New Photon Exposure Buildup Factors

Technical note: Investigating the suitability of existing facilities for a new Lu-177 prostate-specific membrane antigen therapy program

BACKGROUND

¹⁷⁷ Lu prostate-specific membrane antigen (PSMA) therapy prolongs survival for some prostate cancer patients. To adopt this technique, institutions may need to evaluate the suitability of existing infrastructure.

PURPOSE

Develop a methodology to determine whether existing facilities can accommodate a ¹⁷⁷ Lu-PSMA therapy program.

METHODS

Room suitability is defined by both the ability to accommodate ¹⁷⁷ Lu-PSMA therapy workflow and to provide appropriate radiation shielding. Two methods of shielding calculation were performed: (1) National Council on Radiation Protection and Measurements report 151 (NCRP-151), with workload defined in terms of the activity of ¹⁷⁷ Lu administered, and (2) using the RadPro shielding calculator. This methodology was applied to ¹³¹ I therapy, PET-CT uptake, PET-SPECT injection, and orthovoltage therapy rooms.

RESULTS

¹³¹ I therapy rooms were found to meet both shielding and workflow requirements. The shielding was found to be adequate for orthovoltage and PET-SPECT facilities, neglecting patient transit between external washrooms. The workflow was the limiting factor for these rooms due to the requirement of dedicated washrooms that shield the patient and contain possible contamination. The PET-CT facility did not meet either criteria. The NCRP-151 method generally predicted a higher dose rate on the other side of shielding than did the RadPro calculator. The dose rate on the other side of concrete shielding as predicted by the NCRP-151 method increased relative to the dose rate predicted by the RadPro calculator as shielding thickness increased. For lead shielding, the dose rate predicted by the NCRP-151 method decreased relative to the result predicted by the RadPro calculator with increasing material thickness.

CONCLUSIONS

¹³¹ I therapy, PET-CT uptake, PET-SPECT injection, and orthovoltage therapy rooms were considered. The ¹³¹ I treatment rooms were the best candidate for ¹⁷⁷ Lu-PSMA therapy, due to their shielding and capability to accommodate the necessary workflow.

Development and validation of an analytical model allowing accurate predictions of gamma and electron beam dose distributions in a water medical phantom

The aim of this work was to study photon and electron dose distributions in a phantom filled with water using the Monte Carlo Geant4 tool for electron energies ranging from 1 to 21 MeV and for photon energies ranging from 1.25 MeV to 25 MeV, corresponding to conventional radiotherapy Linac energies. The results of the Geant4 calculations were validated based on the relevant experimental data previously published. The results obtained were fitted and analytical models of dose distributions were developed for gamma radiation and electrons. For each of these models, one-dimensional (including dose depth profiles as a function of the depth inside the phantom) and two-dimensional (including the dose distribution as a function of depth and lateral position inside the phantom) dose distributions have been considered. Results are presented for photons and electrons of various energies. The coefficient of determination [Formula: see text] illustrates an excellent match between the developed analytical model and the Geant4 results. It is demonstrated that the analytical models developed in the present study can be applied in various fields such as those used for calibration applications and radiation therapy. It is concluded that the analytical models developed allow for quick, easy and reliable clinical dose estimates and offer promising alternatives to the standard tools and methods used in radiotherapy for treatment planning.

Finite and infinite system gamma ray buildup factor calculations with detailed physics

Examination of physical interactions of photons in materials is a significant subject for buildup factor studies. In most of the buildup calculations, by default, coherent (Rayleigh) scattering is ignored and the Compton scattering is modeled by free-electron Klein-Nishina formula with "simple physics" treatment. In this work, photon buildup factors are calculated for many different cases including "detailed physics" by taking into account coherent and bound-electron Compton scatterings with the Monte Carlo code, MCNP5, and the results are compared with the literature values. They are computed for point isotropic photon sources up to depths of 20 mean free paths and at the three photon energies most widely used (0.06, 0.6 and 6MeV). Calculations are made for both finite and infinite homogeneous ordinary water media. It is concluded that Coherent scattering is very dominant at low energies and for deep penetrations and assumed physical approximation (simple/detailed, finite/infinite) is the critical point for determining shielding material dimensions. After all, it can be stated that all parametric assumptions should be clearly given and indicated in the tabulation of photon buildup factors.

