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1.

Aim

The aim of this work was to assess the suitability of the use of a Gafchromic EBT2 film for the measurement of anisotropy function for microSelectron HDR 192Ir (classic) source with a comparative dosimetry method using a Gafchromic EBT2 film and thermoluminescence dosimeters (TLDs).

Background

Sealed linear radiation sources are commonly used for high dose rate (HDR) brachytherapy treatments. Due to self-absorption and oblique filtration of radiation in the source capsule material, an inherent anisotropy is present in the dose distribution around the source which can be described by a measurable two-dimensional anisotropy function, F(r, θ).

Materials and methods

Measurements were carried out in a specially designed and locally fabricated PMMA phantom with provisions to accommodate miniature LiF TLD rods and EBT2 film dosimeters at identical radial distances with respect to the 192Ir source.

Results

The data of anisotropy function generated by the use of the Gafchromic EBT2 film method are in agreement with their TLD measured values within 4%. The produced data are also consistent with their experimental and Monte Carlo calculated results for this source available in the literature.

Conclusion

Gafchromic EBT2 film was found to be a feasible dosimeter in determining anisotropy in the dose distribution of 192Ir source. It offers high resolution and is a viable alternative to TLD dosimetry at discrete points. The method described in this paper is useful for comparing the performances of detectors and can be applied for other brachytherapy sources as well.  相似文献   

2.
AimBlood irradiators (BI) initial acceptance testing and routine annual dosimetry checks require radiation dose measurements in order to comply with regulatory requirements.BackgroundTraditionally thermo-luminescence dosimeters (TLD) have been used to measure the dose. The EBT3 film is reported to be a better dosimeter for low energy X-rays than its predecessors EBT2 and EBT. To the best of our knowledge, the use of EBT3 films to perform dosimetry on X-ray based BI has not been reported yet.Materials and methodsWe performed routine radiation dosimetry checks using EBT3 films on a new X-ray based BI and compared the results with TLD dosimetry. Calibration films were irradiated with radiation beam from a Co-60 Gamma Knife (GK) radiosurgery machine and, alternatively, using an Ir-192 high dose rate (HDR) brachytherapy device. The films were calibrated to cover a wide dose range from 1 to 40 Gy. Such a wide dose range has not been reported yet in BI film dosimetry.ResultsWe obtained a relative difference of about 6.6% between doses measured using TLD and those measured using EBT3 films. Both irradiation methods using GK or HDR were found to be adequate for the calibration of the EBT3 Gafchromic films.ConclusionsWe recommend the use of EBT3 films in routine X-ray based BI dosimetry checks. The presented method takes advantage of available radiotherapy equipment that can be efficiently used for EBT3 films calibration. The method is fast, reproducible and saves valuable medical physicist's time.  相似文献   

3.
High dose rate brachytherapy (HDR) using 192Ir sources is well accepted as an important treatment option and thus requires an accurate dosimetry standard. However, a dosimetry standard for the direct measurement of the absolute dose to water for this particular source type is currently not available. An improved standard for the absorbed dose to water based on Fricke dosimetry of HDR 192Ir brachytherapy sources is presented in this study. The main goal of this paper is to demonstrate the potential usefulness of the Fricke dosimetry technique for the standardization of the quantity absorbed dose to water for 192Ir sources. A molded, double-walled, spherical vessel for water containing the Fricke solution was constructed based on the Fricke system. The authors measured the absorbed dose to water and compared it with the doses calculated using the AAPM TG-43 report. The overall combined uncertainty associated with the measurements using Fricke dosimetry was 1.4% for k = 1, which is better than the uncertainties reported in previous studies. These results are promising; hence, the use of Fricke dosimetry to measure the absorbed dose to water as a standard for HDR 192Ir may be possible in the future.  相似文献   

