BACKGROUND: Estimating dosimetric parameters for small fields under non-reference conditions leads to significant errors if done based on conventional protocols used for large fields in reference conditions. Hence, further correction factors have been introduced to take into account the influence of spectral quality changes when various detectors are used in non-reference conditions at different depths and field sizes. OBJECTIVE: Determining correction factors (KNR and KNCSF) recommended recently for small field dosimetry formalism by American Association of Physicists in Medicine (AAPM) for different detectors at 6 and 18 MV photon beams. METHODS: EGSnrc Monte Carlo code was used to calculate the doses measured with different detectors located in a slab phantom and the recommended KNR and KNCSF correction factors for various circular small field sizes ranging from 5-30 mm diameters. KNR and KNCSF correction factors were determined for different active detectors (a pinpoint chamber, EDP-20 and EDP-10 diodes) in a homogeneous phantom irradiated to 6 and 18 MV photon beams of a Varian linac (2100C/D). RESULTS: KNR correction factor estimated for the highest small circular field size of 30 mm diameter for the pinpoint chamber, EDP-20 and EDP-10 diodes were 0.993, 1.020 and 1.054; and 0.992, 1.054 and 1.005 for the 6 and 18 MV beams, respectively. The KNCSF correction factor estimated for the lowest circular field size of 5 mm for the pinpoint chamber, EDP-20 and EDP-10 diodes were 0.994, 1.023, and 1.040; and 1.000, 1.014, and 1.022 for the 6 and 18 MV photon beams, respectively. CONCLUSION: Comparing the results obtained for the detectors used in this study reveals that the unshielded diodes (EDP-20 and EDP-10) can confidently be recommended for small field dosimetry as their correction factors (KNR and KNCSF) was close to 1.0 for all small field sizes investigated and are mainly independent from the electron beam spot size.
BACKGROUND: Before treatment planning and dose delivery, quality assurance of multi-leaf collimator (MLC) has an important role in intensity-modulated radiation therapy (IMRT) due to the creation of multiple segments from optimization process. OBJECTIVE: The purpose of this study is to assess the quality control of MLC leaves using EBT3 Gafchromic films. MATERIAL AND METHODS: Leaf Position accuracy and leaf gap reproducibility were checked with Garden fence test. The garden fence test consists of 5 thin bands A) 0.2 Cm width spaced at 2 Cm intervals and B) 1 Cm width spaced at 1 Cm intervals. Each leaf accuracy was analyzed with measuring the full-width half-maximum (FWHM). Maximum and average leaf transmission were measured with gafchromic EBT3 films from Ashland for both 6 MV and 18 MV beams. RESULTS: Leaf positions were found to be in a range between 1.78 - 2.53 mm, instead of nominal 2 mm for the test A and between 9.09 - 10.36 mm, instead of nominal 10 mm for the test B. The Average radiation transmission of the MLC was noted 1.79% and 1.98% of the open 10x10 Cm2 field at isocenter for 6 MV and 18 MV beams, respectively. Maximum radiation transmission was noted 4.1% and 4.4% for 6 MV and 18 MV beams, respectively. CONCLUSION: In this study, application of gafchromic EBT3 films for the quality assurance of Euromechanics multileaf collimator was studied. Our results showed that the average leaf leakage and positional accuracy of this type of MLC were in the acceptance level based on the Protocols.
Cancer stem cells (CSCs) have been identified as the main center of tumor therapeutic resistance. They are highly resistant against current cancer therapy approaches particularly radiation therapy (RT). Recently, a wide spectrum of physical methods has been proposed to treat CSCs, including high energetic particles, hyperthermia (HT), nanoparticles (NPs) and combination of these approaches. In this review article, the importance and benefits of the physical CSCs therapy methods such as nanomaterial-based heat treatments and particle therapy will be highlighted.
Neoplasms/therapy , Neoplastic Stem Cells , Drug Resistance, Neoplasm/physiology , Heavy Ion Radiotherapy/methods , Humans , Hyperthermia, Induced/methods , Nanoparticles/therapeutic use
Background: One of the main problems of dedicated IORT accelerators is to determine dosimetric characteristics of the electron beams. Monte Carlo simulation of IORT accelerator head and produced beam will be useful to improve the accuracy of beam dosimetry. Materials and Methods: Liac accelerator head was modeled using the BEAMnrcMonte Carlo simulation system. Phase-space files were generated at the bottom of the applicators. These phase-space files were used as an input source in DOSXYZnrc and BEAMDP codes for dose calculation and analysis of the characteristic of the electron beams in all applicators and energies. Results: The results of Monte Carlo calculations are in very close agreement with the measurements. There is a decrease in the peak of the initial spectrum when electrons come from the end of accelerator wave guide to the end of applicator. By decreasing the applicator diameter, the mean energy of electron beam decreased. Using applicators and increasing their size, X-ray contamination will increase. The percentage of X-ray contamination increases by applicator diameter. This is related to the increase of the mean energy of electron beams. Conclusion: Application of PMMA collimator leads to, although well below accepted level, the production of bremsstrahlung. The results of this study showed that special design of LIAC head accompanying by PMMA collimator system cause to produce an electron beam with an individual dosimetric characteristic making it a useful tool for intraoperative radiotherapy purposes.
