Monte Carlo-aided dosimetry of the Symmetra model I25.S06 125I, interstitial brachytherapy seed

Update of the CLRP eye plaque brachytherapy database for photon-emitting sources

PURPOSE

To update and extend the Carleton Laboratory for Radiotherapy Physics (CLRP) Eye Plaque (EP) dosimetry database for low-energy photon-emitting brachytherapy sources using egs_brachy, an open-source EGSnrc application. The previous database, CLRP_EPv1, contained datasets for the Collaborative Ocular Melanoma Study (COMS) plaques (10-22 mm diameter) with ¹⁰³ Pd or ¹²⁵ I seeds (BrachyDose-computed, 2008). The new database, CLRP_EPv2, consists of newly calculated three-dimensional (3D) dose distributions for 17 plaques [eight COMS, five Eckert & Ziegler BEBIG, and four others representative of models used worldwide] for ¹⁰³ Pd, ¹²⁵ I, and ¹³¹ Cs seeds.

ACQUISITION AND VALIDATION METHODS

Plaque models are developed with egs_brachy, based on published/manufacturer dimensions and material data. The BEBIG plaques (modeled for the first time) are identical in dimensions to COMS plaques but differ in elemental composition and/or density. Previously benchmarked seed models are used. Eye plaques and seeds are simulated at the center of full-scatter water phantoms, scoring in (0.05 cm)³ voxels spanning the eye for scenarios: (a) "HOMO": simulated TG43 conditions; (b) "HETERO": eye plaques and seeds fully modeled; (c) "HETsi" (BEBIG only): one seed is active at a time with other seed geometries present but not emitting photons (inactive); summation over all i seeds in a plaque then yields "HETsum" (includes interseed effects). For validation, doses are compared to those from CLRP_EPv1 and published data.

DATA FORMAT AND ACCESS

Data are available at https://physics.carleton.ca/clrp/eye_plaque_v2, http://doi.org/10.22215/clrp/EPv2. The data consist of 3D dose distributions (text-based EGSnrc "3ddose" file format) and graphical presentations of the comparisons to previously published data.

POTENTIAL APPLICATIONS

The CLRP_EPv2 database provides accurate reference 3D dose distributions to advance ocular brachytherapy dose evaluations. The fully-benchmarked eye plaque models will be freely distributed with egs_brachy, supporting adoption of model-based dose evaluations as recommended by TG-129, TG-186, and TG-221.

Investigation of a synthetic diamond detector response in kilovoltage photon beams

PURPOSE

An important characteristic of radiation dosimetry detectors is their energy response which consists of absorbed-dose and intrinsic energy responses. The former can be characterized using Monte Carlo (MC) simulations, whereas the latter (i.e., detector signal per absorbed dose to detector) is extracted from experimental data. Such a characterization is especially relevant when detectors are used in nonrelative measurements at a beam quality that differs from the calibration beam quality. Having in mind the possible application of synthetic diamond detectors (microDiamond PTW 60019, Freiburg, Germany) for nonrelative dosimetry of low-energy brachytherapy (BT) beams, we determined their intrinsic and absorbed-dose energy responses in 25-250 kV beams relative to a ⁶⁰ Co beam, which is usually the reference beam quality for detector calibration in radiotherapy.

MATERIAL AND METHODS

Three microDiamond detectors and, for comparison, two silicon diodes (PTW 60017) were calibrated in terms of air-kerma free in air in six x-ray beam qualities (from 25 to 250 kV) and in terms of absorbed dose to water in a ⁶⁰ Co beam at the national metrology laboratory in Sweden. The PENELOPE/penEasy MC radiation transport code was used to calculate the absorbed-dose energy response of the detectors (modeled based on blueprints) relative to air and water depending on calibration conditions. The MC results were used to extract the relative intrinsic energy response of the detectors from the overall energy response. Measurements using an independent setup with a single ophthalmic BEBIG I25.S16 ¹²⁵ I BT seed (effective photon energy of 28 keV) were used as a qualitative check of the extracted intrinsic energy response correction factors. Additionally, the impact of the thickness of the active volume as well as the presence of extra-cameral components on the absorbed-dose energy response of a microDiamond detector was studied using MC simulations.

RESULTS

The relative intrinsic energy response of the microDiamond detectors was higher by a factor of 2 in 25 and 50 kV beams compared to the ⁶⁰ Co beam. The variation in the relative intrinsic energy response of silicon diodes was within 10% over the investigated photon energy range. The use of relative intrinsic energy response correction factors improved the agreement among the absorbed dose to water values determined using microDiamond detectors and silicon diodes, as well as with the TG-43 formalism-based calculations for the ¹²⁵ I seed. MC study of microDiamond detector design features provided a possible explanation for inter-detector response variation at low-energy photon beams by differences in the effective thickness of the active volume.

CONCLUSIONS

MicroDiamond detectors had a non-negligible variation in the relative intrinsic energy response (factor of 2) which was comparable to that in the absorbed-dose energy response relative to water at low-energy photon beams. Silicon diodes, in contrast, had an absorbed-dose energy dependence on photon energy that varied by a factor of 6, whereas the intrinsic energy dependence on beam quality was within 10%. It is important to decouple these two responses for a full characterization of detector energy response especially when the user and reference beam qualities differ significantly, and MC alone is not enough.

A process to describe radiation damage at the molecular level. Application to the 125I seeds in water

The correlation between the absorbed energy and the induced biological damage still has unclear aspects, especially in the low energy and low dose rate irradiation regimes. From the knowledge of the molecular-induced effects (dissociations), it would be possible to better understand the side effects of radiation, such as induced cancers or damage to healthy tissue. With this in view, this paper presents results of a simulation of a ¹²⁵I-seed treatment with an event-by-event MC code (LEPTS) specifically designed to account for the low energy secondary particle interactions, such as electron attachment, vibro-rotational and neutral dissociation interactions. This calculation allowed us to analyze the potential radiation damage not only in connection with the energy deposition, but also in terms of induced molecular dissociations by taking into account ionizing and non-ionizing dissociative processes. We propose that this description of the molecular level damage be the basis for nanodosimetric evaluations.

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.

Monte Carlo dosimetry of the eye plaque design used at the St. Erik Eye Hospital for (125)I brachytherapy

PURPOSE

At St. Erik Eye Hospital in Stockholm, Sweden, ocular tumors of apical height above 6 mm are treated with brachytherapy, using iodine-125 seeds attached to a gold alloy plaque while the treatment planning is performed assuming homogeneous water surroundings. The aim of this work was to investigate the dose-modifying effects of the plaque and the seed fixating silicone rubber glue.

METHODS AND MATERIALS

The impact of the gold plaque and silicone rubber glue was studied with the Monte Carlo N-particle transport code, version 5.

RESULTS

For the 2 cm most proximal to the plaque surface along the plaque's central axis, the eyeball received 104.6-93.0% of the dose in all-water conditions.

