Validation of the collapsed cone algorithm for HDR liver brachytherapy against Monte Carlo simulations

PURPOSETo validate the collapsed cone (CC) algorithm against Monte Carlo (MC) simulations for model-based dose calculations in high-dose-rate (HDR) liver brachytherapy.METHODS AND MATERIALSDoses for liver brachytherapy treatment plans of 10 cases were retrospectively recalculated with a model-based approach using Monte Carlo n-Particle Code (MCNP) 6 (Dm,m-MC) and Oncentra Brachy ACE (Dm,m-ACE). Tissue segmentation consisted of assigning uniform compositions and mass densities to predefined Hounsfield Unit (HU) thresholds. Resulting doses were compared according to dose volume histogram parameters typical for clinical routine. These included the percentage liver volume receiving 5 Gy (V5Gy) or 10 Gy (V10Gy), the maximum dose to one cubic centimeter (D1cc) of organs at risk, the clinical target volume (CTV) fractions receiving 150% (V150), 100% (V100), 95% (V95) and 90% (V90) of the prescribed dose and the absolute doses to 95% (D95) and 90% (D90) of the CTV volumes.RESULTSDoses from Oncentra Brachy ACE agreed well with MC simulations. Differences were seen far from the source, in low-density regions and bone structures. Median percentage deviations were 1.1% for the liver V5Gy and 0.4% for the liver V10Gy, with deviations of largest magnitude amounting to 2.2% and 1.0%, respectively. Organs at risk had median deviations ranging from 0.3% to 1.5% for D1cc, with outliers ranging up to 4.6%. CTV volume parameter deviations ranged between ?1.5% and 0.5%, dose parameter deviations ranged mostly between ?2% and 1%, with two outliers at ?4.0% and ?3.4% for a small CTV.     

Validation of a Monte Carlo tool for patient-specific dose simulations in multi-slice computed tomography

Estimating the dose delivered to the patient in X-ray computed tomography (CT) examinations is not a trivial task. Monte Carlo (MC) methods appear to be the method of choice to assess the 3D dose distribution. The purpose of this work was to extend an existing MC-based tool to account for arbitrary scanners and scan protocols such as multi-slice CT (MSCT) scanners and to validate the tool in homogeneous and heterogeneous phantoms. The tool was validated by measurements on MSCT scanners for different scan protocols under known conditions. Quantitative CT Dose Index (CTDI) measurements were performed in cylindrical CTDI phantoms and in anthropomorphic thorax phantoms of various sizes; dose profiles were measured with thermoluminescent dosimeters (TLD) in the CTDI phantoms and compared with the computed dose profiles. The in-plane dose distributions were simulated and compared with TLD measurements in an Alderson-Rando phantom. The calculated dose values were generally within 10% of measurements for all phantoms and all investigated conditions. Three-dimensional dose distributions can be accurately calculated with the MC tool for arbitrary scanners and protocols including tube current modulation schemes. The use of the tool has meanwhile also been extended to further scanners and to flat-detector CT.     

~(125)Ⅰ植入治疗源的剂量学参数的Monte Carlo模拟

放射性粒子源125I已被广泛用于前列腺和眼睛的植入治疗中。本文采用EGS5蒙特卡罗代码计算了美国医用物理学协会（AAPM）TG-43U1报告中推荐的型号为6711125I近距治疗源（活性区长取0.28cm）的剂量学参数,如剂量率常数、径向剂量函数和各向异性函数。剂量率常数为0.959cGy/h/U,与TG-43U1推荐值和Dolan等已发表的值相差在2.0%以内 径向剂量函数数值与二者均符合较好 随着角度和距离的增加,各向异性函数值数值与二者的复合程度趋佳。并给出了实用性较强的径向剂量函数的拟合公式。     

Monte Carlo dose parameters of the BrachySeed model LS-1 I brachytherapy source

Using a modified EGS4 code and associated user code DOSCGC, the two-dimensional dose rate distribution in water and air-kerma strength are calculated for a BrachySeed (model LS-1) ¹²⁵I brachytherapy source, based on geometry and material data provided by the manufacturer. The AAPM TG-43 dose parameters derived from these results include the dose rate constant, the radial dose function, the anisotropy function, and the anisotropy factor and constant. The value of the dose rate constant so obtained is 0.932±0.003 cGy h⁻¹ U⁻¹. The source strength calculation excludes the contribution from titanium characteristic X-rays (4.5 and 4.9 keV) in the source in order to comply with a new primary calibration standard implemented by the National Institute of Standards and Technology in 1999. A sampling procedure for simulating silver characteristic X-ray production in the mixture material of the source core is developed in the EGS4 code. The calculated results reveal the good dose isotropy of the LS-1 source. The Monte Carlo dose parameters obtained are compared with measurements and calculations of other investigators.     

