Effect of tissue inhomogeneity on dose distribution of continuous activity of low-energy electrons in bone marrow cavities with different topologies

Monte Carlo calculations have previously been performed by Eckerman to evaluate the absorbed fractions of continuous sources of monoenergetic electrons in marrow cavities of human bone. The difference in scattering power of electrons in cortical bone (CB) and the red marrow (RM) was neglected. In the present work the Integrated Tiger Series and Electron-Gamma-Shower Monte Carlo codes were used to investigate the effect of topology of the bone and bone marrow interface on backscatter dose increase to the marrow. Planar, cylindrical, and spherical geometries were included. For the planar geometry, a maximum dose increase of 9 +/- 1 (S.E. of the mean) % was obtained in the region within 12 mg/cm2 from the interface due to a semi-infinite source of electrons with energy greater than 0.5 MeV. An increase of 7 +/- 1% was observed experimentally in the same region due to a semi-infinite source of 32P. This was in good agreement with Monte Carlo calculation. Averaged over the region of RM embedding electron sources between two planar CB/RM interfaces 1000 microns apart, a dose enhancement of 10 +/- 2% was predicted for electron energies from 1 to 1.75 MeV. For the cylindrical interface with 500-microns radius of curvature, the maximum dose increase averaged over the whole cylinder due to an isotropic distribution of monoenergetic electrons inside the cylinder was 12 +/- 1%.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of tissue inhomogeneity on dose distribution of point sources of low-energy electrons

Perturbation in dose distributions of point sources of low-energy electrons at planar interfaces of cortical bone (CB) and red marrow (RM) was investigated experimentally and by Monte Carlo codes EGS and the TIGER series. Ultrathin LiF thermoluminescent dosimeters were used to measure the dose distributions of point sources of 204Tl and 147Pm in RM. When the point sources were at 12 mg/cm2 from a planar interface of CB and RM equivalent plastics, dose enhancement ratios in RM averaged over the region 0-12 mg/cm2 from the interface were measured to be 1.08 +/- 0.03 (SE) and 1.03 +/- 0.03 (SE) for 204Tl and 147Pm, respectively. The Monte Carlo codes predicted 1.05 +/- 0.02 and 1.01 +/- 0.02 for the two nuclides, respectively. However, EGS gave consistently 3% higher dose in the dose scoring region than the TIGER series when point sources of monoenergetic electrons up to 0.75 MeV energy were considered in the homogeneous RM situation or in the CB and RM heterogeneous situation. By means of the TIGER series, it was demonstrated that aluminum, which is normally assumed to be equivalent to CB in radiation dosimetry, leads to an overestimation of backscattering of low-energy electrons in soft tissue at a CB-soft-tissue interface by as much as a factor of 2.     

Radiochromic film dosimetry of a high dose rate beta source for intravascular brachytherapy

Good clinical physics practice requires that dose rates of brachytherapy sources be checked by the institution using them, as recommended by American Association of Physicists in Medicine Task Group 56 and The American College of Radiology. For intravascular brachytherapy with catheter-based systems, AAPM Task Group 60 recommends that the dose rate be measured at a reference point located at a radial distance of 2 mm from the center of the catheter axis. AAPM Task Group 60 also recommends that the dose rate along the catheter axis at a radial distance of 2 mm should be uniform to within +/- 10% in the center two-thirds of the treated length, and the relative dose rate in the plane perpendicular to the catheter axis through the center of the source should be measured at distances from 0.5 mm to R90 (the distance from a point source within which 90% of the energy is deposited) at intervals of 0.5 mm. Radiochromic film dosimetry has been used to measure the dose distribution in a plane parallel to and at a radial distance of 2 mm from the axis of a novel, catheter-based, beta source for intravascular brachytherapy. The dose rate was averaged along a line parallel to the catheter axis at a radial distance of 2 mm, in the centered 24.5 mm of the treated length. This average dose rate agreed with the dose rate measured with a well ionization chamber by the replacement method using source trains calibrated with an extrapolation chamber at the National Institute of Standards and Technology. All of the dose rates in the centered 24.5 mm of a line parallel to the axis at a distance of 2 mm were within +/-10% of the average.     

