[Comparison between Stump Cylinder and custom mold, effect of the shape of the applicator on the dose distribution]. / Comparaison entre Stump Cylinder et moule personnalisé, effet de la forme de l'applicateur sur la distribution de dose.

PURPOSE: The purpose of this study was to compare the efficacy of two applicators used in high dose rate vaginal brachytherapy. The first is the Stump Cylinder used in the "brachycenter" department at the Middle East Institute of Health in Lebanon and the second is the custom mold used in the radiotherapy department at Tenon Hospital in France. MATERIALS AND METHOD: A comparison of the clinical target volume and the doses received by the rectum and bladder was performed in order to determine the best method of treatment and to optimize the dose distribution. 95 patients were treated in both departments. RESULTS: The average values of the D95% dose received by the CTV were respectively 89.43% for the Stump Cylinder and 110.16% for the custom mold. The conformity index was 0.84 for the Stump Cylinder while it was 0.97 for the custom mold, which ensures a better dose distribution. For the rectum, the maximum dose D2cc taken by volume was 71.23% for the Stump Cylinder and 79.51% for the custom mold. The bladder was better protected with Stump Cylinder with a D2cc value of 65.81% against 94.88% for the custom mold. CONCLUSION: The underdosing obtained using the Stump Cylinder was due to the shape of upper part of the cylinder which was not conform with the shape of the vaginal vault in women. A better protection of the organs at risk was observed with the Stump Cylinder since the dose taken by the rectum and bladder using a custom mold can reach the tolerance limits.

Characteristics of The Narrow Spectrum Beams Used in the Secondary Standard Dosimetry Laboratory at the Lebanese Atomic Energy Commission.

The Secondary Standard Dosimetry Laboratory at the Lebanese Atomic Energy Commission has different calibration methods for various types of dosimeters used in industrial, military and medical fields. The calibration is performed using different beams of X-rays (low and medium energy) and Gamma radiation delivered by a Cesium 137 source. The Secondary Standard Dosimetry laboratory in charge of calibration services uses different protocols for the determination of high and low air kerma rate and for narrow and wide series. In order to perform this calibration work, it is very important to identify all the beam characteristics for the different types of sources and qualities of radiation. The following work describes the methods used for the determination of different beam characteristics and calibration coefficients with their uncertainties in order to enhance the radiation protection of workers and patient applications in the fields of medical diagnosis and industrial X-ray. All the characteristics of the X-ray beams are determined for the narrow spectrum series in the 40 and 200 keV range where the inherent filtration, the current intensity, the high voltage, the beam profile and the total uncertainty are the specific characteristics of these X-ray beams. An X-ray software was developed in order to visualize the reference values according to the characteristics of each beam.