Assessment of stereotactic high-resolution detectors for stereotactic body radiotherapy: comparative analysis between myQA® SRS and Gafchromic EBT-XD films.

The study aimed to evaluate dosimetry systems used for stereotactic body radiotherapy (SBRT), specifically 2D array dosimetry and film dosimetry systems, for exploring their characteristics and clinical suitability. For this, high-resolution myQA SRS detectors and Gafchromic EBT-XD films were employed. Film analysis included net optical density (OD) values depending on energy, dose rate, scanner orientation, scanning side, and post-exposure growth. For myQA SRS, signal values were evaluated in terms of dose rate (400-1400 MU/min) and angular dependence (0-180° at 30° intervals) along with couch angles of 0°, 45°, and 90°. Pre-treatment verification included 32 SBRT patients for whom myQA SRS results were compared with those obtained with Gafchromic EBT-XD films. Analysis revealed less than 1% deviation in net OD for energy and dose rate dependence. Scanner orientation caused 2.5% net OD variation, with minimal differences between film front and back scan orientations (variance < 1.0%). A rapid OD rise occurred within six hours post-exposure, followed by gradual increase. The myQA SRS detector showed - 3.7% dose rate dependence (400 MU/min), while the angular dependence at 90° was - 26.7%. A correction factor effectively reduced these differences to < 1%. For myQA SRS, gamma passing rates were-93.6% (2%/1 mm), while those for EBT-XD films were-92.8%. Improved rates were observed with 3%/1 mm: for myQA SRS-97.9%, and for EBT-XD film-98.16%. In contrast, for 2%/2 mm with 10% threshold, for myQA SRS-97.7% and for EBT-XD film-98.97% were obtained. It is concluded that both myQA SRS detectors and EBT-XD films are suitable for SBRT pre-treatment verification, ensuring accuracy and reliability. However, myQA SRS detectors are preferred over EBT-XD film due to the fact that they offer real-time measurements and user-friendly features.

Dose-rate dependence and IMRT QA suitability of EBT3 radiochromic films for pulse reduced dose-rate radiotherapy (PRDR) dosimetry.

BACKGROUND: Pulsed reduced dose rate (PRDR) is an emerging radiotherapy technique for recurrent diseases. It is pertinent that the linac beam characteristics are evaluated for PRDR dose rates and a suitable dosimeter is employed for IMRT QA. PURPOSE: This study sought to investigate the pulse characteristics of a 6 MV photon beam during PRDR irradiations on a commercial linac. The feasibility of using EBT3 radiochromic film for use in IMRT QA was also investigated by comparing its response to a commercial diode array phantom. METHODS: A plastic scintillator detector was employed to measure the photon pulse characteristics across nominal repetition rates (NRRs) in the 5-600 MU/min range. Film was irradiated with dose rates in the 0.033-4 Gy/min range to study the dose rate dependence. Five clinical PRDR treatment plans were selected for IMRT QA with the Delta4 phantom and EBT3 film sheets. The planned and measured dose were compared using gamma analysis with a criterion of 3%/3 mm. EBT3 film QA was performed using a cumulative technique and a weighting factor technique. RESULTS: Negligible differences were observed in the pulse width and height data between the investigated NRRs. The pulse width was measured to be 3.15 ± 0.01 µ s $\mu s$ and the PRF was calculated to be 3-357 Hz for the 5-600 MU/min NRRs. The EBT3 film was found to be dose rate independent within 3%. The gamma pass rates (GPRs) were above 99% and 90% for the Delta4 phantom and the EBT3 film using the cumulative QA method, respectively. GPRs as low as 80% were noted for the weighting factor EBT3 QA method. CONCLUSIONS: Altering the NRRs changes the mean dose rate while the instantaneous dose rate remains constant. The EBT3 film was found to be suitable for PRDR dosimetry and IMRT QA with minimal dose rate dependence.

Non-conventional, burnt Shorea robusta leaf extract mediated green synthesis of zinc oxide nanoparticles and facile removal of eriochrome black T dye from water.