Dose characterization in the near-source region for two high dose rate brachytherapy sources

High dose rate (HDR) 192Ir sources are currently used in intravascular brachytherapy (IVB) for the peripheral arterial system. This poses a demand on evaluating accurate dose parameters in the near-source region for such sources. The purpose of this work is to calculate the dose parameters for the old VariSource HDR 192Ir source and the new microSelectron HDR 192Ir source, using Monte Carlo electron and photon transport simulation. The two-dimensional (2D) dose rate distributions and the air kerma strengths for the two HDR sources were calculated by EGSnrc and EGS4 Monte Carlo codes. Based on these data, the dose parameters proposed in the AAPM TG-60 protocol were derived. The dose rate constants obtained are 13.119+/-0.028 cGy h(-1) U(-1) for the old VariSource source, and 22.751+/-0.031 cGy h(-1) U(-1) for the new microSelectron source at the reference point (r0 = 2 mm, theta = pi/2). The 2D dose rate distributions, the radial dose functions, and the anisotropy functions presented for the two sources cover radial distances ranging from 0.5 to 10 mm. In the near-source region on the transverse plane, the dose effects of the charged particle nonequilibrium and the beta-particle dose contribution were studied. It is found that at radial distances ranging from 0.5 to 2 mm, these effects increase the calculated dose rates by up to 29% for the old VariSource source, and by up to 12% for the new microSelectron source, which, in turn, change values of the radial dose function and the anisotropy function. The present dose parameters, which account for the charged particle nonequilibrium and the beta particle contribution, may be used for accurate IVB dose calculation.     

Experimental investigation of a fast Monte Carlo photon beam dose calculation algorithm

An experimental verification of the recently developed XVMC code, a fast Monte Carlo algorithm to calculate dose distributions of photon beams in treatment planning, is presented. The treatment head is modelled by a point source with energy distribution (primary photons) and an additional head scatter contribution. Utility software is presented, allowing the determination of the parameters for this model using a single measured depth dose curve in water. The simple beam model is considered to be a starting point for more complex models being planned for future versions of the code. This paper is mainly focused on the influence of the different techniques on variance reduction and material property determination for dose distributions. It is demonstrated that XVMC and the simple beam model reproduce measured (by a diamond detector) relative dose distributions with an accuracy of better than +/-2% in various homogeneous and inhomogeneous phantoms. Furthermore, relative dose distributions in solid state phantoms have been measured by film. Also for these cases, measured and calculated dose distributions agree within experimental uncertainty. The short calculation time (depending on voxel resolution, statistical accuracy, field size and energy, a span of 1 min to 1 h using a present-day personal computer) and an interface to a commercial planning system will allow the implementation of the code for routine treatment planning of clinical electron and photon beams.     

Dosimetry characterization of 32P intravascular brachytherapy source wires using Monte Carlo codes PENELOPE and GEANT4

Monte Carlo calculations using the codes PENELOPE and GEANT4 have been performed to characterize the dosimetric parameters of the new 20 mm long catheter-based 32P beta source manufactured by the Guidant Corporation. The dose distribution along the transverse axis and the two-dimensional dose rate table have been calculated. Also, the dose rate at the reference point, the radial dose function, and the anisotropy function were evaluated according to the adapted TG-60 formalism for cylindrical sources. PENELOPE and GEANT4 codes were first verified against previous results corresponding to the old 27 mm Guidant 32P beta source. The dose rate at the reference point for the unsheathed 27 mm source in water was calculated to be 0.215 +/- 0.001 cGy s(-1) mCi(-1), for PENELOPE, and 0.2312 +/- 0.0008 cGy s(-1) mCi(-1), for GEANT4. For the unsheathed 20 mm source, these values were 0.2908 +/- 0.0009 cGy s(-1) mCi(-1) and 0.311 0.001 cGy s(-1) mCi(-1), respectively. Also, a comparison with the limited data available on this new source is shown. We found non-negligible differences between the results obtained with PENELOPE and GEANT4.     

