Comparison of organ dosimetry methods and effective dose calculation methods for paediatric CT.

Computed tomography (CT) is the single biggest ionising radiation risk from anthropogenic exposure. Reducing unnecessary carcinogenic risks from this source requires the determination of organ and tissue absorbed doses to estimate detrimental stochastic effects. In addition, effective dose can be used to assess comparative risk between exposure situations and facilitate dose reduction through optimisation. Children are at the highest risk from radiation induced carcinogenesis and therefore dosimetry for paediatric CT recipients is essential in addressing the ionising radiation health risks of CT scanning. However, there is no well-defined method in the clinical environment for routinely and reliably performing paediatric CT organ dosimetry and there are numerous methods utilised for estimating paediatric CT effective dose. Therefore, in this study, eleven computational methods for organ dosimetry and/or effective dose calculation were investigated and compared with absorbed doses measured using thermoluminescent dosemeters placed in a physical anthropomorphic phantom representing a 10 year old child. Three common clinical paediatric CT protocols including brain, chest and abdomen/pelvis examinations were evaluated. Overall, computed absorbed doses to organs and tissues fully and directly irradiated demonstrated better agreement (within approximately 50 %) with the measured absorbed doses than absorbed doses to distributed organs or to those located on the periphery of the scan volume, which showed up to a 15-fold dose variation. The disparities predominantly arose from differences in the phantoms used. While the ability to estimate CT dose is essential for risk assessment and radiation protection, identifying a simple, practical dosimetry method remains challenging.

A programmable motion phantom for quality assurance of motion management in radiotherapy.

A commercially available motion phantom (QUASAR, Modus Medical) was modified for programmable motion control with the aim of reproducing patient respiratory motion in one dimension in both the anterior-posterior and superior-inferior directions, as well as, providing controllable breath-hold and sinusoidal patterns for the testing of radiotherapy gating systems. In order to simulate realistic patient motion, the DC motor was replaced by a stepper motor. A separate 'chest-wall' motion platform was also designed to accommodate a variety of surrogate marker systems. The platform employs a second stepper motor that allows for the decoupling of the chest-wall and insert motion. The platform's accuracy was tested by replicating patient traces recorded with the Varian real-time position management (RPM) system and comparing the motion platform's recorded motion trace with the original patient data. Six lung cancer patient traces recorded with the RPM system were uploaded to the motion platform's in-house control software and subsequently replicated through the phantom motion platform. The phantom's motion profile was recorded with the RPM system and compared to the original patient data. Sinusoidal and breath-hold patterns were simulated with the motion platform and recorded with the RPM system to verify the systems potential for routine quality assurance of commercial radiotherapy gating systems. There was good correlation between replicated and actual patient data (P 0.003). Mean differences between the location of maxima in replicated and patient data-sets for six patients amounted to 0.034 cm with the corresponding minima mean equal to 0.010 cm. The upgraded motion phantom was found to replicate patient motion accurately as well as provide useful test patterns to aid in the quality assurance of motion management methods and technologies.

Modeling a complex micro-multileaf collimator using the standard BEAMnrc distribution.

PURPOSE: The component modules in the standard BEAMnrc istribution may appear to be insufficient to model micro-multileaf collimators that have trifaceted leaf ends and complex leaf profiles. This note indicates, however, that accurate Monte Carlo simulations of radiotherapy beams defined by a complex collimation device can be completed using BEAMnrc's standard VARMLC component module. METHODS: That this simple collimator model can produce spatially and dosimetrically accurate microcollimated fields is illustrated using comparisons with ion chamber and film measurements of the dose deposited by square and irregular fields incident on planar, homogeneous water phantoms. RESULTS: Monte Carlo dose calculations for on-axis and off-axis fields are shown to produce good agreement with experimental values, even on close examination of the penumbrae. CONCLUSIONS: The use of a VARMLC model of the micro-multileaf collimator, along with a commissioned model of the associated linear accelerator, is therefore recommended as an alternative to the development or use of in-house or third-party component modules for simulating stereotactic radiotherapy and radiosurgery treatments. Simulation parameters for the VARMLC model are provided which should allow other researchers to adapt and use this model to study clinical stereotactic radiotherapy treatments.