4.
ObjectivesTo verify the dosimetric accuracy of treatment plans in high dose rate (HDR) brachytherapy by using Gafchromic EBT2 film and to demonstrate the adequacy of dose calculations of a commercial treatment planning system (TPS) in a heterogeneous medium.MethodsAbsorbed doses at chosen points in anatomically different tissue equivalent phantoms were measured using Gafchromic EBT2 film. In one case, tandem ovoid brachytherapy was performed in a homogeneous cervix phantom, whereas in the other, organ heterogeneities were introduced in a phantom to replicate the upper thorax for esophageal brachytherapy treatment. A commercially available TPS was used to perform treatment planning in each case and the EBT2 films were irradiated with the HDR Ir-192 brachytherapy source.ResultsFilm measurements in the cervix phantom were found to agree with the TPS calculated values within 3% in the clinically relevant volume. In the thorax phantom, the presence of surrounding heterogeneities was not seen to affect the dose distribution in the volume being treated, whereas, a little dose perturbation was observed at the lung surface. Doses to the spinal cord and to the sternum bone were overestimated and underestimated by 14.6% and 16.5% respectively by the TPS relative to the film measurements. At the trachea wall facing the esophagus, a dose reduction of 10% was noticed in the measurements.ConclusionsThe dose calculation accuracy of the TPS was confirmed in homogeneous medium, whereas, it was proved inadequate to produce correct dosimetric results in conditions of tissue heterogeneity.  相似文献   

5.
SM Hsu  CH Wu  JH Lee  YJ Hsieh  CY Yu  YJ Liao  LC Kuo  JA Liang  DY Huang 《PloS one》2012,7(9):e44528
Dose distributions of (192)Ir HDR brachytherapy in phantoms simulating water, bone, lung tissue, water-lung and bone-lung interfaces using the Monte Carlo codes EGS4, FLUKA and MCNP4C are reported. Experiments were designed to gather point dose measurements to verify the Monte Carlo results using Gafchromic film, radiophotoluminescent glass dosimeter, solid water, bone, and lung phantom. The results for radial dose functions and anisotropy functions in solid water phantom were consistent with previously reported data (Williamson and Li). The radial dose functions in bone were affected more by depth than those in water. Dose differences between homogeneous solid water phantoms and solid water-lung interfaces ranged from 0.6% to 14.4%. The range between homogeneous bone phantoms and bone-lung interfaces was 4.1% to 15.7%. These results support the understanding in dose distribution differences in water, bone, lung, and their interfaces. Our conclusion is that clinical parameters did not provide dose calculation accuracy for different materials, thus suggesting that dose calculation of HDR treatment planning systems should take into account material density to improve overall treatment quality.  相似文献   

6.

Introduction

The use of high-dose-rate brachytherapy is currently a widespread practice worldwide. The most common isotope source is 192Ir, but 60Co is also becoming available for HDR. One of main advantages of 60Co compared to 192Ir is the economic and practical benefit because of its longer half-live, which is 5.27 years. Recently, Eckert & Ziegler BEBIG, Germany, introduced a new afterloading brachytherapy machine (MultiSource®); it has the option to use either the 60Co or 192Ir HDR source. The source for the Monte Carlo calculations is the new 60Co source (model Co0.A86), which is referred to as the new BEBIG 60Co HDR source and is a modified version of the 60Co source (model GK60M21), which is also from BEBIG.

Objective and Methods

The purpose of this work is to obtain the dosimetry parameters in accordance with the AAPM TG-43U1 formalism with Monte Carlo calculations regarding the BEBIG 60Co high-dose-rate brachytherapy to investigate the required treatment-planning parameters. The geometric design and material details of the source was provided by the manufacturer and was used to define the Monte Carlo geometry. To validate the source geometry, a few dosimetry parameters had to be calculated according to the AAPM TG-43U1 formalism. The dosimetry studies included the calculation of the air kerma strength S k, collision kerma in water along the transverse axis with an unbounded phantom, dose rate constant and radial dose function. The Monte Carlo code system that was used was EGSnrc with a new cavity code, which is a part of EGS++ that allows calculating the radial dose function around the source. The spectrum to simulate 60Co was composed of two photon energies, 1.17 and 1.33 MeV. Only the gamma part of the spectrum was used; the contribution of the electrons to the dose is negligible because of the full absorption by the stainless-steel wall around the metallic 60Co. The XCOM photon cross-section library was used in subsequent simulations, and the photoelectric effect, pair production, Rayleigh scattering and bound Compton scattering were included in the simulation. Variance reduction techniques were used to speed up the calculation and to considerably reduce the computer time. The cut-off energy was 10 keV for electrons and photons. To obtain the dose rate distributions of the source in an unbounded liquid water phantom, the source was immersed at the center of a cube phantom of 100 cm3. The liquid water density was 0.998 g/cm3, and photon histories of up to 1010 were used to obtain the results with a standard deviation of less than 0.5% (k = 1). The obtained dose rate constant for the BEBIG 60Co source was 1.108±0.001 cGyh-1U-1, which is consistent with the values in the literature. The radial dose functions were compared with the values of the consensus data set in the literature, and they are consistent with the published data for this energy range.  相似文献   