Dose distributions in regions containing beta sources: small scale nonuniformities

An analytic model for the calculation of dose in regions containing slightly nonuniform distributions of beta sources, and a solution for the dose distribution in an infinite, homogeneous medium with a uniform, monoenergetic source distribution and a sinusoidal perturbation of the source are presented.     

Secondary electron fluence perturbation by high-Z interfaces in clinical proton beams: a Monte Carlo study.

Fluence perturbation of secondary electrons from clinical proton beams (50-250 MeV) by thin high-Z planar interfaces was studied with Monte Carlo simulations. Starting from monoenergetic proton pencil beams, proton depth doses and proton fluence spectra were calculated, both in homogeneous water and near thin high-Z interfaces by using the proton transport Monte Carlo code PTRAN. This code was modified extensively to enable modelling of proton transport in non-homogeneous geometries. From the proton fluence spectra in water and in the interface materials, electron generation spectra were calculated analytically and were then used as input for an electron transport calculation with the Monte Carlo code EGS4/PRESTAII to obtain electron doses and electron fluence spectra. The interface materials used in the study were graphite, Al, Ti, Cu, Sn and Au. We found significant electron fluence perturbations on both sides of the planar interfaces, resulting in an electron dose increase upstream and a decrease downstream from the interfaces, with the magnitude of the effect depending strongly on the atomic number of the interface. For the most extreme case studied, 250 MeV protons and a gold interface, we obtained an electron dose increase of 41% upstream of the interface and a decrease of 15% downstream with both perturbations having a spatial extent of about 700 microm. The total dose perturbation due to this effect amounts to a 5% increase upstream and a 2% decrease downstream. A detailed analysis of dose and fluence perturbation is presented for a wide range of materials and proton energies.     

The radial depth-dose distribution of a 188W/188Re beta line source measured with novel,ultra-thin TLDs in a PMMA phantom: comparison with Monte Carlo simulations

The radial depth-dose distribution of a prototype 188W/188Re beta particle line source of known activity has been measured in a PMMA phantom, using a novel, ultra-thin type of LiF:Mg,Cu,P thermoluminescent detector (TLD). The measured radial dose function of this intravascular brachytherapy source agrees well with MCNP4C Monte Carlo simulations, which indicate that 188Re accounts for > or = 99% of the dose between 1 mm and 5 mm radial distance from the source axis. The TLDs were calibrated using a 90Sr/90Y beta secondary standard. Several correction factors are calculated using analytical and Monte Carlo methods. An analysis of the measurement uncertainty is made. Since it is partly determined by components of uncertainty arising from random effects, repeated measurements yield a lower uncertainty. The expanded uncertainty in the absolute dose at 2 mm radial distance equals 11%, 10%, 9% and 8% for 1, 2, 3 and 5 measurements, respectively. After a correction for source non-uniformity, the measured dose rate per unit source activity at 2 mm radial distance equals (1.53 +/- 0.16) Gy min(-1) GBq(-1) (2sigma), in agreement with the value of (1.45 +/- 0.01) Gy min(-1) GBq(-1) (2sigma) predicted by the MCNP4C simulations.     

Calculation of photon energy deposition kernels and electron dose point kernels in water

