EchoSeed Model 6733 Iodine-125 brachytherapy source: improved dosimetric characterization using the MCNP5 Monte Carlo code.

This study primarily aimed to obtain the dosimetric characteristics of the Model 6733 (125)I seed (EchoSeed) with improved precision and accuracy using a more up-to-date Monte-Carlo code and data (MCNP5) compared to previously published results, including an uncertainty analysis. Its secondary aim was to compare the results obtained using the MCNP5, MCNP4c2, and PTRAN codes for simulation of this low-energy photon-emitting source. The EchoSeed geometry and chemical compositions together with a published (125)I spectrum were used to perform dosimetric characterization of this source as per the updated AAPM TG-43 protocol. These simulations were performed in liquid water material in order to obtain the clinically applicable dosimetric parameters for this source model. Dose rate constants in liquid water, derived from MCNP4c2 and MCNP5 simulations, were found to be 0.993 cGyh(-1) U(-1) (±1.73%) and 0.965 cGyh(-1) U(-1) (±1.68%), respectively. Overall, the MCNP5 derived radial dose and 2D anisotropy functions results were generally closer to the measured data (within ±4%) than MCNP4c and the published data for PTRAN code (Version 7.43), while the opposite was seen for dose rate constant. The generally improved MCNP5 Monte Carlo simulation may be attributed to a more recent and accurate cross-section library. However, some of the data points in the results obtained from the above-mentioned Monte Carlo codes showed no statistically significant differences. Derived dosimetric characteristics in liquid water are provided for clinical applications of this source model.

Independent evaluation of an in-house brachytherapy treatment planning system using simulation, measurement and calculation methods.

Accuracy of treatment planning systems may significantly influence the efficacy of brachytherapy. The purpose of this work is a detailed, varied and independent evaluation of an in-house brachytherapy treatment planning software called STPS. Operational accuracy of STPS was investigated. Geometric tests were performed to validate entry and reconstruction of positional information from scanned orthogonal films. MCNP4C Monte Carlo code and TLDs were used for simulation and experimental measurement, respectively. STPS data were also compared with those from a commercial planning system (Nucletron PLATO). Discrepancy values between MCNP and STPS data and also those of PLATO and STPS at Manchester system dose prescription points (AL and AR) of tandem and ovoid configurations were 2.5% ± 0.5% and 5.4% ± 0.4%, respectively. Similar results were achieved for other investigated configurations. Observed discrepancies between MCNP and STPS at the dose prescription point and at 1 cm from the tip of the vaginal applicator were 4.5% and 25.6% respectively, while the discrepancy between the STPS and PLATO data at those points was 2.3%. The software showed submillimeter accuracy in its geometrical reconstructions. In terms of calculation accuracy, similar to PLATO, as attenuation of the sources and applicator body is not considered, dose was overestimated at the tip of the applicator, but based on the available criteria, dose accuracy at most points were acceptable. Our results confirm STPS's geometrical and operational reliability, and show that its dose computation accuracy is comparable to an established commercial TPS using the same algorithm.

EFFECTIVE DOSE ESTIMATION IN WHOLE BODY 18F-FDG PET/CT IMAGING.

Positron emission tomography-computed tomography (PET-CT) with internal administration of the FDG-18 is characterized as a widespread functional imaging modality in diagnostic radiation medicine, which increases the patient effective doses owing to the presence of internal and external radiation sources. Hence, patient effective dose estimation has been pinpointed as a significant factor in radiation protection assessment. A large number of studies have been published in this regard, and various dosimetry methods have been surveyed. According to our previous research, 10 patients had participated in PET-CT scans with three static time sequences imaging. PET effective doses were estimated using a simple method derived from Anderson et al. and Kaushik et al. coefficients, and the CT effective doses were surveyed with a CTDI phantom and cylindrical ionization chamber. The CT dose was tripled owing to the three static time-sequences imaging. The effective doses were calculated using different coefficients and the results of the PET effective doses were compared. The PET-CT effective dose was varied from 17.14 to 18.42 mSv based on Kaushik et al. coefficients which were measured for one low-dose CT scan. This study aimed to survey simple PET-CT effective dose estimation using three static-time imaging approaches which increases the total patient effective doses.

Effect of age-dependent bone electron density on the calculated dose distribution from kilovoltage and megavoltage photon and electron radiotherapy in paediatric MRI-only treatment planning.