A Monte Carlo brachytherapy study for dose distribution prediction in an inhomogeneous medium

The purpose of this study was to present a theoretical analysis of how the presence of bone in interstitial brachytherapy affects dose rate distributions. This study was carried out using a Monte Carlo simulation of the dose distribution in homogeneous medium for 3 commonly used brachytherapy seeds. The 3 seeds investigated in this study are iridium-192 (¹⁹²Ir) iodine-125 (¹²⁵I), and palladium-103 (¹⁰³Pd). The computer code was validated by comparing the specific dose rate (Λ), the radial dose function g(r), and anisotropy function F(r,θ) for all 3 seeds with the AAPM TG-43 dosimetry formalism and current literature. The ¹⁹²Ir seed resulted in a dose rate of 1.115 ± 0.001 cGy-hr⁻¹-U⁻¹, the ¹²⁵I seed resulted in a dose rate of 0.965 ± 0.006 cGy/h⁻¹/U⁻¹, and the ¹⁰³Pd seed resulted in a dose rate of 0.671 ± 0.002 cGy/h⁻¹/U⁻¹. The results for all 3 seeds are in good agreement with the AAPM TG-43 and current literature. The validated computer code was then applied to a simple inhomogeneous model to determine the effect bone has on dose distribution from an interstitial implant. The inhomogeneous model showed a decrease in dose rate of 2% for the ¹⁹²Ir, an increase in dose rate of 84% for ¹²⁵I, and an increase in dose rate of 83% for the ¹⁰³Pd at the surface of the bone nearest to the source.     

A Monte Carlo brachytherapy study for dose distribution prediction in an inhomogeneous medium

The purpose of this study was to present a theoretical analysis of how the presence of bone in interstitial brachytherapy affects dose rate distributions. This study was carried out using a Monte Carlo simulation of the dose distribution in homogeneous medium for 3 commonly used brachytherapy seeds. The 3 seeds investigated in this study are iridium-192 (¹⁹²Ir) iodine-125 (¹²⁵I), and palladium-103 (¹⁰³Pd). The computer code was validated by comparing the specific dose rate (Λ), the radial dose function g(r), and anisotropy function F(r,θ) for all 3 seeds with the AAPM TG-43 dosimetry formalism and current literature. The ¹⁹²Ir seed resulted in a dose rate of 1.115 ± 0.001 cGy-hr⁻¹-U⁻¹, the ¹²⁵I seed resulted in a dose rate of 0.965 ± 0.006 cGy/h⁻¹/U⁻¹, and the ¹⁰³Pd seed resulted in a dose rate of 0.671 ± 0.002 cGy/h⁻¹/U⁻¹. The results for all 3 seeds are in good agreement with the AAPM TG-43 and current literature. The validated computer code was then applied to a simple inhomogeneous model to determine the effect bone has on dose distribution from an interstitial implant. The inhomogeneous model showed a decrease in dose rate of 2% for the ¹⁹²Ir, an increase in dose rate of 84% for ¹²⁵I, and an increase in dose rate of 83% for the ¹⁰³Pd at the surface of the bone nearest to the source.     

Monte Carlo simulations as a feasibility tool for non-metallic land-mine detection by thermal-neutron backscattering

The use of Monte Carlo simulations is presented for modelling a simplified land-mine detector system with thermal neutron backscattering (TNB) analysis based on a ²⁵²Cf-neutron source. Different aspects and a variety of external conditions, related to localisation and identification of a buried object have been investigated. In particular, the influence of moisture in a formation has been assessed, as moisture can be a serious interference for hydrogen as an indicator for explosives. The results of sensitivity calculations confirm that land-mine detection methods, based on an analysis of TNB may be applicable in homogeneous formations with low porosity provided that pore-water remains <5% by weight. In dry limestone, the TNT-based explosives can be well distinguished from other hydrogen-rich materials, except wood. However, in dry siliciclastic sands TNT explosives and wood are distinguishable.     

Monte Carlo simulations of dose distributions with necrotic tumor targeted radioimmunotherapy

Radio-resistant hypoxic tumor cells are significant contributors to the locoregional recurrences and distant metastases that mark failure of radiotherapy. Due to restricted tissue oxygenation, chronically hypoxic tumor cells frequently become necrotic and thus there is often an association between chronically hypoxic and necrotic tumor regions. This simulation study is the first in a series to determine the feasibility of hypoxic cell killing after first targeting adjacent areas of necrosis with either an α- or β-emitting radioimmunoconjugate.     

