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Maharaj KD, Dass J, Ibrahim M, Mahmood T, Rowshanfarzad P. Peripheral Doses Beyond Electron Applicators in Conventional C-Arm Linear Accelerators: A Systematic Literature Review. Technol Cancer Res Treat 2024; 23:15330338241239144. [PMID: 38515394 PMCID: PMC10958816 DOI: 10.1177/15330338241239144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Background: This review investigates peripheral dose levels in electron beam treatments, comparing different manufacturers including Varian, Elekta, and Siemens. Accurate measurement of peripheral dose is vital for patient safety and precise radiation delivery in radiation therapy. Methods: This review followed PRISMA standards, conducting a comprehensive literature search from 1978 to July 2023. Emphasis was on identifying studies analyzing peripheral doses related to various electron beam energies, beam angle, field sizes, cutouts, and applicator combinations. Three major databases including PubMed, Web of Science, and Scopus were searched. Results: A total of 7 articles were included in this review. Strategies such as bolus materials, personalized cutouts, and optimal treatment procedures have all been developed to reduce peripheral radiation exposure and enhance patient safety. Ongoing research in this field is focused on further minimizing the risks associated with out-of-field radiation by improving dose delivery systems. Conclusion: The literature emphasizes importance of precision in electron beam radiation therapy, highlighting the critical need for managing peripheral doses and optimizing hardware to ensure patient safety. It advocates for the use of advanced tools and protocols to maintain a balance between effective treatment while protecting healthy tissues. Continuous research, careful treatment planning, and effective management of peripheral doses are essential.
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Affiliation(s)
- Kapil Dev Maharaj
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Western Australia, Australia
| | - Joshua Dass
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mounir Ibrahim
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Talat Mahmood
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Pejman Rowshanfarzad
- School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, Western Australia, Australia
- Centre for Advanced Technologies in Cancer Research (CATCR), Perth, Western Australia, Australia
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Yamaguchi S, Ieko Y, Ariga H, Yoshioka K. Electron beam detection in radiotherapy using a capacitor dosimeter equipped with a silicon photodiode. Med Biol Eng Comput 2023:10.1007/s11517-023-02870-7. [PMID: 37380785 DOI: 10.1007/s11517-023-02870-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
In this study, a newly developed capacitor dosimeter was evaluated using electron beams commonly utilized in radiotherapy. The capacitor dosimeter comprised a silicon photodiode, 0.47-μF capacitor, and dedicated terminal (dock). Before electron beam irradiation, the dosimeter was charged using the dock. The doses were measured without using a cable by reducing the charging voltages using the currents from the photodiode during irradiation. A commercially available parallel-plane-type ionization chamber and solid-water phantom were used for dose calibration with an electron energy of 6 MeV. In addition, the depth doses were measured using a solid-water phantom at electron energies of 6, 9, and 12 MeV. The doses were proportional to the discharging voltages, and the maximum dose difference in the calibrated doses measured using a two-point calibration was approximately 5% in the range of 0.25-1.98 Gy. The depth dependencies at energies of 6, 9, and 12 MeV corresponded to those measured using the ionization chamber.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Radiology, School of Medicine, Iwate Medical University, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan.