Many combined therapies have been proposed to enhance radiotherapy outcome, but they have several limitations. As a new feasible strategy, combination of radiotherapy with bacteria showed a significant positive impact on the tumor treatment and metastasis inhibition. Although probiotic bacteria and radiotherapy alone can be effective in the treatment of different cancers, the combination of these two therapies seems to enhance therapeutic outcome and is cost-effective. Bacterial cells can act as therapeutic/gene/drug delivery vehicles as well as theranostic agents. In this communication, we reviewed current evidences, studies, suggestions, and future-based directions on combination of radiotherapy and bacteria. In another sections, an overview on tumor hypoxia, bacteria in cancer therapy, and combination of radiotherapy and bacteria is presented. A brief overview on trials and animal studies which used bacteria to protect normal tissues against radiotherapy-induced complications is also included.
Bacteria/growth & development , Drug Delivery Systems , Neoplasms/therapy , Probiotics/therapeutic use , Radiotherapy , Combined Modality Therapy , Humans , Treatment Outcome
BACKGROUND: Gold nanoparticles are emerging as promising agents for cancer therapy and are being investigated as drug carriers, photothermal agents, contrast agents and radiosensitisers. OBJECTIVE: The aim of this study is to understand characteristics of secondary electrons generated from interaction of gold nanoparticles GNPs with x-rays as a function of nanoparticle size and beam energy and thereby further understanding of GNP-enhanced radiotherapy. METHODS: Effective range, defection angle, dose deposition, energy, and interaction processes of electrons produced from the interaction of x-rays with a GNP were calculated by Monte Carlo simulations. The MCNPX code was used to simulate and track electrons generated from 30 and 50 nm diameter GNP when it is irradiated with a cobalt-60 and 6MV photon and electron beam in water. RESULTS: When a GNP was present, depending on beam types used, secondary electron production increased by 10- to 2000-fold compared to absence of a GNP. CONCLUSION: GNPs with larger diameters also contributed to more doses.
BACKGROUND: Gel polymers are considered as new dosimeters for determining radiotherapy dose distribution in three dimensions. OBJECTIVE: The ability of a new formulation of MAGIC-f polymer gel was assessed by experimental measurement and Monte Carlo (MC) method for studying the effect of gold nanoparticles (GNPs) in prostate dose distributions under the internal Ir-192 and external 18MV radiotherapy practices. METHOD: A Plexiglas phantom was made representing human pelvis. The GNP shaving 15 nm in diameter and 0.1 mM concentration were synthesized using chemical reduction method. Then, a new formulation of MAGIC-f gel was synthesized. The fabricated gel was poured in the tubes located at the prostate (with and without the GNPs) and bladder locations of the phantom. The phantom was irradiated to an Ir-192 source and 18 MV beam of a Varian linac separately based on common radiotherapy procedures used for prostate cancer. After 24 hours, the irradiated gels were read using a Siemens 1.5 Tesla MRI scanner. The absolute doses at the reference points and isodose curves resulted from the experimental measurement of the gels and MC simulations following the internal and external radiotherapy practices were compared. RESULTS: The mean absorbed doses measured with the gel in the presence of the GNPs in prostate were 15% and 8 % higher than the corresponding values without the GNPs under the internal and external radiation therapies, respectively. MC simulations also indicated a dose increase of 14 % and 7 % due to presence of the GNPs, for the same experimental internal and external radiotherapy practices, respectively. CONCLUSION: There was a good agreement between the dose enhancement factors (DEFs) estimated with MC simulations and experiment gel measurements due to the GNPs. The results indicated that the polymer gel dosimetry method as developed and used in this study, can be recommended as a reliable method for investigating the DEF of GNPs in internal and external radiotherapy practices.