CONCLUSIONS

The 0.3 mm thick layer of silicone rubber glue, used for seed fixation, attenuates photons little enough to allow characteristic X-rays from the gold alloy plaque to reach the eyeball. Close to the plaque, the dose rates were higher with the plaque and glue present, than in homogeneous water conditions. This is in contrast to what has been reported for more commonly used eye plaques, demonstrating the importance of investigating the dosimetry of individual treatment systems.

New (125)I brachytherapy source IsoSeed I25.S17plus: Monte Carlo dosimetry simulation and comparison to sources of similar design

Purpose

To determine the relative dose rate distribution around the new ¹²⁵I brachytherapy source IsoSeed I25.S17plus and report results in a form suitable for clinical use. Results for the new source are also compared to corresponding results for other commercially available ¹²⁵I sources of similar design.

Material and methods

Monte Carlo simulations were performed using the MCNP5 v.1.6 general purpose code. The model of the new source was prepared from information provided by the manufacturer and verified by imaging a sample of ten non-radioactive sources. Corresponding simulations were also performed for the 6711 ¹²⁵I brachytherapy source, using updated geometric information presented recently in the literature. The uncertainty of the dose distribution around the new source, as well as the dosimetric quantities derived from it according to the Task Group 43 formalism, were determined from the standard error of the mean of simulations for a sample of fifty source models. These source models were prepared by randomly selecting values of geometric parameters from uniform distributions defined by manufacturer stated tolerances.

Results and Conclusions

Results are presented in the form of the quantities defined in the update of the Task Group 43 report, as well as a relative dose rate table in Cartesian coordinates. The dose rate distribution of the new source is comparable to that of sources of similar design (IsoSeed I25.S17, Oncoseed 6711, SelectSeed 130.002, Advantage IAI-125A, I-Seed AgX100, Thinseed 9011). Noticeable differences were observed only for the IsoSeed I25.S06 and Best 2301 sources.

An analytical model to determine interseed attenuation effect in low-dose-rate brachytherapy

Brachytherapy treatment planning systems (BTPS) are employing the American Association of Physicists in Medicine (AAPM) Task Group 43 (TG‐43)‐recommended dosimetric parameters of sources, which are measured in water. The majority of brachytherapy implant volumes are not homogeneous media. Particularly, an implant with multiple seeds significantly changes homogeneity of the implant volume. Heterogeneities, such as attenuation by adjacent seeds or interseed attenuation (ISA), are neglected to this day in all BTPS. The goal of this project is to determine a novel analytical method to evaluate the impact of the dose perturbations (P‐value) and/or interseed attenuation effect (ISA‐value). This method will be validated for low‐ and high‐energy brachytherapy seeds such as  125I and  192Ir using Monte Carlo (MC) simulation techniques. In this analytical model, determination of dose perturbation and interseed attenuation in a multisource brachytherapy implant is based on MC‐simulated 3D kernels of P‐values and ISA data for single active and single dummy configurations, arranged at different distances and orientations relative to each other. The accuracy of the final model in multisource implant configurations has been examined by a comparison of the calculated P‐values and ISA‐values with full Monte Carlo water simulations (FMCWS). This model enabled us to determine the total perturbation and ISA values for any multisource implant, and the results are in excellent agreement with the FMCWS data. The advantage of this model to FMCWS for daily clinical application is the speed of the calculations and ease of the implementation. The new perturbation and ISA formulism have shown a better accuracy for  192Ir than  125I due to Compton scattering and its independence of the atomic number of the chemical composition of the phantom materials. The maximum difference between the ISA model and FMCWS for all cases was less than 5%. This new model can provide inputs for brachytherapy planning software to consider the ISA effect in dose calculations based on TG‐43U1 algorithm. This approach is applicable for energy range of  125I to  192Ir sources.

PACS number: 87.53.Jw

Monte Carlo simulation of COMS ophthalmic applicators loaded with Bebig I25.S16 seeds and comparison with planning system predictions

PURPOSE

To simulate the Bebig model I125.S16 source and obtain AAPM Task Group Report 43 brachytherapy dosimetry parameters for comparison to consensus and previously published values. The seed model will then be incorporated into a Monte Carlo model of COMS eye plaques and simulation results will be used for seed-carrier set modeling in a commercial planning system.

METHODS

PENELOPE was used to simulate the seed and the applicators for different sizes and loading levels. The corresponding TG-43U1 dosimetric parameters of the seed were calculated. Bebig Plaque Simulator was used.

RESULTS

The air kerma strength, the dose rate constant and the radial dose and 2D anisotropy functions found showed a good agreement with those published by other authors. Dose distributions were determined for the 12 and 20 mm COMS plaques loaded with a single seed and for the 12 mm plaque fully loaded. The plaque effect on the eye dose and the interseed absorption were evaluated. If the plaque is loaded with a single seed, the dose in the central axis reduces about 10% at 5-6 mm depth with respect to the case in which the plaque is not present. This reduction does not depend on the plaque size. When the plaque is fully loaded, an additional reduction in the dose with respect to the dose in water is observed mainly due to the effect of the Silastic carrier. The mean dose reduction in the central axis of the 12 mm plaque due to the interseed absorption was 0.5%. A new physics file for the planning system was created with the results obtained from the simulations. Results obtained using this adapted model for the 12 mm plaque fully loaded agreed with the corresponding simulation. Dose rate at the prescription point differs 4.7% when the adapted model is used instead of the default model.

CONCLUSIONS

Simulation results for COMS plaques are consistent with those published for other seeds. The planning system studied appears as a good tool for dose calculation in ophthalmic brachytherapy treatments. The new physics model, built up from Monte Carlo results, has been commissioned by comparing calculations made with the planning system to those obtained from Monte Carlo simulations.

Fast patient-specific Monte Carlo brachytherapy dose calculations via the correlated sampling variance reduction technique

PURPOSE

To demonstrate potential of correlated sampling Monte Carlo (CMC) simulation to improve the calculation efficiency for permanent seed brachytherapy (PSB) implants without loss of accuracy.

METHODS

CMC was implemented within an in-house MC code family (PTRAN) and used to compute 3D dose distributions for two patient cases: a clinical PSB postimplant prostate CT imaging study and a simulated post lumpectomy breast PSB implant planned on a screening dedicated breast cone-beam CT patient exam. CMC tallies the dose difference, ΔD, between highly correlated histories in homogeneous and heterogeneous geometries. The heterogeneous geometry histories were derived from photon collisions sampled in a geometrically identical but purely homogeneous medium geometry, by altering their particle weights to correct for bias. The prostate case consisted of 78 Model-6711 (125)I seeds. The breast case consisted of 87 Model-200 (103)Pd seeds embedded around a simulated lumpectomy cavity. Systematic and random errors in CMC were unfolded using low-uncertainty uncorrelated MC (UMC) as the benchmark. CMC efficiency gains, relative to UMC, were computed for all voxels, and the mean was classified in regions that received minimum doses greater than 20%, 50%, and 90% of D(90), as well as for various anatomical regions.