7.
Gafchromic XRQA radiochromic film, is an effective tool for quality assurance and dose assessment in kilovoltage radiotherapy and diagnostic applications. Like other Gafchromic film products, XRQA film exhibits a variation in dose to reflected optical density response with angle of rotation when analysed with a light source that is partially or fully polarised such as a desktop scanner. Although warnings are not given on manufacturers specifications, this can affect dosimetry accuracy and we recommend that it is essential to scan all XRQA films in the same orientation. The effect is not as pronounced as EBT Gafchromic film. The magnitude of this variation has been measured and shown to be up to 16 ± 2% (1SD) using a fully linear polarised light source was seen with a 90° angle rotation. This would be the maximum variation seen on a desktop scanner with a fully polarised light source. For our standard desktop scanner (Epson v700) a mean variation of 2 ± 1% from 0 cGy to 20 cGy applied dose was measured as compared to 8 ± 2% for EBT Gafchromic. We recommend that to decrease uncertainty in dose measurement, accurate alignment of the calibration films to experimental films be performed on a regular basis. This is especially important if your desktop scanner has a high degree of polarization of its light source.  相似文献   

8.
PurposeThe purpose of the present study was to perform an independent calculation of dosimetric parameters associated with a new 192Ir brachytherapy source model, IRAsource.Materials and methodsThe parameters of air kerma strength (AKS), dose rate constant (DRC), geometry function (GF), radial dose function (RDF), as well as two-dimensional (2D) anisotropy function (AF) of IRAsource 192Ir source model were calculated in this study. The MC n-particle extended (MCNPX) code was also employed for simulating high dose rate (HDR), IRAsource and 192Ir source; and formalism was used for calculating dosimetry parameters based on task group number 43 updated report (TG-43 U1).ResultsThe results of this study were consistent with the ones reported about the IRAsource source by Sarabiasl et al. The AKS per 1 mCi activity and the DRC values were also equal to 3.65 cGycm2 h–1 mCi–1 and 1.094 cGyh–1U–1; respectively. The comparison of the results of the DRC and the RDF reported by Sarabiasl et al. also validated the 192Ir IRAsource simulation in this study. Moreover, the AFs of IRAsource source model were in a good agreement with those of Sarabiasl et al. at different distances, which could be attributed to identical geometries.ConclusionIn line with those reported by Sarabiasl et al., the results of this study confirmed the IRAsource 192Ir source for clinical uses. The calculated dosimetric parameters of the IRAsource source could be utilized in clinical practices as input data sets or for validation of treatment planning system calculations.  相似文献   

9.
A geometric acrylic phantom was designed and built for dose distribution verification in Stereotactic Radiosurgery. Acrylic objects representing the tumor tissue, (target volume (TV)), and the organ at risk (OAR), the brainstem, were inserted inside this phantom. The TV is represented by two semi-spheres of acrylic with a diameter of 13.0 mm, both having a central cavity for accommodation of a TLD-100 detector and a small radiochromic Gafchromic EBT film. The OAR is represented by the two parts of a 38.0 mm length acrylic cylinder with a diameter 18.0 mm and cavities along the cylinder central axis able to accommodate 5 TLD – 100 detectors and another of EBT film between the two cylinder parts. This experimental setup was submitted to a radiosurgical treatment, after which the TL dosimeters were evaluated and their responses were compared with the planned dose values. The radiochromic EBT films showed the dose distributions. The linear accelerator used was a Varian 2300 C/D, generating a 6 MV photon beam. The investigated phantom system was able to check the accuracy of dose delivery to predetermined points and the dose distribution due to stereotactic radiosurgery treatments and proved to be a good tool for quality control in these situations.  相似文献   

10.

Aim

The aim of this study is to evaluate the dose distribution of the Flexisource 192Ir source.

Background

Dosimetric evaluation of brachytherapy sources is recommended by task group number 43 (TG. 43) of American Association of Physicists in Medicine (AAPM).

Materials and methods

MCNPX code was used to simulate Flexisource 192Ir source. Dose rate constant and radial dose function were obtained for water and soft tissue phantoms and compared with previous data on this source. Furthermore, dose rate along the transverse axis was obtained by simulation of the Flexisource and a point source and the obtained data were compared with those from Flexiplan treatment planning system (TPS).