OBJECTIVE: MRI-only treatment planning (TP) can be advantageous in paediatric radiotherapy. However, electron density extraction is necessary for dose calculation. Normally, after bone segmentation, a bulk density is assigned. However, the variation of bone bulk density in patients makes the creation of pseudo CTs challenging. This study aims to assess the effects of bone density variations in children on radiation attenuation and dose calculation for MRI-only TP. METHODS: Bone contents of <15-year-old children were calculated, and substituted in the Oak Ridge National Laboratory paediatric phantoms. The percentage depth dose and beam profile of 150 kVp and 6 MV photon and 6 MeV electron beams were then calculated using Xcom, MCNPX (Monte Carlo N-particle version X) and ORLN phantoms. RESULTS: Using 150 kVp X-rays, the difference in attenuation coefficient was almost 5% between an 11-year-old child and a newborn, and ~8% between an adult and a newborn. With megavoltage radiation, the differences were smaller but still important. For an 18 MV photon beam, the difference of radiation attenuation between an 11-year-old child and a newborn was 4% and ~7.4% between an adult and a newborn. For 6 MeV electrons, dose differences were observed up to the 2 cm depth. The percentage depth dose difference between 1 and 10-year-olds was 18.5%, and between 10 and 15-year-olds was 24%. CONCLUSION: The results suggest that for MRI-only TP of photon- or electron-beam radiotherapy, the bone densities of each age group should be defined separately for accurate dose calculation. Advances in knowledge: This study highlights the need for more age-specific determination of bone electron density for accurate dose calculations in paediatric MRI-only radiotherapy TP.

MRS Shimming: An Important Point Which Should not be Ignored.

BACKGROUND: Proton magnetic resonance spectroscopy (MRS) is a well-known device for analyzing the biological fluids metabolically. Obtaining accurate and reliable information via MRS needs a homogeneous magnetic field in order to provide well-defined peaks and uniform water suppression. There are lots of reasons which can disturb the magnetic field homogeneity which can be corrected by a process known as shimming. This study is intended to recall the importance of shimming and also the significant role of quality control (QC) in achieving an accurate quantification. MATERIAL AND METHOD: An acrylic cylindrical quality control phantom was designed as an analog of brain MRS test phantoms in order to control the accuracy of the obtained signal of a 1.5 T Siemens MRI system which belonged to one of Shiraz hospitals. The signal of NAA, Cho, Cr, the combination of these metabolites and also the distilled water, which was used in this study, was evaluated using separate phantoms. A QC test was performed using Siemens QC phantom and a standard test phantom. RESULTS: The spectrum of our home- made phantom had a significant difference with the expected spectrum. The results of checking the spectrum of metabolites separately also confirmed that there was a systemic problem that affects all the signals originated from all metabolites and even the pure distilled water. The MRS system could not pass QC tests, and peak broadening was common in all spectra. The complex spectrum of standard test phantom was not produced successfully by the MRS system. DISCUSSION: By a simple check of the water peak characteristics, lots of information can be obtained, one of which is the status of shimming that has a considerable effect on the accuracy of the spectrum. Thus, performing an automatic or manual shimming is not a criterion of the spectrum accuracy, and performing a periodic quality control using a test phantom by a specialist is necessary. CONCLUSION: Briefly, the quality control of MRS and all the other clinical device must be taken seriously. Sometimes QC can be the boundary of a right or a wrong decision for the patient.

Revision of orthovoltage chest wall treatment using Monte Carlo simulations.

PURPOSE: Given the high local control rates observed in breast cancer patients undergoing chest wall irradiation by kilovoltage x-rays, we aimed to revisit this treatment modality by accurate calculation of dose distributions using Monte Carlo simulation. METHODS AND MATERIAL: The machine components were simulated using the MCNPX code. This model was used to assess the dose distribution of chest wall kilovoltage treatment in different chest wall thicknesses and larger contour or fat patients in standard and mid sternum treatment plans. Assessments were performed at 50 and 100 cm focus surface distance (FSD) and different irradiation angles. In order to evaluate different plans, indices like homogeneity index, conformity index, the average dose of heart, lung, left anterior descending artery (LAD) and percentage target coverage (PTC) were used. Finally, the results were compared with the indices provided by electron therapy which is a more routine treatment of chest wall. RESULT: These indices in a medium chest wall thickness in standard treatment plan at 50 cm FSD and 15 degrees tube angle was as follows: homogeneity index 2.57, conformity index 7.31, average target dose 27.43 Gy, average dose of heart, lung and LAD, 1.03, 2.08 and 1.60 Gy respectively and PTC 11.19%. Assessments revealed that dose homogeneity in planning target volume (PTV) and conformity between the high dose region and PTV was poor. To improve the treatment indices, the reference point was transferred from the chest wall skin surface to the center of PTV. The indices changed as follows: conformity index 7.31, average target dose 60.19 Gy, the average dose of heart, lung and LAD, 3.57, 6.38 and 5.05 Gy respectively and PTC 55.24%. Coverage index of electron therapy was 89% while it was 22.74% in the old orthovoltage method and also the average dose of the target was about 50 Gy but in the given method it was almost 30 Gy. CONCLUSION: The results of the treatment study show that the optimized standard and mid sternum treatment for different chest wall thicknesses is with 50 cm FSD and zero (vertical) tube angle, while in large contour patients, it is with 100 cm FSD and zero tube angle. Finally, chest wall kilovoltage and electron therapies were compared, which revealed that electron therapy produces a better dose distribution than kilovoltage therapy.

