Comparison of Flattening Filter (FF) and Flattening-Filter-Free (FFF) 6 MV photon beam characteristics for small field dosimetry using EGSnrc Monte Carlo code

The Study of Dosimetric Characteristics of the XHA600D Medical Linear Accelerator Based on a Monte Carlo Code

By investigating the influence of initial electrons on dosimetric characteristics, reasonable incident electron parameters for the nominal 6 MV photon beam of the XHA600D accelerator are finally established, i.e., a 6 MeV monoenergetic electron beam with a radial intensity FWHM of 2.5 mm and an angular divergency of 0.15°. Based on reasonable initial parameters, Percentage Depth Doses (PDDs), Off-Axis Ratios (OARs), total scatter factors, beam qualities, and penumbra widths of both flatteningfilter (FF) and flattening-filter-free (FFF) beams for fields ranging from 4 × 4 to 30 × 30 cm2 are simulated systematically with EGSnrc codes. Not only the simulated dosimetric properties are in excellent agreement with the measurements, but also the dosimetric discrepancies between FF and FFF beams are consistent with the laws of previous studies on other accelerators. Therefore, reasonable incident electron parameters are able to accurately verify the performance of the XHA600D accelerator and can be used for further dosimetry research.

Calculated relative biological effectiveness (RBE) for initial DNA double-strand breaks (DSB) from flattening filter and flattening filter-free 6 MV X-ray fields

Objectives

We evaluated the radiobiological effectiveness based on the yields of DNA double-strand breaks (DSBs) of field induction with flattening filter (FF) and FF-free (FFF) photon beams.

Methods

We used the particle and heavy ion transport system (PHITS) and a water equivalent phantom (30 × 30 × 30 cm³) to calculate the physical qualities of the dose-mean lineal energy (y_D) with 6 MV FF and FFF. The relative biological effectiveness based on the yields of DNA-DSBs (RBE_DSB) was calculated for standard radiation such as 220 kVp X-rays by using the estimating yields of SSBs and DSBs. The measurement points used to calculate the in-field y_D and RBE_DSB were located at a depth of 3, 5, and 10 cm in the water equivalent phantom on the central axis. Measurement points at 6, 8, and 10 cm in the lateral direction of each of the three depths from the central axis were set to calculate the out-of-field y_D and RBE_DSB.

Results

The RBE_DSB of FFF in-field was 1.7% higher than FF at each measurement depth. The RBE_DSB of FFF out-of-field was 1.9 to 6.4% higher than FF at each depth measurement point. As the distance to out-of-field increased, the RBE_DSB of FFF rose higher than those of FF. FFF has a larger RBE_DSB than FF based on the yields of DNA-DSBs as the distance to out-of-field increased.

Conclusions

The out-of-field radiobiological effect of FFF could thus be greater than that of FF since the spreading of the radiation dose out-of-field with FFF could be a concern compared to the FF.

Advances in knowledge

The RBE_DSB of FFF of out-of-field might be larger than FF.

Monte Carlo study on the secondary cancer risk estimations for patients undergoing prostate radiotherapy: A humanoid phantom study

AIM

The aim of this study was to estimate the secondary malignancy risk from the radiation in FFB prostate linac-based radiotherapy for different organs of the patient.

BACKGROUND

Radiation therapy is one of the main procedures of cancer treatment. However, the application the radiation may impose dose to organs of the patient which can be the cause of some malignancies.

MATERIALS AND METHODS

Monte Carlo (MC) simulation was used to calculate radiation doses to patient organs in 18 MV linear accelerator (linac) based radiotherapy. A humanoid MC phantom was used to calculate the equivalent dose s for different organs and probability of secondary cancer, fatal and nonfatal risk, and other risks and parameters related to megavoltage radiation therapy. In out-of-field radiation calculation, it could be seen that neutrons imparted a higher dose to distant organs, and the dose to surrounding organs was mainly due to absorbed scattered photons and electron contamination.

RESULTS

Our results showed that the bladder and skin with 54.89 × 10-3 mSv/Gy and 46.09 × 10-3 mSv/Gy, respectively, absorbed the highest equivalent dose s from photoneutrons, while a lower dose was absorbed by the lung at 3.42 × 10-3 mSv/Gy. The large intestine and bladder absorbed 55.00 × 10-3 mSv/Gy and 49.08 × 10-3, respectively, which were the highest equivalent dose s due to photons. The brain absorbed the lowest out-of-field dose, at 1.87 × 10-3 mSv/Gy.