Results

The values of dose rate constant obtained for water and soft tissue phantoms were equal to 1.108 and 1.106, respectively. The values of the radial dose function are listed in the form of tabulated data. The values of dose rate (cGy/s) obtained are shown in the form of tabulated data and figures. The maximum difference between TPS and Monte Carlo (MC) dose rate values was 11% in a water phantom at 6.0 cm from the source.

Conclusion

Based on dosimetric parameter comparisons with values previously published, the accuracy of our simulation of Flexisource 192Ir was verified. The results of dose rate constant and radial dose function in water and soft tissue phantoms were the same for Flexisource and point sources. For Flexisource 192Ir source, the results of TPS calculations in a water phantom were in agreement with the simulations within the calculation uncertainties. Furthermore, the results from the TPS calculation for Flexisource and MC calculation for a point source were practically equal within the calculation uncertainties.  相似文献   

11.
PurposeAim of this study is to experimental evaluate the impact of a 0.35 T transverse magnetic field on dose distribution in presence of tissue-air and tissue-lung interfaces.MethodsThe investigation was carried out using MRIdian (ViewRay, Cleveland, Ohio) and it consisted of comparing experimental measurements performed by Gafchromic EBT3 film dosimetry, to Montecarlo simulations, carried out in the presence and, as well as, the absence of the magnetic field.A preliminary dose calibration was planned on MRIdian, arranging 3 × 3 cm2 film pieces in a water slab phantom and exposing them at different beam-on times, in a dose range equal to 0.1–12.1 Gy.All experimental measurements were then carried out using the calibrated films and delivering one single beam orthogonally to three different phantoms: without inhomogeneity, with an air gap and with a lung inhomogeneity.The dose distributions measured by EBT3 films in presence of magnetic field were compared to those calculated in the presence and, as well as, the absence of the magnetic field, in terms of gamma analysis. A quantification of electron return effect (ERE) was also performed.ResultsAll the tested plans considering the magnetic field show a gamma-passing rate higher than 98% for 3%/3 mm gamma analysis.In presence of tissue-air interface, the electron return effect causes an over-dosage of +31.9% at the first interface and an under-dosage of −33% at the second interface. The dosimetric variations in presence of tissue-lung interface results to be smaller (+0.8% first interface, −1.3% second interface).ConclusionThe impact of 0.35 T magnetic field is not negligible and it can be effectively modelled by the Montecarlo dose calculation platform available in the MRIdian TPS.  相似文献   

12.
EBT radiochromic films were used to determine skin-dose maps for patients undergone Total Skin Electron Therapy (TSET). Gafchromic EBT radiochromic film is one of the newest radiation-induced auto-developing photon and electron-beam analysis films available for therapeutic radiation dosimetry in radiotherapy applications. EBT films can be particularly useful in TSET; due to patient morphology, underdosed regions typically occur, and the radiochromic film represents a suitable candidate for monitoring them.In this study, TSET was applied to treat cutaneous T-cell lymphoma. The technique for TSET was implemented by using an electron beam with a nominal energy of 6 MeV. The patient was treated in a standing position using dual angled fields in order to obtain the greatest dose uniformity along the patient's longitudinal axis. The electron beam energy was degraded by a PMMA filter. The in vivo dose distribution was determined through the use of EBT films, as well as of thermoluminescent dosimeters for comparison (TLDs). EBT results showed a reasonable agreement with TLDs data.  相似文献   

13.
PurposeWe have established a high-throughput Gafchromic film dosimetry protocol for narrow kilovoltage beams in homogeneous and heterogeneous media for small-animal radiotherapy applications. The kV beam characterization is based on extensive Gafchromic film dosimetry data acquired in homogeneous and heterogeneous media. An empirical model is used for parameterization of depth and off-axis dependence of measured data.MethodsWe have modified previously published methods of film dosimetry to suit the specific tasks of the study. Unlike film protocols used in previous studies, our protocol employs simultaneous multi-channel scanning and analysis of up to nine Gafchromic films per scan. A scanner and background correction were implemented to improve accuracy of the measurements. Measurements were taken in homogeneous and inhomogeneous phantoms at 220 kVp and a field size of 5 × 5 mm2. The results were compared against Monte Carlo simulations.ResultsDose differences caused by variations in background signal were effectively removed by the corrections applied. Measurements in homogeneous phantoms were used to empirically characterize beam data in homogeneous and heterogeneous media. Film measurements in inhomogeneous phantoms and their empirical parameterization differed by about 2%–3%. The model differed from MC by about 1% (water, lung) to 7% (bone). Good agreement was found for measured and modelled off-axis ratios.ConclusionsEBT2 films are a valuable tool for characterization of narrow kV beams, though care must be taken to eliminate disturbances caused by varying background signals. The usefulness of the empirical beam model in interpretation and parameterization of film data was demonstrated.  相似文献   

