Evaluation of ferrous benzoic methylthymol-blue gel as a dosimeter via magnetic resonance imaging

PurposeIn previous studies, methylthymol-blue and benzoic acid have been introduced as a diffuser limiter and sensitivity enhancer in the gel dosimeter composition, respectively. This work focused on analyzing a formulation of the Fricke gel dosimeter consisting of methylthymol-blue and benzoic acid through magnetic resonance imaging.MethodsThe gel dosimeter samples were irradiated using 6, 10, and 15 MV photons with different levels of doses and read using a 1.5 T scanner in order to evaluate the dose–response sensitivity and to study the effect of benzoic acid concentration, diffusion coefficient and temperature and to determine the temporal stability of the gel dosimeter.ResultsInspection of radiological properties revealed that this gel dosimeter can be considered as a tissue equivalent medium. Within the dose range 0 to 1000 cGy, the R1 sensitivity and R2 sensitivity of the gel dosimeter equaled 0.058 ± 0.003 and 0.092 ± 0.004 s⁻¹Gy⁻¹, respectively. The diffusion coefficient was less than 0.85 ± 0.02mm²h⁻¹ for doses higher than 200 cGy. In addition, by changing the temperature from 15C to 25, the R1 sensitivity and R2 sensitivity decreased about 5 and 11%, respectively. Further, no significant energy and dose rate dependence were observed over photon energies of 6, 10, and 15 MV and over the range 65 to 525 cGy min⁻¹.ConclusionsBased on our observation, the ferrous benzoic acid methylthymol-blue gel dosimeter can be suggested to measure the dose distribution. Further analysis is required to clarify its performance in clinical situations.     

Surface dose measurements with GafChromic EBT film for 6 and 18 MV photon beams

The aim of this study was to determine the surface doses using GafChromic EBT films and compare them with plane-parallel ionization chamber measurements for 6 and 18 MV high energy photon beams. The measurements were made in a water equivalent solid phantom in the build-up region of the 6 and 18 MV photon beams at 100 cm SSD for various field sizes. Markus type plane-parallel ion chamber with fixed-separation between collecting electrodes was used to measure the percent depth doses. GafChromic EBT film measurements were performed both on the phantom surface and maximum dose depth at the same geometry with ion chamber measurements. The surface doses found using GafChromic EBT film were 15%, 20%, 29%and 39% ± 2% (1SD) for 6 MV photons, 6%, 11%, 23% and 32% ± 2% (1SD) for 18 MV photons at 5, 10, 20 and 30 cm² field sizes, respectively. GafChromic EBT film provides precise measurements for surface dose in the high energy photons. Agreement between film and plane-parallel chamber measurements was found to be within ±3% for 18 MV photon beams. There was 5% overestimate on the surface doses when compared with the plane-parallel chamber measurements for all field sizes in the 6 MV photon beams.     

Application of the phase-space distribution approach of Monte Carlo for radiation contamination dose estimation from the (n,γ), (γ,n) nuclear reactions and linac leakage photons in the megavoltage radiotherapy facility

AimThe aim of this study was to characterize the radiation contamination inside and outside the megavoltage radiotherapy room.BackgroundRadiation contamination components in the 18 MV linac room are the secondary neutron, prompt gamma ray, electron and linac leakage radiation.Materials and MethodsAn 18 MV linac modeled in a typical bunker employing the MCNPX code of Monte Carlo. For fast calculation, phase-space distribution (PSD) file modeling was applied and the calculations were conducted for the radiation contamination components dose and spectra at 6 locations inside and outside the bunker.ResultsThe results showed that the difference of measured and calculated percent depth-dose (PDD) and photo beam-profile (PBP) datasets were lower than acceptable values. At isocenter, the obtained photon dose and neutron fluence were 2.4 × 10⁻¹⁴ Gy/initial e° and 2.22 × 10^-8 n°/cm², respectively. Then, neutron apparent source strength (Q_N) value was found as 1.34 × 10¹² n°/Gy X at isocenter and the model verified to photon and neutron calculations. A surface at 2 cm below the flattening filter was modeled as phase-space (PS) file for PDD and PBP calculations. Then by use of a spherical cell in the center of the linac target as a PS surface, contaminant radiations dose, fluence and spectra were estimated at 6 locations in a considerably short time, using the registered history of all particles and photons in the 13GB PSD file as primary source in the second step.ConclusionDesigning the PSD file in MC modeling helps user to solve the problems with complex geometry and physics precisely in a shorter run-time.     