The present study evaluates the synthesis of zinc oxide nanoparticles (ZnO NPs) using water extract of Sal leaves (Shorea Robusta) for efficient removal of Eriochrome black-T from the water and wastewater. The material is characterized using FESEM, FTIR, EDX, pHzpc, XRD, BET, and TGA analysis. XRD confirmed the synthesis of ZnO with an average crystallite size of 35.24 nm a surface area of 95.939 m2/g and a pore volume of 0.280 cm3/g. The pHzpc of the material is 7.45. The study evaluates the effects of contact time (0-100 min), pH (3-10), concentration (10-50 mg/L), and temperature (298-328K). The Langmuir isotherm model (R2 = 0.993) and pseudo-second-order kinetic model (R2 = 0.998) were found to be the best-fit models. The maximum uptake capacity is 265.554 mg/g. The interaction is spontaneous (ΔG° -12.889 to-14.898 kJ/mol), endothermic ΔH° (4.290-14.216 kJ/mol) with an increase in spontaneity at the solid-liquid junction. The dye-loaded ZnO NPs were successfully regenerated in dilute NaOH solution and 1:1 methanol water, achieving regeneration efficiencies of 78% and 60%, respectively. The reusability of the ZnO NPs was ascertained for up to three consecutive cycles.

A promising method for synthesizing zinc oxide nanoparticles using water extract from burnt Shorea robusta leaves as a precipitating and capping agent has been demonstrated with a high yield. The method is economical and convenient without the use of any chemical precipitating agents. The prepared material efficiently removes Eriochrome black T dye, commonly used in various industries for dyeing silk and nylon, from the solution.We report the first-ever synthesis of ZnO NP using the water extract of burnt leaves, and its application is tested for dye removal. A high surface area of 95.939 m²/g was determined, which is also higher in comparison to many works published. The maximum adsorption capacity recorded for EBT removal is 265.55 mg/g, which is relatively higher than other commercially synthesized zinc oxide.

Patient-specific QA for the HyperArc technique using gafchromic film with multiple calibration methods.

PURPOSE: This study aims to evaluate different methods for calibrating EBT-XD films to develop a precise pre-treatment verification method for stereotactic radiotherapy (SRT) patients using the HyperArc (HA, Varian Medical System) technique. METHODS: Gafchromic EBT-XD films were calibrated using three different approaches: manual calibration, EDW calibration, and PDD calibration. Films were digitalized with an Epson V850 Pro scanner applying the local scanning protocol. Three clinical treatment plans were selected for evaluation. Patient-specific QA films were irradiated in the Mobius MVP phantom and the STEEV phantom. Scanned film images were converted into dose images using the calibration curves. Gamma analysis was performed to compare film dose and TPS calculated dose with various criteria. RESULTS: The scan-to-scan variation was evaluated to be ≤ 0.2%. The accuracy of the calibration curves was verified and the deviation from the converted dose deviates ≤ 3% from the known delivered dose. The gamma passing rate for all calibration methods was found to be over 94% with clinically relevant criteria. EDW calibration demonstrated higher average gamma passing rates compared to the manual method for single target plans, which is 99% ± 1.2% and 98.8% ± 1.5%, respectively. PDD method demonstrated improved agreement for multiple targets with the result of 99.3% ± 0.8%. CONCLUSIONS: The three calibration methods were validated, and they produced accurate calibration curves for EBT-XD films to enable pre-treatment patient-specific QA for stereotactic radiotherapy.

Participants' Underlying Beliefs of Using WIC Electronic Benefit Transfer (EBT) Cards in Stores in New Jersey.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an essential nutrition assistance program that has led to successful health outcomes and healthcare access. To alleviate discomfort associated with WIC shopping at stores, the Congress mandated the transition to electronic benefit transfer (EBT) card system from paper vouchers. This study aimed to explore the experiences of WIC recipients in using EBT cards in stores. WIC recipients from one WIC clinic in northern New Jersey (N = 220) participated in this study. An online survey was framed under the theory of planned behavior to probe their underlying behavioral, normative, and control beliefs of using EBT cards. Using content analyses, dominating themes of each belief were extracted. Participants composed of Hispanic (91.2%) with mean age of 31.68 (SD = 7.69). Most frequently mentioned advantages of using EBT cards were convenience and ease (34.3%) followed by fast and efficient (28.5%). Participants noted that most people would approve of using EBT cards (70%), especially those who receive the benefits and approve of the public assistance (16.7%). They stated that having improved store inventory and an increase in WIC-authorized stores (17.2%) would make the EBT cards use easy. The transition to EBT cars allowed purchase flexibility, alleviated stigma and the purchase process burdens, but the challenges associated with WIC app usage and store specific issues remained. These challenges should be addressed in future intervention to enable WIC recipients more engaged in using the EBT cards.

