare the measured RAKR values to the manufacturer source calibration certificate. The purpose of this work was to report agreement observed in current clinical practice in the European Union. Materials and methods: A European survey was performed for high- and pulsed-dose-rate (HDR and PDR) highenergy sources (Ir-192 and Co-60), to quantify observed RAKR differences. Medical physicists at eighteen hospitals from eight European countries were contac…

GEC-ESTRO ACROP recommendations on calibration and traceability of LE-LDR photon-emitting brachytherapy sources at the hospital level

2019

Prostate brachytherapy treatment using permanent implantation of low-energy (LE) low-dose rate (LDR) sources is successfully and widely applied in Europe. In addition, seeds are used in other tumour sites, such as ophthalmic tumours, implanted temporarily. The calibration issues for LE-LDR photon emitting sources are specific and different from other sources used in brachytherapy. In this report, the BRAPHYQS (BRAchytherapy PHYsics Quality assurance System) working group of GEC-ESTRO, has developed the present recommendations to assure harmonized and high-quality seed calibration in European clinics. There are practical aspects for which a clarification/procedure is needed, including aspect…

Review of clinical brachytherapy uncertainties: Analysis guidelines of GEC-ESTRO and the AAPM

2014

Background and purpose: A substantial reduction of uncertainties in clinical brachytherapy should result in improved outcome in terms of increased local control and reduced side effects. Types of uncertainties have to be identified, grouped, and quantified. Methods: A detailed literature review was performed to identify uncertainty components and their relative importance to the combined overall uncertainty. Results: Very few components (e.g., source strength and afterloader timer) are independent of clinical disease site and location of administered dose. While the influence of medium on dose calculation can be substantial for low energy sources or non-deeply seated implants, the influence…

Broad-beam transmission data for new brachytherapy sources, Tm-170 and Yb-169

2005

The characteristics of the radionuclides (170)Tm and (169)Yb are highly interesting for their use as high dose-rate brachytherapy sources. The introduction of brachytherapy equipment containing these sources will lead to smaller required thicknesses of the materials used in radiation protection barriers compared with the use of conventional sources such as (192)Ir and (137)Cs. The purpose of this study is to determine the required thicknesses of protection material for the design of the protecting walls. Using the Monte Carlo method, transmission data were derived for broad-beam geometries through lead and concrete barriers, from which the first half value layer and tenth value layer are ob…

Fitted dosimetric parameters of high dose-rate 192Ir sources according to the AAPM TG43 formalism

2001

The purpose of this study is to find fitted functional forms to the anisotropy function, F(r,θ), and the radial dose function, g(r), in order to characterize dose-rate distributions around all the high-intensity 192 Ir sources currently in use. Dosimetry data are at present available as tables for: the microSelectron HDR (“classic” and “new” design models), the PDR source, and the VariSource HDR source, expressed in terms of the AAPM Task Group No. 43 recommendations. There is only one paper out which introduces a functional form to fit the anisotropy function, but only for symmetric sources with respect to the transverse axis. However, dosimetric data of the HDR and PDR sources mentioned a…

Radiation transmission data for radionuclides and materials relevant to brachytherapy facility shielding

2008

To address the limited availability of radiation shielding data for brachytherapy as well as some disparity in existing data, Monte Carlo simulation was used to generate radiation transmission data for 60Co, 137CS, 198Au, 192Ir 169Yb, 170Tm, 131Cs, 125I, and 103pd photons through concrete, stainless steel, lead, as well as lead glass and baryte concrete. Results accounting for the oblique incidence of radiation to the barrier, spectral variation with barrier thickness, and broad beam conditions in a realistic geometry are compared to corresponding data in the literature in terms of the half value layer (HVL) and tenth value layer (TVL) indices. It is also shown that radiation shielding calc…

Monte Carlo study of the dose rate distributions for the Ir2.A85-2 and Ir2.A85-1 Ir-192 afterloading sources