RESULTS

Systematic errors in CMC relative to UMC were less than 0.6% for 99% of the voxels and 0.04% for 100% of the voxels for the prostate and breast cases, respectively. For a 1 × 1 × 1 mm(3) dose grid, efficiency gains were realized in all structures with 38.1- and 59.8-fold average gains within the prostate and breast clinical target volumes (CTVs), respectively. Greater than 99% of the voxels within the prostate and breast CTVs experienced an efficiency gain. Additionally, it was shown that efficiency losses were confined to low dose regions while the largest gains were located where little difference exists between the homogeneous and heterogeneous doses. On an AMD 1090T processor, computing times of 38 and 21 sec were required to achieve an average statistical uncertainty of 2% within the prostate (1 × 1 × 1 mm(3)) and breast (0.67 × 0.67 × 0.8 mm(3)) CTVs, respectively.

CONCLUSIONS

CMC supports an additional average 38-60 fold improvement in average efficiency relative to conventional uncorrelated MC techniques, although some voxels experience no gain or even efficiency losses. However, for the two investigated case studies, the maximum variance within clinically significant structures was always reduced (on average by a factor of 6) in the therapeutic dose range generally. CMC takes only seconds to produce an accurate, high-resolution, low-uncertainly dose distribution for the low-energy PSB implants investigated in this study.

Monte Carlo calculations of AAPM Task Group Report No. 43 dosimetry parameters for the (125)I I-Seed AgX100 source model

PURPOSE

The purpose of this study was to determine the dosimetric parameters of the AgX100, a new (125)I brachytherapy seed model, using Monte Carlo (MC) simulations according to the protocol specified by the updated American Association of Physicists in Medicine Task Group No. 43 Report (TG-43U1) and compare these parameters with those of the established brachytherapy (125)I seed models 6711 and I25.S06.

METHODS AND MATERIALS

Independent verification of the new seed geometry was performed using high-resolution digital radiography and scanning electron microscopy. MCNPX v.2.5 MC simulations of the AgX100 seed were performed to derive its TG-43U1 parameters, the dose rate constant, the radial dose function, and the two- and one-dimensional anisotropy functions in liquid water. A dosimetric error propagation analysis was also performed to include uncertainty because of seed manufacturing tolerances and physics parameters.

RESULTS

The MC-calculated dose rate constant for the AgX100 seed was 0.943cGy·h(-1)·U(-1)±2.6% (k=1) based on the air kerma strength for a simulated point detector. Tabulated results of the radial dose function for line and point source approximations and the two-dimensional anisotropy function are also reported.

CONCLUSIONS

The MC-predicted dose distribution of the AgX100 seed was found to be comparable with that of the model 6711 seed but much different from the dose distribution of the model I25.S06 seeds. However, at shallow distances, there were some dosimetric differences between the AgX100 and 6711 seed, which warrant separate TG-43U1 parameters for use in clinical treatment planning systems.

Experimental measurements and Monte Carlo simulations of dose perturbation around a nonradioactive brachytherapy seed due to 6- and 18-MV photons

PURPOSE

Radioactive seeds used in permanent prostate brachytherapy are composed of high-Z metals and may exceed 100 in a patient. If supplemental external beam treatment is administered afterward, the seeds may cause substantial dose perturbation, which is being investigated in this article.

METHODS AND MATERIALS

Film measurements using 6-MV beam were primarily carried out using Kodak XV2 film layered above and below a nonradioactive iodine-125 ((125)I) seed. Monte Carlo simulations were carried out using DOSXYZnrc. Other experimental comparisons looked at changing beam energy, depth, and field size, including two opposing fields' pair. Effect of multiple seeds spatially spaced 0.5cm vertically was also studied.

RESULTS

For a single (125)I seed, on XV film, there is a localized dose enhancement of 6.3% upstream and -10.9% downstream. With two opposing fields, a cold spot around the seed of ∼3% was noticed. Increasing beam energy and field size decreased the magnitude of this effect, whereas the effect was found to increase with the increasing Z of material. DOSXYZnrc and EBT-2 film verified maximum dose enhancement of +15% upstream and -20% downstream of the (125)I seed surface.

CONCLUSIONS

In general, the dose perturbation because of the seeds was spatially limited to ∼2mm upstream and ∼5mm downstream to the incident beam. Similar to other heterogeneities, the seeds perturbation depends on incident beam energy, field size, and its Z. With multiple seeds spatially apart and multiple radiation fields routinely used in external beam radiotherapy, the cumulative effect may not result in clinically significant dose perturbation.

Reconstruction of brachytherapy seed positions and orientations from cone-beam CT x-ray projections via a novel iterative forward projection matching method

PURPOSE

To generalize and experimentally validate a novel algorithm for reconstructing the 3D pose (position and orientation) of implanted brachytherapy seeds from a set of a few measured 2D cone-beam CT (CBCT) x-ray projections.

METHODS

The iterative forward projection matching (IFPM) algorithm was generalized to reconstruct the 3D pose, as well as the centroid, of brachytherapy seeds from three to ten measured 2D projections. The gIFPM algorithm finds the set of seed poses that minimizes the sum-of-squared-difference of the pixel-by-pixel intensities between computed and measured autosegmented radiographic projections of the implant. Numerical simulations of clinically realistic brachytherapy seed configurations were performed to demonstrate the proof of principle. An in-house machined brachytherapy phantom, which supports precise specification of seed position and orientation at known values for simulated implant geometries, was used to experimentally validate this algorithm. The phantom was scanned on an ACUITY CBCT digital simulator over a full 660 sinogram projections. Three to ten x-ray images were selected from the full set of CBCT sinogram projections and postprocessed to create binary seed-only images.

RESULTS

In the numerical simulations, seed reconstruction position and orientation errors were approximately 0.6 mm and 5 degrees, respectively. The physical phantom measurements demonstrated an absolute positional accuracy of (0.78 +/- 0.57) mm or less. The theta and phi angle errors were found to be (5.7 +/- 4.9) degrees and (6.0 +/- 4.1) degrees, respectively, or less when using three projections; with six projections, results were slightly better. The mean registration error was better than 1 mm/6 degrees compared to the measured seed projections. Each test trial converged in 10-20 iterations with computation time of 12-18 min/iteration on a 1 GHz processor.

CONCLUSIONS

This work describes a novel, accurate, and completely automatic method for reconstructing seed orientations, as well as centroids, from a small number of radiographic projections, in support of intraoperative planning and adaptive replanning. Unlike standard back-projection methods, gIFPM avoids the need to match corresponding seed images on the projections. This algorithm also successfully reconstructs overlapping clustered and highly migrated seeds in the implant. The accuracy of better than 1 mm and 6 degrees demonstrates that gIFPM has the potential to support 2D Task Group 43 calculations in clinical practice.

