Spectroscopic output of I125 and Pd103 low dose rate brachytherapy sources

Radiation protection and dosimetry issues for patients with prostate cancer after I-125 low-dose-rate brachytherapy permanent implant

PURPOSE

The aim of this work was to analyze the exposure rates measured in the proximity of patients who underwent prostate low-dose-rate brachytherapy with I-125 implant. Effective doses to relatives and to population were computed to estimate the time to reach radioprotection dose constraints.

METHODS AND MATERIALS

Measurements were obtained from 180 patients, whereas the body mass index was calculated and reported for 77 patients. The day after the implant, K˙ measurements were conducted at various skin distances and positions and converted to effective doses. A theoretical model was developed to estimate effective doses from total implanted activity. The latter was approximated with a 10-mL vial inside the patient.

RESULTS

The K˙ measurements showed a low correlation with the total implanted activity, albeit an increasing trend of K˙ was observed on increasing the activity. A stronger correlation was found between body mass index and K˙ measurements. The effective dose to population is in general lower than dose constraints as well as the effective doses to relatives, with the exception of children and pregnant women, who command special precautions. We report differences between the experimental model- and theoretical model-based dose evaluation together with their comparison with previous studies found in literature.

CONCLUSIONS

Based on the K˙ measurements and the results of the present analysis, it is possible to provide the patient with radiation safety instructions specifically tailored to his relatives' habits and working environment.

Effect of improved TLD dosimetry on the determination of dose rate constants for (125)I and (103)Pd brachytherapy seeds

PURPOSE

To more accurately account for the relative intrinsic energy dependence and relative absorbed-dose energy dependence of TLDs when used to measure dose rate constants (DRCs) for (125)I and (103)Pd brachytherapy seeds, to thereby establish revised "measured values" for all seeds and compare the revised values with Monte Carlo and consensus values.

METHODS

The relative absorbed-dose energy dependence, f(rel), for TLDs and the phantom correction, Pphant, are calculated for (125)I and (103)Pd seeds using the EGSnrc BrachyDose and DOSXYZnrc codes. The original energy dependence and phantom corrections applied to DRC measurements are replaced by calculated (f(rel))(-1) and Pphant values for 24 different seed models. By comparing the modified measured DRCs to the MC values, an appropriate relative intrinsic energy dependence, kbq (rel), is determined. The new Pphant values and relative absorbed-dose sensitivities, SAD (rel), calculated as the product of (f(rel))(-1) and (kbq (rel))(-1), are used to individually revise the measured DRCs for comparison with Monte Carlo calculated values and TG-43U1 or TG-43U1S1 consensus values.

RESULTS

In general, f(rel) is sensitive to the energy spectra and models of the brachytherapy seeds. Values may vary up to 8.4% among (125)I and (103)Pd seed models and common TLD shapes. Pphant values depend primarily on the isotope used. Deduced (kbq (rel))(-1) values are 1.074 ± 0.015 and 1.084 ± 0.026 for (125)I and (103)Pd seeds, respectively. For (1 mm)(3) chips, this implies an overall absorbed-dose sensitivity relative to (60)Co or 6 MV calibrations of 1.51 ± 1% and 1.47 ± 2% for (125)I and (103)Pd seeds, respectively, as opposed to the widely used value of 1.41. Values of Pphant calculated here have much lower statistical uncertainties than literature values, but systematic uncertainties from density and composition uncertainties are significant. Using these revised values with the literature's DRC measurements, the average discrepancies between revised measured values and Monte Carlo values are 1.2% and 0.2% for (125)I and (103)Pd seeds, respectively, compared to average discrepancies for the original measured values of 4.8%. On average, the revised measured values are 4.3% and 5.9% lower than the original measured values for (103)Pd and (125)I seeds, respectively. The average of revised DRCs and Monte Carlo values is 3.8% and 2.8% lower for (125)I and (103)Pd seeds, respectively, than the consensus values in TG-43U1 or TG-43U1S1.

CONCLUSIONS

This work shows that f(rel) is TLD shape and seed model dependent suggesting a need to update the generalized energy response dependence, i.e., relative absorbed-dose sensitivity, measured 25 years ago and applied often to DRC measurements of (125)I and (103)Pd brachytherapy seeds. The intrinsic energy dependence for LiF TLDs deduced here is consistent with previous dosimetry studies and emphasizes the need to revise the DRC consensus values reported by TG-43U1 or TG-43U1S1.

