Carlos Eduardo de Almeida

Dosimetric parameters for small field sizes using Fricke xylenol gel, thermoluminescent and film dosimeters, and an ionization chamber

Dosimetric measurements in small therapeutic x-ray beam field sizes, such as those used in radiosurgery, that have dimensions comparable to or smaller than the build-up depth, require special care to avoid incorrect interpretation of measurements in regions of high gradients and electronic disequilibrium. These regions occur at the edges of any collimated field, and can extend to the centre of small fields. An inappropriate dosimeter can result in an underestimation, which would lead to an overdose to the patient. We have performed a study of square and circular small field sizes of 6 MV photons using a thermoluminescent dosimeter (TLD), Fricke xylenol gel (FXG) and film dosimeters. PMMA phantoms were employed to measure lateral beam profiles (1 x 1, 3 x 3 and 5 x 5 cm2 for square fields and 1, 2 and 4 cm diameter circular fields), the percentage depth dose, the tissue maximum ratio and the output factor. An ionization chamber (IC) was used for calibration and comparison. Our results demonstrate that high resolution FXG, TLD and film dosimeters agree with each other, and that an ionization chamber, with low lateral resolution, underestimates the absorbed dose. Our results show that, when planning small field radiotherapy, dosimeters with adequate lateral spatial resolution and tissue equivalence are required to provide an accurate basic beam data set to correctly calculate the absorbed dose in regions of electronic disequilibrium.

Relative output factor and beam profile measurements of small radiation fields with an L-alanine/K-Band EPR minidosimeter

The performance of an L-alanine dosimeter with millimeter dimensions was evaluated for dosimetry in small radiation fields. Relative output factor (ROF) measurements were made for 0.5 x 0.5, 1 x 1, 3 x 3, 5 x 5, 10 x 10 cm(2) square fields and for 5-, 10-, 20-, 40-mm-diam circular fields. In beam profile (BP) measurements, only 1 x 1, 3 x 3, 5 x 5 cm2 square fields and 10-, 20-, 40-mm-diam circular fields were used. For square and circular field irradiations, Varian/Clinac 2100, and a Siemens/Mevatron 6 MV linear accelerators were used, respectively. For a batch of 800 L-alanine minidosimeters (miniALAs) the average mass was 4.3+/-0.5 (1 sigma) mg, the diameter was 1.22+/-0.07 (1 sigma) mm, and the length was 3.5+/-0.2 (l sigma) mm. A K-Band (24 GHz) electron paramagnetic resonance (EPR) spectrometer was used for recording the spectrum of irradiated and nonirradiated miniALAs. To evaluate the performance of the miniALAs, their ROF and BP results were compared with those of other types of detectors, such as an ionization chamber (PTW 0.125 cc), a miniTLD (LiF: Mg,Cu,P), and Kodak/X-Omat V radiographic film. Compared to other dosimeters, the ROF results for miniALA show differences of up to 3% for the smallest fields and 7% for the largest ones. These differences were within the miniALA experimental uncertainty (-5-6% at 1 sigma). For BP measurements, the maximum penumbra width difference observed between miniALA and film (10%-90% width) was less than 1 mm for square fields and within 1-2 mm for circular fields. These penumbra width results indicate that the spatial resolution of the miniALA is comparable to that of radiographic film and its dimensions are adequate for the field sizes used in this experiment. The K-Band EPR spectrometer provided adequate sensitivity for assessment of miniALAs with doses of the order of tens of Grays, making this dosimetry system (K-Band/miniALA) a potential candidate for use in radiosurgery dosimetry.

Ferrous Xylenol Gel Measurements for 6 and 10 MV Photons in Small Field Sizes

The Fricke dosimeter is a ferrous sulfate aqueous solution that, when irradiated, oxidizes the Fe2 + ions to Fe3 + . This new concentration, generally determined through spectrophotometry, is directly proportional to the ionizing radiation absorbed energy. The Fricke Xylenol Gel dosimeter (FXG) was developed through the incorporation of swine skin gelatin and xylenol orange. These modifications provided better signal stability and sensitivity for lower absorbed dose measurements, such as those used in radiotherapy. In this work FXG samples were irradiated with absorbed doses of 2 Gy, from 6 MV and 10 MV photons, using small field sizes geometry for dosimetric parameters determination. All the FXG dosimeter readings were accomplished with our specially developed spectrophotometer, using a narrow light beam at the wavelength of 585 nm, where the highest absorbance sensitivity occurs. From our results, we can confirm not only that the FXG dosimetric system (FXG plus a high lateral spatial resolution spectrophotometer) can be used for general dosimetry, but as well for small field size dosimetry of interest in radiosurgery.

