Dosimetric parameters of the new design 103Pd brachytherapy source based on Monte Carlo study

Dosimetric Evaluation and Clinical Application of Radioactive Iodine-125 Brachytherapy Stent in the Treatment of Malignant Esophageal Obstruction

Objective

To evaluate the dosimetric characteristics and the clinical application of radioactive iodine-125 brachytherapy stent (RIBS) in malignant esophageal obstruction.

Methods

The dose distribution of RIBS with different seed spacing, diameter and length was studied by treatment planning system (TPS) calculation, thermoluminescence dosimeter (TLD) measurement and Monte Carlo (MC) data fitting. And the data of esophageal cancer patients who were treat with this type of RIBS was analyzed retrospectively.

Results

Doses around the RIBS calculated by the TPS lay between those measured by the TLDs and those simulated by the MC, and the differences between the three methods were significant (p<0.05), the overall absolute dose differences among the three methods were small. Dose coverage at 1.5 cm from the center was comprehensive when the activity reached 0.6 mCi. Both the conformability and the uniformity of isodose lines produced by a seed spacing of 1.0 cm were superior to those produced by a seed spacing of 1.5 cm. The data of 50 patients treated with RIBS was analyzed. They were followed up until February 2020 when all of the patients died. The overall improvement rate of dysphagia after RIBS implant was 90%. Moderate and severe complications with an incidence of more than 10% were hematemesis (28%), pain (20%), and lung infection (10%). Stent restenosis occurred in 4 patients at a median interval of 108 days from the procedure. The overall incidence of fatal complications was 38% (including hematemesis, infection and asphyxia). The median survival time of patients with and without a history of radiotherapy were 3.4 months and 6 months, respectively, the difference of which was significant (p=0.021). No other factors affecting survival were identified. For patients with and without a history of radiotherapy, the incidences of fatal complications were 51.7% and 19%, respectively (p=0.019). No correlation between dose and stent restenosis was found.

Conclusion

TPS calculations are suitable for clinical applications. RIBS can effectively alleviate obstructive symptoms for patients with malignant esophageal obstruction, but the incidence of fatal complications was high, care should be taken when choosing this treatment.

Design and optimizing a novel ocular plaque brachytherapy with dual-core of 103Pd and 106Ru

In recent decades, eye plaques of brachytherapy have been extensively used as primary treatment as well as a complementary treatment for ocular cancer. The purpose of this study is the development of the eye plaque brachytherapy throughout a new design of eye plaque by combining the COMS plaque and the CCB BEBIG plaque loaded by IRA1-¹⁰³Pd and ¹⁰⁶Ru, respectively. A new dual-core plaque with a diameter of 20 mm was designed in the way that the BEBIG plaque with a diameter of 20 mm loaded by ¹⁰⁶Ru plate is attached to the COMS plaque with a diameter of 20 mm loaded by 24 of IRA1-¹⁰³Pd seeds. Dose calculations for the new plaque were performed by using the MCNP5 code. Dose calculations of dual-core plaque including ¹⁰³Pd seeds (gamma) and ¹⁰⁶Ru plate (beta) were separately done for the sake of MCNP constraints in gamma and beta particle transfer simultaneously. The new dual-core plaque delivers a much higher dose rate to the tumor compared with every single plaque, while the dose rate reached to healthy tissues is slightly higher than each plaque separately. Of course, this is acceptable because the treatment time reduces and subsequently the error in radiation therapy reduces.

Dosimetric characteristics of accelerated partial breast irradiation by interstitial multicatheter brachytherapy with intraoperative free-hand implantation in the treatment of early breast cancer

Introduction

The aim of this study is to evaluate the characteristics of the dosimetry and the skin dose of interstitial brachytherapy by the use of the free‐hand implantation technique toward the treatment of early breast cancer.