CONCLUSIONS

We concluded that secondary neutron portion was higher than other radiation. Then, we recommended more attention to neutrons in the radiation protection in linac based high energy radiotherapy.

Three-dimensional dose comparison of flattening filter (FF) and flattening filter-free (FFF) radiation therapy by using NIPAM gel dosimetry

Intensity-modulated radiotherapy and volumetric modulated arc therapy are modern radiation therapy technologies that can create the desired dose distribution by multileaf collimator movement and dose-rate control. However, the homogeneous dose delivery of small-field irradiation techniques shows disagreement with that of treatment planning system. The removal of the flattening filter by flattening filter free (FFF) beam irradiation increases dose conformity and further reduces treatment delivery time in radiosurgery. This study aims to investigate the dose distribution of FFF and flattened beams for small-field irradiation by using the 3D gel dosimeter. The N-isopropylacrylamide (NIPAM) polymer gel dosimeter was employed to record the 3D dose distribution. In addition, flattened and FFF beams were compared using the gamma evaluation technique. The use of an FFF accelerator resulted in excellent radiation treatments with short delivery times and low doses to normal tissues and organs. Results also showed that the passing rate increased with the decrease of field size (30 × 30, 20 × 20, and 10 × 10 mm²) at post-irradiation times of 24, 48, 72, and 96 h. The passing rates for each field size were retained at the same level when gamma criteria, namely, distance-to-agreement (DTA) = 3 mm/dose difference (DD) = 3%, were used. Nevertheless, the passing rates for each field size decreased slowly after 48 h when DTA = 2 mm/DD = 2%. The Wilcoxon signed-rank test was used to determine statistical difference with a significant level of p < 0.05. The passing rates of flattened and FFF beams showed no significant difference. The edge enhancement effect in the flattened beam was more evident than in the FFF beam. The 3D NIPAM gel dosimeter can be used for dose verification of small field for radiation therapy with high dose rate.

Monte-Carlo simulation of the Siemens Artiste linear accelerator flat 6 MV and flattening-filter-free 7 MV beam line

The aim of our work is to provide the up-to-now missing information on the Siemens Artiste FFF 7 MV beam line using a Monte-Carlo model fit to the realistic dosimetric measurements at the linear accelerator in clinical use at our department. The main Siemens Artiste 6MV and FFF 7MV beams were simulated using the Geant4 toolkit. The simulations were compared with the measurements with an ionization chamber in a water phantom to verify the validation of simulation and tuning the primary electron parameters. Hereafter, other parameters such as surface dose, spectrum, electron contamination, symmetry, flatness/unflatness, slope, and characteristic off-axis changes were discussed for both Flat and FFF mode. The mean electron energy for the FFF beam was 8.8 MeV and 7.5 MeV for Flat 6 MV, the spread energy and spot size of the selected Gaussian distribution source were 0.4 MeV and 1mm, respectively. The dose rate of the FFF beam was 2.8 (2.96) times higher than for the flattened beam for a field size of 10×10 (20×20) cm2. The electron contamination has significant contribution to the surface dose especially for the flattened beam. The penumbra, surface dose and the mean energy of photons decrease by removing the flattening filter. Finally, the results show that off-axis changes have no strong effect on the mean energy of FFF beams, while this effect was more considerable for the flattened beam.

A Monte Carlo Study of the Photon Spectrum due to the Different Materials Used in the Construction of Flattening Filters of LINAC

Different types the spectrum of photons were studied; they were emitted from the flattening filter of a LINAC Varian 2100 C/D that operates at 15 MV. The simplified geometry of the LINAC head was calculated using the MCNPX code based on the studies of the materials of the flattening filter, namely, SST, W, Pb, Fe, Ta, Al, and Cu. These materials were replaced in the flattening filter to calculate the photon spectra at the output of this device to obtain the spectrum that makes an impact with the patient. The different spectra obtained were analyzed and compared to the emission from the original spectra configuration of the LINAC, which uses material W. In the study, different combinations of materials were considered in order to establish differences between the use of different materials and the original material, with the objective of establishing advantages and disadvantages from a clinical standpoint.