0000000000314873
AUTHOR
Vicente Carmona
A program for the independent verification of brachytherapy planning system calculations
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…
Phantom development for daily checks in electron intraoperative radiotherapy with a mobile linac.
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.
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.
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…
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 …
Monte Carlo calculation of dose rate distributions around 0.5 and 0.6 mm in diameter 192Ir wires
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.
Urethral Dose Limit in Boost Permanent Prostate 125I Seed Implants Based on Biologically Effective Dose Values
Dose Escalation in Permanent Brachytherapy for Prostate Cancer: Preliminary Results
EP-1590: Shielding design and fetal dose evaluation of a breast cancer pregnant patient undergoing HDR Ir-192 brachytherapy
Impact of the Tiloop Bra mesh in CT images and dose delivery in breast radiotherapy
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…
The use of nomograms in LDR-HDR prostate brachytherapy
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…
Erratum: “Fitted dosimetric parameters of high dose-rate 192Ir sources according to the AAPM TG43 formalism” [Med. Phys. 28 (4), 654-660 (2001)]
Fitted dosimetric parameters of high dose-rate 192Ir sources according to the AAPM TG43 formalism
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…
Failure mode and effects analysis of skin electronic brachytherapy using Esteya® unit
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…
Evaluation of lens absorbed dose with Cone Beam IGRT procedures
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 …
Fetal dose measurements and shielding efficiency assessment in a custom setup of (192)Ir brachytherapy for a pregnant woman with breast cancer.
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…