Characterization of scanning orientation and lateral response artifact for EBT4 Gafchromic film.

The purpose of this study was to investigate the impact of scanning orientation and lateral response artifact (LRA) effects on the dose-response of EBT4 films and compare it with that of EBT3 films. Dose-response curves for EBT3 and EBT4 films in red-green-blue (RGB) color channels in portrait orientation were created for unexposed films and for films exposed to doses ranging from 0 to 1 000 cGy. Portrait and landscape orientations of the EBT3 and EBT4 films were scanned to investigate the scanning orientation effect in the red channel. EBT3 and EBT4 films were irradiated to assess the LRA in the red channel using a field size of 15 × 15 cm2 and delivered doses of 200, 400, and 600 cGy. Films were scanned at the edge of the scanner bed, and the measured doses were compared with the treatment planning system (TPS) calculated doses at a position 100 mm lateral to the scanner center. At a dose of 200 cGy, the differences in optical density (OD) in the red, green, and blue color channels between EBT3 and EBT4 films were 0.035 (24.8%), 0.042 (49.7%), and 0.022 (64.4%), respectively. The EBT4 film slightly improved the scanning orientation compared to the EBT3 film. The OD difference in the different scanning orientations for the EBT3 and EBT4 films was 0.015 (6.8%) and 0.007 (3.9%), respectively, at a dose of 200 cGy. This is equivalent to a 20 or 10 cGy variation at a dose of 200 cGy. Compared with the TPS calculation, the measurement doses for EBT3 and EBT4 films irradiated at 200 cGy were approximately 16% and 13% higher, respectively, at the 100 mm off-centered position. The EBT4 film showed an improvement concerning the impact of LRA compared with the EBT3 film. This study demonstrated that the response of EBT4 film to a dose in the blue channel was less sensitive and showed an improvement in the scanning orientation and LRA effects.

Brinjal (Solanum melongena) stalk waste as an effective scavenger for Eriochrome Black-T from water and wastewater: an approach towards waste to best.

Stalks of brinjal (Solanum melongena), hereinafter SM, have been exercised as an efficient and sustainable adsorbent material for the elimination of Eriochrome Black-T (EBT) from an aqueous solution. The material was characterized by FTIR, FESEM, BET surface area, pHpzc, and proximate analysis. FTIR spectrum suggests the presence of polyphenolic moieties, responsible for successful dye binding. FESEM images show an unprecedented octopus-like texture containing micropores. The central head transforms the architecture of a flower. The evaluated BET surface area of 10.042 m2/g and pore volume 1.055 × 10-2 cm3/g suggest a porous material. The pHpzc of the material was evaluated to be 7.05, and under optimized conditions, the maximum adsorption capacity was found 52.631 mg/g at pH 7. The operational parameters were studied concerning contact time (0-90 min), pH (5-11), initial concentration (10-40 mg/L), and interfering ions (PO4-3, AsO4-3, Hg+2, Pb+2). Adsorption follows Langmuir isotherm best (R2 = 0.996), and pseudo-second-order kinetics (R2 = 0.991) indicate a monolayer and homogeneous adsorption. 83% regeneration was successful with 0.1(M) sodium hydroxide solution. The material can be reused for up to three cycles with 90% efficiency retention. Analysis of EBT containing industrial effluent indicates that 52.62% of EBT can be removed.