2008

The two most commonly used modalities of cancer treatment in clinical brachytherapy practice today are high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy. In a clinical treatment, quality dose rate distribution data sets of the brachytherapy sources are required for each source model. The purpose of this study is to obtain detailed dose rate distributions around the new BEBIG HDR and PDR Ir-192 brachytherapy sources. These distributions will then be used as input data in the treatment planning systems dedicated to brachytherapy and its calculations can be verified. The Monte Carlo method was used to obtain the dose rate distributions around the sources studied, taking into accoun…

Monte Carlo calculation of dose rate distributions around the Walstam CDC.K-type137Cs sources

2001

Basic dosimetric data for the Walstam CDC.K-type low dose rate 137Cs sources in water have been calculated using Monte Carlo techniques. These sources, CDC.K1 -K3 and CDC.K4, are widely used in a range of applicators and moulds for the treatment of intracavitary and superficial cancers. Our purpose is to improve existing data about these sources using the Monte Carlo simulation code GEANT3. Absolute dose rate distributions in water have been calculated around these sources and are presented as conventional 2D Cartesian look-up tables. Also the AAPM Task Group 43 formalism for dose calculation has been applied. The calculated dose rate constant for the CDC.K1-K3 source is A = 1.106 +/- 0.001…

Failure mode and effects analysis of skin electronic brachytherapy using Esteya® unit

2016

Purpose: Esteya® (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) is an electronic brachytherapy device used for skin cancer lesion treatment. In order to establish an adequate level of quality of treatment, a risk analysis of the Esteya treatment process has been done, following the methodology proposed by the TG-100 guidelines of the American Association of Physicists in Medicine (AAPM). Material and methods: A multidisciplinary team familiar with the treatment process was formed. This team developed a process map (PM) outlining the stages, through which a patient passed when subjected to the Esteya treatment. They identified potential failure modes (FM) and each individual FM…

A Monte Carlo-based dosimetric characterization of Esteya® , an electronic surface brachytherapy unit

2018

PURPOSE The purpose of this work is threefold: First, to obtain the phase space of an electronic brachytherapy (eBT) system designed for surface skin treatments. Second, to explore the use of some efficiency enhancing (EFEN) strategies in the determination of the phase space. Third, to use the phase space previously obtained to perform a dosimetric characterization of the Esteya eBT system. METHODS The Monte Carlo study of the 69.5 kVp x-ray beam of the Esteya® unit (Elekta Brachytherapy, Veenendaal, The Netherlands) was performed with PENELOPE2014. The EFEN strategies included the use of variance reduction techniques and mixed Class II simulations, where transport parameters were fine-tune…

Dosimetric Characteristics of a New Unit for Electronic Skin Brachytherapy

2014

A practical MRI-based reconstruction method for a new endocavitary and interstitial gynaecological template

2015

Purpose: There are perineal templates for interstitial implants such as MUPIT and Syed applicators. Their limitations are the intracavitary component deficit and the necessity to use computed tomography (CT) for treatment planning since both applicators are non-magnetic resonance imaging (MRI) compatibles. To overcome these problems, a new template named Template Benidorm (TB) has been recently developed. Titanium needles are usually reconstructed based on their own artifacts, mainly in T1-weighted sequence, using the void on the tip as the needle tip position. Nevertheless, patient tissues surrounding the needles present heterogeneities that complicate the accurate identification of these …

A monte carlo study of dose rate distribution around the specially asymmetric CSM3-a 137Cs source.