Investigation of LiF, Mg and Ti (TLD-100) Reproducibility.

LiF, Mg and Ti cubical TLD chips (known as TLD-100) are widely used for dosimetry purposes. The repeatability of TL dosimetry is investigated by exposing them to doses of (81, 162 and 40.5 mGy) with 662keV photons of Cs-137. A group of 40 cubical TLD chips was randomly selected from a batch and the values of Element Correction Coefficient (ECC) were obtained 4 times by irradiating them to doses of 81 mGy (two times), 162mGy and 40.5mGy. Results of this study indicate that the average reproducibility of ECC calculation for 40 TLDs is 1.5%, while these values for all chips do not exceed 5%.

A New Approach for Heterogeneity Corrections for Cs-137 Brachytherapy Sources.

BACKGROUND: Most of the current brachytherapy treatment planning systems (TPS) use the TG-43U1 recommendations for dosimetry in water phantom, not considering the heterogeneity effects. OBJECTIVE: The purpose of this study is developing a method for obtaining correction factors for heterogeneity for Cs-137 brachytherapy sources based on pre-calculated MC simulations and interpolation. METHOD: To simulate the effect of phantom heterogeneity on dose distribution around Cs-137 sources, spherical water phantoms were simulated in which there were spherical shells of bone with different thicknesses (0.2cm to 1.8cm with 0.1cm increment) at different distances (from 0.1cm to 10cm, with 0.5cm increment) from the source center. The spherical shells with 0.1cm thickness at different distances from 0.1cm to 10cm were used as tally cells. The doses at these cells were obtained by tally types F6, *F8, and *F4.The results indicate that the percentage differences between the doses in heterogeneity sections with the dose at the same positions inside the homogeneous water phantom vary when the distance of bone section from the source center increases, because of decreasing the average energy of photons reaching the bone layer. Finally, the results of Monte Carlo simulations were used as the input data of MATLAB software, and the percentage dose difference for each new configuration (i.e. different thickness of inhomogenity at different distances from the source) was estimated using the 2D interpolation of MATLAB. RESULTS: According to the results, the algorithm used in this study, is capable of dose estimation with high accuracy. CONCLUSION: The developed method using the results of Monte Carlo simulations and the dose interpolation can be used in treatment planning systems for heterogeneity corrections.

Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code.

BACKGROUND: HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. MATERIALS AND METHODS: In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. RESULTS: The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. CONCLUSION: Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry.

Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media.

To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam.

Investigation of the entrance surface dose and dose to different organs in lumbar spine imaging.

BACKGROUND: Dose assessment using proper dosimeters is especially important in radiation protection optimization and imaging justification in diagnostic radiology. OBJECTIVE: The aim of this study is to obtain the Entrance Skin Dose (ESD) of patients undergoing lumbar spine imaging using two thermoluminescence dosimeters TLD-100 (LiF: Mg, Ti) and GR-200 (LiF: Mg, Cu, P) and also to obtain the absorbed dose to different organs in lumbar spine imaging with several views. METHODS: To measure the ESD values of the patients undergoing lumbar spine imaging, the two TLD types were put on their skin surface. The ESD values for different views of lumbar spine imaging were also measured by putting the TLDs at the surface of the Rando phantom. Several TLD chips were inserted inside different organs of Rando phantom to measure the absorbed dose to different organs in lumbar spine imaging. RESULTS: The results indicate that there is a close agreement between the results of the two dosimeters. Based on the results of this experiment, the ESD dose of the 16 patients included in this study varied between 2.71 mGy and 26.29 mGy with the average of 11.89 mGy for TLD-100, and between 2.55 mGy and 27.41 mGy with the average of 12.32 mGy for GR-200 measurements. The ESDs obtained by putting the two types of TLDs at the surface of Rando phantom are in close agreement. CONCLUSION: According to the results, the GR200 has greater sensitivity than the TLD-100.

