Dosimetry of a small air cavity for clinical electron beams: A Monte Carlo study

Investigating the Effect of Air Cavities of Sinuses on the Radiotherapy Dose Distribution Using Monte Carlo Method

BACKGROUND

Considering that some vital organs exist in the head and neck region, the treatment of tumors in this area is a crucial task. The existence of air cavities, namely sinuses, disrupt the radiotherapy dose distribution. The study aims to analyze the effect of maxillary, frontal, ethmoid and sphenoid sinuses on radiotherapy dose distribution by Monte Carlo method.

MATERIAL AND METHODS

In order to analyze the effect of the cavities on dose distribution, the maxillary, frontal, ethmoid and sphenoid sinus cavities were simulated with (3×3.2×2) cm³, (2×2×3.2) cm³, (1×1×1.2) cm³ and (1×1×2) cm³ dimensions.

RESULTS

In the analysis of the dose distribution caused by cavities, some parameters were observed, including: inhomogeneity of dose distribution in the cavities, inhomogeneity of dose on the edges of the air cavities and dispersion of the radiations after the air cavity. The amount of the dose in various situations showed differences: before the cavity a 0.64% and a 2.76% decrease, a 12.06% and a 17.17% decrease in the air zone, and a 2.25% and a 5.9% increase after the cavity.

CONCLUSION

The results indicate that a drop in dose before the air cavities and in the air zone occurs due to the lack of scattered radiation. Furthermore, the rise in dose was due to the passage of more radiation from the air cavity and dose deposition after the air cavity. The changes in dose distribution are dependent on the cavity size and depth. As a result, this has to be noted in the treatment planning and MU calculations of the patient.

Dosimetric effect by shallow air cavities in high energy electron beams

This study evaluates the dosimetric impact caused by an air cavity located at 2 mm depth from the top surface in a PMMA phantom irradiated by electron beams produced by a Siemens Primus linear accelerator. A systematic evaluation of the effect related to the cavity area and thickness as well as to the electron beam energy was performed by using Monte Carlo simulations (EGSnrc code), Pencil Beam algorithm and Gafchromic EBT2 films. A home-PMMA phantom with the same geometry as the simulated one was specifically constructed for the measurements. Our results indicate that the presence of the cavity causes an increase (up to 70%) of the dose maximum value as well as a shift forward of the position of the depth-dose curve, compared to the homogeneous one. Pronounced dose discontinuities in the regions close to the lateral cavity edges are observed. The shape and magnitude of these discontinuities change with the dimension of the cavity. It is also found that the cavity effect is more pronounced (6%) for the 12 MeV electron beam and the presence of cavities with large thickness and small area introduces more significant variations (up to 70%) on the depth-dose curves. Overall, the Gafchromic EBT2 film measurements were found in agreement within 3% with Monte Carlo calculations and predict well the fine details of the dosimetric change near the cavity interface. The Pencil Beam calculations underestimate the dose up to 40% compared to Monte Carlo simulations; in particular for the largest cavity thickness (2.8 cm).