An anthropomorphic phantom for quality assurance and training in gynaecological brachytherapy

BACKGROUND AND PURPOSE An anthropomorphic water filled polymethylmethacrylate (PMMA) phantom designed to serve as a Quality Assurance (QA) tool and a training aid in brachytherapy of gynaecological tumours is investigated and presented. Several dosimetric parameters associated with the dose rate calculation can be verified with the aid of this phantom such as the source positioning, its imaging reconstruction from radiographs and the accuracy of the algorithm used for manual or computer dose rate calculation. MATERIAL AND METHODS The phantom walls and the internal structure are 5mm thick and consist of PMMA, in the form of the abdomen taken from a female Alderson Phantom Marker points representing the organs of interest were determined from computed tomography scans of a patient of similar size. Three PMMA inserts designed to hold a Farmer type ionization chamber of 0.6 cm(3) were positioned at the points to represent the bladder, rectum and point A. The formalism proposed by the IAEA TRS-277 dosimetry protocol was used for the conversion of readings of the ionization chamber to dose rate values with a modification to take into account the dose rate gradient in the detector. Five 137Cs sources were used and the dose rate was evaluated by measurements and Monte Carlo simulations using the PENELOPE code. Four different treatment planning systems with different algorithms and source reconstruction techniques were also used in this investigation and compared with the manual dose rate calculations made using Karen and Breitmans tables. RESULTS The dose rate calculations performed with Monte Carlo and the four treatment planning systems are in good agreement with the experimental results as well as with the manual calculations when the colpostat shielding and the tandem attenuation are taken into account. The comparison between experiment and calculations by the four treatment planning systems shows a maximum variation of 5.1% between the calculated and measured dose rate at the point A. CONCLUSIONS This phantom is suitable for use during the acceptance tests of treatment planning systems and applicators, as educational tool, for dosimetric research problems and for the QA of brachytherapy sources.

Comparison of Electron Beams from the Siemens Betatron and the Sagittaire Linear Accelerator

Electron beams from two high-energy machines, a Sagittaire linear accelerator and a Siemens betatron, were compared. The linear accelerator has two stationary accelerating sections and a rotating magnetic deflection system, uses a scanning magnet for beam flattening and movable jaws for a collimator, and produces 7–31 MeV electrons in steps of 3 MeV. The betatron uses scattering foils of different materials and thicknesses for beam flattening and cones for a collimator and produces electrons in a range of 6–18 MeV. Appreciable differences in beam energy, dose distribution, beam flatness, surface dose, dmax position, and fall-off slope were found.

6 MV Wedge Photon Beam Profiles with the Fricke Xylenol Gel Dosimeter

Wedged beam are often used in clinical radiotherapy to compensate missing tissues and dose gradients. In this work, the Fricke Xylenol Gel (FXG) dosimeter was used for 6 MV photons radiation wedge field profiles measurements, allowing to infer the wedge filter physical attenuation coefficient. This dosimeter is a chemical system of a Fe3+-Xylenol complex concentration, that when measured spectrophotometrically, the absorbance is directly proportional to the absorbed dose. From theses results one can infer that the FXG can be used also as an alternative dosimetric system for measurements of wedge filters.

Study of the radiation field characteristics of a 137Cs irradiator by Monte Carlo simulation.

Abstract— In this work a study of the energy fluence of the photon beam produced by a commercial irradiator that uses a single collimated 137Cs source is performed by employing the Monte Carlo code PENELOPE. A set of lead attenuators is placed at the exit window of the irradiator to vary the air kerma rate that is required to cover the instrument scales at a particular calibration distance. A possible variation in response due to this beam modification is also investigated for LiF (TLD-100) dosimeters and for a secondary standard radiation protection level ionization chamber. The results show an important enhancement of beam mean energy from 633 to 642 keV as the lead attenuators increase in thicknesses. For this energy range, a maximum response change of 4.5% was found for LiF and 4.4% for the ionization chamber. These results reinforce the idea that a single source may very well be a practical solution for calibration laboratories without compromising the overall uncertainties acceptable for this application.

Build‐up curves of scanned high energy electron beams from the Sagittaire linear accelerator

A study of the build-up curves using an extrapolation chamber for 7, 10, 13, 16, and 19 MeV electron beams, from a Sagittaire linear accelerator, is presented. The effect of the ionization chamber bias polarity, field size, collimation and surface obliquity on the shape of the relative ionization curve was investigated. No clinically significant change is observed except the displacement of the maximum ionization point was observed for the oblique incidence of the beam.

Failure mode and effects analysis based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil

PURPOSE The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. METHODS The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. RESULTS The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. CONCLUSIONS The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different radiotherapy centers. Integrated approaches to device-centric and process specific quality management program specific to each radiotherapy center are the key to a safe quality management program.

Evaluation of rib microstructure in Wistar rats using SR-μCT after radiation therapy simulation for breast cancer

A better understanding of biological interactions that occur after exposure to photon radiation is needed in order to optimize therapeutic regimens and facilitate development and strategies that decrease radiation-induced side effects in humans. In this work, ribs of Wistar rat submitted to radiotherapy simulation were imaged using synchrotron radiation computed microtomography at Elettra Synchrotron Laboratory in Trieste, Italy. Histomorphometric parameters were calculated directly from the 3D microtomographic images and showed significant differences between irradiated and non-irradiated groups.