Comparative Measurements of Radon Concentration in Soil Using Passive and Active Methods in High Level Natural Radiation Area (HLNRA) of Ramsar.

BACKGROUND: Radon and its daughters are amongst the most important sources of natural exposure in the world. Soil is one of the significant sources of radon/thoron due to both radium and thorium so that the emanated thoron from it may cause increased uncertainties in radon measurements. Recently, a diffusion chamber has been designed and optimized for passive discriminative measurements of radon/thoron concentrations in soil. OBJECTIVE: In order to evaluate the capability of the passive method, some comparative measurements (with active methods) have been performed. METHOD: The method is based upon measurements by a diffusion chamber, including two Lexan polycarbonate SSNTDs, which can discriminate the emanated radon/thorn from the soil by delay method. The comparative measurements have been done in ten selected points of HLNRA of Ramsar in Iran. The linear regression and correlation between the results of two methods have been studied. RESULTS: The results show that the radon concentrations are within the range of 12.1 to 165 kBq/m(3) values. The correlation between the results of active and passive methods was measured by 0.99 value. As well, the thoron concentrations have been measured between 1.9 to 29.5 kBq/m(3) values at the points. CONCLUSION: The sensitivity as well as the strong correlation with active measurements shows that the new low-cost passive method is appropriate for accurate seasonal measurements of radon and thoron concentration in soil.

Nanomaterial containing wall paints can increase radon concentration in houses located in radon prone areas.

BACKGROUND: Nowadays, extensive technological advancements have made it possible to use nanopaints which show exciting properties. In IR Iran excessive radon levels (up to 3700 Bq m-3) have been reported in homes located in radon prone areas. Over the past decades, concerns have been raised about the risk posed by residential radon exposure. OBJECTIVE: This study aims at investigating the effect of using nanomaterial containing wall paints on radon concentration in homes. METHODS: Two wooden model houses were used in this study. Soil samples from Ramsar high background radiation areas were used for simulating the situation of a typical house in radon-prone areas. Conventional water-soluble wall paint was used for painting the walls of the 1st house model; while the 2nd house model was painted with the same wall paint with montmorillonitenanoclay. RESULTS: Three days after sealing the house models, radon level was measured by using a portable radon survey meter. The mean radon level inside the 1st house model (conventional paint) was 515.3 ± 17.8 Bq/m(3) while the mean radon concentration in the 2nd house model (nano-painted house model) was 570.8 ± 18.5 Bq/m(3). The difference between these means was statistically significant (P<0.001). CONCLUSION: To the best of our knowledge, this study is the first investigation on the effect of nano-material containing wall paints on indoor radon concentrations.  It can be concluded that nano-material-containing wall paints should not be used in houses with wooden walls located in radon prone areas. Although the mechanism of this effect is not clearly known, decreased porosity in nano-paints might be a key factor in increasing the radon concentration in homes.

SU-E-T-480: Updating the Planar Patterson-Parker Table Using the TG-43U1 Recommended Dosimetric Parameters.

PURPOSE: In this project, the Patterson-Parker Table has been updated for Cs-137 and Ir-192 sources using their recent TG-43U1 dosimetric data. In addition, dose uniformity for the different loading schemes as a function of implant area has been verified. METHODS: The updated Paterson-Parker tables have been generated for planar implants with Cs-137 and Ir-192 sources using their published TG-43U1 dosimetric parameters. Accuracies of the updated tables were examined by two independent methods, namely, Monte Carlo simulation technique and using a commercially available treatment planning system. In addition to the dose values along the central axis of the implant, dose profiles along two orthogonal directions have been evaluated for selection of the optimum radioactivity distribution in each implant geometry. RESULTS: The results of these investigations show that for the same implant size the mg.hr required for delivery of a given dose with Cs-137 is not identical to that of Ir-192. In addition, some differences between the updated Table and the published Paterson-Parkers Tables have been observed. Independent Monte Carlo simulations and treatment planning data for multi-seed implant indicated the accuracy (less than ±5%) of the updated Table. CONCLUSIONS: This work gives complete updated Paterson-Parker Tables for two of the commonly utilized brachytherapy sources. For delivery of a given dose, significant differences (approximately 35%) have been observed between the traditional Paterson-Parker Table and the updated Tables. These differences are attributed to the differences of tissue attenuation, 2D anisotropy functions as well as the availability of the new source dosimetry.

