Standards of radium-226: from Marie Curie to the International Committee for Radionuclide Metrology.

In the early part of the 20th century, the pioneers of radioactivity research, led by Marie Curie, Ernest Rutherford and Stefan Meyer, formed a Commission internationale des étalons de radium. The Commission made arrangements for the preparation and intercomparisons of the international standards of radium, which were identified as the Paris standard and the Vienna standard. Otto Hönigschmid from Vienna prepared a first set of international secondary standards in 1912 and a second set in 1934. In both instances, these secondary standards were compared by gamma-ray measurements with the Paris and Vienna standards. The usage of these international standards of radium in the 20th century is described.

Well-ionization chamber response relative to NIST air-kerma strength standard for prostate brachytherapy seeds.

The response of well-ionization chambers to the emissions of 103Pd and 125I radioactive seed sources used in prostate cancer brachytherapy has been measured. Calibration factors relating chamber response (current or dial setting) to measured air-kerma strength have been determined for seeds from nine manufacturers, each with different designs. Variations in well-ionization chamber response relative to measured air-kerma strength have been observed because of differences in the emitted energy spectrum due to both the radionuclide support material (125I seeds) and the mass ratio of 103Pd to 102Pd (103Pd seeds). Obtaining accurate results from quality assurance measurements using well-ionization chambers at a therapy clinic requires knowledge of such differences in chamber response as a function of seed design.

Recommendations of the American Association of Physicists in Medicine on 103Pd interstitial source calibration and dosimetry: implications for dose specification and prescription.

The National Institute of Standards and Technology (NIST) introduced a national standard for air kerma strength of the ThreaSeed Model 200 103Pd source (the only 103Pd seed available until 1999) in early 1999. Correct implementation of the NIST-99 standard requires the use of dose rate constants normalized to this same standard. Prior to the availability of this standard, the vendor's calibration procedure consisted of intercomparing Model 200 seeds with a 109Cd source with a NIST-traceable activity calibration. The AAPM undertook a comprehensive review of 103Pd source dosimetry including (i) comparison of the vendor and NIST-99 calibration standards; (ii) comparison of original Task Group 43 dosimetry parameters with more recent studies; (iii) evaluation of the vendor's calibration history; and (iv) evaluation of administered-to-prescribed dose ratios from the introduction of 103Pd sources in 1987 to the present. This review indicates that for a prescribed dose of 115 Gy, the administered doses were (a) 124 Gy for the period 1988-1997 and (b) 135 Gy for the period 1997-1999. The AAPM recommends that the following three steps should be undertaken concurrently to implement correctly the 1999 dosimetry data and NIST-99 standard for 103Pd source: (1) the vendor should provide calibrations in terms of air kerma strength traceable to NIST-99 standard, (2) the medical physicist should update the treatment planning system with properly normalized (to NIST-99) dosimetry parameters for the selected 103Pd source model, and (3) the radiation oncologist in collaboration with the medical physicist should decide which clinical experience they wish to duplicate; the one prior to 1997 or the one from 1997 to 1999. If the intent is to duplicate the experience prior to 1997, which is backed by the long-term follow-up and published outcome studies, then the prior prescriptions of 115 Gy should be replaced by 124 Gy to duplicate that experience.

Needs for radioactivity standards and measurements in the life sciences.

For almost 100 years, radioactivity has been one of the major tools in medicine. Therapeutic applications that began with 226Ra and 222Rn implants have rapidly grown to include about 20 radionuclides with radiations specifically chosen to treat at different depths in tissue--ranging from a few millimeters for intravascular therapy to a few centimeters in the case of large solid tumors. Systemic treatments with radiopharmaceuticals have grown from the traditional 131I to more than ten candidate nuclides which are to be labeled to tumor-specific radiopharmaceuticals. Diagnostic radiopharmaceuticals are used in over 13 million procedures in the United States annually. About 40 nuclides are under investigation for these applications including single photon emitters for SPECT (single photon emission computed tomography) and positron emitters for PET (positron emission tomography). In addition to the mainstays of therapeutic and diagnostic radiology, radionuclides are widely used for in vitro tracers in the life sciences and represent one of the main tools in the field of molecular biology.

AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams.