Optimal planning parameters for simultaneous boost IMRT treatment of prostate cancer using a Beam Modulator™

ObjectiveTo determine the optimum energy and beam arrangement for prostate intensity-modulated radiation therapy (IMRT) delivery using an Elekta Beam Modulator? linear accelerator, in order to inform decisions when commissioning IMRT for prostate cancer.MethodsCMS XiO was used to create IMRT plans for a prostate patient. Arrangements with 3, 5, 7, 9 and 11 equally spaced fields, containing both a direct anterior and a direct posterior beam were used, with both 6 MV and 10 MV photons. The effects of varying the maximum number of iterations, leaf increment, number of intensity levels and minimum segment size were investigated. Treatment plans were compared using isodose distributions, conformity indices for targets and critical structures, target dose homogeneity, body dose and plan complexity.ResultsTarget dose conformity and homogeneity and sparing of critical structures improved with an increasing number of beams, although any improvements were small for plans containing more than five fields. Set-ups containing a direct posterior field provided superior conformality around the rectum to anterior beam arrangements. Mean non-target dose and total number of monitor units were higher with 6 MV for all beam arrangements. The dose distribution resulting from seven 6 MV beams was considered clinically equivalent to that with five 10 MV beams.ConclusionMethods have been developed to plan IMRT treatments using XiO for delivery with a Beam Modulator? that fulfil demanding dose criteria, using many different set-ups. This study suggests that 6 MV photons can produce prostate IMRT plans that are comparable to those using 10 MV. Work is ongoing to develop a complete class solution.     

Neutron and high energy photon fluence estimation in CLINAC using gold activation foils

AimThe thermal neutron, epithermal neutron and high-energy photon fluence were measured in this work around the Varian 21EX 23 MV CLINAC, which is operated in Albairouni hospital in Damascus, Syria.BackgroundPhotoneutron measurements around medical CLINAC aim to protect both patients and staff from unwanted radiation.Materials and methodsNeutron and photon activation techniques were applied using gold foils.ResultsIt was found that high-energy photons fluence has practically a constant value in the field size. The thermal and epithermal neutron fluence along ox and oy axes has the same order of magnitude.ConclusionGold foils have been used successfully to measure neutron flux and high-energy photons simultaneously using activation techniques.     

Impact of transverse magnetic fields on dose response of a nanoDot OSLD in megavoltage photon beams

PurposeWe investigated the impact of transverse magnetic fields on the dose response of a nanoDot optically stimulated luminescence dosimetry (OSLD) in megavoltage photon beams.MethodsThe nanoDot OSLD response was calculated via Monte Carlo (MC) simulations. The responses R_Q and R_Q,B without and with the transverse magnetic fields of 0.35–3 T were analyzed as a function of depth at a 10 cm × 10 cm field for 4–18 MV photons in a solid water phantom. All responses were determined based on comparisons with the response under the reference conditions (depth of 10 cm and a 10 cm × 10 cm field) for 6 MV without the magnetic field. In addition, the influence of air-gaps on the nanoDot response in the magnetic field was estimated according to Burlin’s general cavity theory.ResultsThe R_Q as a function of depth for 4–18 MV ranged from 1.013 to 0.993, excepting the buildup region. The R_Q,B increased from 2.8% to 1.5% at 1.5 T and decreased from 3.0% to 1.1% at 3 T in comparison with R_Q as the photon energy increased. The depth dependence of R_Q,B was less than 1%, excepting the buildup region. The top air-gap and the bottom air- gap were responsible for the response reduction and the response increase, respectively.ConclusionsThe response R_Q,B varied depending on the magnetic field intensity, and the variation of R_Q,B reduced as the photon beam energy increased. The air-gaps affected the dose deposition in the magnetic fields.     