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.

IVBTMC, a Monte Carlo dose calculation tool for intravascular brachytherapy

A new Monte Carlo code (IVBTMC) is developed for accurate dose calculations in intravascular brachytherapy (IVBT). IVBTMC calculates the dose distribution of a brachytherapy source with arbitrary size and curvature in a general three-dimensional heterogeneous medium. Both beta and gamma sources are considered. IVBTMC is based on a modified version of the EGSNRC code. A voxel-based geometry is used to describe the target medium incorporating heterogeneities with arbitrary composition and shape. The source term is modeled using appropriate phase-space data. The phase-space data are calculated for three widely used sources (32P, 90Sr/90Y, and 192Ir). To speed up dose calculations for gamma sources, a special version of IVBTMC based on the kerma approximation is developed. The accuracy of the phase-space data model is verified and IVBTMC is validated against other Monte Carlo codes and against reported measurements using radio-chromic films. To illustrate the IVBTMC capabilities, a variety of examples are treated. 32P, 90Sr/90Y, and 192Ir sources with different lengths and degrees of curvature are considered. Calcified plaques with regular and irregular shapes are modeled. The dose distributions are calculated with a spatial resolution ranging between 0.1 and 0.5 mm. They are presented in terms of isodose contour plots. The dosimetric effects of the source curvature and/or the presence of calcified plaques are discussed. In conclusion, IVBTMC has the capability to perform high-precision IVBT dose calculations taking into account the realistic configurations of both the source and the target medium.

Monte Carlo dose calculations in homogeneous media and at interfaces: a comparison between GEPTS, EGSnrc, MCNP, and measurements

Three Monte Carlo photon/electron transport codes (GEPTS, EGSnrc, and MCNP) are bench-marked against dose measurements in homogeneous (both low- and high-Z) media as well as at interfaces. A brief overview on physical models used by each code for photon and electron (positron) transport is given. Absolute calorimetric dose measurements for 0.5 and 1 MeV electron beams incident on homogeneous and multilayer media are compared with the predictions of the three codes. Comparison with dose measurements in two-layer media exposed to a 60Co gamma source is also performed. In addition, comparisons between the codes (including the EGS4 code) are done for (a) 0.05 to 10 MeV electron beams and positron point sources in lead, (b) high-energy photons (10 and 20 MeV) irradiating a multilayer phantom (water/steel/air), and (c) simulation of a 90Sr/90Y brachytherapy source. A good agreement is observed between the calorimetric electron dose measurements and predictions of GEPTS and EGSnrc in both homogeneous and multilayer media. MCNP outputs are found to be dependent on the energy-indexing method (Default/ITS style). This dependence is significant in homogeneous media as well as at interfaces. MCNP(ITS) fits more closely the experimental data than MCNP(DEF), except for the case of Be. At low energy (0.05 and 0.1 MeV), MCNP(ITS) dose distributions in lead show higher maximums in comparison with GEPTS and EGSnrc. EGS4 produces too penetrating electron-dose distributions in high-Z media, especially at low energy (<0.1 MeV). For positrons, differences between GEPTS and EGSnrc are observed in lead because GEPTS distinguishes positrons from electrons for both elastic multiple scattering and bremsstrahlung emission models. For the 60Co source, a quite good agreement between calculations and measurements is observed with regards to the experimental uncertainty. For the other cases (10 and 20 MeV photon sources and the 90Sr/90Y beta source), a good agreement is found between the three codes. In conclusion, differences between GEPTS and EGSnrc results are found to be very small for almost all media and energies studied. MCNP results depend significantly on the electron energy-indexing method.