A protocol is prescribed for clinical reference dosimetry of external beam radiation therapy using photon beams with nominal energies between 60Co and 50 MV and electron beams with nominal energies between 4 and 50 MeV. The protocol was written by Task Group 51 (TG-51) of the Radiation Therapy Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol uses ion chambers with absorbed-dose-to-water calibration factors, N(60Co)D,w which are traceable to national primary standards, and the equation D(Q)w = MkQN(60Co)D,w where Q is the beam quality of the clinical beam, D(Q)w is the absorbed dose to water at the point of measurement of the ion chamber placed under reference conditions, M is the fully corrected ion chamber reading, and kQ is the quality conversion factor which converts the calibration factor for a 60Co beam to that for a beam of quality Q. Values of kQ are presented as a function of Q for many ion chambers. The value of M is given by M = PionP(TP)PelecPpolMraw, where Mraw is the raw, uncorrected ion chamber reading and Pion corrects for ion recombination, P(TP) for temperature and pressure variations, Pelec for inaccuracy of the electrometer if calibrated separately, and Ppol for chamber polarity effects. Beam quality, Q, is specified (i) for photon beams, by %dd(10)x, the photon component of the percentage depth dose at 10 cm depth for a field size of 10x10 cm2 on the surface of a phantom at an SSD of 100 cm and (ii) for electron beams, by R50, the depth at which the absorbed-dose falls to 50% of the maximum dose in a beam with field size > or =10x10 cm2 on the surface of the phantom (> or =20x20 cm2 for R50>8.5 cm) at an SSD of 100 cm. R50 is determined directly from the measured value of I50, the depth at which the ionization falls to 50% of its maximum value. All clinical reference dosimetry is performed in a water phantom. The reference depth for calibration purposes is 10 cm for photon beams and 0.6R50-0.1 cm for electron beams. For photon beams clinical reference dosimetry is performed in either an SSD or SAD setup with a 10x10 cm2 field size defined on the phantom surface for an SSD setup or at the depth of the detector for an SAD setup. For electron beams clinical reference dosimetry is performed with a field size of > or =10x10 cm2 (> or =20x20 cm2 for R50>8.5 cm) at an SSD between 90 and 110 cm. This protocol represents a major simplification compared to the AAPM's TG-21 protocol in the sense that large tables of stopping-power ratios and mass-energy absorption coefficients are not needed and the user does not need to calculate any theoretical dosimetry factors. Worksheets for various situations are presented along with a list of equipment required.

Guidance to users of Nycomed Amersham and North American Scientific, Inc., I-125 interstitial sources: dosimetry and calibration changes: recommendations of the American Association of Physicists in Medicine Radiation Therapy Committee Ad Hoc Subcommittee on Low-Energy Seed Dosimetry.

Dose calculations to patients undergoing implantation of 125I interstitial brachytherapy sources are affected by two recent changes in low-energy seed dosimetry: (a) implantation of a new primary air-kerma strength standard at the National Institute of Standards and Technology (NIST) on 1 January 1999 and (b) publication of revised dose-rate distributions in AAPM's Task Group 43 Report. The guidance herein represents AAPM's recommendations for users of 125I interstitial seed products marketed prior to 1 January 1999 (Nycomed Amersham models 6711 and 6702 and North American Scientific, Inc. models 3631 A/S and 3631 A/M. Implementation of Task Group 43 (TG43) 125I dose calculations involves revising data stored in files of radiation treatment planning software and lowering the prescribed dose to be delivered to patients by as much as 15% to avoid modifying the dose actually delivered to patients. The magnitude of the dose prescription change depends on the dosimetry data used prior to TG43 and the implant geometry. Adapting to the revised NIST calibration standard requires the user to increase the dose-rate constant (or its equivalent by 11.5%) but does not require modification of the prescribed dose. Failure to correctly implement these modifications can result in 20% or even 30% errors.

Determination of a calibration factor for the nondestructive assay of Guidant 32P brachytherapy sources.

A calibration factor ('dial setting') for the nondestructive assay of Guidant TiNi-encapsulated 32P intravascular brachytherapy wire sources has been determined for measurements with the Capintec CRC-12 (sic. 'dose calibrator') ionization chamber. The calibration factor was derived from ionization current measurements with the CRC-12 followed by very quantitative, destructive assays of the 32P content in two sources.