Brinjal (Solanum melongena), being one of the most cultivated vegetables around the globe, generates voluminous waste as stalks which warrant proper management. With this aim, such stalks were converted to a phytosorbent and selected for removal of Eriochrome black-T (EBT), a dye that is used by industry persons and science students in their laboratory experiments. The prepared material is highly porous, water-stable, regenerable, and reusable. The protocol is economically viable, easy, and efficient for industrial effluent treatment as well. With a notable maximum adsorption capacity of 52.631 mg/g, the material could offer an ideal choice for dye decontamination.

ß-CD-Induced Precipitation of Eriochrome Black T Recovered via CTAB-Assisted Foam Fractionation for Adsorption of Trace Cu(II).

In order to remove and reuse the ecotoxic dye Eriochrome black T (EBT) from dyeing wastewater, we used a process called cetyltrimethylammonium bromide (CTAB)-assisted foam fractionation. By optimizing this process with response surface methodology, we achieved an enrichment ratio of 110.3 ± 3.8 and a recovery rate of 99.1 ± 0.3%. Next, we prepared composite particles by adding ß-cyclodextrin (ß-CD) to the foamate obtained through foam fractionation. These particles had an average diameter of 80.9 µm, an irregular shape, and a specific surface area of 0.15 m2/g. Using these ß-CD-CTAB-EBT particles, we were able to effectively remove trace amounts of Cu2+ ions (4 mg/L) from the wastewater. The adsorption of these ions followed pseudo-second-order kinetics and Langmuir isotherm models, and the maximal adsorption capacities at different temperatures were 141.4 mg/g at 298.15 K, 143.1 mg/g at 308.15 K, and 144.5 mg/g at 318.15 K. Thermodynamic analysis showed that the mechanism of Cu2+ removal via ß-CD-CTAB-EBT was spontaneous and endothermic physisorption. Under the optimized conditions, we achieved a removal ratio of 95.3 ± 3.0% for Cu2+ ions, and the adsorption capacity remained at 78.3% after four reuse cycles. Overall, these results demonstrate the potential of ß-CD-CTAB-EBT particles for the recovery and reuse of EBT in dyeing wastewater.

Working With Rural Producers to Expand EBT in Farmers' Markets: A Case Study in Hardeman County, Tennessee.

Rural residents tend to eat less fruits and vegetables, placing them at higher risk of chronic diseases compared with urban residents. Farmers' markets can provide increased access to fresh produce for rural communities. Encouraging markets to accept Supplemental Nutrition Assistance Program (SNAP) benefits through Electronic Benefit Transfer (EBT) can expand access to healthy foods to low-income residents. Rural markets are less likely to accept SNAP compared with urban markets. Rural producers have identified lack of knowledge and limited support about the application process as barriers for accepting SNAP. This case study details how our Extension program helped a rural producer through the SNAP application process. We started with a workshop to inform rural producers about the benefits of accepting SNAP. After the workshop, we provided hands-on support and assistance to help one producer navigate the EBT application process as well as how to implement and advertise SNAP at the market. Implications for practitioners about tips to help producers overcome challenges and barriers for EBT acceptance are discussed.

Online Grocery Shopping and the Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer Card (EBT): Perceptions of Head Start Caregivers.

The objective of this study was to explore perceptions of online grocery shopping and the online United States Department of Agriculture's (USDA) Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer card (EBT) program among Head Start caregivers. Three focus groups were conducted between December 2019 and January 2020. Most participants hadn't tried online grocery shopping. Concerns included others choosing perishables, receiving wrong items, and inappropriate substitutes. Perceived benefits included saving time, preventing impulse buys, and eating healthier. Results have broad applicability in the current COVID-19 pandemic where online grocery shopping and the online SNAP EBT program have rapidly expanded across the United States.

A novel automated robust dual-channel EEG-based sleep scoring system using optimal half-band pair linear-phase biorthogonal wavelet filter bank.