Dose-response of Fricke- and PAGAT-dosimetry gels in kilovoltage and megavoltage photon beams: Impact of LET on sensitivity

Purpose: Dosimetry of ionizing radiation quantifies the energy deposited by an incident beam to the medium. This study presents the relative response of two types of gel dosimeters describing their differences by estimating radiation chemical yields produced in water radiolysis.Methods: Two types of gel dosimeter were used, namely an acid ferrous ion solution infused with xylenol orange known as Fricke gel and a polymer gel based on acrylamide and N,N’-methylenebis(acrylamide) known as PAGAT. Samples were irradiated using two photon beam energies, one from a conventional X-ray tube operated at 44 kV and the other one from a LINAC operated at 6 MV. The dosimeters were analyzed by optical absorbance and magnetic resonance imaging. Additionally, the linear energy transfer of each beam was calculated using Monte Carlo simulations for further estimation of the radiation chemical yields produced during water radiolysis.Results: Obtained results for both gel dosimeters indicate that their response at 44 kV and 6 MV are different, regardless of the read-out technique. On average, the sensitivity at 44 kV was found to be 65 % of the response at 6 MV. The calculated radiation chemical yields are in agreement with the observed experimental results.Conclusions: The main reason for the difference in the response of the dosimeters may be related to the linear energy transfer of each photon beam, which varies the production of primary chemical species during water radiolysis.     

Monte Carlo kilovoltage X-ray tube simulation: A statistical analysis and compact simulation method

IntroductionMonte Carlo (MC) simulations are a powerful tool for improving image quality in X-ray based imaging modalities. An accurate X-ray source model is essential to MC modeling for CBCT but can be difficult to implement on a GPU while maintaining efficiency and memory limitations. A statistical analysis of the photon distribution from a MC X-ray tube simulation is conducted in hopes of building a compact source model.Materials & methodsMC simulations of an X-ray tube were carried out using BEAMnrc. The resulting photons were sorted into four categories: primary, scatter, off-focal radiation (OFR), and both (scatter and OFR). A statistical analysis of the photon components (energy, position, direction) was completed. A novel method for a compact (memory efficient) representation of the PHSP data was implemented and tested using different statistical based linear transformations (PCA, ZCA, ICA), as well as a geometrical transformation.ResultsThe statistical analysis showed all photon groupings had strong correlations between position and direction, with the largest correlation in the primary data. The novel method was successful in compactly representing the primary (error < 2%) and scatter (error < 6%) photon groupings by reducing the component correlations.Discussion & conclusionStatistical linear transforms provide a method of reducing the memory required to accurately simulate an X-ray source in a GPU MC system. If all photon types are required, the proposed method reduces the memory requirements by 3.8 times. When only primary and scatter data is needed, the memory requirement is reduced from gigabytes to kilobytes.     

Monte Carlo studies in Gold Nanoparticles enhanced radiotherapy: The impact of modelled parameters in dose enhancement

PurposeOver the last decades, Gold Nanoparticles (AuNPs) have been presented as an innovative approach in radiotherapy (RT) enhancement. Several studies have proven that the irradiation of tumors containing AuNPs could lead to more effective tumor control than irradiation alone. Studies with low kV photons and AuNPs conclude in encouraging results regarding the level of radioenhancement. However, experimental and theoretical studies with MV photons report controversial findings concerning the correlation between dose enhancement effect and tumor cell killing. The great variation in the experimental protocols and simulations complicates the comparison of their outcomes and depicts the need for limiting the variety of investigated parameters. Our purpose is to point out a possible direction for building realistic Monte Carlo (MC) models that could end up with promising results in MV photons RT enhancement.MethodsWe explored published in silico studies concerning AuNPs enhanced RT from 2010 to 2019. In this review, we discuss the different AuNPs and MV photon beams characteristics that have been reported and their effect in dose enhancement.ResultsAuNPs size, concentration, type of distribution along with photon beams energy and the presence of flattening filter in linear accelerators seem to be the major parameters that determine AuNPs radioenhancement in silico.ConclusionsPrior to AuNPs clinical translation in photon radiotherapy, in silico studies should emphasize on nanodosimetry and track structure codes than condensed history ones. Toxicity estimation and biological aspects should be implemented in MC simulations so as to achieve accurate and realistic modelling of AuNPs driven RT.     