2001

The CSM3 137Cs type stainless-steel encapsulated source is widely used in manually afterloaded low dose rate brachytherapy. A specially asymmetric source, CSM3-a, has been designed by CIS Bio International (France) substituting the eyelet side seed with an inactive material in the CSM3 source. This modification has been done in order to allow a uniform dose level over the upper vaginal surface when this `linear' source is inserted at the top of the dome vaginal applicators. In this study the Monte Carlo GEANT3 simulation code, incorporating the source geometry in detail, was used to investigate the dosimetric characteristics of this special CSM3-a 137Cs brachytherapy source. The absolute do…

Induced attenuation in Ce3+ and Nd3+ doped fibers irradiated with electron beams under low dose regime

2005

Abstract In this paper, we study the feasibility of rare earth doped optical fibers as dosimeters based on the attenuation induced by electron beams under standard conditions in radiotherapy. Neodymium and cerium doped fibers have been irradiated with 10 MeV electrons, the radiation-induced loss and the dynamic response have been measured in the wavelength range 1200–1600 nm. The sensitivity of the fibers is of the order of 0.1 (dB/m)/Gy and has a linear dependence on the dose.

Evaluation of the shielding in a treatment room with an electronic brachytherapy unit.

2017

Esteya® (Elekta Brachytherapy, Veenendaal, The Netherlands) is an electronic brachytherapy (eBT) system based on a 69.5 kVp x-ray source and a set of collimators of 1 to 3 cm in diameter, used for treating non-melanoma skin cancer lesions. This study aims to estimate room shielding requirements for this unit. The non-primary (scattered and leakage) ambient dose equivalent rates were measured with a Berthold LB-133 monitor (Berthold Technologies, Bad Wildbad, Germany). The latter ranges from 17 mSv h-1 at 0.25 m distance from the x-ray source to 0.1 mSv h-1 at 2.5 m. The necessary room shielding was then estimated following US and some European guidelines. The room shielding for all barriers…

Dosimetric characteristics of a new unit for electronic skin brachytherapy

2013

PURPOSE: Brachytherapy with radioactive high dose rate (HDR) (192)Ir source is applied to small skin cancer lesions, using surface applicators, i.e. Leipzig or Valencia type. New developments in the field of radiotherapy for skin cancer include electronic brachytherapy. This technique involves the placement of an HDR X-ray source close to the skin, therefore combining the benefits of brachytherapy with the reduced shielding requirements and targeted energy of low energy X-rays. Recently, the Esteya(®) Electronic Brachytherapy System (Esteya EBS, Elekta AB-Nucletron, Stockholm, Sweden) has been developed specifically for HDR brachytherapy treatment of surface lesions. The system provides rad…

Commissioning and periodic tests of the Esteya® electronic brachytherapy system

2015

A new electronic brachytherapy unit from Elekta, called Esteya(®), has recently been introduced to the market. As a part of the standards in radiation oncology, an acceptance testing and commissioning must be performed prior to treatment of the first patient. In addition, a quality assurance program should be implemented. A complete commissioning and periodic testing of the Esteya(®) device using the American Association of Physicists in Medicine (AAPM), Groupe Europeen de Curietherapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO) guidelines for linacs and brachytherapy units as well as our personal experience is described in this paper. In addition to the methodology, r…

QA of dynamic MLC based on EPID portal dosimetry.

2010

Abstract Purpose Dynamic delivery of intensity modulated beams (dIMRT) requires not only accurate verification of leaf positioning but also a control on the speed of motion. The latter is a parameter that has a major impact on the dose delivered to the patient. Time consumed in quality assurance (QA) procedures is an issue of relevance in any radiotherapy department. Electronic portal imaging dosimetry (EPID) can be very efficient for routine tests. The purpose of this work is to investigate the ability of our EPID for detecting small errors in leaf positioning, and to present our daily QA procedures for dIMRT based on EPID. Methods and materials A Varian 2100 CD Clinac equipped with an 80 …

Brachytherapy treatment planning for complex applicators based on the AAPM TG-43 dosimetry algorithm: Case studies and clinical impact

2009

Technical note: Monte Carlo derivation of TG-43 dosimetric parameters for radiation therapy resources and 3M Cs-137 sources