Evaluation of the dose distribution for prostate implants using various 125I and 103Pd sources

Recently, several different models of 125I and 103Pd brachytherapy sources have been introduced in order to meet the increasing demand for prostate seed implants. These sources have different internal structures; hence, their TG-43 dosimetric parameters are not the same. In this study, the effects of the dosimetric differences among the sources on their clinical applications were evaluated. The quantitative and qualitative evaluations were performed by comparisons of dose distributions and dose volume histograms of prostate implants calculated for various designs of 125I and 103Pd sources. These comparisons were made for an identical implant scheme with the same number of seeds for each source. The results were compared with the Amersham model 6711 seed for 125I and the Theragenics model 200 seed for 103Pd using the same implant scheme.

Photon spectrometry for the determination of the dose-rate constant of low-energy photon-emitting brachytherapy sources

Accurate determination of dose-rate constant (lambda) for interstitial brachytherapy sources emitting low-energy photons (< 50 keV) has remained a challenge in radiation dosimetry because of the lack of a suitable absolute dosimeter for accurate measurement of the dose rates near these sources. Indeed, a consensus value of lambda taken as the arithmetic mean of the dose-rate constants determined by different research groups and dosimetry techniques has to be used at present for each source model in order to minimize the uncertainties associated with individual determinations of lambda. Because the dosimetric properties of a source are fundamentally determined by the characteristics of the photons emitted by the source, a new technique based on photon spectrometry was developed in this work for the determination of dose-rate constant. The photon spectrometry technique utilized a high-resolution gamma-ray spectrometer to measure source-specific photon characteristics emitted by the low-energy sources and determine their dose-rate constants based on the measured photon-energy spectra and known dose-deposition properties of mono-energetic photons in water. This technique eliminates many of the difficulties arising from detector size, the energy dependence of detector sensitivity, and the use of non-water-equivalent solid phantoms in absolute dose rate measurements. It also circumvents the uncertainties that might be associated with the source modeling in Monte Carlo simulation techniques. It was shown that the estimated overall uncertainty of the photon spectrometry technique was less than 4%, which is significantly smaller than the reported 8-10% uncertainty associated with the current thermo-luminescent dosimetry technique. In addition, the photon spectrometry technique was found to be stable and quick in lambda determination after initial setup and calibration. A dose-rate constant can be determined in less than two hours for each source. These features make it ideal to determine the dose-rate constant of each source model from a larger and more representative sample of actual sources and to use it as a quality assurance resource for periodic monitoring of the constancy of lambda for brachytherapy sources used in patient treatments.

Brachytherapy dosimetry parameters calculated for a Cs131 source

A comprehensive analysis of the IsoRay Medical model CS-1 Rev2 131Cs brachytherapy source was performed. Dose distributions were simulated using Monte Carlo methods (MCNP5) in liquid water, Solid Water, and Virtual Water spherical phantoms. From these results, the in-water brachytherapy dosimetry parameters have been determined, and were compared with those of Murphy et al. [Med. Phys. 31, 1529-1538 (2004)] using measurements and simulations. Our results suggest that calculations obtained using erroneous cross-section libraries should be discarded as recommended by the 2004 AAPM TG-43U1 report. Our Mclambda value of 1.046+/-0.019 cGy h(-1) U(-1) is within 1.3% of that measured by Chen et al. [Med. Phys. 32, 3279-3285 (2005)] using TLDs and the calculated results of Wittman and Fisher [Med. Phys. 34, 49-54 (2007)] using MCNP5. Using the discretized energy approach of Rivard [Appl. Radiat. Isot. 55, 775-782 (2001)] to ascertain the impact of individual 131Cs photons on radial dose function and anisotropy functions, there was virtual equivalence of results for 29.461< or =Egamma< or = 34.419 keV and for a mono-energetic 30.384 keV photon source. Comparisons of radial dose function and 2D anisotropy function data are also included, and an analysis of material composition and cross-section libraries was performed.

Monte Carlo and experimental dosimetry of an I125 brachytherapy seed

We have performed a comprehensive dosimetric characterization of the Oncura model 6711 125I seed using both experimental [LiF thermoluminscent dosimetry (TLD)] and theoretical (Monte Carlo photon transport) methods. In addition to determining the dosimetric parameters of the 6711, this report quantified: (1) the angular dependence of LiF TLD energy response functions for both point and volume detectors in water, poly(methylmethacrylate), and solid water media; and (2) the contribution of underlying geometric uncertainties to the overall uncertainty of Monte Carlo derived dosimetric parameters according to the National Institute of Standards and Technology Report 1297 methodology. The theoretical value for the dose rate constant in water was 0.942 cGy U(-1) h(-1)+/-1.76% [combined standard uncertainty (CSU) with coverage factor k=1] and the experimental value was 0.971 cGy U(-1) h(-1)+/-6.1%. Agreement between experimental and theoretical radial dose function values was well within the k= 1 CSU, while agreement between experimental and theoretical anisotropy function values was within the k= 1 CSU only after incorporating the use of polar angle-dependent energy response functions. The angular dependence of the relative energy response was found to have a complex and significant dependence on measurement medium and internal geometry of the source.

Polymer gel dosimetry for the TG-43 dosimetric characterization of a new 125I interstitial brachytherapy seed

In this work, a polymer gel-magnetic resonance (MR) imaging method is employed for the dosimetric characterization of a new 125I low dose rate seed (IsoSeed model I25.S17). Two vials filled with PABIG gel were prepared in-house and one new seed as well as one commercially available 125I seed of similar dose rate and well-known dosimetric parameters (IsoSeed model I25.S06) were positioned in each vial. Both seeds in each vial were MR scanned simultaneously on days 11 and 26 after implantation. The data obtained from the known seed in each vial are used to calibrate the gel dose response which, for the prolonged irradiation duration necessitated by the investigated dose rates, depends on the overall irradiation time. Data for this study are presented according to the AAPM TG-43 dosimetric formalism. Polymer gel results concerning the new seed are compared to corresponding, published dosimetric results obtained, for the purpose of the new seed clinical implementation, by our group using the established methods of Monte Carlo (MC) simulation and thermo-luminescence dosimetry (TLD). Polymer gel dosimetry yields an average dose rate constant value of lambda = (0.921 +/- 0.031) cGy h(-1) U(-1) relative to (MC)lambda = (0.929 +/- 0.014) cGy h(-1) U(-1), (TLD)lambda = (0.951 +/- 0.044) cGy h(-1) U(-1) and the average value of Lambda = (0.940 +/- 0.051) cGy h(-1) U(-1) proposed for the clinical implementation of the new seed. Results for radial dose function, g(L)(r), and anisotropy function, F(r, theta), also agree with corresponding MC calculations within experimental uncertainties which are smaller for the polymer gel method compared to TLD. It is concluded that the proposed polymer gel-magnetic resonance imaging methodology could be used at least as a supplement to the established techniques for the dosimetric characterization of new low energy and low dose rate interstitial brachytherapy seeds.