Effects of changes in the physics of EGSnrc compared to EGS4/PRESTA on energy deposition kernels for monoenergetic photons and on dose point kernels for beta sources in water are investigated. In the diagnostic energy range, Compton binding corrections were found to increase the primary energy fraction up to 4.5% at 30 keV with a corresponding reduction of the scatter component of the kernels. Rayleigh scattered photons significantly increase the scatter component of the kernels and reduce the primary energy fraction with a maximum 12% reduction also at 30 keV where the Rayleigh cross section in water has its maximum value. Sampling the photo-electron angular distribution produces a redistribution of the energy deposited by primaries around the interaction site causing differences of up to 2.7 times in the backscattered energy fraction at 20 keV. Above the pair production threshold, the dose distribution versus angle of the primary dose component is significantly different from the EGS4 results. This is related to the more accurate angular sampling of the electron-positron pair direction in EGSnrc as opposed to using a fixed angle approximation in default EGS4. Total energy fractions for photon beams obtained with EGSnrc and EGS4 are almost the same within 0.2%. This fact suggests that the estimate of the total dose at a given point inside an infinite homogeneous water phantom irradiated by broad beams of photons will be very similar for kernels calculated with both codes. However, at interfaces or near boundaries results can be very different especially in the diagnostic energy range. EGSnrc calculated kernels for monoenergetic electrons (50 keV, 100 keV, and 1 MeV) and beta spectra (32P and 90Y) are in excellent agreement with reported EGS4 values except at 1 MeV where inclusion of spin effects in EGSnrc produces an increase of the effective range of electrons. Comparison at 1 MeV with an ETRAN calculation of the electron dose point kernel shows excellent agreement.     

Scattering effects on the dosimetry of iridium-192.

Dosimetry calculations for iridium-192 sources generally assume that a sufficient medium surrounds both the iridium source(s) and the point of calculation so that full scattering conditions exist. In several clinical applications the iridium sources may be anatomically located so that the full scattering requirement is not satisfied. To assess the magnitude of this problem, relative measurements were made with a small ionization chamber in phantoms near air and lung-equivalent interfaces. Dose reduction caused by decreasing the volume of scattering material near these interfaces was then evaluated for a few clinical applications. The results show that reductions on the order of 8% may be expected at the interface with minimal dose reduction within the volume of the implant itself. In addition, the results indicate the verification of source strength of iridium sources in phantom require phantom dimensions determined by the source-chamber separation distance.     

An empirical model for independent dose verification of the Gamma Knife treatment planning

A formalism for an independent dose verification of the Gamma Knife treatment planning is developed. It is based on the approximation that isodose distribution for a single shot is in the shape of an ellipsoid in three-dimensional space. The dose profiles for a phantom along each of the three major axes are fitted to a function which contains the terms that represent the contributions from a point source, an extrafocal scattering, and a flat background. The fitting parameters are extracted for all four helmet collimators, at various shot locations, and with different skull shapes. The 33 parameters of a patient's skull shape obtained from the Skull Scaling Instrument measurements are modeled for individual patients. The relative doses for a treatment volume in the form of 31 x 31 x 31 matrix of points are extracted from the treatment planning system, the Leksell Gamma-Plan (LGP). Our model evaluates the relative doses using the same input parameters as in the LGP, which are skull measurement data, shot location, weight, gamma-angle of the head frame, and helmet collimator size. For 29 single-shot cases, the discrepancy of dose at the focus point between the calculation and the LGP is found to be within -1% to 2%. For multi-shot cases, the value and the coordinate of the maximum dose point from the calculation agree within +/-7% and +/-3 mm with the LGP results. In general, the calculated doses agree with the LGP calculations within +/-10% for the off-center locations. Results of calculation with this method for the dimension and location of the 50% isodose line are in good agreement with results from Leksell GammaPlan. Therefore, this method can be served as a useful tool for secondary quality assurance of Gamma Knife treatment plans.     