Electron interaction with gel dosimeters: effective atomic numbers for collisional, radiative and total interaction processes.

The effective atomic number is widely employed in radiation studies, particularly for the characterization of interaction processes in dosimeters, biological tissues and substitute materials. Gel dosimeters are unique in that they comprise both the phantom and dosimeter material. In this work, effective atomic numbers for total and partial electron interaction processes have been calculated for the first time for a Fricke gel dosimeter, five hypoxic and nine normally oxygenated polymer gel dosimeters. A range of biological materials are also presented for comparison. The spectrum of energies studied spans 10 keV to 100 MeV, over which the effective atomic number varies by 30%. The effective atomic numbers of gels match those of soft tissue closely over the full energy range studied; greater disparities exist at higher energies but are typically within 4%.

The accuracy of the pencil beam convolution and anisotropic analytical algorithms in predicting the dose effects due to attenuation from immobilization devices and large air gaps.

When a photon beam passes through the treatment couch or an immobilization device, it may traverse a large air gap (up to 15 cm or more) prior to entering the patient. Previous studies have investigated the ability of various treatment planning systems to calculate the dose immediately beyond small air gaps, typically less than 5 cm thick, such as those within the body. The aim of this study is to investigate the ability of the Eclipse anisotropic analytical algorithm (AAA) and pencil beam convolution (PBC) algorithm to calculate the dose beyond large air gaps. Depth dose data in water for a 6 MV photon beam, 10 x 10 cm2 field size, and 100 cm SSD were measured beyond a range of air gaps (1-15 cm). The thickness of the water equivalent material positioned before the air gap ranged from 0.2 to 4 cm. Dose was calculated with the Eclipse PBC algorithm and AAA. The scattered and primary dose components were calculated from the measurements. The measured results indicate that as the air gap increases (from 1 to 15 cm) the dose reduces at the water surface and that beyond an air gap a secondary buildup region is required to re-establish electronic equilibrium. The dose beyond the air gap is also reduced at depths beyond the secondary buildup region. The PBC algorithm did not predict any reduction in dose beyond the air gap. AAA predicted the secondary buildup region but did not predict the reduction in dose at depths beyond it. The reduction in dose beyond the secondary buildup region was shown to be particularly relevant for air gaps of 5 cm or more when there was a 2 cm of water equivalent material positioned before the air gap. For these cases, where electronic equilibrium is established in the material positioned before the air gap, both algorithms were found to overestimate the dose by 2.0%-5.5%. It was concluded that the dose to depths of up to 15 cm beyond a large air gap is reduced due to a decrease in scattered radiation, produced in the material positioned before the air gap, reaching the point of interest. This effect is not well modeled by the Eclipse AAA and PBC algorithm and may result in dose calculation errors greater than 2.5%. Due to the contribution of other uncertainties in the radiation therapy treatment planning and delivery process, dose calculation errors of this magnitude are not consistent with the recommendation of the International Commission on Radiation Units and Measurements that the absorbed dose to the target volume be delivered with an uncertainty of less than +/- 5%.

In vitro dissolution studies of uranium bearing material in simulated lung fluid.