MCPI©: A sub-minute Monte Carlo dose calculation engine for prostate implants

An accelerated Monte Carlo code [Monte Carlo dose calculation for prostate implant (MCPI)] is developed for dose calculation in prostate brachytherapy. MCPI physically simulates a set of radioactive seeds with arbitrary positions and orientations, merged in a three-dimensional (3D) heterogeneous phantom representing the prostate and surrounding tissue. MCPI uses a phase space data source-model to account for seed self-absorption and seed anisotropy. A "hybrid geometry" model (full 3D seed geometry merged in 3D mesh of voxels) is used for rigorous treatment of the interseed attenuation and tissue heterogeneity effects. MCPI is benchmarked against the MCNP5 code for idealized and real implants, for 103Pd and 125I seeds. MCPI calculates the dose distribution (2-mm voxel mesh) of a 103Pd implant (83 seeds) with 2% average statistical uncertainty in 59 s using a single Pentium 4 PC (2.4 GHz). MCPI is more than 10(3) and 10(4) times faster than MCNP5 for prostate dose calculations using 2- and 1-mm voxels, respectively. To illustrate its usefulness, MCPI is used to quantify the dosimetric effects of interseed attenuation, tissue composition, and tissue calcifications. Ignoring the interseed attenuation effect or slightly varying the prostate tissue composition may lead to 6% decreases of D100, the dose delivered to 100% of the prostate. The presence of calcifications, covering 1%-5% of the prostate volume, decreases D80, D90, and D100 by up to 32%, 37%, and 58%, respectively. In conclusion, sub-minute dose calculations, taking into account all dosimetric effects, are now possible for more accurate dose planning and dose assessment in prostate brachytherapy.

Monte Carlo and thermoluminescence dosimetry of the new IsoSeed® model I25.S17 I125 interstitial brachytherapy seed

Monte Carlo simulation and experimental thermoluminescence dosimetry were utilized for the dosimetric characterization of the new IsoSeed model I25.S17 125I interstitial brachytherapy seed. The new seed design is similar to that of the selectSeed and 6711 seeds, with the exception of its molybdenum marker. Full dosimetric data are presented following the recommendations in the Update of the AAPM Task Group 43 report (TG-43U1). A difference of 3.3% was found between Monte Carlo dose rate constant results calculated by air kerma strengths from simulations using a point detector and a detector resembling the solid angle subtended to the seed by the Wide Angle Free Air Chamber (WAFAC) in the primary standard calibration geometry. Following the TG-43U1 recommendations, an average value of lambdaMC = (0.929 +/- 0.014) cGy h(-1) U(-1) was adopted for the new seed. This value was then averaged with the measured value of lambdaEXP = (0.951 +/- 0.044) cGy h(-1) U(-1) to yield the proposed dose rate constant for the new seed that is equal to lambda = (0.940 +/- 0.051) cGy h(-1) U(-1). The Monte Carlo calculated radial dose function and two-dimensional (2-D) anisotropy function results for the new seed were found in agreement with experimental results to within statistical uncertainty of repeated measurements. Monte Carlo simulations were also performed for 125I seeds of similar geometry and dimensions for the purpose of comparison. The new seed presents dosimetric characteristics that are very similar to that of the selectSeed. In comparison to the most extensively studied Amersham 6711 seed, the new one presents similar dosimetric characteristics with a slightly reduced dose rate constant (1.5%).

Polymer gel dosimetry close to an125I interstitial brachytherapy seed

Despite its advantages, the polymer gel-magnetic resonance imaging (MRI) method has not, as yet, been successfully employed in dosimetry of low energy/low dose rate photon-emitting brachytherapy sources such as 125I or 103Pd interstitial seeds. In the present work, two commercially available 125I seed sources, each of approximately 0.5 U, were positioned at two different locations of a polymer gel filled vial. The gel vial was MR scanned with the sources in place 19 and 36 days after seed implantation. Calibration curves were acquired from the coupling of MRI measurements with accurate Monte Carlo dose calculations obtained simulating the exact experimental setup geometry and materials. The obtained gel response data imply that while linearity of response is sustained, sensitivity (calibration curve slope) is significantly increased (approximately 60%) compared to its typical value for the 192Ir (or 60Co and 6 MV LINAC) photon energies. Water equivalence and relative energy response corrections of the gel cannot account for more than 3-4% of this increase, which, therefore, has to be mainly attributed to physicochemical processes related to the low dose rate of the sources and the associated prolonged irradiation time. The calibration data obtained from one 125I source were used to provide absolute dosimetry results for the other 125I source, which were found to agree with corresponding Monte Carlo calculations within experimental uncertainties. It is therefore suggested that, regardless of the underlying factors accounting for the gel dose response to 125I irradiations, polymer gel dosimetry of new 125I or 103Pd sources should be carried out as originally proposed by Heard and Ibbot (2004 J. Phys.: Conf. Ser. 3 221-3), i.e., by irradiating the same gel sample with the new low dose rate source, as well as with a well-characterized low dose rate source which will provide the dose calibration curve for the same irradiation conditions.

Dosimetric effects of seed anisotropy and interseed attenuation for Pd103 and I125 prostate implants

A Monte Carlo study is carried out to quantify the effects of seed anisotropy and interseed attenuation for 103Pd and 125I prostate implants. Two idealized and two real prostate implants are considered. Full Monte Carlo simulation (FMCS) of implants (seeds are physically and simultaneously simulated) is compared with isotropic point-source dose-kernel superposition (PSKS) and line-source dose-kernel superposition (LSKS) methods. For clinical pre- and post-procedure implants, the dose to the different structures (prostate, rectum wall, and urethra) is calculated. The discretized volumes of these structures are reconstructed using transrectal ultrasound contours. Local dose differences (PSKS versus FMCS and LSKS versus FMCS) are investigated. The dose contributions from primary versus scattered photons are calculated separately. For 103Pd, the average absolute total dose difference between FMCS and PSKS can be as high as 7.4% for the idealized model and 6.1% for the clinical preprocedure implant. Similarly, the total dose difference is lower for the case of 125I: 4.4% for the idealized model and 4.6% for a clinical post-procedure implant. Average absolute dose differences between LSKS and FMCS are less significant for both seed models: 3 to 3.6% for the idealized models and 2.9 to 3.2% for the clinical plans. Dose differences between PSKS and FMCS are due to the absence of both seed anisotropy and interseed attenuation modeling in the PSKS approach. LSKS accounts for seed anisotropy but not for the interseed effect, leading to systematically overestimated dose values in comparison with the more accurate FMCS method. For both idealized and clinical implants the dose from scattered photons represent less than 1/3 of the total dose. For all studied cases, LSKS prostate DVHs overestimate D90 by 2 to 5% because of the missing interseed attenuation effect. PSKS and LSKS predictions of V150 and V200 are overestimated by up to 9% in comparison with the FMCS results. Finally, effects of seed anisotropy and interseed attenuation must be viewed in the context of other significant sources of dose uncertainty, namely seed orientation, source misplacement, prostate morphological changes and tissue heterogeneity.