2005

In clinical brachytherapy dosimetry, a detailed dose rate distribution of the radioactive source in water is needed in order to plan for quality treatment. Two Cs-137 sources are considered in this study; the Radiation Therapy Resources 67-800 source (Radiation Therapy Resources Inc., Valencia, CA) and the 3M model 6500/6D6C source. A complete dosimetric dataset for both sources has been obtained by means of the Monte Carlo GEANT4 code. Dose rate distributions are presented in two different ways; following the TG43 formalism and in a 2D rectangular dose rate table. This 2D dose rate table is helpful for the TPS quality control and is fully consistent with the TG43 dose calculation formalism…

Monte Carlo dosimetric characterization of the Cs-137 selectron/LDR source: evaluation of applicator attenuation and superposition approximation effe…

2004

The purpose of this study is to calculate the dose rate distribution for the Amersham Cs-137 pellet source used in brachytherapy with the Selectron low-dose-rate remote afterloading system in gynaecological applications using the Monte Carlo code GEANT4. The absolute dose rate distribution for the pellet source was obtained and presented as a one-dimensional absolute dose rate table as well as in the Task Group 43 dose-calculation formalism. In this study, excellent agreement was found between the point source theoretical model using fitted polynomial values and Monte Carlo calculations of the dose rate distribution for the pellet source. A comparison study was also made between the dose ra…

High-dose-rate brachytherapy boost for prostate cancer: Analysis of dose-volume histogram parameters for predicting late, rectal toxicity

2017

PURPOSE: To determine the significance of dose-volume histogram parameters for predicting late rectal toxicity (LRT) after single-fraction high-dose-rate brachytherapy (HDRBT) boost and external beam radiotherapy (EBRT) in prostate cancer. MATERIALS AND METHODS: Three hundred patients with intermediate- or high-risk prostate cancer were included between August 2010 and March 2015. Treatment comprised a single-fraction HDRBT boost of 15.0 Gy plus EBRT (46.0 Gy delivered in 23 fractions) or an HDRBT boost of 9.5 Gy plus EBRT (60.0 Gy delivered in 30 fractions) if the seminal vesicles were infiltrated using real-time transrectal ultrasound-based planning. LRT was evaluated every 3 months after…

Transit dose comparisons for60Co and192Ir HDR sources

2016

The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) 60Co sources along a transfer tube as compared to 192Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom. The movement of the source was included by displacing their positions along the connecting tube from …

Evaluation of lens absorbed dose with Cone Beam IGRT procedures

2015

The purpose of this work is to evaluate the absorbed dose to the eye lenses due to the cone beam computed tomography (CBCT) system used to accurately position the patient during head-and-neck image guided procedures. The on-board imaging (OBI) systems (v.1.5) of Clinac iX and TrueBeam (Varian) accelerators were used to evaluate the imparted dose to the eye lenses and some additional points of the head. All CBCT scans were acquired with the Standard-Dose Head protocol from Varian. Doses were measured using thermoluminescence dosimeters (TLDs) placed in an anthropomorphic phantom. TLDs were calibrated at the beam quality used to reduce their energy dependence. Average dose to the lens due to …

Towards clinical application of RayStretch for heterogeneity corrections in LDR permanent 125-I prostate brachytherapy

2017

Purpose RayStretch is a simple algorithm proposed for heterogeneity corrections in low-dose–rate brachytherapy. It is built on top of TG-43 consensus data, and it has been validated with Monte Carlo (MC) simulations. In this study, we take a real clinical prostate implant with 71 125I seeds as reference and we apply RayStretch to analyze its performance in worst-case scenarios. Methods and Materials To do so, we design two cases where large calcifications are located in the prostate lobules. RayStretch resilience under various calcification density values is also explored. Comparisons against MC calculations are performed. Results Dose–volume histogram–related parameters like prostate D90, …

Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry

2015

Purpose: A surface electronic brachytherapy (EBT) device is in fact an x-ray source collimated with specific applicators. Low-energy (<100 kVp) x-ray beam dosimetry faces several challenges that need to be addressed. A number of calibration protocols have been published for x-ray beam dosimetry. The media in which measurements are performed are the fundamental difference between them. The aim of this study was to evaluate the surface dose rate of a low-energy x-ray source with small field applicators using different calibration standards and different small-volume ionization chambers, comparing the values and uncertainties of each methodology. Methods: The surface dose rate of the EBT unit …

Un método sencillo para la reconstrucción en braquiterapia basado en los escanogramas de la TAC

2000

En este trabajo se analiza un metodo de reconstruccion geometrica basado en los escanogramas de la TAC a utilizar en braquiterapia. Se describe asimismo el proceso de planificacion que ha propiciado la introduccion de dicho metodo.