Nowadays, the hectic work life of people has led to sleep deprivation. This may further result in sleep-related disorders and adverse physiological conditions. Therefore, sleep study has become an active research area. Sleep scoring is crucial for detecting sleep-related disorders like sleep apnea, insomnia, narcolepsy, periodic leg movement (PLM), and restless leg syndrome (RLS). Sleep is conventionally monitored in a sleep laboratory using polysomnography (PSG) which is the recording of various physiological signals. The traditional sleep stage scoring (SSG) done by professional sleep scorers is a tedious, strenuous, and time-consuming process as it is manual. Hence, developing a machine-learning model for automatic SSG is essential. In this study, we propose an automated SSG approach based on the biorthogonal wavelet filter bank's (BWFB) novel least squares (LS) design. We have utilized a huge Wisconsin sleep cohort (WSC) database in this study. The proposed study is a pioneering work on automatic sleep stage classification using the WSC database, which includes good sleepers and patients suffering from various sleep-related disorders, including apnea, insomnia, hypertension, diabetes, and asthma. To investigate the generalization of the proposed system, we evaluated the proposed model with the following publicly available databases: cyclic alternating pattern (CAP), sleep EDF, ISRUC, MIT-BIH, and the sleep apnea database from St. Vincent's University. This study uses only two unipolar EEG channels, namely O1-M2 and C3-M2, for the scoring. The Hjorth parameters (HP) are extracted from the wavelet subbands (SBS) that are obtained from the optimal BWFB. To classify sleep stages, the HP features are fed to several supervised machine learning classifiers. 12 different datasets have been created to develop a robust model. A total of 12 classification tasks (CT) have been conducted employing various classification algorithms. Our developed model achieved the best accuracy of 83.2% and Cohen's Kappa of 0.7345 to reliably distinguish five sleep stages, using an ensemble bagged tree classifier with 10-fold cross-validation using WSC data. We also observed that our system is either better or competitive with existing state-of-art systems when we tested with the above-mentioned five databases other than WSC. This method yielded promising results using only two EEG channels using a huge WSC database. Our approach is simple and hence, the developed model can be installed in home-based clinical systems and wearable devices for sleep scoring.

In-vitro toxicity assessment of a textile dye Eriochrome Black T and its nano-photocatalytic degradation through an innovative approach using Mf-NGr-CNTs-SnO2 heterostructures.

The present study aimed to assess the in-vitro toxicity of a popular azodye, Eriochrome Black T (EBT) which may be an environmental hazard causing water pollution if released by textile industries as waste effluents to nearby water ponds. We explored the toxic potential of EBT at 200, 400 and 800 µg/ml concentrations, which were selected based on quantification of EBT present in the pond water near carpet industries. We investigated the permeability of EBT across the organ barriers and found it to be 6.48 ± 0.44% at the highest concentration. EBT also showed up to 26.46 ± 0.533% hemolytic potential on human RBCs. MTT assay revealed toxicity of up to 64.9 ± 10.12%. A dose-dependent increase in intracellular ROS levels and Caspase 3/7 activity was observed and confocal microscopy also demonstrated a similar trend of cellular apoptosis indicating ROS mediated induction of apoptosis as a mechanism of EBT induced cytotoxicity. After establishing the toxicity of EBT, an innovative nano-photocatalytic approach for dye remediation was applied by using as synthesized Mf-NGr-CNTs-SnO2 heterostructures. This catalyst showed dye degradation potential of up to 82% in 2 h in the presence of sun light. The degraded dye products were tested to have up to 30% reduced cellular toxicity as compared to the parent compound. This work successfully establishes the toxicity of EBT along with devising an innovative approach towards dye degradation where the catalyst is adhered on melamine foam and not being mixed in the effluents directly, thereby, reducing the possibility of catalyst being leached out into the river water.

Evaluating dosimetric accuracy of the 6 MV calibration on EBT3 film in the use of Ir-192 high dose rate brachytherapy.