Inhaled uranium (U) bearing material will partially dissolve in the fluid lining of the lung, followed by a combination of retention, re-distribution, and excretion of the U. The rate of dissolution influences the retention time at the site of deposition, and the extent to which the material is available for re-distribution to other tissues. The consequential radiation dose is dependent upon the material distribution in the body and the exposure time to various tissues. The International Commission on Radiological Protection, ICRP 66 [International Commission on Radiological Protection (ICRP), 1994. Human Respiratory Tract Model for Radiological Protection. ICRP Publication 66] recommends the use of experimentally determined solubility coefficients in dose modelling. Material specific absorption parameters allow for better dose estimation than using ICRP default values for F (fast), M (moderate) and S (slow) classifications of U compounds. In vitro dissolution tests were carried out on U material collected from two U mines located in Australia. A static technique was designed in which particle samples were sandwiched between two 0.1-mum pore size membrane filters. The filter sandwich was exposed to a solvent (simulated lung fluid) for selected time intervals, at controlled test conditions for temperature and pH. The collected solution was analysed for U concentration using ICP-MS. The resulting dissolution curves were fitted with a double or triple exponential equation to determine the dissolution coefficients.

The effective atomic number of dosimetric gels.

Radiological properties of gel dosimeters and phantom materials are often compared against each other and against water or tissue by consideration parameters including their effective atomic number, Zeff. Effective atomic numbers have been calculated for a range of ferrous-sulphate and polymeric gel dosimeters using mass attenuation coefficient data over the energy range 10 keV to 10 MeV. Data is presented relative to water to allow direct comparison over a range of energies. These data provide energy specific values of Zeff which improves on the practice of applying a power-law based formula to estimate an energy independent value. For applications that require a single value of Zeff, the data presented here allows the choice of a value appropriate to the energy of the photon source or a spectrum-weighted average. Studying the variation of Zeff, which is equivalent to taking into account the variation of mass attenuation coefficients with photon energy, it is found that gels typically match water better than water matches human tissues. As such, the subtle differences in effective atomic number between water and gels are small and may be considered negligible. Consideration of the mean disparity over a large energy range shows, broadly, BANG-1 to be the most water equivalent gel.

Systematic variations in polymer gel dosimeter calibration due to container influence and deviations from water equivalence.

There are a number of gel dosimeter calibration methods in contemporary usage. The present study is a detailed Monte Carlo investigation into the accuracy of several calibration techniques. Results show that for most arrangements the dose to gel accurately reflects the dose to water, with the most accurate method involving the use of a large diameter flask of gel into which multiple small fields of varying dose are directed. The least accurate method was found to be that of a long test tube in a water phantom, coaxial with the beam. The large flask method is also the most straightforward and least likely to introduce errors during the set-up, though, to its detriment, the volume of gel required is much more than other methods.

An experimental MOSFET approach to characterize (192)Ir HDR source anisotropy.

The dose anisotropy around a (192)Ir HDR source in a water phantom has been measured using MOSFETs as relative dosimeters. In addition, modeling using the EGSnrc code has been performed to provide a complete dose distribution consistent with the MOSFET measurements. Doses around the Nucletron 'classic' (192)Ir HDR source were measured for a range of radial distances from 5 to 30 mm within a 40 x 30 x 30 cm(3) water phantom, using a TN-RD-50 MOSFET dosimetry system with an active area of 0.2 mm by 0.2 mm. For each successive measurement a linear stepper capable of movement in intervals of 0.0125 mm re-positioned the MOSFET at the required radial distance, while a rotational stepper enabled angular displacement of the source at intervals of 0.9 degrees . The source-dosimeter arrangement within the water phantom was modeled using the standardized cylindrical geometry of the DOSRZnrc user code. In general, the measured relative anisotropy at each radial distance from 5 mm to 30 mm is in good agreement with the EGSnrc simulations, benchmark Monte Carlo simulation and TLD measurements where they exist. The experimental approach employing a MOSFET detection system of small size, high spatial resolution and fast read out capability allowed a practical approach to the determination of dose anisotropy around a HDR source.

A comparison of mammography spectral measurements with spectra produced using several different mathematical models.