Estimation of background spectrum in a shielded HPGe detector using Monte Carlo simulations

Monte Carlo simulations are powerful tools used to estimate the background γ-radiation detected by high-resolution gamma-ray spectrometry systems with a HPGe (high purity germanium) detector contained inside a lead shield. The purpose of this work was to examine the applicability of Monte Carlo simulations to predict the optimal lead thickness necessary to reduce the background effect in spectrometer measurements. GEANT4 code was applied to simulate the background radiation spectrum at different thicknesses of lead. The simulated results were compared with experimental measurements of background radiation taken at the same shielding thickness. The results show that the background radiation detected depends on the thickness, size and lining of the shield. Simulation showed that 12 cm lead thick is the optimal shielding thickness.     

Cell death following BNCT: A theoretical approach based on Monte Carlo simulations

In parallel to boron measurements and animal studies, investigations on radiation-induced cell death are also in progress in Pavia, with the aim of better characterisation of the effects of a BNCT treatment down to the cellular level. Such studies are being carried out not only experimentally but also theoretically, based on a mechanistic model and a Monte Carlo code. Such model assumes that: (1) only clustered DNA strand breaks can lead to chromosome aberrations; (2) only chromosome fragments within a certain threshold distance can undergo misrejoining; (3) the so-called "lethal aberrations" (dicentrics, rings and large deletions) lead to cell death. After applying the model to normal cells exposed to monochromatic fields of different radiation types, the irradiation section of the code was purposely extended to mimic the cell exposure to a mixed radiation field produced by the ¹⁰B(n,α) ⁷Li reaction, which gives rise to alpha particles and Li ions of short range and high biological effectiveness, and by the ¹⁴N(n,p)¹⁴C reaction, which produces 0.58 MeV protons. Very good agreement between model predictions and literature data was found for human and animal cells exposed to X- or gamma-rays, protons and alpha particles, thus allowing to validate the model for cell death induced by monochromatic radiation fields. The model predictions showed good agreement also with experimental data obtained by our group exposing DHD cells to thermal neutrons in the TRIGA Mark II reactor of the University of Pavia; this allowed to validate the model also for a BNCT exposure scenario, providing a useful predictive tool to bridge the gap between irradiation and cell death.     

Monte Carlo dosimetry of the eye plaque design used at the St. Erik Eye Hospital for 125I brachytherapy

PurposeAt St. Erik Eye Hospital in Stockholm, Sweden, ocular tumors of apical height above 6 mm are treated with brachytherapy, using iodine-125 seeds attached to a gold alloy plaque while the treatment planning is performed assuming homogeneous water surroundings. The aim of this work was to investigate the dose-modifying effects of the plaque and the seed fixating silicone rubber glue.Methods and MaterialsThe impact of the gold plaque and silicone rubber glue was studied with the Monte Carlo N-particle transport code, version 5.ResultsFor the 2 cm most proximal to the plaque surface along the plaque's central axis, the eyeball received 104.6–93.0% of the dose in all-water conditions.ConclusionsThe 0.3 mm thick layer of silicone rubber glue, used for seed fixation, attenuates photons little enough to allow characteristic X-rays from the gold alloy plaque to reach the eyeball. Close to the plaque, the dose rates were higher with the plaque and glue present, than in homogeneous water conditions. This is in contrast to what has been reported for more commonly used eye plaques, demonstrating the importance of investigating the dosimetry of individual treatment systems.     

Praseodymium-142 microspheres for brachytherapy of nonresectable hepatic tumors

PurposeTo perform dosimetric study of ¹⁴²Pr microspheres for the use as a possible choice of radionuclide in microsphere brachytherapy of nonresectable hepatic tumor for faster dose delivery and facilitated dosimetry for quality assurance.Methods and MaterialsDose distributions of ¹⁴²Pr and ⁹⁰Y microspheres within hepatic tumors and blood vessels were calculated using MCNPX2.6 Monte Carlo code. The biological effective doses (BEDs) for ¹⁴²Pr and ⁹⁰Y microspheres were calculated and compared using the linear-quadratic model.ResultsDose distributions due to beta particles were similar for both ¹⁴²Pr and ⁹⁰Y. Total initial activity required to achieve the same total dose of 150 Gy at 2 cm from the center of the tumor was 0.662 GBq and 0.191 GBq for ¹⁴²Pr and ⁹⁰Y, respectively. For α/β ratio equal to 10 Gy, calculated BED values were 301.0 and 194.7 for ¹⁴²Pr and ⁹⁰Y, respectively, considering a total physical dose of 150 Gy.ConclusionsTotal dose delivery and dose distributions for both ¹⁴²Pr and ⁹⁰Y within tumors and blood vessels were obtained and compared. Shorter half-life of ¹⁴²Pr is an advantage, enabling a faster dose delivery. The higher BED found for ¹⁴²Pr implies potential improvement in the treatment effectiveness. ¹⁴²Pr showed to be an attractive option for applications in microsphere brachytherapy.     