National radioactivity standards for beta-emitting radionuclides used in intravascular brachytherapy.

The uses of beta-particle emitting radionuclides in therapeutic medicine are rapidly expanding. To ensure the accurate assays of these nuclides prior to administration, radioactivity standards are needed. The National Institute of Standards and Technology (NIST), the national metrological standards laboratory for the United States, uses high-efficiency liquid scintillation counting to standardize solutions of such beta emitters, including 32P, 90Sr/90Y, and 188Re. Additional measurements are made on radionuclidic impurities, half lives, and other decay-scheme parameters (such as branching decay ratios or gamma-ray abundances) using HPGe detectors and reentrant ionization chambers. Following such measurements at NIST, standards are disseminated in three ways: Standard Reference Materials (SRMs), calibrations for source manufacturers, and calibration factors for commercial instruments. Uncertainties in the activity calibrations for these nuclides are of the order of +/-0.5% (at approximately 1-standard deviation confidence intervals).

Measurement standards for strontium-89 for use in bone palliation.

Strontium-89 standards have been prepared for use in calibrating instruments in the measurement chain from production in reactors to administration in the clinic or radiopharmacy. Alternate reactor production schemes were evaluated to yield high purity 89Sr with minimum 85Sr impurity. Following purification to remove radionuclidic impurities, samples of 89Sr were standardized by high-efficiency liquid-scintillation counting with a relative expanded uncertainty (intended to approximate two standard deviations) of 0.48%. A Standard Reference Material, SRM 4426A, was prepared and distributed to radiopharmaceutical manufacturers and other customers. The standard sources of 89Sr were used in different geometries to calibrate high purity Ge semiconductor detectors, re-entrant ionization chambers and commercial radionuclide calibrators. The latter included Capintec dose calibrators and the Capintec beta C NaI(Tl) scintillation counter.

Report of the ad hoc committee of the AAPM radiation therapy committee on 125I sealed source dosimetry.

PURPOSE: Two developments in 125I-sealed source dosimetry have necessitated swift and accurate implementation of TG43 dosimetry in clinic: (a) the dosimetry constants of 125I endorsed by the AAPM Task Group 43 Report result in calculated dose rate that deviates by as much as 15% from currently accepted dose-rate distributions, and (b) The National Institute of Standards and Technology (NIST) has proposed modifying the 125I air-kerma strength standard by approximately 10%. METHODS AND MATERIALS: The ad hoc committee of AAPM Radiation Therapy Committee describes specific procedures to implement these two developments without causing confusion and mistakes. CONCLUSIONS: Confusion and mistakes may be avoided when the following two general steps are taken: 1) STEP I, TG-43 implementation, and 2) STEP II, new air-kerma strength standard implementation when available from NIST.

Standards for radioiodines.

The National Institute of Standards and Technology, NIST (formerly National Bureau of Standards), is the nation's standards laboratory for civilian technology. NIST develops and maintains the nation's physical measurement standards for medical therapy and diagnostics. For the past 50 years, NIST has developed radioactivity Standard Reference Materials (SRMs) for radioiodines as well as decay-scheme data and test methods for use by the radiopharmaceutical manufacturers in their quality assurance and quality control at the point of manufacture. Methods of standardizing radioiodines include 4 pi beta-gamma coincidence counting (131I), 4 pi beta-gamma anti-coincidence counting (129I), 4 pi(e,x)-gamma coincidence counting (123I), and x-gamma sum peak coincidence counting (125I). NIST also uses sources standardized by these techniques to calibrate re-entrant ionization chambers (dose calibrators) and scintillation counters. SRMs of 131I and 125I are now available on an annual basis, and the long-lived 129I has recently been reissued.

Investigation of applicability of alanine and radiochromic detectors to dosimetry of proton clinical beams.

Cancer therapy studies using proton accelerators are underway in several major medical centers in the U.S., Russia, Japan and elsewhere. To facilitate dosimetry intercomparisons between these laboratories, alanine-based detectors produced at the National Institute of Standards and Technology and commercially available radiochromic films were studied for their possible use as passive transfer dosimeters for clinical proton beams. Evaluation of characteristics of these instruments, including the LET dependence of their response of proton energy, was carried out at the Institute of Theoretical and Experimental Physics. Results of absolute dose measurements were regarded as a preliminary step of dose intercomparison between ITEP and NIST. Measurements made in a number of experiments showed average agreement between the ITEP and NIST dosimetry standards to 2.5%.