| | - Yoshiro Ieko
- Department of Radiation Oncology, Iwate Medical University Hospital, Iwate Medical University, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Hisanori Ariga
- Department of Radiation Oncology, Iwate Medical University Hospital, Iwate Medical University, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
| | - Kunihiro Yoshioka
- Department of Radiology, School of Medicine, Iwate Medical University, 2-1-1, Idaidori, Yahaba, Iwate, 028-3695, Japan
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Matuszak N, Kruszyna-Mochalska M, Skrobala A, Ryczkowski A, Romanski P, Piotrowski I, Kulcenty K, Suchorska WM, Malicki J. Nontarget and Out-of-Field Doses from Electron Beam Radiotherapy. Life (Basel) 2022; 12:858. [PMID: 35743890 PMCID: PMC9225003 DOI: 10.3390/life12060858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023] Open
Abstract
In clinical radiotherapy, the most important aspects are the dose distribution in the target volume and healthy organs, including out-of-field doses in the body. Compared to photon beam radiation, dose distribution in electron beam radiotherapy has received much less attention, mainly due to the limited range of electrons in tissues. However, given the growing use of electron intraoperative radiotherapy and FLASH, further study is needed. Therefore, in this study, we determined out-of-field doses from an electron beam in a phantom model using two dosimetric detectors (diode E and cylindrical Farmer-type ionizing chamber) for electron energies of 6 MeV, 9 MeV and 12 MeV. We found a clear decrease in out-of-field doses as the distance from the field edge and depth increased. The out-of-field doses measured with the diode E were lower than those measured with the Farmer-type ionization chamber at each depth and for each electron energy level. The out-of-field doses increased when higher energy megavoltage electron beams were used (except for 9 MeV). The out-of-field doses at shallow depths (1 or 2 cm) declined rapidly up to a distance of 3 cm from the field edge. This study provides valuable data on the deposition of radiation energy from electron beams outside the irradiation field.
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Affiliation(s)
- Natalia Matuszak
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Radiobiology Laboratory, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Marta Kruszyna-Mochalska
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (A.R.); (P.R.)
| | - Agnieszka Skrobala
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (A.R.); (P.R.)
| | - Adam Ryczkowski
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (A.R.); (P.R.)
| | - Piotr Romanski
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (A.R.); (P.R.)
| | - Igor Piotrowski
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Radiobiology Laboratory, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Katarzyna Kulcenty
- Radiobiology Laboratory, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Wiktoria Maria Suchorska
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Radiobiology Laboratory, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Julian Malicki
- Department of Electroradiology, Poznan University of Medical Sciences, 61-866 Poznan, Poland; (M.K.-M.); (A.S.); (I.P.); (W.M.S.); (J.M.)
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznan, Poland; (A.R.); (P.R.)
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Dróżdż A, Waluś M, Zieliński M, Malesa B, Kruszyna-Mochalska M, Kulcenty K, Adamczyk B, Nowaczyk P, Malicki J, Pracz J. Verification of electron beam parameters in an intraoperative linear accelerator using dosimetric and radiobiological response methods. Rep Pract Oncol Radiother 2021; 26:1029-1034. [PMID: 34992877 PMCID: PMC8726448 DOI: 10.5603/rpor.a2021.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The availability of linear accelerators (linac) for research purposes is often limited and therefore alternative radiation sources are needed to conduct radiobiological research. The National Centre for Radiation Research in Poland recently developed an intraoperative mobile linac that enables electron irradiation at energies ranging from 4 to 12 MeV and dose rates of 5 or 10 Gy/min. The present study was conducted to evaluate the electron beam parameters of this intraoperative linac and to verify the set-up to evaluate out-of-field doses in a water phantom, which were determined through dosimetric and biological response measurements. MATERIALS AND METHODS The distribution of radiation doses along and across the radiation beam were measured in a water phantom using a semiconductor detector and absolute doses using an ionisation chamber. Two luminal breast cancer cell lines (T-47D and HER2 positive SK-BR-3) were placed in the phantom to study radiation response at doses ranging from 2 to 10 Gy. Cell response was measured by clonogenic assays. RESULTS AND CONCLUSION The electron beam properties, including depth doses and profiles, were within expected range for the stated energies. These results confirm the viability of this device and set-up as a source of megavoltage electrons to evaluate the radiobiological response of tumour cells.