3台医科达加速器束流匹配后互换执行容积旋转调强放射治疗计划的剂量准确性分析

目的:探讨放疗科3台加速器束流匹配后互换执行容积旋转调强放射治疗（VMAT）计划的准确性。方法:随机选取18例头颈部、胸腹部和盆腔部患者,采用Synergy1、Synergy2和VersaHD 3台加速器模型分别制作VMAT放疗计划PlanSynergy1,PlanSynergy1和PlanVersaHD。同一VMAT计划（6 MV X射线）分别在3台加速器执行,采用电离室和Delta4分别测量绝对点剂量误差和相对三维剂量γ通过率（3 mm/3%）。互换执行VMAT计划后,点剂量和相对剂量的测量结果与治疗计划系统（TPS）计算的结果比较,评估3台加速器束流匹配后VMAT计划互换执行的可行性。结果:PlanSynergy1计划分别在Synergy1、Synergy2、VersaHD执行时,测得的点剂量与TPS计算的偏差分别为-0.27%±0.87%、-0.88%±1.74%和0.37%±2.18%,测量的相对剂量与TPS计算相比,γ通过率分别为99.84%±0.31%、98.89%±1.32%和99.16%±1.12%;PlanSynergy2计划分别在Synergy1、Synergy2、VersaHD执行时测得的点剂量与TPS计算的偏差分别为0.24%±1.98%、0.15%±1.97%和-0.09%±0.66%,测量的相对剂量与TPS计算相比,γ通过率分别为98.75%±1.38%、99.77%±0.42%和99.41%±1.66%;PlanVersaHD计划分别在Synergy1、Synergy2、VersaHD执行时测得的点剂量与TPS计算的偏差分别为-0.57%±1.07%、-0.42%±2.10%和-1.55%±1.62%,测量的相对剂量与TPS计算相比,γ通过率分别为97.79%±1.61%、98.75%±1.37%和99.78%±0.60%。在3台加速器互换执行VMAT计划中,点剂量偏差均在3%以内,相对剂量偏差的γ通过率均在95%以上,均满足临床要求。结论:3台医科达加速器束流（6 MV X射线）匹配后可互换执行VMAT计划。     

Beta dosimetry with microMOSFETs for endovascular brachytherapy

The aim of this study was to investigate if microMOSFETs are suitable for the dosimetry and quality assurance of beta sources. The microMOSFET dosimeters have been tested for their angular dependence in a 6 MeV electron beam. The dose rate dependence was measured with an iridium-192 afterloading source. By varying the source-to-surface distance (SSD) in a 12 MeV electron beam the dose rate dependence in an electron beam was also investigated. To measure a depth dose curve the dose rate at 2, 5, 8 and 12 mm distance from the beta source train axis was determined with the OPTIDOS and the microMOSFET detector. A comparison between the two detector types shows that the microMOSFET is suitable for quality assurance of beta sources for endovascular brachytherapy (EVBT). The homogeneity of the source is checked by measurements at five points (for the 60 mm source at 10, 20, 30, 40 and 50 mm) along the source train. The microMOSFET was then used to evaluate the influence of a common stent type (single layer stainless steel) on the dose distribution in water. The stent led to a dose inhomogeneity of +/-8.5%. Additionally the percentage depth dose curves with and without a stent were compared. The depth dose curves show good agreement which means that the stent does not change the beta spectrum significantly.     

Monte Carlo dose characterization of a new 90Sr/90Y source with balloon for intravascular brachytherapy

Beta emitting source wires or seeds have been adopted in clinical practice of intravascular brachytherapy for coronary vessels. Due to the limitation of penetration depth, this type of source is normally not applicable to treat vessels with large diameter, e.g., peripheral vessel. In the effort to extend application of its beta source for peripheral vessels, Novoste has recently developed a new catheter-based system, the Corona 90Sr/90Y system. It is a source train of 6 cm length and is jacketed by a balloon. The existence of the balloon increases the penetration of the beta particles and maintains the source within a location away from the vessel wall. Using the EGSnrc Monte Carlo system, we have calculated the two-dimensional (2-D) dose rate distribution of the Corona system in water for a balloon diameter of 5 mm. The dose rates on the transverse axis obtained in this study are in good agreement with calibration results of the National Institute of Standards and Technology for the same system for balloon diameters of 5 and 8 mm. Features of the 2-D dose field were studied in detail. The dose parameters based on AAPM TG-60 protocol were derived. For a balloon diameter of 5 mm, the dose rate at the reference point (defined as r0 = 4.5 mm, 2 mm from the balloon surface) is found to be 0.01028 Gy min(-1) mCi(-1). A new formalism for a better characterization of this long source is presented. Calculations were also performed for other balloon diameters. The dosimetry for this source is compared with a 192Ir source, commonly used for peripheral arteries. In conclusion, we have performed a detailed dosimetric characterization for a new beta source for peripheral vessels. Our study shows that, from dosimetric point of view, the Corona system can be used for the treatment of an artery with a large diameter, e.g., peripheral vessel.     