PURPOSE: In the framework of developing the integration of a MRI-Linac system, configurations of MRI-Linac units were simulated in order to improve the dose distribution in tangential breast radiotherapy using transverse and longitudinal magnetic field geometries of Lorentz force for both medial and lateral tangential fields. METHODS: In this work, the geant4 Monte Carlo (MC) code was utilized to compare dose distributions in breast radiotherapy for Linac-MR systems in the transverse and longitudinal geometries within humanoid phantoms across a range of magnetic field strengths of 0.5 and 1.5 T. The dose increment due to scattering from the coils was investigated for both geometries as well. Computed tomography images of two patients were used for MC simulations. One patient had intact breast while the other was mastectomized. In the simulations, planning and methods of chest wall irradiation were similar to the actual clinical planning. RESULTS: In a longitudinal geometry, the magnetic field is shown to restrict the lateral spread of secondary electrons to the lung, heart, and contralateral organs, which reduced the mean dose of the ipsilateral lung and heart by means of 17.2% and 6% at 1.5 T, respectively. The transverse configuration exhibits a significant increase in tissue interface effects, which increased dose buildup in the entrance regions of the lateral and medial tangent beams to the planning target volume (PTV) and improved dose homogeneity within the PTV. The improved relative average homogeneity index for two patients to the PTV at magnetic field strength of 1.5 T with respect to no magnetic field case evaluated was 11.79% and 34.45% in the LRBP and TRBP geometries, respectively. In both geometries, the simulations show significant mean dose reductions in the contralateral breast and chest wall skin, respectively, by a mean of 16.6% and 24.9% at 0.5 T and 17.2% and 28.1% at 1.5 T in the transverse geometry, and 10.56% and 14.6% at 0.5 T and 11.3% and 16.3% at 1.5 T in the longitudinal geometry. Considering the scattered photons which reflected from the coils, the average relative dose of each voxel is slightly increased by 0.53% and 0.32% in the LRBP and TRBP geometries, respectively. CONCLUSIONS: Orienting the B0 magnetic field parallel to the photon beam axis, LRBP geometry, tends to restrict the radial spread of secondary electrons which resulted in dose reduction to the lung. Dosimetry issues observed in both Linac-MR geometries, such as changes to the lateral dose distribution, significantly exhibited dose reduction in the contralateral organs on a representative breast plan. Further, the results show sharper edge dose volume histogram curves at 1.5 T for both geometries, especially in the LRBP configuration.
Breast Neoplasms/radiotherapy , Magnetic Resonance Imaging , Monte Carlo Method , Particle Accelerators , Humans , Phantoms, Imaging , Radiometry , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted
PURPOSE: To investigate the improvement in dose distribution in tangential breast radiotherapy using a reversible transverse magnetic field that maintains the same direction of Lorentz force between two fields. The investigation has a potential application in future Linac-MR units. METHODS: Computed tomography images of four patients and magnetic fields of 0.25-1.5 Tesla (T) were used for Monte Carlo simulation. Two patients had intact breast while the other two had mastectomy. Simulations of planning and chest wall irradiation were similar to the actual clinical process. The direction of superior-inferior magnetic field for the medial treatment beam was reversed for the lateral beam. RESULTS: For the ipsilateral lung and heart mean doses were reduced by a mean (range) of 45.8% (27.6%-58.6%) and 26.0% (20.2%-38.9%), respectively, depending on various treatment plan setups. The mean V20 for ipsilateral lung was reduced by 55.0% (43.6%-77.3%). In addition acceptable results were shown after simulation of 0.25 T magnetic field demonstrated in dose-volume reductions of the heart, ipsilateral lung, and noninvolved skin. CONCLUSIONS: Applying a reversible magnetic field during breast radiotherapy, not only reduces the dose to the lung and heart but also produces a sharp drop dose volume histogram for planning target volume, because of bending of the path of secondary charged particles toward the chest wall by the Lorentz force. The simulations have shown that use of the magnetic field at 1.5 T is not feasible for clinical applications due to the increase of ipsilateral chest wall skin dose in comparison to the conventional planning while 0.25 T is suitable for all patients due to dose reduction to the chest wall skin.