SU-E-T-467: Monte Carlo Dosimetric Study of the New Flexisource Co-60 High Dose Rate Source.

2017

Recently, a new HDR 60Co brachytherapy source, Flexisource Co-60, has been developed (Nucletron B.V.). This study aims to obtain quality dosimetric data for this source for its use in clinical practice as required by AAPM and ESTRO.Penelope2008 and GEANT4 Monte Carlo codes were used to dosimetrically characterize this source. Water composition and mass density was that recommended by AAPM. Due to the high energy of the 60Co, dose for small distances cannot be approximated by collisional kerma. Therefore, we have considered absorbed dose to water for r0.75 cm and collisional kerma from 0.75r20 cm. To provide adequate spatial resolution, cells were 0.01 cm in thickness for r2 cm from the sour…

SU-F-T-13: Transit Dose Comparisons for Co-60 and Ir-192 HDR Sources

2016

Purpose: The purpose of this study is to compare the transit dose due to the movement of high dose rate (HDR) Ir-192 and Co-60 sources along the transfer tube. This is performed by evaluating air-kerma differences in the vicinity of the transfer tube when both sources are moved with the same velocity from a HDR brachytherapy afterloader into a patient. Methods: Monte Carlo simulations have been performed using PENELOPE2014. mHDR-v2 and Flexisource sources have been considered. Collisional kerma has been scored. The sources were simulated within a plastic catheter located in an infinite air phantom. The movement of the seed was included by displacing their positions along the connecting cath…

A simple analytical method for heterogeneity corrections in low dose rate prostate brachytherapy

2015

In low energy brachytherapy, the presence of tissue heterogeneities contributes significantly to the discrepancies observed between treatment plan and delivered dose. In this work, we present a simplified analytical dose calculation algorithm for heterogeneous tissue. We compare it with Monte Carlo computations and assess its suitability for integration in clinical treatment planning systems. The algorithm, named as RayStretch, is based on the classic equivalent path length method and TG-43 reference data. Analytical and Monte Carlo dose calculations using Penelope2008 are compared for a benchmark case: a prostate patient with calcifications. The results show a remarkable agreement between …

Fetal dose measurements and shielding efficiency assessment in a custom setup of (192)Ir brachytherapy for a pregnant woman with breast cancer.

2015

To assess the radiation dose to the fetus of a pregnant patient undergoing high-dose-rate (HDR) (192)Ir interstitial breast brachytherapy, and to design a new patient setup and lead shielding technique that minimizes the fetal dose.Radiochromic films were placed between the slices of an anthropomorphic phantom modeling the patient. The pregnant woman was seated in a chair with the breast over a table and inside a leaded box. Dose variation as a function of distance from the implant volume as well as dose homogeneity within a representative slice of the fetal position was evaluated without and with shielding.With shielding, the peripheral dose after a complete treatment ranged from 50 cGy at…

SU-E-T-343: Valencia Applicator Commissioning Using a Micro-Chamber Array

2014

Purpose: In the commissioning and QA of surface isotope-based applicators, source-indexer distance (SID) has a great influence in the flatness, symmetry and output. To these purposes, methods described in the literature are the use of a special insert at the entrance of dwell chamber or radiochromic films. Here we present the experience with a micro-chamber array to perform the commissioning and QA of Valencia applicators. Methods: Valencia applicators have been used, the classic and the new extra-shielded version. A micro-chamber array has been employed, 1000 SRS (PTW), with 977 liquid filled, 2.3×2.3×0.5 mm3 sized ion chambers covering 11×11 cm2, which spacing is 2.5 mm in the central 5.5…