MO-F-BRB-01: Extracting Material Information from the CT Numbers by Artificial Neural Network for Use in the Monte Carlo Simulations of Tissues in Brachytherapy.

PURPOSE: The Artificial Neural Networks (ANNs) are useful in solving nonlinear processes, without the need to mathematical models of the parameters. Since the relationship between the CT numbers and material compositions is not linear, we can use the AANs for tissue density calibration. The aim of this study is to obtain the composition and mass density of different tissues which are necessary in Monte Carlo simulation of different tissues in brachytherapy treatment planning using ANNs. METHODS: The ANNs were used for mass density calibration. First, the density and composition of several tissues of the body, along with their corresponding CT numbers are used as the training samples. After the network is trained, it would give us the material information, i.e. mass density, and material composition corresponding to each CT numbers. The tissue compositions and densities predicted by the ANN for each CT number, were compared with the real values of such parameters. The tissue parameters predicted by the ANN were used as the phantom materials for obtaining the dose at different distances from Pd-103, and Cs-137 brachytherapy sources. Finally the dose at different distances of the real phantoms were compared with dose around the phantoms predicted by ANN. RESULTS: The ANN used in this study, can predict the material compositions of different tissues precisely. For example, it can give the mass densities of bone, water, and muscle with the percentage differences of 0.62%, - 1.1%, and 0.33% respectively. Comparing the dose distribution inside the water phantom predicted by Artificial Neural Networks and the real water phantom, shows the percentage difference of less than 0.7% and 2% for Cs-137 and Pd-103 respectively. CONCLUSIONS: The ANNs are applicable in determination of tissue parameters from the CT images data, and the material compositions and density obtained by this methods can be used for material definition in Monte Carlo simulations.

SU-E-T-501: Perturbation of TG-43 Parameters of the Brachytherapy Sources under Insufficient Scattering Materials.

PURPOSE: According to the TG-43 recommendations of American Association of Physicist in Medicine (AAPM), the dosimetry parameters of brachytherapy sources are obtained in a water phantom with full scattering conditions. However, in many actual clinical treatments the source are not surrounded with sufficient tissue in all directions to provide the full scattering condition. HDR brachytherapy of the breast or 125I eye-plaque treatment of the ocular melanoma are among the treatment sites that fits this category. In this project, the impact of insufficient phantom material surrounding the 137Cs, 192Ir, and 103Pd brachytherapy source on their TG43 dosimetric characteristics has been investigated. METHODS: In this study, the effect of the insufficient tissue (referred here as missing tissues) around the brachytherapy sources on their TG-43 dosimetric parameters have been investigated using MCNP5 Monte Carlo code. The brachytherapy sources were simulated in different locations inside a cubical water phantom with the dimensions of 30*30*30 cm3 . The variation of the dosimetric parameters of the three sources (i.e. Î>, g(r), and F(r,θ)) were compared to the values from full scattering conditions (i.e. source at the center of the phantom). RESULTS: The results of this study indicate the variation of g(r)and 2D anisotropy function of the brachytherapy sources as a function of the missing tissue thickness. These changes increase by decreasing the energy of the photons emitted by the brachytherapy sources. These differences are mainly due to the lack of full scattering condition for the points near the phantom boundary. CONCLUSIONS: Unlike the published data for symmetric, but insufficient phantom material around the source, the impact of asymmetric phantom materials have been evaluated on dosimetric characteristics of the brachytherapy sources.

Natural and artificial radioactivity distribution in soil of Fars Province, Iran.

Fars province is a large populated large province located in the southwest of Iran. This work presents a study of natural and radioactivity levels in soil samples of this province. For this purpose, 126 samples were gathered from different regions of the province and analysed by gamma spectroscopy to quantify radioactivity concentrations of radionuclides using a high-purity germanium detector and spectroscopy system. The results of this investigation show the average concentrations of 271 ± 28 Bq kg(-1), 6.37 ± 0.5 Bq kg(-1), 14.9 ± 0.9 Bq kg(-1) and 26.3 ± 1.9 Bq kg(-1) for (40)K, (137)Cs, (232)Th and (238)U in soil, respectively. Finally, baseline maps were established for the concentrations of each of the radionuclides in different regions. The absorbed dose rate and the annual effective dose (AED) were also calculated for the radionuclides according to the guidelines of UNSCEAR 2000. The average AED from the radioactivity content of soil in this province was found to be 39.9 ± 1.8 µSv.