Due to the relatively complex nature of spectral measurements from x-ray machines, many researchers use mathematical models to simulate the spectra they need. However, there is concern over their accuracy, and hence the impact that their accuracy may have, on subsequent calculations that rely upon the spectra modelled. With this in mind spectral measurements have been performed on a mammography machine and a comparison with spectra calculated using several different models is presented. Several different techniques have been investigated in the spectral measurements to allow for pulse pileup and other effects of high count rate. Comparison with half value layer (HVL) measurements shows that the use of a gating signal in conjunction with the air-free path provides accurate results without the need for a pinhole collimator. Comparison of the measured spectra with those calculated using different models proposed in the literature suggests that accurate results can be produced by all models, but only if the user attempts to match the calculated HVL of the modelled spectrum with the physically measured HVL. If this is not done the modelled spectra may be in error. The impact of such an error is demonstrated in calculations of mean glandular dose, which indicate a possible underestimate of the dose by up to 20%.

A temporal method of avoiding the Cerenkov radiation generated in organic scintillator dosimeters by pulsed mega-voltage electron and photon beams.

The output signal of an organic scintillator probe consists of a scintillation signal and Cerenkov and fluorescence radiation (CFR) signal when the probe is exposed to a mega-voltage photon or electron beam. The CFR signal is usually unwanted because it comes from both the scintillator and light guide and so it is not proportional to the absorbed dose in the scintillator. A new organic scintillator detector system has been constructed for absorbed dose measurement in pulsed mega-voltage electron and photon beams that are commonly used in radiotherapy treatment, eliminating most of the CFR signal. The new detector system uses a long decay constant BC-444G (Bicron, Newbury, OH, USA) scintillator which gives a signal that can be time resolved from the prompt CFR signal so that the measured contribution of prompt signal is negligible. The response of the new scintillator detector system was compared with the measurements from a plastic scintillator detector that were corrected for the signal contribution from the CFR, and to appropriately corrected ion chamber measurements showing agreement in the 16 MeV electron beam used.

Transit dose of an Ir-192 high dose rate brachytherapy stepping source.

Clinical dosimetry for high dose rate (HDR) brachytherapy with a single stepping source generally neglects the transit dose. This study investigates the effects of the transit dose in the target volume of an HDR brachytherapy stepping source. A video method was used to analyse the entrance, exit and the interdwell transit speed of the source for different path lengths and step sizes ranging from 2.5 mm to 995 mm. The transit speed was found to vary with the step size and path length. For the travelled distances of 2.5, 5.0, 10.0, 230 and 995 mm, the average transit speeds were 54, 72, 233, 385 and 467 mm s(-1) respectively. The results also show that the manufacturer has attempted to compensate for the effects of interdwell transit dose by reducing the actual dwell time of the source. A well-type chamber was used to determine the dose differences between two sets of measurements, one being the stationary dose only and the other being the sum of stationary and transit doses. Single catheters of active lengths of 20 and 40 mm, different dwell times of 0.5, 1, 2 and 5 s and different step sizes of 2.5, 5 and 10 mm were used in the measurements with the well-type chamber. Most of the measured dose differences between stationary and stationary plus interdwell source movement were within 2%. The additional dose due to the source transit can be as high as 24.9% for the case of 0.5 s dwell time, 10 mm step size and 20 mm active length. The dose difference is mainly due to the entrance and exit source movement but not the interdwell movement.

Inhalation doses for aboriginal people reoccupying former nuclear weapons testing ranges in South Australia.

The Australian Government plans to rehabilitate the former nuclear weapons testing ranges at Maralinga and Emu in South Australia and to allow access to the areas for the Pitjantjatjara (Aboriginal) people who are the traditional owners of the land. The major radiological hazard posed by reoccupation of the ranges arises from inhalation of residual plutonium. The committed effective dose that these people might receive from inhalation on reoccupation of the lands is computed for a range of sites. The estimated doses for permanent occupancy range up to 300 mSv y-1 indicating the need for substantial rehabilitation before these areas are suitable for unrestricted access.

Determination of the ratios of 239Pu and 240Pu to 241Am for nuclear weapons test sites in Australia.

