Kenneth R. Kase

Measurements of dose from secondary radiation outside a treatment field

Radiation dose to organs outside the radiotherapy treatment field can be significant and therefore is of clinical interest. We have made measurements of dose at distances up to 70 cm from the central axes of 5 X 5, 15 X 15 and 25 X 25 cm radiation fields of 300 kVp, 4 MV and 8 MV X rays, and 60Co gamma rays, at the surface and at depths in water of 5 and 10 cm. Contributions to the total secondary radiation dose from water scatter, machine (collimator) scatter and leakage radiation have been separated. We have found that the component of dose from water scatter can be described by a simple exponential function of distance from the central axis of the radiation field for all energies and field sizes. Machine scatter contributes 20 to 40% of the total secondary dose depending on machine, field size and distance from the field. Leakage radiation contributes very little dose, but becomes the dominant component at distances beyond 60 cm from the central axis. Estimates of the risk of second tumors in long term survivors indicate a small incremental increase above the natural incidence rate based on information from the 1980 BEIR Committee report.

Measurements of dose from secondary radiation outside a treatment field: effects of wedges and blocks

Radiation dose outside the radiotherapy treatment field can be significant and therefore is of clinical interest in estimating organ doses. In a previous paper we reported the results of measurements made using unmodified radiation fields. We have extended this study to include the effects of wedge filters and blocks. For a given dose on the central axis of a radiation field, wedges can cause a factor of 2 to 4 increase in dose at any point outside the field compared with the dose when no wedge is used. Adding blocks to a treatment field can cause an increase in dose at points outside the field, but the effect is much smaller than the effect of a wedge, and generally less than a factor of 2. From the results of these measurements, doses to selected organs outside the field for specified treatment geometries were estimated, and the potential for reducing these organ doses by additional shielding was assessed.

Reconstruction of 4-MV bremsstrahlung spectra from measured transmission data

Transmission data for 4-MV bremsstrahlung beams have been measured with a combination of lead and aluminum attenuators. From these data, the original energy spectra have been reconstructed using an iterative least-squares technique, previously evaluated by simulation studies. The spectra on the central axis for three similar 4-MV linear accelerators indicated no significant differences. When studying the spectra at 5 degrees and 9 degrees off the central axis, that at 9 degrees showed the expected increase of low-energy photons. All these spectra showed a maximum photon energy of 4.5 +/- 0.2 MeV. When the magnetron power was reduced, the spectrum on the central axis shifted to lower energies and the maximum photon energy decreased to 3.5 +/- 0.2 MeV. The result of this experimental study confirms the conclusions from the previous stimulation, that the numerical technique for analysis of transmission data can accurately represent 4-MV bremsstrahlung spectra and detect differences in energy distribution with changes in machine tuning and position in the radiation field for a 4-MV bremsstrahlung beam.

Effect of X-irradiation dose rate on the clonagenic survival of human and experimental animal hematopoietic tumor cell lines: evidence for heterogeneity.

It is a generally accepted principle of radiation biology that hematopoietic progenitor cells demonstrate dose rate independent killing by x-irradiation over the clinically relevant range for total body irradiation (TBI) (5-25 rad/min). To determine whether low dose rate (5 rad/min, or 20 rad/min) compared to conventional dose rate (200 rad/min) x-irradiation altered the clonagenic survival of leukemia and lymphoma cell lines, several permanent cell lines were studied. These included: bg/bg cl 1, mouse basophillic leukemia; LW12, [W/fu rat acute myelogenous leukemia (AML)]; and human cell lines: JY and Daudi (B-cell lymphomas); K45, (T-cell leukemia); K562, (erythroleukemia); HL60 and KG1 (monomyeloid leukemias), and U937 (human histiocytic/monocytic lymphoma). Dose rate independent killing was demonstrated at several plating densities with mouse and rat leukemia lines and all human leukemia lines tested except lines HL60 and U937. With HL60, increased plating density increased the D0 at each dose rate. This effect was not attributable to an increased plating efficiency. With line U937 there was a clear dose-rate effect with increase in D0 from 88 rad, n 4.6 at 200 rad/min, to D0 = 166, n 2.3 at 5 rad/min. The data demonstrate that some human hematopoietic tumor derived cell lines of myeloid/monocyte/macrophage lineage can exhibit atypical repair of irradiation damage in vitro. This repair may be enhanced by conditions relevant to clinical TBI including low irradiation dose-rate and cell to cell interactions by tumor cells in close proximity.

Giant dipole resonance neutron yields produced by electrons as a function of target material and thickness

This paper characterizes the functional dependence of the giant dipole resonance neutron yield produced by electrons in terms of the atomic number (Z) and thickness (T) of the target. The yields were calculated by integrating, over the photon energy, the product of the differential photon track length and published photoneutron cross sections. The EGS4 Monte Carlo code and analytical formulas were used to calculate the differential photon track length. In thick targets, the Giant Dipole Resonance neutron yield approaches a saturation value as target thickness T increases to 10 radiation lengths. A formula, 8 x 10(-6) x (Z1/2 + 0.12 Z3/2 - 0.001 Z5/2) n electron-1 MeV-1, developed from EGS4 calculations, estimates thick-target neutron yields for incident electron energies Eo above 50 MeV. Giant dipole resonance neutron yields, calculated by several analytic formulas for the differential photon track length, are compared with EGS4 calculations. Modifications to the analytic formulas are suggested. A scaling function is derived to estimate, from the thick-target formula, neutron yields produced in thin targets.