Materials & Methods

Seventeen patients diagnosed with early breast cancer were selected for the study. The implantation of the catheters for postoperative interstitial brachytherapy was performed using the free‐hand technique. The total tumor dose to the tumor cavity plus 2 cm margin was 3400 cGy, twice daily for 10 fractions in 5 days. The dosage to the target and the organ at risk (OAR) were recorded for analysis. The skin dose of the patient and the phantom were measured with Gafchromic film (EBT3) and the results were compared with the skin dose calculated by the brachytherapy treatment planning system.

Results

The median conformal index is 94% (range 89%–99%), and the median homogeneity index is 71%. The median skin dose measured from the skin of the patients was 20.1% lower than the skin dose calculated from the treatment planning system and consistent with the phantom surface measurement experiment. There were no grade 3 or above acute toxicity recorded.

Conclusions

Interstitial brachytherapy by the use of the free‐hand implantation technique for early breast cancer is feasible and avoids the need for a second surgical intervention. The calculated skin dose was overestimated by at least 20%. The results of this study may help in building a modification model for the prediction of skin toxicity in any future study.

A Monte Carlo study on the radio-sensitization effect of gold nanoparticles in brachytherapy of prostate by 103Pd seeds

103Pd seed is being used for prostate brachytherapy. Additionally, the dose enhancement effect of gold nanoparticles (GNP) has been reported in previous studies. The aim of this study was to characterize the dosimetric effect of gold nanoparticles in brachytherapy with a 103Pd source. Two brachytherapy seeds including 103 Pd source was simulated using MCNPX Monte Carlo code. The seeds’ models were validated by comparing the MC with reported results. Then, GNPs (10 nm in diameter) with a concentration of 7mg Au/g were simulated uniformly inside the prostate of a humanoid computational phantom. Additionally, the dose enhancement factor (DEF) of nanoparticles was calculated for both modeled brachytherapy seeds. A good agreement was found between the MC calculated and the reported dosimetric parameters. For both seeds, an average DEF of 23% was obtained in tumor volume for prostate brachytherapy. The application of GNPs in conjunction with 103Pd seed in brachytherapy can enhance the delivered dose to the tumor and consequently leads to better treatment outcome.

DOSE COEFFICIENTS FOR LIVER CHEMOEMBOLISATION PROCEDURES USING MONTE CARLO CODE

The aim of the present study is the estimation of radiation burden during liver chemoembolisation procedures. Organ dose and effective dose conversion factors, normalised to dose-area product (DAP), were estimated for chemoembolisation procedures using a Monte Carlo transport code in conjunction with an adult mathematical phantom. Exposure data from 32 patients were used to determine the exposure projections for the simulations. Equivalent organ (H_T) and effective (E) doses were estimated using individual DAP values. The organs receiving the highest amount of doses during these exams were lumbar spine, liver and kidneys. The mean effective dose conversion factor was 1.4 Sv Gy^-1 m^-2 Dose conversion factors can be useful for patient-specific radiation burden during chemoembolisation procedures.

Effective dose in percutaneous transhepatic biliary drainage examination using PCXMC2.0 and MCNP5 Monte Carlo codes

OBJECTIVES

To estimate the organ equivalent doses and the effective doses (E) in patient undergoing percutaneous transhepatic biliary drainage (PTBD) examinations, using the MCNP5 and PCXMC2 Monte Carlo-based codes.

METHODS

The purpose of this study is to estimate the organ doses to patients undergoing PTBD examinations by clinical measurements and Monte Carlo simulation. Dose area products (DAP) values were assessed during examination of 43 patients undergoing PTBD examination separated into groups based on the gender and the dimensions and location of the beam.

RESULTS

Monte Carlo simulation of photon transport in male and female mathematical phantoms was applied using the MCNP5 and PCXMC2 codes in order to estimate equivalent organ doses. Regarding the PTBD examination the organ receiving the maximum radiation dose was the lumbar spine. The mean calculated HT for the lumbar spine using the MCNP5 and PCXMC2 methods respectively, was 117.25 mSv and 131.7 mSv, in males. The corresponding doses were 139.45 mSv and 157.1 mSv respectively in females. The HT values for organs receiving considerable amounts of radiation during PTBD examinations were varied between 0.16% and 73.2% for the male group and between 1.10% and 77.6% for the female group. E in females and males using MCNP5 and PCXMC2.0 was 5.88 mSv and 6.77 mSv, and 4.93 mSv and 5.60 mSv.