14.
PurposeA dosimetric audit of Ir-192 high dose rate (HDR) brachytherapy remote after-loading units was carried out in 2019. All six brachytherapy departments on the island of Ireland participated in an end-to-end test and in a review of local HDR dosimetry procedures.Materials and methodsA 3D-printed customised phantom was created to position the following detectors at known distances from the HDR source: a Farmer ionization chamber, GafChromic film and thermoluminescent dosimeters (TLDs). Dedicated HDR applicator needles were used to position an Ir-192 source at 2 cm distance from these detectors. The end-to-end dosimetry audit pathway was performed at each host site and included the stages of imaging, applicator reconstruction, treatment planning and delivery. Deviations between planned and measured dose distributions were quantified using gamma analysis methods. Local procedures were also discussed between auditors and hosts.ResultsThe mean difference between Reference Air Kerma Rate (RAKR) measured during the audit and RAKR specified by the vendor source certificate was 1.3%. The results of end-to-end tests showed a mean difference between calculated and measured dose of 2.5% with TLDs and less than 0.5% with Farmer chamber measurements. GafChromic films showed a mean gamma passing rates of >95% for plastic and metal applicators with 2%/1 mm global tolerance criteria.ConclusionsThe results of this audit indicate dosimetric consistency between centres. The ‘end to end’ dosimetry audit methodology for HDR brachytherapy has been successfully implemented in a multicentre environment, which included different models of Ir-192 sources and different treatment planning systems.The ability to create a 3D-printed water-equivalent phantom customised to accurately position all three detector types simultaneously at controlled distances from the Ir-192 source under evaluation gives good reproducibility for end-to-end methodology.  相似文献   

15.
PurposeFricke dosimetry has shown great potential in the direct measurement of the absolute absorbed dose for 192Ir sources used in HDR brachytherapy. This work describes the determination of the correction factors necessary to convert the absorbed dose in the Fricke solution to the absorbed dose to water. Methods: The experimental setup for Fricke irradiation using a 192Ir source was simulated. The holder geometry used for the Fricke solution irradiation was modelled for MC simulation, using the PENELOPE. Results: The values of the factors determined for validation purposes demonstrated differences of less than 0.2% when compared to the published values. Four factors were calculated to correct: the differences in the density of the solution (1.0004 ± 0.0004); the perturbations caused by the holder (0.9989 ± 0.0004); the source anisotropy and the water attenuation effects (1.0327 ± 0.0012); and the distance from the center of the detection volume to the source (7.1932 ± 0.0065). Conclusion: Calculated corrections in this work show that the largest correction comes from the inverse squared reduction of the dose due to the point of measurement shift from the reference position of 1 cm. This situation also causes the correction due to volume averaging and attenuation in water to be significant. Future versions of the holder will aim to reduce these effects by having a position of measurement closer to the reference point thus requiring smaller corrections.  相似文献   

16.
In this work, the apparent treatment dose that kV planar or CBCT imaging contributes to Gafchromic EBT3 film used for in vivo dosimetry, was investigated. Gafchromic EBT3 film pieces were attached to a variety of phantoms and irradiated using the linear accelerator’s built-in kV imaging system, in both kV planar mode and CBCT mode. To evaluate the sensitivity of the film in the clinical scenario where dose contributions are received from both imaging and treatment, additional pieces of film were irradiated using base doses of 50 cGy and then irradiated using selected kV planar and CBCT techniques. For kV planar imaging, apparent treatment doses of up to 3.4 cGy per image pair were seen. For CBCT, apparent treatment doses ranged from 0.22 cGy to 3.78 cGy. These apparent doses were reproducible with and without the inclusion of the 50 cGy base dose. The contribution of apparent treatment dose from both planar kV as well as CBCT imaging can be detected, even in conjunction with an actual treatment dose. The magnitude of the apparent dose was found to be dependent on patient geometry, scanning protocol, and measurement location. It was found that the apparent treatment dose from the imaging could add up to 8% of additional uncertainty to the in vivo dosimetry result, if not taken into account. It is possible for this apparent treatment dose to be accounted for by subtraction of the experimentally determined apparent doses from in vivo measurements, as demonstrated in this work.  相似文献   

17.

