Doped silica fibre thermoluminescence measurements of radiation dose in the use of 223Ra.

Using tailor-made sub-mm dimension doped-silica fibres, thermoluminescent dosimetric studies have been performed for α-emitting sources of 223RaCl2 (the basis of the Bayer Healthcare product Xofigo®). The use of 223RaCl2 in the palliative treatment of bone metastases resulting from late-stage castration-resistant prostate cancer focuses on its favourable uptake in metabolically active bone metastases. Such treatment benefits from the high linear energy transfer (LET) and associated short path length (<100µm) of the α-particles emitted by 223Ra and its decay progeny. In seeking to provide for in vitro dosimetry of the α-particles originating from the 223Ra decay series, investigation has been made of the TL yield of various forms of Ge-doped SiO2 fibres, including photonic crystal fibre (PCF) collapsed, PCF uncollapsed, flat and single-mode fibres. Irradiations of the fibres were performed at the UK National Physical Laboratory (NPL). Notable features are the considerable sensitivity of the dosimeters and an effective atomic number Zeff approaching that of bone, the glass fibres offering the added advantage of being able to be placed directly into liquid. The outcome of present research is expected to inform development of doped fibre dosimeters of versatile utility, including for applications as detailed herein.

A novel technique to optimise the length of a linear accelerator treatment room maze without compromising radiation protection.

Simulations with the FLUktuierende KAskade (FLUKA) Monte Carlo code were used to establish the possibility of introducing lead to cover the existing concrete walls of a linear accelerator treatment room maze, in order to reduce the dose of the scattered photons at the maze entrance. In the present work, a pilot study performed at Singleton Hospital in Swansea was used to pioneer the use of lead sheets of various thicknesses to absorb scattered low energy photons in the maze. The dose reduction was considered to be due to the strong effect of the photoelectric interaction in lead resulting in attenuation of the back-scattered photons. Calculations using FLUKA with mono-energetic photons were used to represent the main components of the x-ray spectrum up to 10 MV. Mono-energetic photons were used to enable the study of the behaviour of each energy component from the associated interaction processes. The results showed that adding lead of 1 to 4 mm thickness to the walls and floor of the maze reduced the dose at the maze entrance by up to 80%. Subsequent scatter dose measurements performed at the maze entrance of an existing treatment room with lead sheet of 1.3 mm thickness added to the maze walls and floor supported the results from the simulations. The dose reduction at the maze entrance with the lead in place was up to 50%. The variation between simulation and measurement was attributed to the fact that insufficient lead was available to completely cover the maze walls and floor. This novel proposal of partly, or entirely, covering the maze walls with lead a few millimetres in thickness has implications for the design of linear accelerator treatment rooms since it has the potential to provide savings, in terms of space and costs, when an existing maze requires upgrading in an environment where space is limited and the maze length cannot be extended sufficiently to reduce the dose.

Dose reduction of scattered photons from concrete walls lined with lead: Implications for improvement in design of megavoltage radiation therapy facility mazes.

PURPOSE: This study explores the possibility of using lead to cover part of the radiation therapy facility maze walls in order to absorb low energy photons and reduce the total dose at the maze entrance of radiation therapy rooms. METHODS: Experiments and Monte Carlo simulations were utilized to establish the possibility of using high-Z materials to cover the concrete walls of the maze in order to reduce the dose of the scatteredphotons at the maze entrance. The dose of the backscatteredphotons from a concrete wall was measured for various scattering angles. The dose was also calculated by the FLUKA and EGSnrc Monte Carlo codes. The FLUKA code was also used to simulate an existing radiotherapy room to study the effect of multiple scattering when adding lead to cover the concrete walls of the maze. Monoenergetic photons were used to represent the main components of the x ray spectrum up to 10 MV. RESULTS: It was observed that when the concrete wall was covered with just 2 mm of lead, the measured dose rate at all backscattering angles was reduced by 20% for photons of energy comparable to Co-60 emissions and 70% for Cs-137 emissions. The simulations with FLUKA and EGS showed that the reduction in the dose was potentially even higher when lead was added. One explanation for the reduction is the increased absorption of backscatteredphotons due to the photoelectric interaction in lead. The results also showed that adding 2 mm lead to the concrete walls and floor of the maze reduced the dose at the maze entrance by up to 90%. CONCLUSIONS: This novel proposal of covering part or the entire maze walls with a few millimeters of lead would have a direct implication for the design of radiation therapy facilities and would assist in upgrading the design of some mazes, especially those in facilities with limited space where the maze length cannot be extended to sufficiently reduce the dose.