Recent measurements of the plutonium contamination at former nuclear weapons test sites in Australia have used the 59.5 keV gamma ray from the 241Am impurity to estimate levels of 239Pu and 240Pu. Measurements of the activity ratio of 239Pu to 241Am are presented for sites where suitable samples could be collected. Measurements of 240Pu were also made when interferences from fission products were absent. All measurements were made using a planar Ge detector of sufficient resolution to separate the 51.6 keV 239Pu gamma ray from the Ge K x-ray escape peaks and Compton scattering continuum from the much stronger 59.5 keV 241Am gamma ray. Results are given for most of the plutonium-contaminated sites in Australia.

Measurements of activation induced by environmental neutrons using ultra low-level gamma-ray spectrometry.

The flux of environmental neutrons is being studied by activation of metal discs of selected elements. Near the earth's surface the total neutron flux is in the order of 10(-2) cm(-2)s(-1), which gives induced activities of a few mBq in the discs. Initial results from this technique, involving activation at ground level for several materials (W, Au, Ta, In, Re, Sm, Dy and Mn) and ultra low-level gamma-ray spectrometry in an underground laboratory located at 500 m.w.e., are presented. Diffusion of environmental neutrons in water is also measured by activation of gold at different depths.

Measurements of 60Co in spoons activated by neutrons during the JCO criticality accident at Tokai-mura in 1999.

Neutron activated items from the vicinity of the place where the JCO criticality accident occurred have been used to determine the fluence of neutrons around the facility and in nearby residential areas. By using underground laboratories for measuring the activation products, it is possible to extend the study to also cover radionuclides with very low activities from long-lived radionuclides. The present study describes gamma-ray spectrometry measurements undertaken in a range of underground laboratories for the purpose of measuring (60)Co more than 2 years after the criticality event. The measurements show that neutron fluence determined from (60)Co activity is in agreement with previous measurements using the short-lived radionuclides (51)Cr and (59)Fe. Limits on contamination of the samples with (60)Co are evaluated and shown to not greatly affect the utility of neutron fluence determinations using (60)Co activation.

Ultra low-level gamma ray spectrometry of thorium in human bone samples.

Following the use of in vivo measurements of 210Pb to estimate retrospectively radon exposure, interest has been expressed in the use of in vivo measurements of 208Tl to estimate thorium intake. To aid with calibration and to determine the optimum part of the body on which in vivo measurements should be made, the distribution of 208Tl and 228Ac amongst different human bones was measured in the underground laboratory HADES. The 208Tl activity was determined by the 2614.5 keV and the 583.2 keV gamma ray lines. The 225Ac activity was determined by the 911.2 keV and the 969.0 keV gamma ray lines. The background under those peaks when measured on the 106% relative efficiency coaxial HPGe detector in HADES is of the order of 1 d(-1), resulting in detection limits in the order of 1 mBq for both radionuclides for a typical 10 g bone sample and for a measuring time of I week.

An investigation into the impact of anatomical variation upon mean glandular dose produced within a standard breast.

By using the EGS4 Monte Carlo computer program the normalised mean glandular dose (MGD) was calculated for a breast model that is intended to reflect the composition of an "average" breast. The reliability of the calculation was established by comparing the predictions with previously published values for a breast model. The breast model used was then altered in order to reflect the possible extremes in glandular distribution that could occur within a compressed breast. These results show that the MGD could vary by up to a factor of four depending upon where the majority of glandular tissue is located within the breast. The impact of this variation in MGD upon risk assessment within mammography is then discussed.

Investigation of photon beam models in heterogeneous media of modern radiotherapy.