Aim

The purpose of the study was to examine the energy dependence of Gafchromic EBT radiochromic dosimetry films, in order to assess their potential use in intensity-modulated radiotherapy (IMRT) verifications.

Materials and methods

The film samples were irradiated with doses from 0.1 to 12 Gy using photon beams from the energy range 1.25 MeV to 25 MV and the film response was measured using a flat-bed scanner. The samples were scanned and the film responses for different beam energies were compared.

Results

A high uncertainty in readout of the film response was observed for samples irradiated with doses lower than 1 Gy. The relative difference exceeds 20% for doses lower than 1 Gy while for doses over 1 Gy the measured film response differs by less than 5% for the whole examined energy range. The achieved uncertainty of the experimental procedure does not reveal any energy dependence of Gafchromic EBT film response in the investigated energy range.

Conclusions

Gafchromic EBT film does not show any energy dependence in the conditions typical for IMRT but the doses measured for pre-treatment plan verifications should exceed 1 Gy.  相似文献   

18.
PurposeIntra-Operative Electron Radiation Therapy (IOERT) is used to treat rectal cancer at our institution, and in vivo measurements with Gafchromic EBT3® films were introduced as quality assurance. The purpose of this work was to quantify the uncertainties associated with digitization of very small EBT3 films irradiated simultaneously, in order to optimize in vivo dosimetry for IOERT.MethodsFilm samples of different sizes - M1 (5×5cm2), M2 (1.5×1.5 cm2), M3 (1.0×1.5 cm2) and M4 (0.75×1.5 cm2) – were used to quantify typical variations (uncertainties) due to scanner fluctuations, misalignment, film inhomogeneity, long-term effect of film cutting, small rotations, film curling, edge effects and the influence of opaque templates. Fitting functions and temporal validity of sensitometric curves were also assessed.ResultsFilm curling, intra-film variability and scanner fluctuations are important effects that need to be minimized or considered in the uncertainty budget. Small rotations, misalignments and film cutting have little or no influence on the readings. Most fitting functions perform well, but the quantity used for dose quantification determines over- or under-valuation of dose in the long term. Edge effects and the influence of opaque templates need to be well understood, to allow optimization of methodology to the intended purpose.ConclusionThe proposed method allows practical and simultaneous digitization of up to ten small irradiated film samples, with an experimental uncertainty of 1%.  相似文献   

19.
20.
PurposeTo investigate dose perturbations created by high-atomic number (Z) materials in high dose rate (HDR) Iridium-192 (192Ir) treatment region.Methods and materialsA specially designed parallel plate ion chamber with 5 μm thick window was used to measure the dose rates from 192Ir source downstream of the high-Z materials. A Monte Carlo (MC) code was employed to calculate the dose rates in both upstream and downstream of the high-Z interfaces at distances ranging from 0.01 to 2 mm. The dose perturbation factor (DPF) was defined as the ratio of dose rate with and without high-Z material in a water phantom. For verifying the Z dependence, both 0.1- and 1.0 mm-thick sheets of Pb, Au, Ta, Sn, Cu, Fe, Ti and Al were used.Results/conclusionsThe DPF depends on the Z and thickness of layer. At the downstream of a 0.1 mm layer of Pb, Au, Ta, Sn, Cu, Fe, Ti and Al, the DPF by MC were 3.73, 3.42, 3.04, 1.71, 1.04, 0.98, 0.92, or 0.94 respectively. When Z is greater than or equal to 50, the MC and experimental results disagree significantly (>20%) due to large DPF gradient but are in agreement for Z less than or equal to 29. Thin layers of Z greater than or equal to 50 near a 192Ir source in water produce significant dose perturbations (i.e. increases) in the vicinity of the medium-high-Z interfaces and may thus cause local over-dose in 192Ir brachytherapy. Conversely, this effect may potentially be used to deliver locally higher doses to targeted tissue.  相似文献   

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