Preparation and Calibration of Carrier-Free 209Po Solution Standards.

Carrier-free 209Po solution standards have been prepared and calibrated. The standards, which will be disseminated by the National Institute of Standards and Technology as Standard Reference Material SRM 4326, consist of (5.1597 ±0.0024) g of a solution of polonium in nominal 2 mol · L-1 hydrochloric acid (having a solution density of (1.031±0.004) g · mL-1 at 22 °C) that is contained in 5 mL flame-sealed borosilicate glass ampoules, and are certified to contain a 209Po alpha-particle emission rate concentration of (85.42±0.29) s-1 · g-1 (corresponding to a 209Po activity concentration of (85.83 ±0.30) Bq · g-1) as of the reference time of 1200 EST 15 March 1994. The calibration was based on 4πα liquid scintillation (LS) measurements with two different LS counting systems and under wide variations in measurement and sample conditions. Confirmatory measurements by 2πα gas-flow proportional counting were also performed. The only known radionuclidic impurity, based on α- and photon-emission spectrometry, is a trace quantity of 208Po. The 208Po to 209Po impurity ratio as of the reference time was 0.00124 ±0.00020. All of the above cited uncertainty intervals correspond to a combined standard uncertainty multiplied by a coverage factor of k = 2. Although 209Po is nearly a pure α emitter with only a weak electron capture branch to 209Bi, LS measurements of the 209Po a decay are confounded by an a transition to a 2.3 keV ( Jπ= 1/2-) level in 205Pb which was previously unknown to be a delayed isomeric state.

A radiation accident at an industrial accelerator facility.

On 11 December 1991, a radiation overexposure occurred at an industrial radiation facility in Maryland. The radiation source was a 3-MV potential drop accelerator designed to produce high electron beam currents for materials-processing applications. This accelerator is capable of producing a 25 milliampere swept electron beam that is scanned over a width of 112.5 cm and which emerges from the accelerator vacuum system through a titanium double window assembly. During maintenance on the lower window pressure plate, an operator placed his hands, head, and feet in the beam. This was done with the filament voltage of the electron source turned "off," but with the full accelerating potential on the high voltage terminal. The operator's body, especially his extremities and head, were exposed to electron dark current. In an attempt to reconstruct the accident, radiochromic film and alanine measurements were made with the accelerator operated at two beam currents. Measured dose rates ranged from approximately 40 cGy s-1 inside the victim's shoe to 1,300 cGy s-1 at the hand position. Approximately 3 mo after the accident, it was necessary to amputate the four digits of the victim's right hand and most of the four digits of his left hand. Electron paramagnetic resonance spectrometry, which measures the concentration of radiation-induced paramagnetic centers in calcified tissues, was used to estimate the dose to the victim's extremities. A mean dose estimate of 55.0 +/- 3.5 Gy (95% confidence level) averaged over the mass of the bone was obtained for the victim's left middle finger (middle phalanx).

Radioassays of yttrium-90 used in nuclear medicine.

Yttrium-90 radioassays are required in nuclear medicine at the gigabecquerel activity level (GBq) for measuring injected activity, and at the becquerel level for measuring individual tissue samples in biodistribution studies. A method of standardizing 90Y for activity using high-efficiency liquid-scintillation counting is described. Solution standards were used to establish the calibration factors for commercial radionuclide calibrators. Detection efficiencies are also presented for liquid-scintillation counting, NaI(T1) bremsstrahlung counting and Cerenkov counting.

Experimental validation of radiopharmaceutical absorbed dose to mineralized bone tissue.

Therapeutic and palliative uses of bone-seeking radiopharmaceuticals are undergoing clinical trials for human subjects. Radiation dosimetry for these applications is based on the Medical Internal Radiation Dosimetry (MIRD) schema. An experimental method for dosimetry of bone tissue based on electron paramagnetic resonance (EPR) spectrometry is described. Preliminary results for beagle bone exposed to radiopharmaceuticals under clinical conditions have indicated that the EPR dose measurements give approximately the calculated dose, but suggest that the dose distribution may be non-uniform.