Dosimetric parameters estimation using PENELOPE Monte-Carlo simulation code: Model 6711 a 125I brachytherapy seed

The dosimetric parameters for characterization of a low-energy interstitial brachytherapy source (125)I are examined. In this work, the radial dose function, g(r), anisotropy function F(r,theta), and the absolute dose rate, Lambda, around (125)I seed model 6711 have been estimated by means of the PENELOPE Monte-Carlo (MC) simulation code. The results obtained are in good agreement with the corresponding values recommended by TG-43 that are based in experimental and MC published results.

Evaluation of the new cesium-131 seed for use in low-energy x-ray brachytherapy

Characterization measurements and calculations were performed on a new medical seed developed by IsoRay Inc. in Richland, Washington, that utilizes the short-lived isotope 131Cs. This model has recently received FDA 510(k) clearance. The objective of this work was to characterize the dosimetric properties of the new seed according to the AAPM Task Group 43 recommendations. Cesium-131 is a low-energy x-ray emitter, with the most prominent peaks in the 29 keV to 34 keV region. The intended application is brachytherapy for treating cancers in prostate, breast, head and neck, lung, and pancreas. The evaluations performed included air-kerma strength, radial dose function, anisotropy in phantom, half-life, energy spectra, and internal activity. The results indicate the CS-1 seeds have a dose-rate constant of 0.915 cGy hr(-1) U(-1) in water, dose penetration characteristics similar to 125I and 103Pd, anisotropy function values on the order of 0.71 at short distances and small angles, and an average anisotropy factor of 0.964. The overall dosimetric characteristics are similar to 125I and 103Pd seeds with the exception of half-life, which is 9.7 days, as compared to 17 days for 103Pd and 60 days for 125I. The shorter half-life may offer significant advantages in biological effectiveness.

Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations

Since publication of the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report in 1995 (TG-43), both the utilization of permanent source implantation and the number of low-energy interstitial brachytherapy source models commercially available have dramatically increased. In addition, the National Institute of Standards and Technology has introduced a new primary standard of air-kerma strength, and the brachytherapy dosimetry literature has grown substantially, documenting both improved dosimetry methodologies and dosimetric characterization of particular source models. In response to these advances, the AAPM Low-energy Interstitial Brachytherapy Dosimetry subcommittee (LIBD) herein presents an update of the TG-43 protocol for calculation of dose-rate distributions around photon-emitting brachytherapy sources. The updated protocol (TG-43U1) includes (a) a revised definition of air-kerma strength; (b) elimination of apparent activity for specification of source strength; (c) elimination of the anisotropy constant in favor of the distance-dependent one-dimensional anisotropy function; (d) guidance on extrapolating tabulated TG-43 parameters to longer and shorter distances; and (e) correction for minor inconsistencies and omissions in the original protocol and its implementation. Among the corrections are consistent guidelines for use of point- and line-source geometry functions. In addition, this report recommends a unified approach to comparing reference dose distributions derived from different investigators to develop a single critically evaluated consensus dataset as well as guidelines for performing and describing future theoretical and experimental single-source dosimetry studies. Finally, the report includes consensus datasets, in the form of dose-rate constants, radial dose functions, and one-dimensional (1D) and two-dimensional (2D) anisotropy functions, for all low-energy brachytherapy source models that met the AAPM dosimetric prerequisites [Med. Phys. 25, 2269 (1998)] as of July 15, 2001. These include the following 125I sources: Amersham Health models 6702 and 6711, Best Medical model 2301, North American Scientific Inc. (NASI) model MED3631-A/M, Bebig/Theragenics model I25.S06, and the Imagyn Medical Technologies Inc. isostar model IS-12501. The 103Pd sources included are the Theragenics Corporation model 200 and NASI model MED3633. The AAPM recommends that the revised dose-calculation protocol and revised source-specific dose-rate distributions be adopted by all end users for clinical treatment planning of low energy brachytherapy interstitial sources. Depending upon the dose-calculation protocol and parameters currently used by individual physicists, adoption of this protocol may result in changes to patient dose calculations. These changes should be carefully evaluated and reviewed with the radiation oncologist preceding implementation of the current protocol.

The effect of the radial function on I-125 seeds used for permanent prostate implantation

The purpose of this study was to evaluate the integrity of eight commercially-available low-activity Iodine-125 (125I) seeds for their radial function g(r) and its effect on the dose delivered to the adjacent critical structures when used in permanent prostate implants (PPI). Ten previously treated patients were retrospectively used in this comparison. The Amersham Health Oncura seed was used to peripherally design an isodose distribution with urethral and anterior rectal wall sparing. Plan criteria included minimum coverage of 144 Gy to the planning target volume (PTV), < or = 70% dose to 150% of the PTV volume (V150-PTV), and the quantity of needles < or = 70% of the size of the PTV, in cc. Upon completion of the Oncura plan, the seed type was changed and the activity was adjusted until the V100-PTV for each of the other 7 seed types matched the V100-PTV defined by the Oncura seed. Computed tomography (CT)-based postimplant dosimetry was used to determine the dose to 40% (D40) of the bulb of the penis (in Gy). Dose-volume histograms (DVH) were used to evaluate the differences to V100 (in %) and D40 (in Gy) of the anterior rectal wall and bulb of the penis, and V100 (in %) of the urethra. The data was tabulated. Radioactive 125I sources included in this study were 125I Source 2301 (Best); I-Plant (MedTech), IoGold (Mentor), Oncura (Amersham Health), ProstaSeed (UroCor), SelectSeed (Nucletron), SourceTech (Bard), and Symmetra (UroMed). The sizes of the PTV for the 10 patients ranged from 18.82 cc to 48.99 cc. The Oncura seed was used as the reference seed and all other seed types were normalized to it for data comparison. It was determined that the dose rate constant (Delta) and anisotropy factor (phi) contribute to the activity needed to achieve comparable V100-PTV doses, but a strong dependence on the radial function g(r) was found to effect the doses to the critical structures studied. Values of g(r) at 4 cm were calculated and the IoGold and SourceTech seeds were determined to have the highest g(r) values, with ProstaSeed and SelectSeed having the lowest values. 125I Source 2301 and IoGold required less activity per seed to achieve the same dose to the V100-PTV due to the higher dose rate and anisotrophy constants (Delta.phi). The seed types with silver were less penetrating and resulted in the production of characteristic x-rays that modified the energy spectrum and influenced the radial function. The seeds requiring the lowest activity showed the highest dose to the anterior rectal wall, a posterior adjacent structure; the urethra, an interior structure; and the bulb, an inferior structure. This study was designed to investigate the integrity of eight different commercially-available seed types, and their dependence on the g(r) in seed choice. It was determined that the dose rate constant and anisotropy factor determine the activity needed for implantation but a strong dependence on the radial function was found to effect the doses to the adjacent structures.