Analysis of the EBT3 Gafchromic film irradiated with 6 MV photons and 6 MeV electrons using reflective mode scanners

We explore in our study the effects of electrons and X-rays irradiations on the newest version of the Gafchromic EBT3 film. Experiments are performed using the Varian “TrueBeam 1.6” medical accelerator delivering 6 MV X-ray photons and 6 MeV electron beams as desired. The main interest is to compare the responses of EBT3 films exposed to two separate beams of electrons and photons, for radiation doses ranging up to 500 cGy. The analysis is done on a flatbed EPSON 10000 XL scanner and cross checked on a HP Scanjet 4850 scanner. Both scanners are used in reflection mode taking into account landscape and portrait scanning positions. After thorough verifications, the reflective scanning method can be used on EBT3 as an economic alternative to the transmission method which was also one of the goals of this study. A comparison is also done between single scan configuration including all samples in a single A4 (HP) or A3 (EPSON) format area and multiple scan procedure where each sample is scanned separately on its own. The images analyses are done using the ImageJ software. Results show significant influence of the scanning configuration but no significant differences between electron and photon irradiations for both single and multiple scan configurations. In conclusion, the film provides a reliable relative dose measurement method for electrons and photons irradiations in the medical field applications.     

A structural analytic method on the phase space data of Linac 4 MV photons based on the real world

PurposeIt was given that the characteristics of the fluence distribution and the energy spectrum structure of 4MV photons on the Phase Space (PhSp) plane and a method to analyzing the characteristics.MethodsAfter the PhSp file of 4 MV photons was acquired by the method of Monte Carlo (MC) calculation, the photons recorded by PhSp file were grouped based on the energy bin, and it was analyzed that the spatial distribution and energy spectrum structure of the photons. The photons in each energy group were continually grouped to sub-files according to momentum bin, and the primary and scattered photons could be separated according to the character of the fluence distribution of the photons in the sub-files.ResultsThe energy of 4 MV beam is a continuous spectrum. The energy constituent on a pixel at different distances from the center point is different, and the average energy on the center axis of the field is the highest; The photons with 0–1.0 MeV had 42.6% of all; that with energy more than 3.0 MeV had 11.7%; greater than 4 MeV, just 1.5%. The primary and scattered photons were easy collected according to the distribution characteristics of sub-groups.ConclusionsThe work to acquire and analyze the PhSp file of the 4 MV beam is significant. 4 MV, 6 MV, 8 MV, 10 MV and 15 MV energy beams basically cover the beams of radiotherapy, and a database of the energy beams could be built for the MC related research of other scholars.     

A practical tool to evaluate dose distributions using radiochromic film in radiation oncology

PurposeTriple channel algorithm and specific procedures make more reliable radiochromic dosimetry for treatment planning verification and quality assurance in radiation therapy. A tool to obtain radiochromic dose distributions and compare them with the ones resulting from a treatment planning system was developed and applied.MethodsThe tool was developed as Microsoft Excel macro; it builds dose calibration curves against net optical density of Gafchromic EBT3 film, produces axial, coronal and sagittal dose maps and allows to evaluate them against dose distributions calculated by the Varian treatment planning system Eclipse using gamma index and gamma angle.ResultsThe net optical density standard errors of estimate of calibration curves at 6 MV Varian DBX600 linac energy were 0.2%, 0.4% and 0.2% for the red, green and blue channels. Tests of these curves by means of three independent eight dose points measurement series, at 15 MV and 6 MV Varian 2100C linac and at 6 MV DBX600 linac energies, showed less than 2% of dose errors for the red channel and less than 3% for the green channel in the range 100–450 cGy. The comparisons between dose distributions from Gafchromic EBT3 triple channel algorithm and the ones from Eclipse analytic anisotropic algorithm (AAA) showed values of gamma index 95th percentile between 0.6 and 1.0.ConclusionThe obtained results encourage the application of this tool in radiation therapy quality assurance.     

