Liquid embolisation material reduces the delivered radiation dose: a physical experiment.

OBJECTIVE: To test a new hypothesis that the glue/contrast admixture used for embolisation reduces the dose delivered to AVMs using an experimental model. METHOD: A model was created using a block of "solid water" (6 x 5 x 2 cm) with twelve wells of different depths. Different concentrations of the glue admixture (Enbucrilate + Lipiodol) were used. The model was irradiated using a 5MV beam with a clinical LINAC system and the dose was checked upstream and downstream. Dose was measured using Kodak XV film, a Vidar 16 bit film scanner and software for therapeutic film dosimetry measurements (RIT software). RESULTS: The radiation dose varied with the distance beyond the glue solid water interface. For distances of 0, 2 and 5 mm to the film, the mean reduction was 13.65% (SD = 2.94), 6.87% (SD = 1.95) and 1.75% (SD = 1.14), respectively. There was also correlation with the Lipiodol concentration in the mixture. The maximum reductions for 80, 50 and 20% Lipiodol concentrations were 16.1% (SD = 1.32), 14.85% (SD = 0.98) and 10% (SD = 1.21), respectively. There was no correlation between the glue depth and the dose delivered. CONCLUSION: The hypothesis that the glue mixture used for embolisation reduces the radiation dose delivered was experimentally confirmed with this study.

Poster - Thurs Eve-21: Experience with the Velocity(TM) pre-commissioning services.

As the first Canadian users of the Velocity™ program offered by Siemens, we would like to share our experience with the program. The Velocity program involves the measurement of the commissioning data by an independent Physics consulting company at the factory test cell. The data collected was used to model the treatment beams in our planning system in parallel with the linac delivery and installation. Beam models and a complete data book were generated for two photon energies including Virtual Wedge, physical wedge, and IMRT, and 6 electron energies at 100 and 110 cm SSD. Our final beam models are essentially the Velocity models with some minor modifications to customize the fit to our liking. Our experience with the Velocity program was very positive; the data collection was professional and efficient. It allowed us to proceed with confidence in our beam data and modeling and to spend more time on other aspects of opening a new clinic. With the assistance of the program we were able to open a three-linac clinic with Image-Guided IMRT within 4.5 months of machine delivery.

Fractionated (split dose) radiosurgery in patients with recurrent brain metastases: implications for survival.

Radiosurgery is conventionally prescribed for brain metastases with a single dose of radiation. Fractionation has been advocated to improve tumour control. A multivariate analysis of prognostic factors including fractionation has been performed in two consecutive prospective radiosurgery protocols with and without fractionation in order to identify an association, if any, between fractionation and survival. A surgically applied stereotactic head frame was used. Radiosurgery planning was based on a contrast-enhanced CT. Sixty-nine patients underwent the two-fraction regimen and 35 patients had a single treatment. Multivariate analysis showed that the presence of extracranial malignancy, performance status, multiple brain metastases, patient gender and the time from the initial treatment to radiosurgery were independent determinants for survival. Fractionation was also an independent determinant with two-fraction patients surviving a median of 30 weeks versus single fraction patients who survived a median of 16 weeks. Fractionated radiosurgery was associated with improved survival and deserves further investigation.

The regional Monte Carlo method: a dose calculation method based on accuracy requirement.

In this work we propose the regional Monte Carlo (RMC) method of dose calculation. This method combines the Monte Carlo (MC) algorithm and a non-MC algorithm (such as the convolution method) for optimal speed and accuracy in dose calculation for both photon and electron beams and for various irradiation and patient geometries. For specific regions in the geometry where high accuracy is required but difficult to obtain with analytical or empirical calculations, such as critical organs surrounded by complicated inhomogeneities, the MC algorithm is used. For regions with simple geometries, or where a high degree of dose accuracy is not critical, the non-MC algorithm is used to increase speed. There are two aspects of the RMC method. The first one involves determining critical regions and boundaries, and the other involves the actual implementation and mixing of the two computational algorithms. Two examples of different geometries are used to illustrate the different ways to apply the RMC method. The possibility to extend the method to more complicated geometries and inhomogeneities, as well as the ability of the method to incorporate different calculation algorithms, are also discussed.

Monte Carlo based phase-space evolution for electron dose calculation.

A system of computer codes based on phase-space evolution is developed and applied to low energy therapeutic electron beams. Monte Carlo (EGS4) is used to pre-calculate the electron transport and dose deposition in a 0.5 cm width cubic voxel. Dose calculations at larger scales are computed from the pre-calculated data using phase-space evolution. This approach has the theoretical accuracy of Monte Carlo with potentially significant speed gains resulting from the pre-calculation. This study demonstrates the accuracy of this technique while providing a preliminary assessment of the calculation time. For a 4.3 MeV electron beam in water with a 0.5 cm thick slab of either water (homogeneous), air, or aluminum at 1 cm depth, we observe differences relative to Monte Carlo of less than 3% along the central axis for a pencil-beam. For a 3.5 cm x 3.5 cm field we observe a maximum difference on the central axis of 4% in the build-up region and less than 0.1 cm in the fall-off region for all three phantoms. Calculation times are disappointing; however, there is high potential for their reduction to values comparable to or better than condensed history Monte Carlo while retaining clinically acceptable accuracy.