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Affiliation(s)
| | - Martyna Waluś
- National Centre for Nuclear Research, Otwock-Swierk, Poland
| | | | - Bożena Malesa
- National Centre for Nuclear Research, Otwock-Swierk, Poland
| | - Marta Kruszyna-Mochalska
- Medical Physics Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Beata Adamczyk
- Breast Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Nowaczyk
- Breast Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Julian Malicki
- Medical Physics Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Pracz
- Department of Nuclear Equipment HITEC, National Centre For Nuclear Research, Swierk, Poland
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The PanCareSurFup consortium: research and guidelines to improve lives for survivors of childhood cancer. Eur J Cancer 2018; 103:238-248. [DOI: 10.1016/j.ejca.2018.08.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/10/2018] [Accepted: 08/26/2018] [Indexed: 01/20/2023]
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Experimental validatıon of peripheral dose distribution of electron beams for eclipse electron Monte Carlo algorithm. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s1460396917000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAimThe accuracy of two calculation algorithms of the Varian Eclipse treatment planning system (TPS), the electron Monte Carlo algorithm (eMC) and general Gaussian pencil beam algorithm (GGPB) for calculating peripheral dose distribution of electron beams was investigated.MethodsPeripheral dose measurements were carried out for 6, 9, 12, 15, 18 and 22 MeV electron beams using parallel plate ionisation chamber and EBT3 film in the slab phantom. Measurements were performed for 6×6, 10×10 and 25×25 cm2 cone sizes at dmax of each energy up to 20 cm beyond the field edges. The measured and TPS calculated data were compared.ResultsThe TPS underestimated the out-of-field doses. The difference between measured and calculated doses increase with the cone size. For ionisation chamber measurement, the largest deviation between calculated and measured doses is <4·29% using the eMC, but can increase up to 8·72% of the distribution using GGPB. For film measurement, the minimum gamma analysis passing rates between measured and calculated dose distributions for all field sizes and energies used in this study were 91·2 and 74·7% for eMC and GGPB, respectively.FindingsThe use of GGPB for planning large field treatments with 6 MeV could lead to inaccuracies of clinical significance.
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Kry SF, Bednarz B, Howell RM, Dauer L, Followill D, Klein E, Paganetti H, Wang B, Wuu CS, George Xu X. AAPM TG 158: Measurement and calculation of doses outside the treated volume from external-beam radiation therapy. Med Phys 2017; 44:e391-e429. [DOI: 10.1002/mp.12462] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 05/17/2017] [Accepted: 05/25/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Stephen F. Kry
- Department of Radiation Physics; MD Anderson Cancer Center; Houston TX 77054 USA
| | - Bryan Bednarz
- Department of Medical Physics; University of Wisconsin; Madison WI 53705 USA
| | - Rebecca M. Howell
- Department of Radiation Physics; MD Anderson Cancer Center; Houston TX 77054 USA
| | - Larry Dauer
- Departments of Medical Physics/Radiology; Memorial Sloan-Kettering Cancer Center; New York NY 10065 USA
| | - David Followill
- Department of Radiation Physics; MD Anderson Cancer Center; Houston TX 77054 USA
| | - Eric Klein
- Department of Radiation Oncology; Washington University; Saint Louis MO 63110 USA
| | - Harald Paganetti
- Department of Radiation Oncology; Massachusetts General Hospital and Harvard Medical School; Boston MA 02114 USA
| | - Brian Wang
- Department of Radiation Oncology; University of Louisville; Louisville KY 40202 USA
| | - Cheng-Shie Wuu
- Department of Radiation Oncology; Columbia University; New York NY 10032 USA
| | - X. George Xu
- Department of Mechanical, Aerospace, and Nuclear Engineering; Rensselaer Polytechnic Institute; Troy NY 12180 USA
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Cardenas CE, Nitsch PL, Kudchadker RJ, Howell RM, Kry SF. Out-of-field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators. J Appl Clin Med Phys 2016; 17:442-455. [PMID: 27455499 PMCID: PMC5690067 DOI: 10.1120/jacmp.v17i4.6216] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/17/2016] [Accepted: 03/03/2016] [Indexed: 11/23/2022] Open
Abstract
Out-of-field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high-energy electron beams. To better understand the extent of these exposures, we measured out-of-field dose characteristics of electron applicators for high-energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out-of-field dose profiles and percent depth-dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out-of-field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out-of-field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central-axis, which was found to be higher than typical out-of-field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for special cases.
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