Proton or photon radiosurgery for cardiac ablation of ventricular tachycardia? Breath and ECG gated robust optimization

PurposeVentricular tachycardia (VT) is a life-threatening heart disorder. The aim of this preliminary study is to assess the feasibility of stereotactic body radiation therapy (SBRT) photon and proton therapy (PT) plans for the treatment of VT, adopting robust optimization technique for both irradiation techniques.MethodsECG gated CT images (in breath hold) were acquired for one patient. Conventional planning target volume (PTV) and robust optimized plans (25GyE in single fraction) were simulated for both photon (IMRT, 5 and 9 beams) and proton (SFO, 2 beams) plans. Robust optimized plans were obtained both for protons and photons considering in the optimization setup errors (5 mm in the three orthogonal directions), range (±3.5%) and the clinical target volume (CTV) motion due to heartbeat and breath-hold variability.ResultsThe photon robust optimization method, compared to PTV-based plans, showed a reduction in the average dose to the heart by about 25%; robust optimization allowed also reducing the mean dose to the left lung from 3.4. to 2.8 Gy for 9-beams configuration and from 4.1 to 2.9 Gy for 5-beams configuration. Robust optimization with protons, allowed further reducing the OAR doses: average dose to the heart and to the left lung decreased from 7.3 Gy to 5.2 GyE and from 2.9 Gy to 2.2 GyE, respectively.ConclusionsOur study demonstrates the importance of the optimization technique adopted in the treatment planning system for VT treatment. It has been shown that robust optimization can significantly reduce the dose to healthy cardiac tissues and that PT further increases this gain.     

Ultrasound-Triggered Phase Transition Sensitive Magnetic Fluorescent Nanodroplets as a Multimodal Imaging Contrast Agent in Rat and Mouse Model

Ultrasound-triggered phase transition sensitive nanodroplets with multimodal imaging functionality were prepared via premix Shirasu porous glass (SPG) membrane emulsification method. The nanodroplets with fluorescence dye DiR and SPIO nanoparticles (DiR-SPIO-NDs) had a polymer shell and a liquid perfluoropentane (PFP) core. The as-formed DiR-SPIO-NDs have a uniform size of 385±5.0 nm with PDI of 0.169±0.011. The TEM and microscopy imaging showed that the DiR-SPIO-NDs existed as core-shell spheres, and DiR and SPIO nanoparticles dispersed in the shell or core. The MTT and hemolysis studies demonstrated that the nanodroplets were biocompatible and safe. Moreover, the proposed nanodroplets exhibited significant ultrasound-triggered phase transition property under clinical diagnostic ultrasound irradiation due to the vaporization of PFP inside. Meanwhile, the high stability and R₂ relaxivity of the DiR-SPIO-NDs suggested its applicability in MRI. The in vivo T₂-weighted images of MRI and fluorescence images both showed that the image contrast in liver and spleen of rats and mice model were enhanced after the intravenous injection of DiR-SPIO-NDs. Furthermore, the ultrasound imaging (US) in mice tumor as well as MRI and fluorescence imaging in liver of rats and mice showed that the DiR-SPIO-NDs had long-lasting contrast ability in vivo. These in vitro and in vivo findings suggested that DiR-SPIO-NDs could potentially be a great MRI/US/fluorescence multimodal imaging contrast agent in the diagnosis of liver tissue diseases.     

Cancer risk after breast proton therapy considering physiological and radiobiological uncertainties