Breast Neoplasms/radiotherapy , Magnetic Fields , Magnetic Resonance Imaging , Radiotherapy, Image-Guided/methods , Breast Neoplasms/diagnostic imaging , Humans , Monte Carlo Method , Radiotherapy Dosage , Tomography, X-Ray Computed
BACKGROUND: Radiation-sensitive polymer gels are among the most promising three-dimensional dose verification tools and tissue-like phantom developed to date. OBJECTIVE: The aim of this study is an investigating of percentage depth dose enhancement within the gel medium with used of conformal distribution gold nanoparticle as contrast agents by high atomic number material. METHODS: In this work the normoxic polymer gel dosimeter MAGICA tissue-equivalence was first theoretically verified using MCNPX Monte Carlo code and experimentally by percentage depth dose curves within the gel medium. Then gold nanoparticles (GNPs) of 50nm diameter with different concentrations of 0.1mM, 0.2mM, and 0.4mM were embedded in MAGICA gel and irradiated by 18MV photon beam. RESULTS: Experimental results have shown dose increase of 10%, 2% and 4% in 0.1mM, 0.2mM and 0.4mM concentrations, respectively. Simulation results had good agreement in the optimum concentration of 0.1mM. The largest error between experimental and simulation results was equal to 9.28% stood for 0.4mM concentration. CONCLUSION: The results showed that the optimum concentration of gold nanoparticles to achieve maximum absorbed dose in both experimental and simulation was 0.1 mM and so it can be used for clinical studies.
PURPOSE: The aim of this study was to evaluate and analytically compare different calculation algorithms applied in our country radiotherapy centers base on the methodology developed by IAEA for treatment planning systems (TPS) commissioning (IAEA TEC-DOC 1583). MATERIAL & METHODS: Thorax anthropomorphic phantom (002LFC CIRS inc.), was used to measure 7 tests that simulate the whole chain of external beam TPS. The dose were measured with ion chambers and the deviation between measured and TPS calculated dose was reported. This methodology, which employs the same phantom and the same setup test cases, was tested in 4 different hospitals which were using 5 different algorithms/ inhomogeneity correction methods implemented in different TPS. The algorithms in this study were divided into two groups including correction based and model based algorithms. RESULTS: A total of 84 clinical test case datasets for different energies and calculation algorithms were produced, which amounts of differences in inhomogeneity points with low density (lung) and high density (bone) was decreased meaningfully with advanced algorithms. The number of deviations outside agreement criteria was increased with the beam energy and decreased with advancement of the TPS calculation algorithm. CONCLUSION: Large deviations were seen in some correction based algorithms, so sophisticated algorithms, would be preferred in clinical practices, especially for calculation in inhomogeneous media. Use of model based algorithms with lateral transport calculation, is recommended. Some systematic errors which were revealed during this study, is showing necessity of performing periodic audits on TPS in radiotherapy centers.
A novel water equivalent formulation of PRESAGE dosimeter more suitable for radiotherapy applications has been introduced and its radiological water equivalency has been investigated. Furthermore, its radiological properties have been compared with an existing PRESAGE formulation over an energy range from 10 to 20 MeV. Monte Carlo simulation method has been implemented to determine and compare depth dose profiles in both of the PRESAGE formulations at two different photon energies (140 KV(P) and 6 MV). The results show that our proposed PRESAGE formulation is more water equivalent than its known formulation especially for low photon energy beams.
Polyurethanes , Radiotherapy Dosage , Humans , Monte Carlo Method , Radiometry/methods
Over the past few years there has been much interest in the development of three-dimensional dosimeters to determine the complex absorbed dose distribution in modern radiotherapy techniques such as IMRT and IGRT. In routine methods used for three-dimensional dosimetry, polymer gels are commonly used. Recently, a novel transparent polymer dosimeter, known as PRESAGE, has been introduced in which a radiochromic color change is observed upon radiation. PRESAGE has some advantages over usual polymer gel dosimeters. It has been noted that the sensitivity of PRESAGE can be changed when different amounts of the components are used for its fabrication. This study has focused on the assessment of dosimetric characteristics of PRESAGE for various amounts of components in its formulation. To achieve this, PRESAGE dosimeters were fabricated using various amounts of their constituting components. Then the dosimeters were irradiated to (60)Co gamma photons for a range of radiation doses from 0 to 50 Gy. Consequently, the light absorption changes of the dosimeters were measured by a spectrophotometer at different post-irradiation time periods. It was generally observed that as the concentration of the radical initiator is increased, the PRESAGE dosimeter sensitivity is increased while its stability is decreased. Furthermore, it was noted that with the high concentration of the radical initiator and leuco dye, the sensitivity of PRESAGE is decreased.
Radiometry/instrumentation , Radiometry/methods , Absorption , Cobalt Radioisotopes , Electrons , Gamma Rays , Light , Linear Models , Phantoms, Imaging , Photons , Polymers/radiation effects , Sensitivity and Specificity , Spectrophotometry , Time Factors , Water