Impact of the differential fluence distribution of brachytherapy sources on the spectroscopic dose-rate constant

PURPOSE

To investigate why dose-rate constants for (125)I and (103)Pd seeds computed using the spectroscopic technique, Λ spec, differ from those computed with standard Monte Carlo (MC) techniques. A potential cause of these discrepancies is the spectroscopic technique's use of approximations of the true fluence distribution leaving the source, φ full. In particular, the fluence distribution used in the spectroscopic technique, φ spec, approximates the spatial, angular, and energy distributions of φ full. This work quantified the extent to which each of these approximations affects the accuracy of Λ spec. Additionally, this study investigated how the simplified water-only model used in the spectroscopic technique impacts the accuracy of Λ spec.

METHODS

Dose-rate constants as described in the AAPM TG-43U1 report, Λ full, were computed with MC simulations using the full source geometry for each of 14 different (125)I and 6 different (103)Pd source models. In addition, the spectrum emitted along the perpendicular bisector of each source was simulated in vacuum using the full source model and used to compute Λ spec. Λ spec was compared to Λ full to verify the discrepancy reported by Rodriguez and Rogers. Using MC simulations, a phase space of the fluence leaving the encapsulation of each full source model was created. The spatial and angular distributions of φ full were extracted from the phase spaces and were qualitatively compared to those used by φ spec. Additionally, each phase space was modified to reflect one of the approximated distributions (spatial, angular, or energy) used by φ spec. The dose-rate constant resulting from using approximated distribution i, Λ approx,i, was computed using the modified phase space and compared to Λ full. For each source, this process was repeated for each approximation in order to determine which approximations used in the spectroscopic technique affect the accuracy of Λ spec.

RESULTS

For all sources studied, the angular and spatial distributions of φ full were more complex than the distributions used in φ spec. Differences between Λ spec and Λ full ranged from -0.6% to +6.4%, confirming the discrepancies found by Rodriguez and Rogers. The largest contribution to the discrepancy was the assumption of isotropic emission in φ spec, which caused differences in Λ of up to +5.3% relative to Λ full. Use of the approximated spatial and energy distributions caused smaller average discrepancies in Λ of -0.4% and +0.1%, respectively. The water-only model introduced an average discrepancy in Λ of -0.4%.

CONCLUSIONS

The approximations used in φ spec caused discrepancies between Λ approx,i and Λ full of up to 7.8%. With the exception of the energy distribution, the approximations used in φ spec contributed to this discrepancy for all source models studied. To improve the accuracy of Λ spec, the spatial and angular distributions of φ full could be measured, with the measurements replacing the approximated distributions. The methodology used in this work could be used to determine the resolution that such measurements would require by computing the dose-rate constants from phase spaces modified to reflect φ full binned at different spatial and angular resolutions.

Using matrix summation method for three dimensional dose calculation in brachytherapy

AIM

The purpose of this study is to calculate radiation dose around a brachytherapy source in a water phantom for different seed locations or rotation the sources by the matrix summation method.

BACKGROUND

Monte Carlo based codes like MCNP are widely used for performing radiation transport calculations and dose evaluation in brachytherapy. But for complicated situations, like using more than one source, moving or rotating the source, the routine Monte Carlo method for dose calculation needs a long time running.

MATERIALS AND METHODS

The MCNPX code has been used to calculate radiation dose around a (192)Ir brachytherapy source and saved in a 3D matrix. Then, we used this matrix to evaluate the absorbed dose in any point due to some sources or a source which shifted or rotated in some places by the matrix summation method.

RESULTS

Three dimensional (3D) dose results and isodose curves were presented for (192)Ir source in a water cube phantom shifted for 10 steps and rotated for 45 and 90° based on the matrix summation method. Also, we applied this method for some arrays of sources.

CONCLUSION

The matrix summation method can be used for 3D dose calculations for any brachytherapy source which has moved or rotated. This simple method is very fast compared to routine Monte Carlo based methods. In addition, it can be applied for dose optimization study.