BackgroundThe reduced normal tissue dose burden from protons can reduce the risk of second cancer for breast cancer patients. Breathing motion and the impact of variable relative biological effectiveness (RBE) are however concerns for proton dose distributions. This study aimed to quantify the impact of these factors on risk predictions from proton and photon therapy.Materials and methodsTwelve patients were planned in free breathing with protons and photons to deliver 50 Gy (RBE) in 25 fractions (assuming RBE = 1.1 for protons) to the left breast. Second cancer risk was evaluated with several models for the lungs, contralateral breast, heart and esophagus as organs at risk (OARs). Plans were recalculated on CT-datasets acquired in extreme phases to account for breathing motion. Proton plans were also recalculated assuming variable RBE for a range of radiobiological parameters.ResultsThe OARs received substantially lower doses from protons compared to photons. The highest risks were for the lungs (average second cancer risks of 0.31% and 0.12% from photon and proton plans, respectively). The reduced risk with protons was maintained, even when breathing and/or RBE variation were taken into account. Furthermore, while the total risks from the photon plans were seen to increase with the integral dose, no such correlation was observed for the proton plans.ConclusionsProtons have an advantage over the photons with respect to the induction of cancer. Uncertainties in physiological movements and radiobiological parameters affected the absolute risk estimates, but not the general trend of lower risk associated with proton therapy.     

Synthesis and evaluation of thermoluminescence properties of ZrO2:Mg for radiotherapy dosimetry

This study aimed to investigate the thermoluminescent properties of ZrO₂:Mg irradiated with a 6 MV X-ray beam and its potential application in radiotherapy dosimetry. ZrO₂ powder was synthesized using the sol–gel method and Mg was used as a dopant. Irradiations were performed with ZrO₂:Mg chips located at the center of a 10 × 10 cm² radiation field at a source surface distance of 100 cm, below a stack of solid water slabs, at the depth of maximum absorbed dose. The investigated characteristics of the material included linearity with radiation dose, reproducibility, accuracy, sensitivity and fading. Regarding the intrinsic difference of the samples, the glow curves of the investigated ZrO₂:Mg chips exposed to 1 Gy of 6 MV X-rays exhibited three or four peaks. The ZrO₂:Mg samples showed a 47% fading at 24 h after irradiation, and the reproducibility of the thermoluminescence reading of ZrO₂:Mg for equal irradiation conditions was ± 21%. The thermoluminescence response of the investigated ZrO₂:Mg samples to various absorbed doses from 0.5 to 2.5 Gy showed a gentle increase of the thermoluminescence intensity with increasing absorbed dose. The obtained results show that ZrO₂:Mg is not an appropriate candidate for X-ray photons in radiotherapy, due to low thermoluminescence peak temperature, low reproducibility, low sensitivity to various absorbed doses and significant fading.

     

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

AimThe aim of this study was to estimate the secondary malignancy risk from the radiation in FFB prostate linac-based radiotherapy for different organs of the patient.BackgroundRadiation therapy is one of the main procedures of cancer treatment. However, the application the radiation may impose dose to organs of the patient which can be the cause of some malignancies.Materials and methodsMonte Carlo (MC) simulation was used to calculate radiation doses to patient organs in 18 MV linear accelerator (linac) based radiotherapy. A humanoid MC phantom was used to calculate the equivalent dose s for different organs and probability of secondary cancer, fatal and nonfatal risk, and other risks and parameters related to megavoltage radiation therapy. In out-of-field radiation calculation, it could be seen that neutrons imparted a higher dose to distant organs, and the dose to surrounding organs was mainly due to absorbed scattered photons and electron contamination.ResultsOur results showed that the bladder and skin with 54.89 × 10⁻³ mSv/Gy and 46.09 × 10⁻³ mSv/Gy, respectively, absorbed the highest equivalent dose s from photoneutrons, while a lower dose was absorbed by the lung at 3.42 × 10⁻³ mSv/Gy. The large intestine and bladder absorbed 55.00 × 10⁻³ mSv/Gy and 49.08 × 10⁻³, respectively, which were the highest equivalent dose s due to photons. The brain absorbed the lowest out-of-field dose, at 1.87 × 10⁻³ mSv/Gy.ConclusionsWe concluded that secondary neutron portion was higher than other radiation. Then, we recommended more attention to neutrons in the radiation protection in linac based high energy radiotherapy.     

