Broad beam transmission data for the shielding of brachytherapy facilities

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

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.

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…

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

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…

Design and evaluation of a HDR skin applicator with flattening filter

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…

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

Monte Carlo calculation of the TG-43 dosimetric parameters of a new BEBIG Ir-192 HDR source

Background and 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 that is 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 sou…

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

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

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 brachytherapy sources

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

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

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

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…

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

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

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…

Prescription Depth in Surface Skin Brachytherapy

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

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…

SU-E-I-83: Detectability Limits of a New Positron Emission Mammography in Relation to Tumour-Size, Tumour-To-Background Ratio and Activity Concentration

Purpose:Positron emission mammography(PEM) improves spatial resolution and sensitivity, making it suitable for early breast tumours detection. The aim of this study is to evaluate the limits of a dedicated breast PET in terms of tumour‐size, tumour‐to‐background activity concentration ratio (TBR) and activity concentration. Methods: A dedicated PEM is evaluated. To characterize the device, we use a phantom of 15 cm of diameter containing 6 inserts of inner diameters 18, 15, 11, 8, 5 and 3 mm. To evaluate the detectability limits images are acquired by varying the TBR from 10 to 2 and without background activity concentration. In all the studies the activity concentration for the 6 inserts i…

Radiation dose distribution around a mobile linear accelerator Mobetron using Monte Carlo simulation

The aim of this work is to analyze the scattered radiation produced by the mobile accelerator Mobetron. To do so detailed Monte Carlo simulation using two different codes, Penelope2011 and Geant4, were performed. Experimental measurements were also done to validate them. To quantify the attenuation of the internal structures present in the accelerator head on the scattered radiation produced, some of the main structural shielding in the Mobetron has been incorporated into the simulation. Results are compared with experimental measurements. Some discrepancies between the calculated and measured dose values were found. These differences can be traced back to the importance of the radiation co…

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

A generic TG-186 shielded applicator for commissioning model-based dose calculation algorithms for high-dose-rate Ir-192 brachytherapy

PurposeA joint working group was created by the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy and Oncology (ESTRO), and the Australasian Brachytherapy Group (ABG) with the charge, among others, to develop a set of well-defined test case plans and perform calculations and comparisons with model-based dose calculation algorithms (MBDCAs). Its main goal is to facilitate a smooth transition from the AAPM Task Group No. 43 (TG-43) dose calculation formalism, widely being used in clinical practice for brachytherapy, to the one proposed by Task Group No. 186 (TG-186) for MBDCAs. To do so, in this work a hypothetical, generic high-dose rate (HDR) Ir-19…

HDR Valencia skin applicators: A proposed commissioning procedure

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

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 …

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

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

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

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

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…

Monte Carlo evaluation of kerma in an HDR brachytherapy bunker

In recent years, the use of high dose rate (HDR) after-loader machines has greatly increased due to the shift from traditional Cs-137/Ir-192 low dose rate (LDR) to HDR brachytherapy. The method used to calculate the required concrete and, where appropriate, lead shielding in the door is based on analytical methods provided by documents published by the ICRP, the IAEA and the NCRP. The purpose of this study is to perform a more realistic kerma evaluation at the entrance maze door of an HDR bunker using the Monte Carlo code GEANT4. The Monte Carlo results were validated experimentally. The spectrum at the maze entrance door, obtained with Monte Carlo, has an average energy of about 110 keV, m…

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

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

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

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

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

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

Study of encapsulated T170m sources for their potential use in brachytherapy

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)]

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

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%.

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

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

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

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

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.

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…

A Generic High-Dose-Rate 192Ir Source Model for Model-Based Dose Calculation Methods in Brachytherapy Beyond the TG-43 Formalism

Technical note: Dosimetric study of a new Co-60 source used in brachytherapy

The purpose of this study is to obtain the dosimetric parameters of a new Co-60 source used in high dose rate brachytherapy and manufactured by BEBIG (Eckert & Ziegler BEBIG GmbH, Germany). The Monte Carlo method has been used to obtain the dose rate distribution in the updated TG-43U1 formalism of the American Association of Physicists in Medicine. In addition, to aid the quality control process on treatment planning systems (TPS), a two-dimensional rectangular dose rate table, coherent with the TG-43U1 dose calculation formalism, is given. These dosimetric data sets can be used as input data of the TPS calculations and to validate them.

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

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

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 …

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

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 …

Phantom size in brachytherapy source dosimetric studies

An important point to consider in a brachytherapy dosimetry study is the phantom size involved in calculations or experimental measurements. As pointed out by Williamson [Med. Phys. 18, 776-786 (1991)] this topic has a relevant influence on final dosimetric results. Presently, one-dimensional (1-D) algorithms and newly-developed 3-D correction algorithms are based on physics data that are obtained under full scatter conditions, i.e., assumed infinite phantom size. One can then assume that reference dose distributions in source dosimetry for photon brachytherapy should use an unbounded phantom size rather than phantom-like dimensions. Our aim in this paper is to study the effect of phantom s…

Monte Carlo dosimetric study of the Flexisource Co-60 high dose rate source.