EP-1131: Octavius 4D 1000 SRS, a new instrument for SBRT VMAT IMRT verification. Commissioning and clinical implementation

2013

An approach to using conventional brachytherapy software for clinical treatment planning of complex, Monte Carlo-based brachytherapy dose distributio…

2009

Certain brachytherapy dose distributions, such as those for LDR prostate implants, are readily modeled by treatment planning systems (TPS) that use the superposition principle of individual seed dose distributions to calculate the total dose distribution. However, dose distributions for brachytherapy treatments using high-Z shields or having significant material heterogeneities are not currently well modeled using conventional TPS. The purpose of this study is to establish a new treatment planning technique (Tufts technique) that could be applied in some clinical situations where the conventional approach is not acceptable and dose distributions present cylindrical symmetry. Dose distributi…

Monte Carlo dosimetry of the Buchler high dose rate 192Ir source.

2001

In this study a complete set of dosimetric data is presented for the high dose rate (HDR) source from Amersham used in the Buchler remote afterloading HDR unit. These data have been calculated by means of the Monte Carlo simulation code GEANT taking into account the detailed geometry of the source. Absolute dose rate distributions in water were calculated around this source and are presented as conventional 2D Cartesian look-up tables. All dosimetric quantities recommended by the AAPM Task Group 43 report have been calculated. Quantities determined are: dose rate constant, radial dose function, anisotropy function, anisotropy factor and anisotropy constant. The dose rate distributions of th…

SU-E-T-691: Shielding Evaluation of a Treatment Room with An Electronic Brachytherapy System

2015

Purpose: Esteya™ (Elekta) is a brachytherapy electronic system used for treating skin cancer lesions. This unit is based on a 69.5 kV X-ray source and a surface applicator which produces a circular beam of a specific diameter, which varies from 1 to 3 cm. This study aims to establish the radiation protection measures for the system. Methods: A characterization of the scattered and leakage radiation of the system was implemented by means of experimental measurements. The scattered radiation measurements were performed with a Berthold LB133 ionization chamber, evaluating the dose rate for different distances from the applicator surface. The patient was simulated through water equivalent solid…

Air-kerma evaluation at the maze entrance of HDR brachytherapy facilities.

2014

In the absence of procedures for evaluating the design of brachytherapy (BT) facilities for radiation protection purposes, the methodology used for external beam radiotherapy facilities is often adapted. The purpose of this study is to adapt the NCRP 151 methodology for estimating the air-kerma rate at the door in BT facilities. Such methodology was checked against Monte Carlo (MC) techniques using the code Geant4. Five different facility designs were studied for (192)Ir and (60)Co HDR applications to account for several different bunker layouts.For the estimation of the lead thickness needed at the door, the use of transmission data for the real spectra at the door instead of the ones emit…

Surface brachytherapy: Joint report of the AAPM and the GEC-ESTRO Task Group No. 253.

2020

The surface brachytherapy Task Group report number 253 discusses the common treatment modalities and applicators typically used to treat lesions on the body surface. Details of commissioning and calibration of the applicators and systems are discussed and examples are given for a risk-based analysis approach to the quality assurance measures that are necessary to consider when establishing a surface brachytherapy program.

TG-43U1-based dosimetric characterization of model 67-6520 137 Cs brachytherapy source

2009

Dosimetric Deviation of Leipzig and Valencia Skin Applicators When Used without Cap

2016

Dosimetric Uncertainties in the Practice of Clinical Brachytherapy

2011

SU-GG-T-227: Dynamic IMRT Split Beam Technique Verification Using EPID Based Dosimetry