Localized beta dosimetry of 131I-labeled antibodies in follicular lymphoma.

The purpose of this study is to assess the multicellular dosimetry of 131I-labeled antibody in follicular lymphoma based on histological measurements on human tumor biopsy tissue. Photomicrographs of lymph node specimens were analyzed by first-order treatment to determine the mean values and statistical variations of the radii of follicles (260 +/- 90 microns), interfollicular distances (740 +/- 160 microns), and the number density of follicles [60 +/- 18 in a volume of (2 X 1480 microns)3]. Based on these measurements, two geometrical models were developed for localized beta dosimetry. The first, a regular cubic lattice model, assumes no variation in follicular radius of follicles and interfollicular distance. The second, a randomized distribution model, is a more complicated but more realistic representation of observed histological specimens. In this model, Monte Carlo methods were used to reconstruct the spatial distribution of follicles by simulating the distribution of the radii of follicles, interfollicular distances, and the number density of follicles. Dose calculations were performed using Berger's point kernels for absorbed-dose distribution for beta particles in water, assuming the 131I-labeled antibodies as point sources. It was assumed that the activity concentration of the labeled antibody within the follicles was ten times the activity concentration in the interfollicular spaces. The spatial distribution of localized dose was calculated for a tumor having an average dose of 40 Gy. The localized dose was found to be highly nonuniform, ranging from 20 to 90 Gy, and varying by a factor of about 2 from the average tumor dose.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of analytic source models for head scatter factor calculation and planar dose calculation for IMRT

The purpose of this study was to choose an appropriate head scatter source model for the fast and accurate independent planar dose calculation for intensity-modulated radiation therapy (IMRT) with MLC. The performance of three different head scatter source models regarding their ability to model head scatter and facilitate planar dose calculation was evaluated. A three-source model, a two-source model and a single-source model were compared in this study. In the planar dose calculation algorithm, in-air fluence distribution was derived from each of the head scatter source models while considering the combination of Jaw and MLC opening. Fluence perturbations due to tongue-and-groove effect, rounded leaf end and leaf transmission were taken into account explicitly. The dose distribution was calculated by convolving the in-air fluence distribution with an experimentally determined pencil-beam kernel. The results were compared with measurements using a diode array and passing rates with 2%/2 mm and 3%/3 mm criteria were reported. It was found that the two-source model achieved the best agreement on head scatter factor calculation. The three-source model and single-source model underestimated head scatter factors for certain symmetric rectangular fields and asymmetric fields, but similar good agreement could be achieved when monitor back scatter effect was incorporated explicitly. All the three source models resulted in comparable average passing rates (>97%) when the 3%/3 mm criterion was selected. The calculation with the single-source model and two-source model was slightly faster than the three-source model due to their simplicity.     

A high-precision, high-resolution and fast dosimetry system for beta sources applied in cardiovascular brachytherapy

A fast dosimetry system based on plastic scintillator detectors has been developed which allows three-dimensional measurement of the radiation field in water of beta-sources appropriate for application in cardiovascular brachytherapy. This system fulfills the AAPM Task Group 60 recommendations for dosimetry of cardiovascular brachytherapy sources. To demonstrate the use of the system, measurements have been performed with an 90Y-wire source. The dose distribution was determined with a spatial resolution of better than 0.2 mm, with only a few minutes needed per scan. The scintillator dosemeter was absolutely calibrated in terms of absorbed dose to water with a precision of +/-7.5%. The relative precision achievable is +/-2.5%. The response of the system is linear within +/-2% for dose rates from 0.5 mGy s(-1) to 500 mGy s(-1).