Dose reduction of scattered photons from concrete walls lined with lead: Implications for improvement in design of megavoltage radiation therapy facility mazes.

PURPOSE: This study explores the possibility of using lead to cover part of the radiation therapy facility maze walls in order to absorb low energy photons and reduce the total dose at the maze entrance of radiation therapy rooms. METHODS: Experiments and Monte Carlo simulations were utilized to establish the possibility of using high-Z materials to cover the concrete walls of the maze in order to reduce the dose of the scattered photons at the maze entrance. The dose of the backscattered photons from a concrete wall was measured for various scattering angles. The dose was also calculated by the FLUKA and EGSnrc Monte Carlo codes. The FLUKA code was also used to simulate an existing radiotherapy room to study the effect of multiple scattering when adding lead to cover the concrete walls of the maze. Monoenergetic photons were used to represent the main components of the x ray spectrum up to 10 MV. RESULTS: It was observed that when the concrete wall was covered with just 2 mm of lead, the measured dose rate at all backscattering angles was reduced by 20% for photons of energy comparable to Co-60 emissions and 70% for Cs-137 emissions. The simulations with FLUKA and EGS showed that the reduction in the dose was potentially even higher when lead was added. One explanation for the reduction is the increased absorption of backscattered photons due to the photoelectric interaction in lead. The results also showed that adding 2 mm lead to the concrete walls and floor of the maze reduced the dose at the maze entrance by up to 90%. CONCLUSIONS: This novel proposal of covering part or the entire maze walls with a few millimeters of lead would have a direct implication for the design of radiation therapy facilities and would assist in upgrading the design of some mazes, especially those in facilities with limited space where the maze length cannot be extended to sufficiently reduce the dose.

Preclinical assessment of a new magnetic resonance-based technique for determining bone quality by characterization of trabecular microarchitecture.

The utility of HR-CT to study longitudinal changes in bone microarchitecture is limited by subject radiation exposure. Although MR is not subject to this limitation, it is limited both by patient movement that occurs during prolonged scanning at distal sites, and by the signal-to-noise ratio that is achievable for high-resolution images in a reasonable scan time at proximal sites. Recently, a novel MR-based technique, fine structure analysis (FSA) (Chase et al. Localised one-dimensional magnetic resonance spatial frequency spectroscopy. PCT/US2012/068284 2012, James and Chase Magnetic field gradient structure characteristic assessment using one-dimensional (1D) spatial frequency distribution analysis. 7932720 B2, 2011) has been developed which provides both high-resolution and fast scan times, but which generates at a designated set of spatial positions (voxels) a one-dimensional signal of spatial frequencies. Appendix 1 provides a brief introduction to FSA. This article describes an initial exploration of FSA for the rapid, non-invasive characterization of trabecular microarchitecture in a preclinical setting. For L4 vertebrae of sham and ovariectomized (OVX) rats, we compared FSA-generated metrics with those from CT datasets and from CT-derived histomorphometry parameters, trabecular number (Tb.N), bone volume density (BV/TV), trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp). OVX caused a reduction of the higher frequency structures that correspond to a denser trabecular lattice, while increasing the preponderance of lower frequency structures, which correspond to a more open lattice. As one example measure, the centroid of the FSA spectrum (which we refer to as fSAcB) showed strong correlation in the same region with CT-derived histomorphometry values: Tb.Sp: r -0.63, p < 0.001; Tb.N: r 0.71, p < 0.001; BV/TV: r 0.64, p < 0.001, Tb.Th: r 0.44, p < 0.05. Furthermore, we found a 17.5% reduction in fSAcB in OVX rats (p < 0.0001). In a longitudinal study, FSA showed that the age-related increase in higher frequency structures was abolished in OVX rats, being replaced with a 78-194% increase in lower frequency structures (2.4-2.8 objects/mm range), indicating a more sparse trabecular lattice (p < 0.05). The MR-based fine structure analysis enables high-resolution, radiation-free, rapid quantification of bone structures in one dimension (the specific point and direction being chosen by the clinician) of the spine.

Glass beads and Ge-doped optical fibres as thermoluminescence dosimeters for small field photon dosimetry.

An investigation has been made of glass beads and optical fibres as novel dosimeters for small-field photon radiation therapy dosimetry. Commercially available glass beads of largest dimension 1.5 mm and GeO2-doped SiO2 optical fibres of 5 mm length and 120 µm diameter were characterized as thermoluminescence dosimeters. Results were compared against Monte-Carlo simulations with BEAMnrc/DOSXYZnrc, EBT3 Gafchromic film, and a high-resolution 2D-array of liquid-filled ionization chambers. Measurements included relative output factors and dose profiles for square-field sizes of 1, 2, 3, 4, and 10 cm. A customized Solid-Water® phantom was employed, and the beads and fibres were placed at defined positions along the longitudinal axis to allow accurate beam profile measurement. Output factors and the beam profile parameters were compared against those calculated by BEAMnrc/DOSXYZnrc. The output factors and field width measurements were found to be in agreement with reference measurements to within better than 3.5% for all field sizes down to 2 cm2 for both dosimetric systems, with the beads showing a discrepancy of no more than 2.8% for all field sizes. The results confirm the potential of the beads and fibres as thermoluminescent dosimeters for use in small photon radiation field sizes.

The VANILLA sensor as a beam monitoring device for X-ray radiation therapy.

Cancer treatments such as intensity-modulated radiotherapy (IMRT) require increasingly complex methods to verify the accuracy and precision of the treatment delivery. In vivo dosimetry based on measurements made in an electronic portal imaging device (EPID) has been demonstrated. The distorting effect of the patient anatomy on the beam intensity means it is difficult to separate changes in patient anatomy from changes in the beam intensity profile. Alternatively, upstream detectors scatter and attenuate the beam, changing the energy spectrum of the beam, and generate contaminant radiation such as electrons. We used the VANILLA device, a Monolithic Active Pixel Sensor (MAPS), to measure the 2D beam profile of a 6 MV X-ray beam at Bristol Hospital in real-time in an upstream position to the patient without clinically significant disturbance of the beam (0.1% attenuation). MAPSs can be made very thin (~20 µm) with still a very good signal-to-noise performance. The VANILLA can reconstruct the collimated beam edge with approximately 64 µm precision.

Determination of the energy response of closely tissue-equivalent diamond dosimeters for radiotherapy dosimetry.

A monoenergetic X-ray syncrotron source was used to determine the energy response of a diamond detector in the range 5-25 keV, clarifying the elemental composition of the detector. The response is shown to be influenced by the detector housing and electrical contacts. A model for the energy response of the detector is determined that is valid in the 5 keV-15 MeV with an accuracy of 5% and therefore can be used to correct the dosimeter response to low-energy and scattered radiation.

Review of doped silica glass optical fibre: their TL properties and potential applications in radiation therapy dosimetry.

Review is made of dosimetric studies of Ge-doped SiO(2) telecommunication fibre as a 1-D thermoluminescence (TL) system for therapeutic applications. To-date, the response of these fibres has been investigated for UV sources, superficial X-ray beam therapy facilities, a synchrotron microbeam facility, electron linear accelerators, protons, neutrons and alpha particles, covering the energy range from a few eV to several MeV. Dosimetric characteristics include, reproducibility, fading, dose response, reciprocity between TL yield and dose-rate and energy dependence. The fibres produce a flat response to fixed photon and electron doses to within better than 3% of the mean TL distribution. Irradiated Ge-doped SiO(2) optical fibres show limited signal fading, with an average loss of TL signal of ~0.4% per day. In terms of dose response, Ge-doped SiO(2) optical fibres have been shown to provide linearity to x and electron doses, from a fraction of 1 Gy up to 2 kGy. The dosimeters have also been used in measuring photoelectron generation from iodinated contrast media; TL yields being some 60% greater in the presence of iodine than in its absence. The review is accompanied by previously unpublished data.

An investigation of the thermoluminescence of Ge-doped SiO2 optical fibres for application in interface radiation dosimetry.

We investigate the ability of high spatial resolution (∼120 µm) Ge-doped SiO2 TL dosimeters to measure photoelectron dose enhancement resulting from the use of a moderate to high-Z target (an iodinated contrast media) irradiated by 90 kVp X-rays. We imagine its application in a novel radiation synovectomy technique, modelled by a phantom containing a reservoir of I2 molecules at the interface of which the doped silica dosimeters are located. Measurements outside of the iodine photoelectron range are provided for using a stepped-design that allows insertion of the fibres within the phantom. Monte Carlo simulation (MCNPX) is used for verification. At the phantom medium I2-interface additional photoelectron generation is observed, ∼60% above that in the absence of the I2, simulations providing agreement to within 3%. Percentage depth doses measured away from the iodine contrast medium reservoir are bounded by published PDDs at 80 kVp and 100 kVp.

Investigation and development of a measurement technique for the spatial energy distribution of home-use intense pulsed light (IPL) systems.

The current annual global market for domestic intense pulse light (IPL) hair removal has been estimated at US $1 billion and continues to grow. The five key technological parameters to consider in cutaneous photo-therapy are wavelength, energy density, pulse duration, spot size and spatial distribution. Uneven energy distribution in the treatment area can result in over or under treatment of the treated area, thus causing dissatisfaction or harmful results. This study investigates a method of measuring and analysing spatial distribution of a number of commercially available home-use IPL systems as there is no quantitative method to conduct and compare spatial distribution at the present. Using a CCD camera and a phosphorescent screen to extend the pulse duration, averaged time frames were analysed using Matlab mathematic software. 3D graphical images of the data are presented to show the spatial profile of five commercially available IPL systems. Numerical analysis of the data was completed by two methods, arithmetical mean roughness and path difference.

Treatment planning for a synchrotron-based radiotherapy modality.

Contrast enhanced radiotherapy (CERT) achieves biologically localised dose enhancement through the preferential uptake of high-Z media by the tumour cells. A treatment planning software originally developed for boron neutron capture therapy (BNCT) has been developed to evaluate treatment plans for CERT. A realistic test case of a brain tumour based on actual CT scans was used to calculate dose distributions with and without the presence of an iodinated contrast medium. An enhancement of dose was observed at all depths with the introduction of iodine and the corresponding dose enhancement factors were calculated for various concentrations.

X-ray synchrotron microdosimetry: experimental benchmark of a general-purpose Monte Carlo code.

Microdosimetry is useful in mixed-field radiation treatment strategies but relies on an understanding of electron physics at sub-micron dimensions. Monochromatic synchrotron light will be valuable in the development of Monte Carlo models of radiation transport at this length scale. In addition, synchrotron light offers new treatment strategies benefiting from high degrees of brightness and coherence including binary therapies such as photoactivation therapy (PAT) utilising photoelectric enhancement occurring in the kilovoltage range. Microdosimetric spectra for monoenergetic beams have been obtained in the range 15-33 keV with a tissue-equivalent proportional counter (TEPC) and have been compared to Monte Carlo calculations based on atomic models initially. Transport of electrons in molecular systems can also be considered where fundamental interaction data are also obtainable in synchrotron beams via photon scattering experiments utilising the optical model. In the absence of data from liquid water systems, MOSFET and silica-based optical fibre TLD are emerging contenders for experimental verification of microdosimetric spectra in the solid-state and glassy-state phases, respectively.

Microdosimetry in X-ray synchrotron based binary radiation therapy.

Synchrotron light offers new radiation treatment strategies including binary therapies, such as photoactivation therapy (PAT) where the photoelectric interaction in a high-Z material leads to a localized source of high LET particles, e.g. Auger electrons. Microdosimetry is used to assess the efficacy of mixed field and binary radiation treatments and describes the clustering of radiation damage on the micron scale due to particles of differing type, energy and origin. The modeling of microdosimetric distributions in varying treatment scenarios, however, relies on accurate electron physics at sub-micron dimensions, challenging the capabilities of current Monte Carlo codes. The intercomparison of measured and modeled microdosimetric spectra from monochromatic X-rays therefore provides a test of electron transport algorithms and fundamental cross-section data. Microdosimetric spectra are compared for Monte Carlo calculations based on atomic and molecular models of the solid and gaseous components of the detector and to spectra calculated in a water medium for spherical volumes of 100 and 1000 nm diameter. Radiobiology experiments show substantial variation in the photon radiobiological effect (RBE) for end-points, such as cell death and transformation. The microdosimetric model indicates that, with careful tuning of the synchrotron energy, a radiobiological advantage can be achieved in photoactivation therapies in addition to dose enhancement.

Response corrections for solid-state detectors in megavoltage photon dosimetry.

Solid-state detectors offer high sensitivity, stability and resolution and are frequently the dosimeter of choice for on-line dosimetry and small field therapies such as stereotactic radiosurgery. The departure from tissue equivalence of many solid-state devices, including diodes and MOSFETs, has to be carefully considered at lower energies and for Compton scattered radiation where the strongly Z-dependent photoelectric effect is significant. A modification of Burlin cavity theory is proposed that treats primary and scatter photon spectra separately and this has been applied to determine the correction factors for diode detector measurements of 6 and 15 MV linear accelerator beams. Uncorrected, an unshielded diode overestimates the dose at depth by as much as 15% for the 6 MV beam. The model predicts the effect to within 1% for both energies offering a basis for the correction of diodes for use in routine dosimetry.

Response of silicon diode dosemeters to scattered radiation from megavoltage photon beams.

Dose response effects of diodes due to the high atomic number of silicon relative to water are investigated. While quality chances in the primary component of a megavoltage beam with depth are minimal. Compton scattered photons are shown to have a substantial effect on the quality leading to their enhanced absorption in silicon via the photoelectric effect. Monte Carlo methods were used to study and model this phenomenon. Measurements of dose rate, depth and field size dependence are examined for commercially available diode detectors and ionisation chambers.

Application of diamond detectors to the dosimetry of 45 and 100 kvp therapy beams: comparison with a parallel-plate ionization chamber and Monte Carlo.

Diamond detectors have become an increasingly popular dosimetric method where either high spatial resolution is required or where photon or electron spectra are likely to change with depth or field size. However, little work has been previously reported for superficial energies. This paper reports the response of a commercially available diamond detector (PTW Freiburg/IPTB Dubna) at 45 kVp (0.55 mm Al first HVL) and 100 kVp (2.3 mm Al first HVL) including dose and dose-rate linearity, percentage depth-dose and output factors as a function of applicator size. Comparisons are made with Br J. Radiol. supplement 25 data, measurements using a PTW parallel-plate chamber and Monte Carlo simulations based on spectra determined from transmission measurements in aluminium. Excellent agreement was obtained for percentage depth-dose curves between Monte Carlo and diamond after correcting for sublinearity of the dose-rate response and energy dependence of the diamond detector. However, significant differences were noted between diamond/Monte Carlo and the parallel-plate chamber, which is attributed to the perturbation caused by the polyethylene base of the chamber

Experimental simulation of A-bomb gamma ray spectra for radiobiology studies.

Improved radiation protection of humans requires a better understanding of the mechanisms of radiation action and accurate estimates of radiation risk for both internal and external radiations. The Japanese atomic bomb survivors represent one of the most important sources of human data on the late carcinogenic effects of ionising radiations. The present study was undertaken to investigate whether it would be possible to use hospital radiotherapy/radiobiology equipment to mimic the spectra encountered in Hiroshima and Nagasaki. The estimated total gamma ray fluence spectra (including both prompt and delayed photons) at both Hiroshima and Nagasaki, for distances of 500, 1000, 1500 and 2000 m have been evaluated using DS86 data and previously unpublished information for delayed gamma radiations which constitute the major contribution to survivor doses. Monte Carlo (EGS4) simulations were performed to transport these photons through the body in order to investigate the variation in electron spectra for various body organs. The electron spectra obtained for these fluences at, for example, the colon, have been matched with combinations of electron spectra produced by linear accelerators to within 5% SD. These will, for the first time, enable a direct link to be made between radiobiological studies (for example, on mammography spectra) and the epidemiological data from Japan, which currently underpin radiation risk estimates.

Monte Carlo methods for the in vivo analysis of cisplatin using X-ray fluorescence.

A Monte Carlo method has been used to model the measurement of cisplatin uptake with in vivo X-ray fluorescence. A user-code has been written for the EGS4 Monte Carlo system that incorporates linear polarisation and multiple element fluorescence extensions. The yield of fluorescent photons to the mainly Compton scattered background is computed for our detector arrangement. The detector consists of a mutually orthogonal arrangement of X-ray tube, aluminium polariser and high purity germanium scintillation detector. The influence of tube voltage on the minimum detectable concentration is modelled for 100 through 150 kVp X-radiation. The code is able to predict absorbed dose to the patient which will influence the optimal choice of tube voltage. The influence of alterations to collimator design and scatterer construction can also be examined. A minimum detectable concentration of 50 ppm is determined from measurements with a 115 kVp X-ray source and a 615 ppm cisplatin sample in a water phantom.

High-resolution dosimetry using radiochromic film and a document scanner.

A method of reading exposed radiochromic film is described which has significant advantages over conventional densitometry. The method employs a document scanner and associated software for imaging the film. The resulting images are easily analysed using standard software to yield high-resolution dose maps. A calibration was performed which relates scanner signal to dose, allowing for the determination of dose at any point on an exposed film. Results obtained using a broad-band densitometer are compared to those where the scanner has been used. The technique was used to measure the dose distribution around a COMS-type ophthalmic applicator.