This study investigates the performance of photon beam models in dose calculations involving heterogeneous media in modern radiotherapy. Three dose calculation algorithms implemented in the CMS FOCUS treatment planning system have been assessed and validated using ionization chambers, thermoluminescent dosimeters (TLDs) and film. The algorithms include the multigrid superposition (MGS) algorithm, fast Fourier Transform Convolution (FFTC) algorithm and Clarkson algorithm. Heterogeneous phantoms used in the study consist of air cavities, lung analogue and an anthropomorphic phantom. Depth dose distributions along the central beam axis for 6 MV and 10 MV photon beams with field sizes of 5 cm x 5 cm and 10 cm x 10 cm were measured in the air cavity phantoms and lung analogue phantom. Point dose measurements were performed in the anthropomorphic phantom. Calculated results with three dose calculation algorithms were compared with measured results. In the air cavity phantoms, the maximum dose differences between the algorithms and the measurements were found at the distal surface of the air cavity with a 10 MV photon beam and a 5 cm x 5 cm field size. The differences were 3.8%. 24.9% and 27.7% for the MGS. FFTC and Clarkson algorithms. respectively. Experimental measurements of secondary electron build-up range beyond the air cavity showed an increase with decreasing field size, increasing energy and increasing air cavity thickness. The maximum dose differences in the lung analogue with 5 cm x 5 cm field size were found to be 0.3%. 4.9% and 6.9% for the MGS. FFTC and Clarkson algorithms with a 6 MV photon beam and 0.4%. 6.3% and 9.1% with a 10 MV photon beam, respectively. In the anthropomorphic phantom, the dose differences between calculations using the MGS algorithm and measurements with TLD rods were less than +/-4.5% for 6 MV and 10 MV photon beams with 10 cm x 10 cm field size and 6 MV photon beam with 5 cm x 5 cm field size, and within +/-7.5% for 10 MV with 5 cm x 5 cm field size, respectively. The FFTC and Clarkson algorithms overestimate doses at all dose points in the lung of the anthropomorphic phantom. In conclusion, the MGS is the most accurate dose calculation algorithm of investigated photon beam models. It is strongly recommended for implementation in modern radiotherapy with multiple small fields when heterogeneous media are in the treatment fields.

Absolute x-ray dosimetry on a synchrotron medical beam line with a graphite calorimeter.

PURPOSE: The absolute dose rate of the Imaging and Medical Beamline (IMBL) on the Australian Synchrotron was measured with a graphite calorimeter. The calorimetry results were compared to measurements from the existing free-air chamber, to provide a robust determination of the absolute dose in the synchrotron beam and provide confidence in the first implementation of a graphite calorimeter on a synchrotron medical beam line. METHODS: The graphite calorimeter has a core which rises in temperature when irradiated by the beam. A collimated x-ray beam from the synchrotron with well-defined edges was used to partially irradiate the core. Two filtration sets were used, one corresponding to an average beam energy of about 80 keV, with dose rate about 50 Gy/s, and the second filtration set corresponding to average beam energy of 90 keV, with dose rate about 20 Gy/s. The temperature rise from this beam was measured by a calibrated thermistor embedded in the core which was then converted to absorbed dose to graphite by multiplying the rise in temperature by the specific heat capacity for graphite and the ratio of cross-sectional areas of the core and beam. Conversion of the measured absorbed dose to graphite to absorbed dose to water was achieved using Monte Carlo calculations with the EGSnrc code. The air kerma measurements from the free-air chamber were converted to absorbed dose to water using the AAPM TG-61 protocol. RESULTS: Absolute measurements of the IMBL dose rate were made using the graphite calorimeter and compared to measurements with the free-air chamber. The measurements were at three different depths in graphite and two different filtrations. The calorimetry measurements at depths in graphite show agreement within 1% with free-air chamber measurements, when converted to absorbed dose to water. The calorimetry at the surface and free-air chamber results show agreement of order 3% when converted to absorbed dose to water. The combined standard uncertainty is 3.9%. CONCLUSIONS: The good agreement of the graphite calorimeter and free-air chamber results indicates that both devices are performing as expected. Further investigations at higher dose rates than 50 Gy/s are planned. At higher dose rates, recombination effects for the free-air chamber are much higher and expected to lead to much larger uncertainties. Since the graphite calorimeter does not have problems associated with dose rate, it is an appropriate primary standard detector for the synchrotron IMBL x rays and is the more accurate dosimeter for the higher dose rates expected in radiotherapy applications.