Bremsstrahlung dose to patients in rotational electron therapy.

Dose and integral dose from bremsstrahlung in a 10-MeV electron beam were measured for irradiation of large areas with 120 degrees-arc rotational fields. The maximum bremsstrahlung dose ranged from 2% to 7% of the maximum electron dose for the different beam arrangements, while the integral dose showed the same range of variation. The concomitant bremsstrahlung beam should be collimated by the x-ray photon collimators and the use of narrow field rotations avoided.

Radiation protection principles of NCRP.

The current recommendations of the National Council on Radiation Protection and Measurements (NCRP) relative to ionizing radiation are based on radiation protection principles that developed historically as information about radiation effects on human populations became available. Because the NCRP Charter states that the NCRP will cooperate with the International Commission on Radiological Protection (ICRP), the basic principles and recommendations for radiation protection of the NCRP are closely coupled with those of the ICRP. Thus, the fundamental principles of justification, optimization, and dose limitation as initially stated in ICRP Publication 26 have been adopted and applied by the NCRP in its recommendations. ICRP and NCRP recommendations on dose limitation for the general public and for occupationally exposed individuals are based on the same analyses of radiation risk, and, while similar, there are differences reflecting the aspects of radiation application and exposure circumstances unique to the United States. The NCRP has recently extended its guidance to address exposure to individuals engaged in space activities. Several reports have been issued or are in preparation to provide recommendations on dose limitation and the development of radiation safety programs to apply the radiation protection principles in space activities. The biological basis for these recommendations is provided in these and accompanying NCRP reports. Recommendations for the application of basic radiation protection principles have been made in many reports over the years. Those that are most current appear in approximately 50 reports published in the last 15 y. These address radiation safety practices in industrial and medical institutions, control of radionuclides in the environment, protection of the public, and assessment of radiation risk. Some of the aspects of these recommendations will be discussed. Current recommendations related to radiation safety practice are based on the principles and dose limits specified in Report No. 116. The limits are based on estimates of the risk of fatal cancer and an assessment of the risk that should be tolerated by workers who are occupationally exposed and by the general public. These levels of risk are related to other risks that individuals accept in their lives. Looking to the future, one might consider other directions that the NCRP could take in developing radiation safety recommendations that are still based upon the stated principles, such as relating dose to loss of life expectancy instead of fatal cancer risk. It may also be that the principles of justification, optimization, and dose limitation should be reconsidered. For example, the NCRP may make recommendations about the relationship of radiation dose to various biological effects or outcomes and the resulting estimates of risk, but not specify dose limits. This would relieve the NCRP of the necessity to speculate about acceptable risks. One can also imagine that the principle of justification could be applied not only to the introduction of a new source of radiation, but also to the removal of an existing source of radiation, i.e., the idea of justifying decontamination efforts. It is clear that as we move into the 21st century there will be a continuing need for the NCRP to identify the principles upon which radiation protection is to be based and to provide guidance on the application of those principles for the many beneficial uses of radiation and radioactive materials in society.

Postal intercomparison of absorbed dose for high energy x rays with thermoluminescence dosimeters.

This study concerns the accuracy and precision of the IAEA/WHO LiF TLD system used in intercomparison by mail of absorbed doses from 60Co gamma-radiation and 4-25 MV x rays. The system employs 160 mg LiF powder in polystyrene capsules, which are placed at 5 or 7 cm depth in water and irradiated to doses close to 200 rad (2.00 Gy). The dosimeters are mailed to the IAEA Dosimetry Laboratory and read out under conditions to minimize variatons in instrument sensitivity. The precision of the readout technique, using 3 capsules per irradiation and the readout of 5 aliquots per capsule, is characterized by 0.2% standard deviation of the resulting mean. Since random errors during the irradiation are added, the detectable systematic descrepancy in dose delivery, at the 95% confidence level, is +/- 2% for 60Co gamma and +/- 3% for high-energy x rays.

Comparisons of electron beam dose measurements in water and polystyrene using various dosimeters

A comparison has been made of central axis percent depth dose and absorbed dose in electron beams of 7.8 and 10.2 MeV, measured with devices of differing geometry and construction. Flat and cylindrical ionization chambers have been used as well as thin thermoluminescent dosimeters. The ionization chambers had walls of air equivalent or tissue equivalent plastic. Results indicate that central axis depth dose measurements are independent of measuring device. No significant difference was found among the various ionization chambers with air equivalent walls in the determination of absorbed dose. The dose determined by the tissue-equivalent wall chamber was about 3% higher than the dose determined by the other ionization chambers. Dose maximum on the central axis in water is about 4% greater than when this same quantity is calculated from data measured in polystyrene.

Design and dosimetric properties of an intraoperative radiation therapy system using an orthovoltage x ray unit

A 300 kVp orthovoltage therapy machine has been installed in an operating room for intraoperative radiation therapy (IORT). A description is presented of the physical aspects of the treatment system including applicator design, radiation field data, dosimetry, and radiation shielding of the operating room.