2010

Purpose: On dynamic IMRT plans with Millenium 80 (Varian) fields wider of 15 cm must be splitted. Since the EPIDdosimetry software does not allow to sum splitted subfluences in the same dosimetric portal image they have to be measured separately and compared independently with the subfluences previously calculated by the TPS Eclipse. The purpose of our work is the development of a tool to: 1) analyze the correct match between the two abutted ports for splitted fields. 2) study the effect of gravity and analyze repercussions of possible misalignments and 3) illustrate that the gamma evaluation should be made with the global summed fluence per field instead of with the individual subfluences.…

Assaying multiple 125 I seeds with the well-ionization chamber SourceCheck 4π 33005 and a new insert

2015

PURPOSE To provide a practical solution that can be adopted in clinical routine to fulfill the AAPM-ESTRO recommendations regarding quality assurance of seeds used in prostate permanent brachytherapy. The aim is to design a new insert for the well-ionization chamber SourceCheck(4π) 33005 (PTW, Germany) that allows evaluating the mean air-kerma strength of up to ten (125)I seeds with one single measurement instead of measuring each seed individually. MATERIAL AND METHODS The material required is: a) the SourceCheck(4π) 33005 well-ionization chamber provided with a PTW insert to measure the air-kerma strength S K of one single seed at a time; b) a newly designed insert that accommodates ten s…

Commissioning and quality assurance procedures for the HDR Valencia skin applicators

2016

The Valencia applicators (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) are cup-shaped tungsten applicators with a flattening filter used to collimate the radiation produced by a high-dose-rate (HDR) 192 Ir source, and provide a homogeneous absorbed dose at a given depth. This beam quality provides a good option for the treatment of skin lesions at shallow depth (3-4 mm). The user must perform commissioning and periodic testing of these applicators to guarantee the proper and safe delivery of the intended absorbed dose, as recommended in the standards in radiation oncology. In this study, based on AAPM and GEC-ESTRO guidelines for brachytherapy units and our experience, a set …

Broad beam transmission curves for new radionuclides in brachytherapy

2007

Evaluation of high-energy brachytherapy source electronic disequilibrium and dose from emitted electrons

2009

Purpose: The region of electronic disequilibrium near photon-emitting brachytherapysources of high-energy radionuclides ( C 60 o , C 137 s , I 192 r , and Y 169 b ) and contributions to total dose from emitted electrons were studied using the GEANT4 and PENELOPEMonte Carlo codes. Methods: Hypothetical sources with active and capsule materials mimicking those of actual sources but with spherical shape were examined. Dose contributions due to sourcephotons, x rays, and bremsstrahlung; source β − , Auger electrons, and internal conversionelectrons; and water collisional kerma were scored. To determine if conclusions obtained for electronic equilibrium conditions and electrondose contribution t…

TH-C-AUD A-07: Evaluation of the Correction Factor Due to the Lack of Full Scatter Conditions in Cs-137 and Ir-192 Brachytherapy Dosimetric Studies

2008

Purpose: Use of a finite phantom to derive dose rate distributions around brachytherapysources implies a lack of backscattering material near the phantom periphery. Conventional planning algorithms and newly‐developed 3D correction algorithms are based on physics data under full scatter conditions. Presently, most published Monte Carlodosimetric studies have been obtained using either a spherical phantom (15cm in radius) or a cylinder phantom (40×40cm2). The study objective was to derive a simple relationship to correlate the radial dose function, g(r), obtained for each one of these phantoms to that obtained for an unbounded phantom. Method and Materials: Assuming bare point sources of 137…

Dosimetric characterization of Ir-192 LDR elongated sources

2008

Ir-192 wires have been used in low-dose-rate brachytherapy for many years. Commercially available treatment planning systems approximate the dose rate distribution of the straight or curved wires applying the superposition principle using one of the following methods: (i) The wire is modeled as a set of point sources, (ii) the wire is modeled as a set of small straight segment wires, (iii) the values of the parameters and functions of the American Association of Physicists in Medicine (AAPM) Task Group 43 protocol are obtained for wire lengths between 3 and 7 cm assuming some simplifications. The dose rate distributions obtained using these methods for linear wires of different lengths and …