Brachytherapy dosimetry parameters calculated for a new 103Pd source

A new brachytherapy source having 103Pd adsorbed onto silver beads has been designed. The dose distributions of this source have been characterized using version 5 of the MCNP Monte Carlo radiation transport code available from Oak Ridge National Laboratory. These results are presented in terms of the updated AAPM Task Group No. 43 (TG-43U1) formalism, dosimetry parameters, and recommended calculation methodology.

Monte Carlo calculated TG-43 dosimetry parameters for the SeedLink™ 125Iodine brachytherapy system

The SeedLink brachytherapy system is comprised from an assembly of I-Plant 3500 interstitial brachytherapy seeds and bioresorbable spacers joined together by a 6-mm-long titanium sleeve centered over each seed. This device is designed to maintain specified spacing between seeds during treatment thereby decreasing implant preparation time and reducing radionuclide migration within the prostate and periprostatic region. Reliable clinical treatment and planning applications necessitate accurate dosimetric data for source evaluation, therefore the authors report the results of a Monte Carlo study designed to calculate the AAPM Task Group Report No. 43 dosimetric parameters for the SeedLink brachytherapy source and compare these values against previously published Monte Carlo study results of the I-Plant 3500 brachytherapy seed. For this investigation, a total of 1 x 10(9) source photon histories were processed for each set of in-water and in-air calculations using the MCNP4C2 Monte Carlo radiation transport code (RSICC). Statistically, the radial dose function, g(r), and the dose-rate constant, lambda, were identical to the values calculated previously for the Model 3500 with the dose-rate constant evaluated to be lambda = 1.000+/-0.026 cGyh(-1) U(-1). The titanium sleeve used in SeedLink to bind together Model 3500 seeds and spacers resulted in slightly greater dosimetric anisotropy as exhibited in the anisotropy function, F(r, theta), the anisotropy factor, phi(an) (r), and the anisotropy constant, phi(an), which was calculated to be phi(an) = 0.91 +/- 0.01, or roughly 2% lower than the value calculated previously for the Model 3500. These results indicate that the radiological characteristics of the SeedLink dosimetry system are comparable to those obtained for previously characterized single seeds such as the Implant Sciences Model 3500 I-Plant seed.

A novel approach for the adsorption of iodine-125 on silver wire as matrix for brachytherapy source for the treatment of eye and prostate cancer

The adsorption of iodine-125 on silver wire bits coated with palladium to be sealed in titanium capsules as brachytherapy sources was studied. A method was optimized to obtain quantitative adsorption of 125I on the palladium treated silver wires. A comparative evaluation of palladium coated and uncoated (bare) silver wires on the adsorption of 125I was made. While, the adsorption of bare silver wires showed low, inconsistent uptake (approximately 60%) of 125I with high leachability (approximately 4%), the Pd coated silver wires showed quantitative and consistent uptake of 125I (approximately 90%) and exhibited low leachability (0.01%). 125I adsorbed on Pd coated silver wires could be used as a matrix for the preparation of interstitial sources in eye and prostate cancer therapy.

Monte carlo investigation of the dosimetric properties of the new 103Pd BrachySeedPd-103 Model Pd-1 source

Recently, 103Pd brachytherapy sources have been increasingly used for interstitial implants as an alternative to 125I sources. The BrachySeedPd-103 Model Pd-1 seed is one of the latest in a series of new brachytherapy sources that have become available commercially. The dosimetric properties of the seed were investigated by Monte Carlo simulation, which was performed using the Integrated Tiger Series CYLTRAN code. Following the AAPM Task Group 43 formalism, the dose rate constant, radial dose function, and anisotropy parameters were determined. The dose rate constant, A, was calculated to be 0.613 +/- 3% cGy h(-1) U(-1). This air kerma strength was derived from Monte Carlo simulation using the point extrapolation method. The radial dose function, g(r), was computed at distances from 0.15 to 10 cm. The anisotropy function, F(r,theta), and anisotropy factor, phi(an)(r), were calculated at distances from 0.5 to 7 cm. The anisotropy constant, phi(an), was determined to be 0.978, which is closer to unity than most other 103Pd seeds, indicating a high degree of uniformity in dose distribution. The dose rate constant and the radial dose function were also investigated by analytical modeling, which served as an independent evaluation of the Monte Carlo data, and found to be in good agreement with the Monte Carlo results.

Comprehensive Monte Carlo calculations of AAPM Task Group Report No. 43 dosimetry parameters for the Model 3500 I-Plant 125I brachytherapy source

The Model 3500 I-Plant 125I brachytherapy source, produced by Implant Sciences Corporation, is created through a novel technique which utilizes ion implantation of 124Xe into a ceramic matrix followed by neutron activation of the substrate. Clinical dosimetry parameters were calculated using MCNP. For data processing, a 0.376 cm active length was used for the geometry function. The 2-D anisotropy function, F(r, 0), exhibited less anisotropy than the Amersham Health Model 6711 source, and decreased as radial distance, r, increased. The anisotropy constant, phi an, was 0.933; dose rate constant, lambda, was 1.017 +/- 0.005 cGy/h/U; and radial dose function, g(r), for r = (0.1, 0.2, 0.5, 2, 5, 10 cm) was 0.990, 1.014, 1.030, 0.872, 0.448, and 0.114, respectively. In general, there was good agreement with experimental results recently obtained by others using thermoluminescent dosimeters.

Monte Carlo calculations of dosimetry parameters of the urocor prostaseed 125I source

This report presents the results of Monte Carlo calculations of the dosimetric parameters of the Urocor ProstaSeed 1251 seed source. This source contains five spherical silver markers, of 0.5 mm diameter, with 1251 deposited on the spheres through ion exchange. The silver spheres are then encapsulated within a 0.8 mm in diameter and 4.5 mm long cylindrical shell of titanium, as is common to this type of sources. Physical dimensions of the source are confirmed by measurement. Four (4) geometric models of the source, based on different assumptions on the locations of the silver spheres within the seed, were used in dose rate calculations. Monte Carlo photon transport simulation was used to calculate the dosimetric parameters of dose rate constant, radial dose function, and anisotropy function using these geometric models of the source. The Monte Carlo calculated dose rate constant of the ProstaSeed source was found equal to 0.925 cGy/Uh with approximate uncertainties of 5%. Radial dose function values and anisotropy function values were derived from the relative dose distribution around the source calculated by the Monte Carlo code. The calculated values of these dosimetric parameters agree with previously published thermoluminescence-dosimeter-measured values for this source after consideration of measurement and calculation uncertainties.