Dosimetry errors in endovascular high-dose-rate brachytherapy

Monte Carlo data were used to demonstrate the dosimetry of the microSelectron high-dose-rate (HDR) iridium 192 (¹⁹²Ir) stepping source. These data were used to assess the accuracy of the Nucletron brachytherapy planning system (BPS version 13) for peripheral vessel endovascular brachytherapy. Dose rates from the high-dose-rate (HDR) source are calculated using the Monte Carlo code MCNP4A. Calculations are made at 0.25-cm intervals in the longitudinal direction on sleeves of radii of 1 and 0.25 cm. The Monte Carlo data are summed and weighted to simulate the longitudinal dose distribution at a distance of 1 and 0.25 cm from an ¹⁹²Ir source stepping through a straight pathway. A comparison is made between the simulated Monte Carlo dosimetry and the Nucletron brachytherapy planning system’s dosimetry. This study illustrates and quantifies the dosimetric errors at small distances associated with a point source dose calculation algorithm. The effects of step size, dwell time optimization, and active length on the accuracy of BPS v.13 for HDR endovascular brachytherapy are demonstrated.     

A quantitative three-dimensional dose attenuation analysis around Fletcher-Suit-Delclos due to stainless steel tube for high-dose-rate brachytherapy by Monte Carlo calculations

PurposeThe commercially available brachytherapy treatment-planning systems today, usually neglects the attenuation effect from stainless steel (SS) tube when Fletcher-Suit-Delclos (FSD) is used in treatment of cervical and endometrial cancers. This could lead to potential inaccuracies in computing dwell times and dose distribution. A more accurate analysis quantifying the level of attenuation for high-dose-rate (HDR) iridium 192 radionuclide (¹⁹²Ir) source is presented through Monte Carlo simulation verified by measurement.Methods and MaterialsIn this investigation a general Monte Carlo N-Particles (MCNP) transport code was used to construct a typical geometry of FSD through simulation and compare the doses delivered to point A in Manchester System with and without the SS tubing. A quantitative assessment of inaccuracies in delivered dose vs. the computed dose is presented. In addition, this investigation expanded to examine the attenuation-corrected radial and anisotropy dose functions in a form parallel to the updated AAPM Task Group No. 43 Report (AAPM TG-43) formalism. This will delineate quantitatively the inaccuracies in dose distributions in three-dimensional space. The changes in dose deposition and distribution caused by increased attenuation coefficient resulted from presence of SS are quantified using MCNP Monte Carlo simulations in coupled photon/electron transport. The source geometry was that of the Vari Source wire model VS2000. The FSD was that of the Varian medical system. In this model, the bending angles of tandem and colpostats are 15° and 120°, respectively. We assigned 10 dwell positions to the tandem and 4 dwell positions to right and left colpostats or ovoids to represent a typical treatment case. Typical dose delivered to point A was determined according to Manchester dosimetry system.Results and ConclusionsBased on our computations, the reduction of dose to point A was shown to be at least 3%. So this effect presented by SS–FSD systems on patient dose is of concern.     

Dead layer thickness characterization of an HPGe detector by measurements and Monte Carlo simulations

To fully characterize the front dead layer (DL) of an HPGe detector at low photon energy range, its intrinsic efficiency curve was measured using a ²⁴¹Am radioactive source in 10−60 keV energy range. A comparison between experimental efficiency and MCNPX results showed that the DL value of 0.4 μm initially quoted by the manufacturer has to be changed to 7.5 μm to reproduce measurements.     