PURPOSE: To evaluate the dosimetric accuracy of EBT3 film calibrated with a 6 MV beam for high dose rate brachytherapy and propose a novel method for direct film calibration with an Ir-192 source. METHODS: The 6 MV calibration was performed in water on a linear accelerator (linac). The Ir-192 calibration was accomplished by irradiating the film wrapped around a cylinder applicator with an Ir-192 source. All films were scanned 1-day post-irradiation to acquire calibration curves for all three (red, blue, and green) channels. The Ir-192 calibration films were also used for single-dose comparison. Moreover, an independent test film under a H.A.M. applicator was irradiated and the 2D dose distribution was obtained separately for each calibration using the red channel data. Gamma analysis and point-by-point profile comparison were performed to evaluate the performance of both calibrations. The uncertainty budget for each calibration system was analyzed. RESULTS: The red channel had the best performance for both calibration systems in the single-dose comparison. We found a significant 4.89% difference from the reference for doses <250 cGy using the 6 MV calibration, while the difference was only 0.87% for doses >600 cGy. Gamma analysis of the 2D dose distribution showed the Ir-192 calibration had a higher passing rate of 91.9% for the 1 mm/2% criterion, compared to 83.5% for the 6 MV calibration. Most failing points were in the low-dose region (<200 cGy). The point-by-point profile comparison reported a discrepancy of 2%-3.6% between the Ir-192 and 6 MV calibrations in this low-dose region. The linac- and Ir-192-based dosimetry systems had an uncertainty of 4.1% (k = 2) and 5.66% (k = 2), respectively. CONCLUSIONS: Direct calibration of EBT3 films with an Ir-192 source is feasible and reliable, while the dosimetric accuracy of 6 MV calibration depends on the dose range. The Ir-192 calibration should be used when the measurement dose range is below 250 cGy.

A new analytical model for the response curve in megavoltage photon beams of the radiochromic EBT3 films measured with flatbed scanners.

PURPOSE: The aim of this work is to study a new analytical model which describes the dose-response curve in megavoltage photon beams of the radiochromic EBT3 film measured with two commercially available flatbed scanners. This model takes into account the different increase of the number of two types of absorbents in the film with absorbed dose and it allows to identify parameters that depend on the flatbed scanner and the film model, and parameters that exclusively depend on the production lot. In addition, the new model is also compared with other models commonly used in the literature in terms of its performance in reducing systematic calibration uncertainties. METHODS AND MATERIALS: The new analytical model consists on a linear combination of two saturating exponential functions for every color channel. The exponents modeling the growing of each kind of absorbent are film model and scanner model-dependent, but they do not depend on the manufacturing lot. The proposed model considers the different dose kinetics of each absorbent and the apparent effective behavior of one of the absorbents in the red color channel of the scanner. The dose-response curve has been measured using EBT3 films, a percentage depth dose (PDD) calibration method in a dose range between 0.5 and 25 Gy, and two flatbed scanners: a Microtek 1000 XL and an EPSON 11000 XL. The PDD calibration method allows to obtain a dense collection of calibration points which have been fitted to the proposed response curve model and to other published models. The fit residuals were used to evaluate the performance of each model compared with the new analytical model. RESULTS: The model presented here does not introduce any systematic deviations up to the degree of accuracy reached in this work. The residual distribution is normally shaped and with lower variance than the distributions of the other published models. The model separates the parameters reflecting specific characteristics of the dosimetry system from the linear parameters which depend only on the production lot and are related to the relative abundance of each type of absorbent. The calibration uncertainty is reduced by a mean factor of two by using this model compared with the other studied models. CONCLUSIONS: The proposed model reduces the calibration uncertainty related to systematic deviations introduced by the response curve. In addition, it separates parameters depending on the flatbed scanner and the film model from those depending on the production lot exclusively and therefore provides a better characterization of the dosimetry system and increases its reliability.

[Improvement of Nonuniformity on Flatbed Scanner for Radiochromic Film Dosimetry Using Average Correction Factor with Multi-direction Scan Data].

In order to correct the lateral effect caused by the light source of the flatbed scanner in the Gafchromic film EBT3, the usefulness of the correction method using the average value of the correction coefficient considering the scan directions were evaluated. EBT3 was scanned from four directions to measure the optical density (OD) of the red, blue, and, red/blue components and the correction coefficient were calculated. For the correction coefficients, average values were calculated for the purpose of use, when the scan directions could not be aligned (average lateral effect correction). Correction accuracy was verified with the pass rate of gamma analysis (3 mm/3%, threshold 30%) of the dose distribution using the EBT3 film irradiated with the step pattern. OD of the red, blue, and, red/blue components in the scanning vertical direction tended to be higher in the center than in the peripheral portion. The pass rate of the step pattern was the red component's before correction, from 26.9 to 45.1% (before correction), from 84.1 to 96.7% (after correction), the red/blue component, from 37.6 to 48.4% (before correction) and from 84.4 to 96.7% (after correction). When using the correction coefficient using the average value, the pass rate was 89.8% for the red component and 94.7% for the red/blue component. The lateral effect correction improves the accuracy of the dose distribution verification, and the correction coefficient using the average value is useful when the scanning direction is different from that at the time of obtaining the dose concentration curve.