CONCLUSION

The doses remain high compared to other invasive operations in interventional radiology. There is a reasonable good coincidence between the MCNP5 and PCXMC2.0 calculation for most of the organs.

Monte Carlo characterization of 169Yb as a high-dose-rate source for brachytherapy application by FLUKA code

Higher initial dose rate and simplifying HDR room treatment of 169Yb element among other brachytherapy sources has led to investigating its feasibility as high‐dose‐rate seed. In this work, Monte Carlo calculation was performed to obtain dosimetric parameters of 169Yb, Model M42 source at different radial distances according to AAPM TG‐43U1 and HEBD Report about HDR sources in both air vacuum and spherical homogeneous water phantom. The deposited energy resulted by FLUKA as Monte Carlo code using binning estimators around 169Yb source was converted into radial dose rate distribution in polar coordinates surrounding the brachytherapy source. The results indicate a dose rate constant of 1.14±0.04cGy.h−1.U−1 with approximate uncertainty of 0.04%, air kerma strength, 1.082±2.6E−06U.mCi−1 and anisotropy function ranging from 0.386 to 1.00 for radial distances of 0.5–10 cm and polar angles of 0°–180°. Overall, FLUKA dosimetric outputs were benchmarked with those published by Cazeca et al. via MCNP5 as one of validate dosimetry datasets related to 169Yb HDR source. As a result, it seems that FLUKA code can be applicable as a valuable tool to Monte Carlo evaluation of novel HDR brachytherapy sources.

PACS number: 87.15.ak

Experimental measurements and Monte Carlo calculations for (103)Pd dosimetry of the 12 mm COMS eye plaque

Monte Carlo simulations and TLD dosimetry have been performed to determine the dose distributions along the central axis of the 12 mm COMS eye plaques loaded with IRA1-(103)Pd seeds. Several simulations and measurements have been employed to investigate the effect of Silastic insert and air in front of the eye on dosimetry results along the central axis of the plaque and at some critical ocular structures. Measurements were performed using TLD-GR200A circular chip dosimeters in a PMMA eye phantom. The central axis TLD chips locations were arranged in one central column of eye phantom, in 3 mm intervals. The off-axis TLD chips locations were arranged in three off-axis columns around the central axis column. Version 5 of the MCNP code was also used to evaluate the dose distribution around the plaque. The presence of the Silastic insert results in dose reduction of 14% at 5 mm; also about 7% dose reduction appears at the interface point, due to the air presence and lack of the scattering condition. The overall dosimetric parameters for the COMS eye plaque loaded with new palladium seeds are similar to a commercial widely used seed such as Theragenics200. As the dose calculations under TG-43 assumptions do not consider the effect of the plaque backing and Silastic insert for accurate dosimetry, it's suggested to apply the effect of the eye plaque materials and air on dosimetry results along the central axis of the plaque and at some critical ocular structures.

Thermoluminescent and Monte Carlo dosimetry of IR06-103Pd brachytherapy source

This work presents experimental dosimetry results for a new P103d brachytherapy seed, in accordance with the AAPM TG‐43U1 recommendation that all new low‐energy interstitial brachytherapy seeds should undergo one Monte Carlo (MC) and at least one experimental dosimetry characterization. Measurements were performed using TLD‐GR200A circular chip dosimeters using standard methods employing thermoluminescent dosimeters in a Perspex phantom. The Monte Carlo N‐particle (MCNP) code, version 5 was used to evaluate the dose‐rate distributions around this model P103d source in water and Perspex phantoms. The consensus value for dose‐rate constant of the IR06‐P103d source was found equal to 0.690 cG⋅h−1⋅U−1. The anisotropy function, F(r, θ), and the radial dose function, gL(r), of the seed were measured in Perspex phantom and calculated in both Perspex and liquid water phantom. The measured values were also found in good agreement with corresponding MC calculations.

PACS number: 87.53.Jw