Dosimetric characteristics of the DRAXIMAGE model LS-1 1-125 interstitial brachytherapy source design: a Monte Carlo investigation

(Received 5 June 2001; accepted for publication 26 December 2001; published 19 March 2002) We have used Monte Carlo photon transport simulations to evaluate dosimetric characteristics of a new 125I seed, the DRAXIMAGE BrachySeed (model LS-1) source for interstitial brachytherapy and to calculate the dosimetric parameters recommended by the AAPM Task Group 43 (TG-43). To eliminate thick end welds, preformed closed-ended Ti shells are welded together near the transverse plane. The radioactivity is localized near the seed ends in order to maximize isotropy at typical prescription distances. Transmission radiography reveals that its internal components can move by as much as 200 microm under the influence of gravitational forces affecting the dose-rate constant and relative dose distribution by as much as 5% and 10%, respectively. However, the clinical dose distribution can be well represented by a weighted average of dose distributions corresponding to three different orientation-dependent internal geometry configurations. This average dose distribution agrees closely (within 1% at 1 cm) with that derived from the geometry specified by the vendor model (seed components uniformly spaced), from which the recommended relative dosimetry parameters were derived. An average dose-rate constant of 0.935 cGy h(-1) U(-1) is recommended for clinical application and values of 0.919, 0.963, and 0.920 for vertical orientation, horizontal orientation, and the vendor specified geometries, respectively. The NIST wide-angle free-air chamber realization of the air-kerma strength primary standard, SKN99, was explicitly simulated. We show that the output of Ag characteristic x rays is about half that of the model 6711 source resulting in a relative dose distribution between that of the model 6711 source and pure 125I x-ray emitters. Finally, it is demonstrated that the TG-43 point-source formalism more accurately estimates solid-angle weighted dose at small distances if one uses a radial dose function data prepared using a point-source, rather than line-source, geometry factor.

Dosimetric properties of the new 125I BrachySeed model LS-1 source

The BrachySeed model LS-1 is one of the latest in a series of new brachytherapy 125I seeds that have recently become available commercially for interstitial implants. The dosimetric properties of the seed were investigated analytically, experimentally, and by Monte Carlo simulation. Following the AAPM Task Group 43 formalism, the radial dose function, dose rate constant, and anisotropy parameters were determined. Experimental measurements were made in solid water-equivalent phantoms using GafChromic MD-55-2 films, with correction for the low energy film response. Analyses were carried out from absolute measurements, as well as relative measurements against the Nycomed Amersham OncoSeed Model 6711, which also served to validate our experimental methodology. A small, but systematic difference in the absolute measurements was observed depending on the duration of the irradiation. Monte Carlo simulation was performed using the Integrated Tiger Series CYLTRAN code. We benchmarked the code by comparing the dose parameters of Model 6702 with published values. The radial dose function, g(r), of the Model LS-1 seed was computed at distances from 0.25 to 10 cm by analytical and Monte Carlo calculations with reasonably good agreement. The suggested dose rate constant, A, based on the Monte Carlo simulation is 0.90+/-0.03 cGy h(-1) U(-1). This value is smaller than, but overlaps the experimental determination of 0.98+/-0.06 cGy h(-1) U(-1). The anisotropy function, F(r, theta), and anisotropy factor, phi(an)(r), compared favorably with those of the Model 6711.

Prostate brachytherapy: comparison of dose distribution with different 125I source designs

PURPOSE

To evaluate the interchangeability of various commercially available iodine 125 ((125)I) sources and to assess the dosimetric effect of a change in source.

MATERIALS AND METHODS

A modified peripherally loading prostate brachytherapy plan to deliver 145 Gy was devised by using a model (125)I source, which until recently was the only available (125)I source. A dose-volume histogram was generated. By using the available radial dose functions and anisotropy distributions for eight other currently commercially available sources, the same implant placement was planned and dose-volume histogram distributions tabulated. This exercise was performed for 15-, 45-, and 60-cm(3) glands. No implants were placed, and no physical radiation measurements were made. Dose calculations were theoretic: They were generated by using a widely available treatment planning system.

RESULTS

There was little difference in dose distribution to the volume receiving 100% of the prescribed dose (<6%); only one source showed a difference greater than 2%. Large differences, up to -40% to +60%, were seen in the volume of tissue encompassed within internal high-dose regions receiving 150% or 200% of the prescribed dose. These findings held true, irrespective of gland size, within a clinically relevant range (15-60 cm(3)) and for a uniformly loaded radionuclide distribution.

CONCLUSION

Reviewing only peripheral dose at or near the prescription dose of 145 Gy revealed little difference in doses for various source designs. Marked differences in high-dose regions were seen and may affect the dose received by internal sites. Effects of these changes on cure and/or complications remain speculative.

Monte Carlo-aided dosimetry of the new Bebig IsoSeed 103Pd interstitial brachytherapy seed

A new model 103Pd interstitial brachytherapy source, the IsoSeed 103Pd, was recently introduced by Bebig Isotopentechnik und Umweltdiagnostik GmbH for permanent implant applications. This study presents the first quantitative theoretical study of the seed's dosimetric quantities. Monte Carlo photon transport (MCPT) simulation techniques have been used to evaluate the dose-rate distributions around the model IsoSeed 103Pd source in liquid water and air phantoms. These results have been used to calculate and tabulate the anisotropy function, F(r, theta), radial dose function, g(r), and anisotropy factors, phi(r), and dose-rate constant as defined by AAPM Task Group 43 (TG-43) Report. Cartesian "away" and "along" tables, giving the dose rates per unit air-kerma strength in water in the range 0.1-3 cm distance around the seed have also been tabulated. The dose-rate constant, lambda, was evaluated by simulating the wide-angle, free-air chamber (WAFAC) calibration geometry recently implemented by NIST (National Institute of Standards and Technology) to realize the primary standard of air-kerma strength (SK,N99) for low-energy photon-emitting brachytherapy sources. The dose-rate constant has been found to be lambda=0.660+/-0.017 in units of dose-rate per unit air-kerma strength (cGy x h(-1) x U(-1)).

Monte Carlo dosimetry of the selectSeed 125I interstitial brachytherapy seed

This work provides full dosimetric data for the new selectSeed 125I prostate seed source to be distributed by Nucletron B.V. The AAPM TG-43 dosimetric formalism and the new 1999 NIST air kerma strength calibration standard have been followed. Air kerma strength, dose rate constant, radial dose functions, anisotropy functions, and anisotropy factors were calculated using Monte Carlo simulation. Corresponding calculations were also performed for the commercially available 6711 seed source, which is of similar design, for reasons of comparison. The calculated dose rate constant of the selectSeed was 0.954+/-0.005 cGy h(-1) U(-1) compared to 0.953+/-0.005 cGy h(-1) U(-1) for the 6711 source design. The latter value for the 6711 source suggests that the correction factor proposed by NIST for conversion of dose rate constants to the new 1999 NIST calibration standard may be overestimated by 2-3%. Radial dose functions of the two sources were found in good agreement for radial distances up to 4 cm, the selectSeed being less penetrating at greater radial distances (approximately 4% at 10 cm). The selectSeed source presents similar anisotropy characteristics with the 6711 source design. For both source designs, a distance and polar angle dependent discontinuity of anisotropy function values was observed owing to the dose contribution of radioactivity distributed on the ends of the cylindrical source cores. Variation of dosimetric parameters with possible variation in radioactive silver halide coating thickness of the silver source core of the new source was also investigated.