Assessment of skin dose in breast cancer radiotherapy: on-phantom measurement and Monte Carlo simulation.

AIM: The main purpose of the present study is assessment of skin dose in breast cancer radiotherapy. BACKGROUND: Accurate assessment of skin dose in radiotherapy can provide useful information for clinical considerations. MATERIALS AND METHODS: A RANDO phantom was irradiated using a 6 MV Siemens Primus linac with medial and tangential radiotherapy fields for simulating breast cancer treatment. Dosimetry was also performed on various positions across the fields using an EBT3 radiochromic film. Similar conditions of measurement on the RANDO phantom including field size, irradiation angle, number of fields, etc. were subsequently simulated via the Monte Carlo N-Particle Transport code (MCNP). Ultimately, dose values for corresponding points from both methods were compared. RESULTS: Considering dosimetry using radiochromic films on the RANDO phantom, there were points having underdose and overdose based on the prescribed dose and skin tolerance levels. In this respect, 81.25% and 18.75% of the points had underdose and overdose, respectively. In some cases, several differences were observed between the measurement and the MCNP simulation results associated with skin dose. CONCLUSION: Based on the results of the points which had underdose, it was suggested that a bolus should be used for the given points. With regard to overdose points, it was advocated to consider skin tolerance dose in treatment planning. Differences between the measurement and the MCNP simulation results might be due to voxel size of tally cells in simulations, effect of beam's angle of incidence, validation time of linac's head, lack of electronic equilibrium in the build-up region, as well as MCNP tally type.

Characterization of natural rubber as a bolus material for electron beam radiotherapy.

BACKGROUND: Bolus is an accessory that is directly placed on the surface region to shift the radiation dose up to the skin during high energy photon and electron beam irradiations. The aim of this study was to mold the bolus using natural rubber material and assess both the physical and dosimetric characteristics. MATERIALS AND METHODS: A natural rubber with additional plasticizer material was fabricated as a bolus sheet. The physical properties of natural rubber bolus sheets have been investigated using computed tomography (CT) images. Gafchromic EBT3 films were used to acquire the dose at depth of 0, 2, 3, and 3.5 cm for the 9-MeV therapeutic electron beam. A comparison of our natural rubber bolus sheets to the commercial bolus sheets was studied. RESULTS: The in-house natural rubber bolus sheets with the thickness of 0.32 and 0.52 cm were successfully made. Relative electron density of the two sheets was consistent with each other. However, similar to the commercial boluses, the natural rubber boluses were not provided with the same CT number over the whole sheet. Different bolus material gave different dose at the surface. Both material and thickness of the bolus showed a stronger impact on the dose beyond the depth of maximum dose. CONCLUSION: Because of the density, simple fabrication, and vast availability, natural rubber material has an effective potential to be used as a bolus sheet in radiotherapy.

Energy and dose dependence of GafChromic EBT3-V3 film across a wide energy range.