Evaluation of Gafchromic® EBT3 films characteristics in therapy photon,electron and proton beams

PurposeTo evaluate the uncertainties and characteristics of radiochromic film-based dosimetry system using the EBT3 model Gafchromic^® film in therapy photon, electron and proton beams.Material and methodsEBT3 films were read using an EPSON Expression 10000XL/PRO scanner. They were irradiated in five beams, an Elekta SL25 6 MV and 18 MV photon beam, an IBA 100 MeV 5 × 5 cm² proton beam delivered by pencil-beam scanning, a 60 MeV fixed proton beam and an Elekta SL25 6 MeV electron beam. Reference dosimetry was performed using a FC65-G chamber (Elekta beam), a PPC05 (IBA beam) and both Markus 1916 and PPC40 Roos ion-chambers (60 MeV proton beam). Calibration curves of the radiochromic film dosimetry system were acquired and compared within a dose range of 0.4–10 Gy. An uncertainty budget was estimated on films irradiated by Elekta SL25 by measuring intra-film and inter-film reproducibility and uniformity; scanner uniformity and reproducibility; room light and film reading delay influences.ResultsThe global uncertainty on acquired optical densities was within 0.55% and could be reduced to 0.1% by placing films consistently at the center of the scanner. For all beam types, the calibration curves are within uncertainties of measured dose and optical densities. The total uncertainties on calibration curve due to film reading and fitting were within 1.5% for photon and proton beams. For electrons, the uncertainty was within 2% for dose superior to 0.8 Gy.ConclusionsThe low combined uncertainty observed and low beam and energy-dependence make EBT3 suitable for dosimetry in various applications.     

Investigating in-field and out-of-field neutron contamination in high-energy medical linear accelerators based on the treatment factors of field size,depth, beam modifiers,and beam type

PurposeWe analysed the effects of field size, depth, beam modifier and beam type on the amount of in-field and out-of-field neutron contamination for medical linear accelerators (linacs).MethodsMeasurements were carried out for three high-energy medical linacs of Elekta Synergy Platform, Varian Clinac DHX High Performance and Philips SL25 using bubble detectors. The photo-neutron measurements were taken in the first two linacs with 18 MV nominal energy, whereas the electro-neutrons were measured in the three linacs with 9 MeV, 10 MeV, 15 MeV and 18 MeV.ResultsThe central neutron doses increased with larger field sizes as a dramatic drop off was observed in peripheral areas. Comparing with the jaws-shaped open-field of 10 × 10 cm, the motorised and physical wedges contributed to neutron contamination at central axis by 60% and 18%, respectively. The similar dose increment was observed in MLC-shaped fields. The contributions of MLCs were in the range of 55–59% and 19–22% in Elekta and Varian linacs comparing with 10 × 10 and 20 × 20 cm open fields shaped by the jaws, respectively. The neutron doses at shallow depths were found to be higher than the doses found at deeper regions. The electro-neutron dose at the 18 MeV energy was higher than the doses at the electron energies of 15 MeV and 9 MeV by a factor of 3 and 50, respectively.ConclusionThe photo- and electro-neutron dose should be taken into consideration in the radiation treatment with high photon and electron energies.     

Segmented photon beams technique for irradiation of postmastectomy patients

AimTo present the segmented photon beams technique (SPBT) for irradiation of postmastectomy patients.BackgroundIn majority of techniques for irradiation of posmastectomy patients, a few adjacent photon or electron beams were usually implemented in order to encompass different parts of the target. In the presented SPBT technique, the radiotherapy plan consists of 6 isocentric photon beams and the area CTV includes both the chest wall and the supraclavicular area. This makes it possible to provide a uniform dose to the CTV with no hot and cold points and enables the determination of doses for the entire volume of critical organs.Methods and materialThe treatment forward-IMRT plan comprises six isocentric 4 and 15 MV photon beams. Modulation of the dose distribution for each field was obtained by applying three segments on average. The total dose of 45 Gy was administered in 20 fractions. Dose distributions in target volume and organs at risk were evaluated for 70 randomly chosen patients.ResultsOn average, 94.8% of the CTV volume received doses within 95–107% of the prescribed dose. The average volume of the heart receiving a dose of 30 Gy and lager was 2% for patients with left breast cancer. The average dose to the lung on the irradiation side was always lower than 15.5 Gy and the average V20 Gy was below 35.5%.ConclusionsThe SPBT complies with requirements for high dose homogeneity within the target volume and satisfactory level of sparing of organs at risk.