Dosimetric investigation of 103Pd permanent breast seed implant brachytherapy based on Monte Carlo calculations

PurposePermanent breast seed implant using ¹⁰³Pd is emerging as an effective adjuvant radiation technique for early stage breast cancer. However, clinical dose evaluations follow the water-based TG-43 approach with its considerable approximations. Toward clinical adoption of advanced TG-186 model-based dose evaluations, this study presents a comprehensive investigation for permanent breast seed implant considering both target and normal tissue doses.Methods and MaterialsDose calculations are performed with the free open-source Monte Carlo (MC) code, egs_brachy, using two types of virtual patient models: TG43sim (simulated TG-43 conditions) and MCref (heterogeneous tissue modeling from patient CT, seeds at implant angle) for 35 patients. The sensitivity of dose metrics to seed orientation and tissue segmentation are assessed.ResultsIn the target volume, D₉₀ is 14.1 ± 5.8% lower with MCref than with TG43sim, on average. Conversely, normal tissue doses are generally higher with MCref than with TG43sim, for example, by 22 ± 13% for skin D_1cm2, 82 ± 7% for ribs D_max, and 71 ± 23% for heart D_1cm3. Discrepancies between MCref and TG43sim doses vary over the patient cohort, as well as with the tissue and metric considered. Skin doses are particularly sensitive to seed orientation, with average difference of 4% (maximum 28%) in D_1cm2 for seeds modeled vertically (egs_brachy default) compared with those aligned with implant angle.ConclusionsTG-43 dose evaluations generally underestimate doses to critical normal organs/tissues while overestimating target doses. There is considerable variation in MCref and TG43sim on a patient-by-patient basis, motivating clinical adoption of patient-specific MC dose calculations. The MCref framework presented herein provides a consistent modeling approach for clinical implementation of advanced TG-186 dose calculations.     

Dosimetric influence of seed spacers and end-weld thickness for permanent prostate brachytherapy

PurposeThe aim of this study was to analyze the dosimetric influence of conventional spacers and a cobalt chloride complex contrast (C4) agent, a novel marker for MRI that can also serve as a seed spacer, adjacent to ¹⁰³Pd, ¹²⁵I, and ¹³¹Cs sources for permanent prostate brachytherapy.Methods and MaterialsMonte Carlo methods for radiation transport were used to estimate the dosimetric influence of brachytherapy end-weld thicknesses and spacers near the three sources. Single-source assessments and volumetric conditions simulating prior patient treatments were computed. Volume–dose distributions were imported to a treatment planning system for dose–volume histogram analyses.ResultsSingle-source assessment revealed that brachytherapy spacers primarily attenuated the dose distribution along the source long axis. The magnitude of the attenuation at 1 cm on the long axis ranged from −10% to −5% for conventional spacers and approximately −2% for C4 spacers, with the largest attenuation for ¹⁰³Pd. Spacer perturbation of dose distributions was less than manufacturing tolerances for brachytherapy sources as gleaned by an analysis of end-weld thicknesses. Volumetric Monte Carlo assessment demonstrated that TG-43 techniques overestimated calculated doses by approximately 2%. Specific dose–volume histogram metrics for prostate implants were not perturbed by inclusion of conventional or C4 spacers in clinical models.ConclusionsDosimetric perturbations of single-seed dose distributions by brachytherapy spacers exceeded 10% along the source long axes adjacent to the spacers. However, no dosimetric impact on volumetric parameters was noted for brachytherapy spacers adjacent to ¹⁰³Pd, ¹²⁵I, or ¹³¹Cs sources in the context of permanent prostate brachytherapy implants.     

瓦里安高剂量率铱源剂量学参数的蒙特卡罗模拟研究

目的 采用美国医学物理师学会（AAPM）和欧洲放射治疗和肿瘤学会（ESTRO）推荐的蒙特卡罗方法对瓦里安GammaMed Plus HDR ¹⁹²Ir源的剂量学参数进行模拟研究。方法 基于EGSnrc蒙特卡罗软件,建立该型号¹⁹²Ir源精确的计算模型。采用公式推导、双线性插值及单位转换等方法,分别得到了单位活度空气比释动能强度、剂量率常数、径向剂量函数以及各向异性函数,并将结果与文献报道数据进行分析比较。结果 研究得到的单位活度空气比释动能强度为9.781×10^-8 U/Bq,剂量率参数为1.113 cGy·h^-1·U^-1,与文献报道的相差在0.4%以内。本研究的径向剂量函数、各向异性函数与文献数据能较好吻合。结论 基于EGSnrc蒙特卡罗软件能对¹⁹²Ir源剂量学特性进行定量研究,这将为进一步研究后装剂量分布,精确评价临床放疗剂量提供理论依据。     

Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source

PurposeThe Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Z_eff) for saline (Z_eff = 7.56) versus water (Z_eff = 7.42).MethodsBalloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface (D_s) of and 1 cm away (D_1cm) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans.ResultsSingle-dwell plans show a 4.4–6.1% decrease in D_s for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% D_s decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D_1cm decreases 3.6–5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D_1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively.ConclusionsThe dosimetric effect introduced by saline versus water filling for Xoft balloon applicator–based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies.