The effect of nanoparticle coating on biological, chemical and biophysical parameters influencing radiosensitization in nanoparticle-aided radiation therapy.

Nanoparticle-based composites have the potential to meet requirements for radiosensitization in both therapeutic and diagnostic applications. The radiosensitizing properties of nanoparticles could be reliant on the nature of their coating layer. Any gains in reduced toxicity and aggregation or improved delivery to tumor cells for coated nanoparticles must be weighed against the loss of dose enhancement. The radiosensitization potential of coated NPs is confirmed by numerous studies but in most of them, the coating layer is mostly applied to reduce toxicity of the NPs and for stability and biocompatibility aims. While the direct effects of the coating layer in radiosensitization-were ignored and not considered. This review provides an overview of double-edged impact of nanoparticle coating on the radiosensitization potential of nanostructures and discusses the challenges in choosing appropriate coating material in the aim of achieving improved radioenhancement. Coating layer could affect the radiosensitization processes and thereby the biological outcomes of nanoparticle-based radiation therapy. The physicochemical properties of the coating layer can be altered by the type of the coating material and its thickness. Under low-energy photon irradiation, the coating layer could act as a shield for nanoparticles capable of absorb produced low-energy electrons which are important levers for local and nanoscopic dose enhancement. Also, it seems that the coating layer could mostly affect the chemical process of ROS production rather than the physicochemical process. Based on the reviewed literature, for the irradiated coated nanoparticles, the cell survival and viability of cancer cells are decreased more than normal cells. Also, cell cycle arrest, inhibition of cell proliferation, DNA damage, cell death and apoptosis were shown to be affected by coated metallic nanoparticles under irradiation.

Radiation-induced dormancy of intracerebral melanoma: endotoxin inflammation leads to both shortened tumor dormancy and long-term survival with localized senescence.

Radiation therapy (RT) treats approximately half of all cancers and most brain cancers. RT is variably effective at inducing a dormant tumor state i.e. the time between RT and clinical recurrence of tumor growth. Interventions that significantly lengthen tumor dormancy would improve long-term outcomes. Inflammation can promote the escape of experimental tumors from metastatic dormancy in the lung. Previously we showed intracerebral B16F10 melanoma dormancy varied with RT dose; 20.5 Gy induced dormancy lasted ~ 2 to 4 weeks-sufficient time to study escape from dormancy. Tumors were followed over time using bioluminescence. Surprisingly, some tumors in endotoxin-treated mice exited from dormancy slower; a large fraction of the mice survived more than 1-year. A cohort of mice also experienced an accelerated exit from dormancy and increased mortality indicating there might be variation within the tumor or inflammatory microenvironment that leads to both an early deleterious effect and a longer-term protective effect of inflammation. Some of the melanin containing cells at the site of the original tumor were positive for senescent markers p16, p21 and ßGal. Changes in some cytokine/chemokine levels in blood were also detected. Follow-up studies are needed to identify cytokines/chemokines or other mechanisms that promote long-term dormancy after RT.

Nanoscopic biodosimetry using plasmid DNA in radiotherapy with metallic nanoparticles.

Nanoscopic lesions (complex damages), are the most lethal lesions for the cells. As nanoparticles have become increasingly popular in radiation therapy and the importance of analyzing nanoscopic dose enhancement has increased, a reliable tool for nanodosimetry has become indispensable. In this regard, the DNA plasmid is a widely used tool as a nanodosimetry probe in radiobiology and nano-radiosensitization studies. This approach is helpful for unraveling the radiosensitization role of nanoparticles in terms of physical and physicochemical effects and for quantifying radiation-induced biological damage. This review discusses the potential of using plasmid DNA assays for assessing the relative effects of nano-radiosensitizers, which can provide a theoretical basis for the development of nanoscopic biodosimetry and nanoparticle-based radiotherapy.

The use of the normal tissue non-complication probability (NTCP0) in the safety evaluations as a new alternative of assessing the side-effects of the radiation oncology treatments.

PURPOSE: To encourage the use of the NTCP0 for evaluating safety as a new alternative of assessing the S-Es of the radiation oncology treatments; and the use of the 'NTCP0cal' methodology that calculates/estimates NTCP0. METHOD: Revisions of studies related to use of the NTCP in the evaluations of S-Es. Development of the first version of the Matlab application of our methodology, which provides three options, two of them employ the well-known aspects of a phenomenological model, or the relationship with the TNTCP; where NTCP0 = 100%-TNTCP; and the third option determines NTCP0 from an assumed NTCP discrete probabilistic distribution from the binomial distribution, where one of its parameters is automatically defined from a databased of the Disease locations Vs. Late complications. RESULT: As result of revisions of some QUANTEC studies, we can say that: (1) The majority of current NTCP models are DVH-based; (2) The risk of toxicity is the way of evaluating the S-Es of the radiation oncology treatments; and (3) The NTCP are used mainly for evaluations of individual or principal complications or Endpoints of the radiation treatments. The 'NTCP0cal' Matlab application developed in this study has three calculation options. Two of the options provide additional graphical information about the distributions. CONCLUSIONS: The NTCP0 is a new radiobiological concept, its introduction let to correct some current P + and UTCP formulations, and will allow evaluating S-Es in whatever activity involving ionizing radiation, like radiation treatments; and its phenomenological model function of dose prescribed (D = n*d) will allow calculating values of NTCP0 for a range of dose per fraction (d) in a treatment with a determined number of fractions (n), or for range of n for a constant d. The DVH is irrelevant for this model. For whatever radiation treatment given to a population of similar patients under similar circumstances, the NTCP0 is calculated as ratio of the number of patients without acute/late complications and total of them. When this number is unknown, then NTCP0 can be obtained using the 'NTCP0cal' application.

Radiobiological modeling of acute esophagitis after radiation therapy of head, neck, and thorax tumors: The influence of chemo-radiation.

Aim: The aim of this study was to evaluate the performance of various radiobiological models in predicting the occurrence of acute esophagitis (AE) during radiation therapy (RT) of head, neck, and thoracic tumors with concurrent and sequential chemotherapy. According to recent studies, the probability of AE following RT by normal tissue complication probability models is predictable. Materials and Methods: A total of 100 patients with nasopharynx, larynx, Hodgkin's lymphoma, spinal metastases, and oral cavity and lung tumors were included in the study. Half of these patients were treated by concurrent chemo-radiotherapy (Con. CRT) and the other half were treated by radiotherapy alone or sequential chemo-radiotherapy (RT + seq. CRT). Radiobiological models of several types were used as follows,: Lyman-generalized equivalent uniform dose (gEUD), Lyman-MED, log-logistic, logit, and logistic. Parameters were estimated using maximum likelihood estimation, and models were compared using Akaike information criteria. Results: Based on follow-up data, the behavior of dose-response curves differed markedly between the Con. CRT and RT + seq. CRT groups. The best fit with clinical results was offered by the Lyman-MED model for the Con. CRT group and the Lyman-gEUD model for the RT + seq. CRT group. Depending on the model used, the parameter of D50 was considerably lower (up to three times) in the Con. CRT group compared to the RT + seq. CRT group. Conclusions: The incidence of AE significantly differed between the two treatment groups in all the models. New parameter estimates could be used for predicting the probability of acute esophagitis after chemo-RT.

The use of the normal tissue non-complication probability (NTCP0) methodology as a new alternative of assessing side-effects in brachytherapy treatments.

Background: The NTCP methodology evaluating side-effects (S-Es) was initially used in radiotherapy (RT), and later was extended to brachytherapy (BT). The NTCP0 methodology has been recently introduced in RT. Given the advantages, this methodology could replace NTCP. Materials and methods: Revisions of studies related to use of NTCP in the evaluations of S-Es in BT. Development of the first versions of two Matlab applications of the NTCP0 methodology. These applications have three options. Two of them employ the well-known aspects of a phenomenological model, or the probabilistic relationship between NTCP0 and total NTCP (TNTCP) that is the sum(NTCP(x i )) i: i th complication i:1..nc: Number of complications; where NTCP0 = 100% - TNTCP; and the third option assumes a NTCP(xi) discrete probabilistic distribution generated by the binomial distribution, where one of its parameters is automatically obtained from a databased of the Disease locations Vs. Late complications. Results: The NTCP0cal and NTCP0calDr Matlab applications have been developed, and respectively used for fractional continuous low dose-rate BT. Conclusions: NTCP0 is defined as the ratio of the number of patients without acute/late complications and total of them, and also can be obtained using our Matlab applications. NTCP0 works do not disregard the last 10-15 years of NTCP research; but NTCP0 was not considered during these years. A generic example was used for showing the variations of the late complications and NTCP0 for a BT treatment of a constant number of fractions and six different dose per fraction values.

Accelerated brachytherapy with the Xoft electronic source used in association with iodine, gold, bismuth, gadolinium, and hafnium nano-radioenhancers.

PURPOSE: The current study was designed to calculate the dose enhancement factor (DEF) of iodine (I), gold (Au), bismuth (Bi), gadolinium (Gd), and hafnium (Hf) nanoparticles (NP)s by Monte Carlo (MC) modeling of an electronic brachytherapy source in resection cavities of breast tumors. METHODS AND MATERIALS: The GEANT4 MC code was used for simulation of a phantom containing a water-filled balloon and a Xoft source (50 kVp) to irradiate the margins of a resected breast tumor. NPs with a diameter of 20 nm and concentrations from 1 to 5% w/w were simulated in a tumor margin with 5 mm thickness as well as a hypothetical breast model consisting of spherical island-like residual tumor-remnants. The DEFs for all NPs were calculated in both models. RESULTS: In the margin-loaded model, for the concentration of 1% w/w heavy atom, DEFs of 2.5, 2.3, 2.1, 2, and 1.7 were calculated for Bi, Au, I, Hf, and Gd NPs (descending order), which increased, almost linearly with concentration for all NPs. Moreover, normal tissue dose behind the NP-loaded margin declined significantly depending on NP type and concentration. When modeling residual tumor islands, DEF values were very close to the margin-loaded values except for Bi and I, where DEFs of 2.55 and 1.7 were seen, respectively. CONCLUSIONS: Considerable dose enhancements were obtained for the heavy atom NPs studied in the partial breast brachytherapy with a Xoft electronic source. In addition, normal tissue doses were lowered in the points beyond the NP-loaded margin. The findings revealed promising outcomes and the probability of improved tumor control for NP-aided brachytherapy with the Xoft electronic source.

Predicting the Risk of Radiation Pneumonitis and Pulmonary Function Changes after Breast Cancer Radiotherapy.

BACKGROUND: Radiotherapy plays an important role in the treatment of breast cancer. In the process of radiotherapy, the underling lung tissue receives higher doses from treatment field, which led to incidence of radiation pneumonitis. OBJECTIVE: The present study aims to evaluate the predictive factors of radiation pneumonitis and related changes in pulmonary function after 3D-conformal radiotherapy of breast cancer. MATERIAL AND METHODS: In prospective basis study, thirty-two patients with breast cancer who received radiotherapy after surgery, were followed up to 6 months. Respiratory symptoms, lung radiologic changes and pulmonary function were evaluated. Radiation pneumonitis (RP) was graded according to common terminology criteria for adverse events (CTCAE) version 3.0. Dose-volume parameters, which included percentage of lung volume receiving dose of d Gy (V5-V50) and mean lung dose (MLD), were evaluated for RP prediction. Pulmonary function evaluated by spirometry test and changes of FEV1 and FVC parameters. RESULTS: Eight patients developed RP. Among the dose-volume parameters, V10 was associated to RP incidence. When V10<40% and V10≥40% the incidences of RP were 5.26% and 61.54%, respectively. The FEV1 and FVC had a reduction 3 and 6 months after radiotherapy, while only FEV1 showed significant reduction. The FEV1 had more reduction in the patients who developed RP than patients without RP (15.25±3.81 vs. 9.2±0.93). CONCLUSION: Pulmonary function parameters, especially FEV1, significantly decreased at 3 and 6 months after radiotherapy. Since most patients with breast cancer who developed RP did not show obvious clinical symptoms, so spirometry test is beneficial to identify patients with risk of radiation pneumonitis.

Shielding characteristics of nanocomposites for protection against X- and gamma rays in medical applications: effect of particle size, photon energy and nano-particle concentration.

In recent decades, nanomaterials have been extensively investigated for many applications. Composites doped with different metal nanoparticles have been suggested as effective shielding materials to replace conventional lead-based materials. The use of concretes as structural and radiation protective material has been influenced by the addition of nanomaterials. Several elements with high atomic number and density, such as lead, bismuth, and tungsten, have the potential to form nanoparticles that offer significant enhancements in the shielding ability of composites. Their performance for a range of particle concentrations, particle sizes, and photon energies have been investigated. This review is an attempt to gather the data published in the literature about the application of nanomaterials in radiation shielding, including the use of polymer composites and concretes for protection against X-rays and gamma radiation.

Design and fabrication of a Nano-based neutron shield for fast neutrons from medical linear accelerators in radiation therapy.

BACKGROUND: Photo-neutrons are produced at the head of the medical linear accelerators (linac) by the interaction of high-energy photons, and patients receive a whole-body-absorbed dose from these neutrons. The current study aimed to find an efficient shielding material for fast neutrons. METHODS: Nanoparticles (NPs) of Fe3O4 and B4C were applied in a matrix of silicone resin to design a proper shield against fast neutrons produced by the 18 MeV photon beam of a Varian 2100 C/D linac. Neutron macroscopic cross-sections for three types of samples were calculated by the Monte Carlo (MC) method and experimentally measured for neutrons of an Am-Be source. The designed shields in different concentrations were tested by MCNPX MC code, and the proper concentration was chosen for the experimental test. A shield was designed with two layers, including nano-iron oxide and a layer of nano-boron carbide for eliminating fast neutrons. RESULTS: MC simulation results with uncertainty less than 1% showed that for discrete energies and 50% nanomaterial concentration, the macroscopic cross-sections for iron oxide and boron carbide at the energy of 1 MeV were 0.36 cm- 1 and 0.32 cm- 1, respectively. For 30% nanomaterial concentration, the calculated macroscopic cross-sections for iron oxide and boron carbide shields for Am-Be spectrum equaled 0.12 cm- 1 and 0.15 cm- 1, respectively, while they are 0.15 cm- 1 and 0.18 cm- 1 for the linac spectrum. In the experiment with the Am-Be spectrum, the macroscopic cross-sections for 30% nanomaterial concentration were 0.17 ± 0.01 cm- 1 for iron oxide and 0.21 ± 0.02 cm- 1 for boron carbide. The measured transmission factors for 30% nanomaterial concentration with the Am-Be spectrum were 0.71 ± 0.01, 0.66 ± 0.02, and 0.62 ± 0.01 for the iron oxide, boron carbide, and double-layer shields, respectively. In addition, these values were 0.74, 0.69, and 0.67, respectively, for MC simulation for the linac spectrum at the same concentration and thickness of 2 cm. CONCLUSION: Results achieved from MC simulation and experimental tests were in a satisfactory agreement. The difference between MC and measurements was in the range of 10%. Our results demonstrated that the designed double-layer shield has a superior macroscopic cross-section compared with two single-layer nanoshields and more efficiently eliminates fast photo-neutrons.

Proposals of models for new formulations of the current complication-free cure (P+) and uncomplicated tumor control probability (UTCP) concepts, and total normal tissue complication probability of late complications.

This study proposes phenomenological models for total normal tissue complication probability (TNTCP) and NTCP0. NTCP0 is a new acronym for reformulating the current complication-free cure (P+) and uncomplicated tumor control probability (UTCP) concepts, and TNTCP will reformulate the current NTCP involving multiple organs at risks. The current probabilistic concepts are incoherently formulated with mathematical operations of tumor control probability (TCP) and normal tissue complication probability (NTCP) that are associated with different stochastic processes and random variables. NTCP0 is equal to NTCP0 (normal tissue non-complication probability) that is calculated as the ratio of a number of patients of a population without late complications and a total of them. As a cumulative distribution function (CDF) of late complications, TNTCP = sum(NTCPi), where NTCPi is the NTCP of the ith late complication. TNTCP is also a new acronym, and the probabilistic complement of NTCP0, then NTCP0 = 100% - TNTCP. The NTCP0/TNTCP (D(d)) proposing models are based on the relationship between the NTCP0/TNTCP and total dose (D = n×d; where d = dose per fraction, and n = number of fractions). TNTCP(D) model will be correlated with LKB model (the normal CDF) that is an increasing function; and NTCP0(D) model with a decreasing function, which additionally will define clear limits of three possible regions for NTCP0: 0 and 100% deterministic, and a stochastic. These models are function D, which is widely used for characterizing radiation therapies.

In vitro and in vivo characteristics of doxorubicin-loaded cyclodextrine-based polyester modified gadolinium oxide nanoparticles: a versatile targeted theranostic system for tumour chemotherapy and molecular resonance imaging.

ß-Cyclodextrine-based polyester was coated on the surface of gadolinium oxide nanoparticles (NPs) and then functionalised with folic acid to produce an efficient pH-sensitive targeted theranostic system (Gd2O3@PCD-FA) for doxorubicin delivery and magnetic resonance imaging (MRI). Gd2O3@PCD-FA was fully characterised by FTIR, vibrating sample magnetometer, TGA, XRD, SEM and TEM analyses. The dissolution profile of DOX showed a pH sensitive release. No significant toxicity was observed for the targeted NPs (Gd2O3@PCD-FA) and DOX-loaded NPs inhibiting M109 cells viability more efficiently than free DOX. Moreover, the negligible hemolytic activity of the targeted NPs showed their appropriate hemocompatibility. The preferential uptake was observed for the developed Gd2O3@PCD-FA-DOX NPs in comparison with Dotarem using T1- and T2-weighted MRI in the presence of folate receptor-positive and folate receptor-negative cancer cells (M109 and 4T1, respectively). Furthermore, in vivo studies revealed that Gd2O3@PCD-FA-DOX not only exhibited considerably relaxivity performance as a contrast agent for MRI, but also improved in vivo anti-tumour efficacy of the system. The results suggest that Gd2O3@PCD-FA-DOX improves its therapeutic efficacy in the treatment of solid tumours and also reduces the adverse effects, so it could be proposed as a promising drug delivery system for chemotherapy and molecular imaging diagnosis in MRI.

Influence of the size of nano- and microparticles and photon energy on mass attenuation coefficients of bismuth-silicon shields in diagnostic radiology.

Recent studies have shown that the particle size of the shielding material and photon energy has significant effects on the efficiency of radiation-shielding materials. The purpose of the current study was to investigate the shielding properties of the bismuth-silicon (Bi-Si) composite containing varying percentages of micro- and nano-sized Bi particles for low-energy X-rays. Radiation composite shields composed of nano- and micro-sized Bi particles in Si-based matrix were constructed. The mass attenuation coefficients of the designed shields were experimentally assessed for diagnostic radiology energy range. In addition, the mass attenuation coefficients of the composite were comprehensively investigated using the MCNPX Monte Carlo (MC) code and XCOM. The X-ray attenuation for two different micro-sized Bi composites of radii of 50 µm and 0.50 µm showed enhancement in the range of 37-79% and 5-24%, respectively, for mono-energy photons (60-150 keV). Furthermore, the experimental and MC results indicated that nano-structured composites had higher photon attenuation properties (approximately 11-18%) than those of micro-sized samples for poly-energy X-ray photons. The amount of radiation attenuation for lower energies was more than that of higher energies. Thus, it was found that the shielding properties of composites were considerably strengthened by adding Bi nano-particles for lower energy photons.

Layered double hydroxide nanoparticles as an appealing nanoparticle in gene/plasmid and drug delivery system in C2C12 myoblast cells.

Gene and drug delivery systems need crucial update in the issue of nanocarriers. Layered double hydroxides (LDHs) are known as biocompatible inorganic lamellar nanomaterials with versatile properties. In the present study, Zn/Al-LDH nanoparticle was synthesized and characterized by FTIR, XRD, SEM, TEM and Zeta potential tests and then intercalated with valproate and methyldopa by co-precipitation and ion exchange methods. These nanocarriers were applied as high activity nanolayers-based delivery systems. On the other hand, Zn/Al-LDH + plasmid/gene (pCEP4/Cdk9) evaluated on C2C12 myoblast cells. Co-operation loading indicated high efficiency of sorting and release of drugs. Additionally, the Real-Time PCR and Western blotting results for plasmid-gene (pCEP4/Cdk9) delivery showed that Zn/Al-LDH nanoparticles can be used as an effective carrier in cellular uptake and release of genes for gene therapy. Easy and cost-effective production of Zn/Al-LDH nanoparticles proposed them as potential alternatives for the traditional routs of drug/gene delivery.

Iron oxide/bismuth oxide nanocomposites coated by graphene quantum dots: "Three-in-one" theranostic agents for simultaneous CT/MR imaging-guided in vitro photothermal therapy.

BACKGROUND: The all-in-one nanoprobes (NPs) have drawn biomedical attention in the cancer therapy field due to simultaneously combing the capabilities of therapeutic and diagnostic methods into a single nanoprobe. METHOD: In this study, we developed a theranostic probe based on superparamagnetic iron oxide (SPIO) and bismuth oxide (Bi2O3) with graphene quantum dots (GQDs) coating to investigate the physical properties for in vitro CT/MR dual-modal biomedical imaging and cancer-specific photothermal therapy (PTT). RESULT: The GQDs-Fe/Bi nanocomposites showed strong light absorbance profile with wide-band in the near-infrared region, without any sharp peak or decline. The highest photo-to-thermal conversion efficacy (η), was found to be 31.8% with the high photostability upon the irradiation of NIR 808-nm laser. The results of in vitro photothermal ablation of cancerous cells demonstrated that the cells significantly killed in the presence of NPs (∼53.4%) with a dose-dependent manner in comparison to only laser group (3.0%). In GQDs-Fe/Bi nanocomposites, Bi with a high atomic number (Z = 83) exhibited a superior X-ray attenuation capability (175%) than the clinical CT agent-used dotarem, also, SPIO with excellent magnetization property showed strong T2-relaxation shortening capability (r2 = 62.34 mM-1.s-1) as a contrast agent for CT/MR imaging. CONCLUSION: Our results demonstrate that the developed NPs can incorporate dual-modality imaging capability into a photo absorber for CT/MR imaging-guided tumor PTT.

Determination of the dose enhancement exclusively in tumor tissue due to the presence of GNPs.

PURPOSE: The purpose of this study is to investigate the differences between obtained percentage dose enhancements in areas around nanoparticles in GNPs (gold nanoparticles) enriched medium and percentage dose enhancements in the entire GNPs enriched medium including nanoparticles region. METHODS AND MATERIALS: To verify the accuracy of Ir-192 source simulation, the obtained values of air kerma strength, dose rate constants, and radial dose functions were compared against previously published results. Then a 1 cm × 1 cm× 1 cm tumor volume loaded with different diameters of GNPs were considered at a source to the tumor center of 1 cm. Finally, dose enhancements were obtained for 50, 100 and 200 nm GNPs as a function of various concentrations of the radiosensitizer and depth in phantom. RESULTS: Calculations showed that dose enhancement could be customized by varying the size of nanoparticles, concentrations and radial distance from the source. The highest PDEGNP (The ratio of the increased deposited dose in the tumor region to the dose deposition in the no nano gold-containing structure) was acquired by 50 nm nanoparticles, 30 mg/g concentrations and in the highest distance from the source. (PDEGNP) and (PDEaround-GNP) due to the presence of 7-30 mg/g concentration of GNPs ranged from 3-18.19% and 3.45-21.13%, respectively. The results of this study revealed that the correlation is significant at the 0.01 level and there is a non-negligible difference (up to 3%) between (Daround-GNP)and (DGNP). CONCLUSION: By considering exclusively determination of dose enhancement in the just tumor tissue, calculating (Daround-GNP) Instead of DGNP may be a strategy for clinical use of nanoparticles in the radiation therapy. The results showed that with the increasing trend of dose enhancement in the GNPs loaded-tumor, dose enhancement decreases with an increase in the size of GNPs.

AN ANALYSIS OF OPERATING PHYSICIAN AND PATIENT RADIATION EXPOSURE DURING RADIAL CORONARY ANGIOPLASTIES.

The objective of this study was to evaluate radiation exposure levels in conjunction with operator dose implemented, patient vascular characteristics, and other technical angiographic parameters. In total, 756 radial coronary angioplasties were evaluated in a major metropolitan general hospital in Tabriz, Iran. The classification of coronary lesions was based on the ACC/AHA system. One interventional cardiologist performed all of the procedures using a single angiography unit. The mean kerma-area product and mean cumulative dose for all cases was 5081 µGy m2 and 814.44 mGy, respectively. Average times of 26.16 and 9.1 min were recorded for the overall procedure and fluoroscopy, respectively. A strong correlation was demonstrated between types of lesions, number of stents and vessels treated in relation to physician radiation exposure. It was determined that operator radiation exposure levels for percutaneous coronary interventions lesions (complex) were higher than that of simple and moderate lesions. In addition, operator radiation exposure levels increased with the treatment of more coronary vessels and implementation of additional stents.

Shielding properties of the ordinary concrete loaded with micro- and nano-particles against neutron and gamma radiations.

The shielding properties of ordinary concrete doped with some micro and nano scaled materials were studied in the current study. Narrow beam geometry was simulated using MCNPX Monte Carlo code and the mass attenuation coefficient of ordinary concrete doped with PbO2, Fe2O3, WO3 and H4B (Boronium) in both nano and micro scales was calculated for photon and neutron beams. Mono-energetic beams of neutrons (100-3000 keV) and photons (142-1250 keV) were used for calculations. The concrete doped with nano-sized particles showed higher neutron removal cross section (7%) and photon attenuation coefficient (8%) relative to micro-particles. Application of nano-sized material in the composition of new concretes for dual protection against neutrons and photons are recommended. For further studies, the calculation of attenuation coefficients of these nano-concretes against higher energies of neutrons and photons and different particles are suggested.

A REVIEW ON THE RADIATION THERAPY TECHNOLOGIST RECEIVED DOSE FROM INDUCED ACTIVATION IN HIGH-ENERGY MEDICAL LINEAR ACCELERATORS.

Despite all advantages for using high-energy photons for radiotherapy, high-energy photon beams (≥10 MV) induce photonuclear and neutron capture interactions, which result in producing radionuclide byproducts inside the Linac head and bunker, exposing radiation therapy technologists (RTTs) and patients to excessive dose. By the use of higher photon energy, greater number of monitor unit, greater field size and adding treatment accessories, induced dose rate become greater in the isocenter mainly due to activation of high-Z materials inside the Linac head. Activated radionuclides disintegrate with γ, ß+ and ß- rays with half-lives between 2 min up to more than 5 years. Several researches estimated additional exposure to an RTT depend on treatment strategies, beam energy, and delay time before entrance to the treatment room between 0.1 and 4.9 mSv/y and proposed at least 2 min delay before entrance to the treatment room after treatments with high-energy photon beams.

An overview on small-field dosimetry in photon beam radiotherapy: Developments and challenges.

Small fields are more repeatedly used for radiation therapy as small segments in intensity-modulated radiotherapy or as in the form of independent fields in stereotactic radiosurgery and other novel equipment such as cyberknife and tomotherapy. Nevertheless, the application of small fields for radiotherapy of lung makes the dose calculation and planning inaccurate due to the existence of electronic disequilibrium and intrinsic deficiencies within most of the analytical dose calculation algorithms. The current review attempts to gather the information in this regard and focuses on the current progresses and retaining issues associated with this type of photon beams.