AIM: To determine the energy and dose dependence of GafChromic EBT3-V3 film over an energy range 0.2 mm Al HVL to 6 MV. BACKGROUND: The decay scheme of a brachytherapy source may be complex and the spectrum of energy can be wide. LiF TLDs are the golden standard recommended for dosimetric measures in brachytherapy, for their energy independence, but TLDs could be not available in some centres. An alternative way to perform dose measurements is to use GafChromic films, but they show energy dependence. METHODS AND MATERIALS: Films have been irradiated at increasing dose with three different beams: 6 MV beam, TPR20, 10 = (0.684 ±â€¯0.01), HVL = (2.00 ±â€¯0.01)mmAl and HVL = (0.20 ±â€¯0.01)mmAl. Calibration curves were generated using the same dose range (0cGy to 850cGy) for the three energies. Using the 6 MV calibration curve as reference, the film response in terms of net optical density (OD) was evaluated. RESULTS: The difference in the calibration curve obtained by irradiating the film with 6 MV and 2 mm Al HVL energy beams is less than 3 %, within the calibration uncertainty, in the dose range 500-850cGy. The OD of EBT3-V3 film is significantly lower at 0.2 mmAl HVL compared to 6 MV, showing differences up to 25 %. CONCLUSION: Within the range 6 MV-2 mm Al HVL and dose higher than 500cGy, GafChromic EBT3-V3 films are energy independent. In this dose range, films can be calibrated in a simple geometry, using a 6 MV Linac beam, and can be used for brachytherapy sources dose measures. The use of EBT3 films can be extended to reference dosimetry in Ir-192 clinical brachytherapy.

6X acuros algorithm validation in the presence of inhomogeneities for VMAT treatment planning.

AIM: To validate the Acuros®XB (AXB) dose calculation algorithm for a 6 MV beam from the Varian TrueBeam treatment units. BACKGROUND: Currently Anisotropic Analytic Algorithm (AAA) is clinically used on authors' department but AXB could replace it for VMAT treatments in regions where inhomogeneities and free air are present. MATERIALS AND METHODS: Two steps are followed in the validation process of a new dose calculation algorithm. The first is to check the accuracy of algorithm for a homogenous phantom and regular fields. Multiple fields of increasing complexity have been acquired using a Mapcheck diode array. The accuracy of the algorithm was evaluated using the gamma analysis method. The second is to validate the algorithm in the presence of heterogeneous media. Planar absolute dose was measured with GafChromic®EBT2 film and was compared with the dose calculated by AXB. Gamma analysis was performed between Mapcheck measurements and AXB dose calculations, at a range of clinical source-surface distance. RESULTS: For SSDs ranging from 80 to 100 cm, the results show a minimum pass rate of 95% between AXB and Mapcheck acquisition. For open 6 MV photon beam interacting with a phantom with an air gap, the agreement after the air gap between AXB and GafChromic®EBT2 is less than 1% in the 3 × 3cm2 field and less than 2% in the 10 × 10 cm2 field. CONCLUSIONS: AXB has advanced modelling of lateral electron transport that enables a more accurate dose calculation in heterogeneous regions and, compared with AAA, improves accuracy between different density interfaces. This will be of particular benefit for head/neck treatments.

Phantom design and dosimetric characterization for multiple simultaneous cell irradiations with active pencil beam scanning.

A new phantom was designed for in vitro studies on cell lines in horizontal particle beams. The phantom enables simultaneous irradiation at multiple positions along the beam path. The main purpose of this study was the detailed dosimetric characterization of the phantom which consists of various heterogeneous structures. The dosimetric measurements described here were performed under non-reference conditions. The experiment involved a CT scan of the phantom, dose calculations performed with the treatment planning system (TPS) RayStation employing both the Pencil Beam (PB) and Monte Carlo (MC) algorithms, and proton beam delivery. Two treatment plans reflecting the typical target location for head and neck cancer and prostate cancer treatment were created. Absorbed dose to water and dose homogeneity were experimentally assessed within the phantom along the Bragg curve with ionization chambers (ICs) and EBT3 films. LETd distributions were obtained from the TPS. Measured depth dose distributions were in good agreement with the Monte Carlo-based TPS data. Absorbed dose calculated with the PB algorithm was 4% higher than the absorbed dose measured with ICs at the deepest measurement point along the spread-out Bragg peak. Results of experiments using melanoma (SKMel) cell line are also presented. The study suggested a pronounced correlation between the relative biological effectiveness (RBE) and LETd, where higher LETd leads to elevated cell death and cell inactivation. Obtained RBE values ranged from 1.4 to 1.8 at the survival level of 10% (RBE10). It is concluded that dosimetric characterization of a phantom before its use for RBE experiments is essential, since a high dosimetric accuracy contributes to reliable RBE data and allows for a clearer differentiation between physical and biological uncertainties.