Purpose: Recently, a new HDR 60 Co brachytherapy source, Flexisource Co-60, has been developed (Nucletron B.V. Veenendaal, The Netherlands). This study aims to obtain dosimetric data for this source for its use in clinical practice as required by AAPM and ESTRO. Material and methods: Two Monte Carlo radiation transport codes were used: Penelope2008 and GEANT4. The source was centrally-positioned in a 100 cm radius water phantom. Absorbed dose and collisional kerma were obtained using 0.01 cm (close) and 0.1 cm (far) sized voxels to provide high-resolution dosimetry near (far from) the source. Dose rate distributions obtained with the two Monte Carlo codes were compared. Results and Discussi…

Establishing Universal Test Cases for Benchmarking Model-Based Dose Calculations beyond TG-43

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

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

Monte Carlo dosimetric study of the BEBIG Co-60 HDR source

Although not as widespread as Ir-192, Co-60 is also available on afterloading equipment devoted to high dose rate brachytherapy, mainly addressed to the treatment of gynaecological lesions. 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 are no dosimetric data available in the literature. The Monte Carlo code GEANT4 has been used to obtain the TG43 parameters and the 2D dose rate table in Cartesian coordinates of the BEBIG Co-60 HDR source. The dose rate constant, radial dose function and anisotropy function have been calculated and are presented in a tabular form as w…

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

Monte Carlo dosimetric study of the medium dose rate CSM40 source

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

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

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…

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

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…

Flattering filter design for HDR surface applicators

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

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…

Dosimetric study of the 15mm ROPES eye plaque

The main aim of this paper is to make a study of dose-rate distributions obtained around the 15 mm, radiation oncology physics and engineering services, Australia (ROPES) eye plaque loaded with {sup 125}I model 6711 radioactive seeds. In this study, we have carried out a comparison of the dose-rate distributions obtained by the algorithm used by the Plaque Simulator (PS) (BEBIG GmbH, Berlin, Germany) treatment planning system with those obtained by means of the Monte Carlo method for the ROPES eye plaque. A simple method to obtain the dose-rate distributions in a treatment planning system via the superposition of the dose-rate distributions of a seed placed in the eye plaque has been develo…

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

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 and experimental derivation of TG43 dosimetric parameters for CSM-type Cs-137 sources

In this study, complete dosimetric datasets for the CSM2 and CSM3 Cs-137 sources were obtained using the Monte Carlo GEANT4 code. The application of this calculation method was experimentally validated with thermoluminescent dosimetry (TLD). Functions and parameters following the TG43 formalism are presented: the dose rate constant, the radial dose functional, and the anisotropy function. In addition, to aid the quality control process on treatment planning systems, a two-dimensional (2D) rectangular dose rate table (the traditional along-away table), coherent with the TG43 dose calculation formalism, is given. The data given in this study complement existing information for both sources on…

Dosimetry revisited for the HDR I192r brachytherapy source model mHDR-v2

Purpose: Recently, the manufacturer of the HDR I 192 r mHDR-v2 brachytherapysource reported small design changes (referred to herein as mHDR-v2r) that are within the manufacturing tolerances but may alter the existing dosimetric data for this source. This study aimed to (1) check whether these changes affect the existing dosimetric data published for this source; (2) obtain new dosimetric data in close proximity to the source, including the contributions from I 192 r electrons and considering the absence of electronic equilibrium; and (3) obtain scatterdose components for collapsed cone treatment planning system implementation. Methods: Three different Monte Carlo(MC) radiation transport co…

QA of dynamic MLC based on EPID portal dosimetry.

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

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

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 effects.

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…

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

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

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…

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

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…

A generic high-dose rate192Ir brachytherapy source for evaluation of model-based dose calculations beyond the TG-43 formalism

Purpose: In order to facilitate a smooth transition for brachytherapy dose calculations from the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) formalism to model-b ...

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

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…

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

Monte Carlo dosimetric study of Best Industries and Alpha Omega Ir-192 brachytherapy seeds

Ir-192 seeds are widely used in the USA for low dose rate interstitial brachytherapy. There are two commercially available models: those manufactured by Best Industries filtered with stainless steel, and those manufactured by Alpha-Omega seeds filtered with Pt. Newly developed 3D correction algorithms for brachytherapy are based on dosimetry data obtained on unbounded phantom size, allowing corrections for heterogeneities and actual tissue boundaries. Published dosimetric datasets for both seeds have been obtained under bounded conditions. The aim of the present study is to obtain dosimetric datasets for these seeds under full scatter conditions. The Monte Carlo GEANT4 code has been used to…

Maximum Likelihood Estimation and non-linear least squares fitting with Levenberg-Marquardt Algorithm implementation in FPGA devices for high resolution hodoscopy

This work compares two possible solutions to achieve a higher resolution in a hodoscope based on Plastic Scintillating Fibers (PSF) by obtaining the point of maximum incidence of the radioactive beam. The two fitting algorithms proposed have been tested and implemented in Field Programmable Gate Array (FPGA) devices. On one hand, a probabilistic model based on the Maximum Likelihood Estimation (MLE) and on the other hand, non-linear least-squares fit with the Levenberg-Marquardt Algorithm (LMA).

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

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

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.…

Study and simulation of the read-out electronics design for a high-resolution plastic scintillating fiber based hodoscope

Abstract This work presents the study and simulation of a high-resolution charged particle detection device for beam positioning, monitoring and calibration, together with its read-out proposal. To provide the precise positional information of the beam, the detection system has been based on Plastic Scintillating Fibers (PSF), while the read-out on a Silicon-PhotoDiode (Si-PD) array. To carry out the study, a PSF prototype with one detection plane has been experimentally tested with a β particle source. Besides, Monte Carlo simulations of the complete system have also been conducted. Both simulations and experimental tests give consistency to the results obtained. The work presented in this…

Commissioning and quality assurance procedures for the HDR Valencia skin applicators

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

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

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

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

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 …