Robert E. Wallace

An analysis of MCNP cross-sections and tally methods for low-energy photon emitters

Monte Carlo calculations are frequently used to analyse a variety of radiological science applications using low-energy (10-1000 keV) photon sources. This study seeks to create a low-energy benchmark for the MCNP Monte Carlo code by simulating the absolute dose rate in water and the air-kerma rate for monoenergetic point sources with energies between 10 keV and 1 MeV. The analysis compares four cross-section datasets as well as the tally method for collision kerma versus absorbed dose. The total photon attenuation coefficient cross-section for low atomic number elements has changed significantly as cross-section data have changed between 1967 and 1989. Differences of up to 10% are observed in the photoelectric cross-section for water at 30 keV between the standard MCNP cross-section dataset (DLC-200) and the most recent XCOM/NIST tabulation. At 30 keV, the absolute dose rate in water at 1.0 cm from the source increases by 7.8% after replacing the DLC-200 photoelectric cross-sections for water with those from the XCOM/NIST tabulation. The differences in the absolute dose rate are analysed when calculated with either the MCNP absorbed dose tally or the collision kerma tally. Significant differences between the collision kerma tally and the absorbed dose tally can occur when using the DLC-200 attenuation coefficients in conjunction with a modern tabulation of mass energy-absorption coefficients.

Dosimetric characterization of a new design 103palladium brachytherapy source

Low-energy gamma emitting isotopes encapsulated for permanent implant are in routine use in the treatment of prostate cancer. New source designs require full dosimetric analysis and calibration standardization before responsible clinical application. The results of one such experimental measurement and analysis are here reported for a new design of 103palladium source, model MED3633 (North American Scientific, Inc.). By AAMP Task Group #43 recommendations, the reference material for brachytherapy dosimetry is liquid water. The dose measurements were made using standard methods employing thermoluminescent dosimeters in a water equivalent plastic phantom. Precision machined bores in the phantom located dosimeters and source(s) in a reproducible fixed geometry providing for transverse-axis and angular dose profiles over a range of distances from 0.17 to 7 cm. The data were analyzed in terms of parameters recommended by AAPM TG43. The dose-rate constant, lambda, was evaluated with reference to a 60 cobalt standard, accounting for response variation with isotope energy spectrum. The radial dose function, g(r), the anisotropy function, F(r, theta), the anisotropy factor, phi,un(r), and the point-source approximation anisotropy constant, phi(un), were derived from one- and two-dimensional dose distribution data measured in the phantom, accounting for finite dosimeter volume and with attention to interchip effects. The results are compared to TG43 and other existing data for 103Pd sources. The new source is comparable to the model 200 103Pd source design, demonstrating equivalent radial dose function, g(r). The dose surrounding a MED3633 source may be slightly more isotropic than for the model 200 source. The air-kerma strength of the MED3633 source used in this study was provided by the manufacturer and is traceable to the NIST 1999 standard. The evaluated dose-rate constant, lambda, with NIST traceable strength calibration is lower than that of the model 200 source, with that manufacturers strength calibration.

Comparison of I-125 sources used for permanent interstitial implants.

The increase in the number of manufacturers of 125I sources used in prostate brachytherapy has generated many questions in the radiation oncology community. In this investigation, the physical and dosimetric characteristics were evaluated for the following sources listed by marketing company and source model: Nycomed-Amersham 6711 (OncoSeed), Nycomed-Amersham 6702, Mentor IoGold, UroMed Symmetra, Imagyn IsoSTAR, UroCor, (PSA, Mallincrkrodt) ProstaSeed, Syncor PharmaSeed, SourceTech Medical, (BARD) 125Implant (BrachySource), Med-Tec I-Plant, Best Medical Model 2301, DraxImage BrachySeed, and International Brachytherapy, Inc. (IBT) InterSource125. The investigation examined the differences in design, construction, and the dosimetric characteristics created from each source. The dosimetric characteristics of the new sources were compared to that of the Amersham 6711 source. Parameter studies have led to the development of a simple equation that can be used to clinically convert the standard 6711 source strength to an equivalent strength of a new source.

Prospective Study of Stereotactic Radiosurgery Without Whole Brain Radiotherapy in Patients with Four or Less Brain Metastases: Incidence of Intracranial Progression and Salvage Radiotherapy

This prospective study was conducted to evaluate the treatment outcome after stereotactic radiosurgery (SRS) alone with special attention to its influence on intracranial freedom from progression (FFP), local control, time to whole brain radiotherapy (WBRT), and survival. Forty-one patients with brain metastases who met the inclusion criteria were enrolled in this prospective cohort and treated by SRS alone between January 1998 and September 2001. The overall local control rate was 76%. The one year actuarial intracranial FFP was 33%. Ten patients (24%) had relapse at treated site. Twenty-three patients (56%) had intracranial progression with a median time of 4.25 months (1–24.6). Salvage radiotherapy was given in 21 patients (51%). Only 12 (29%) patients required WBRT with the median time to WBRT after SRS of 4.85 months. Nine patients (22%) underwent additional SRS at the median time of 5 months after the first procedure. The median survival was 10 months. At the time of follow up, 16 patients (39%) were still alive with a range of 6–31 months. This prospective study suggests that the omission of WBRT in the initial treatment of patients with SRS for four or less brain metastases may allow up to 70% of patients to avoid WBRT.

Implications of tissue heterogeneity for radiosurgery in head and neck tumors

PURPOSE This study was undertaken to investigate the perturbation of small radiation beams by low density heterogeneities and to evaluate the ability of a Monte Carlo code to account for such perturbation. Performance of an inexpensive film scanning system was also evaluated. METHODS AND MATERIALS Film and diode measurements were made in an acrylic phantom in which the size and position of an air gap were varied. Monte Carlo analysis was used to obtain additional verification of the measurements, to provide insight into photon and electron transport phenomena not directly measurable, and as a benchmark for the code. RESULTS With 10 MV photons and a 1 cm circular field, a small 3-mm air cavity placed 2.6 cm deep in acrylic (full buildup) results in a reduction in central axis dose of 21% immediately following the cavity. Equilibrium is then reestablished over the next centimeter, after which the dose exceeds that of the homogeneous case by 3-4%. The loss in central axis equilibrium is highly field-size dependent, with some loss occurring even for the largest (32 mm) collimator. In addition, the presence of the air cavity produces a significant increase in dose up to 2 cm lateral and outside the primary field. CONCLUSIONS Tissue heterogeneities are not presently accounted for in radiosurgery calculations, yet have the ability to perturb dose significantly. Targets may potentially be underdosed, and adjacent critical structures overdosed. Inability to account for tissue heterogeneities may limit the use of the radiosurgery approach in some areas. A Monte Carlo approach may be the method of choice for small field dose calculation when tissue heterogeneities are encountered.

Initial clinical results of stereotactic radiotherapy for the treatment of craniopharyngiomas.

The efficacy and toxicity of stereotactic radiotherapy (SRT) for the treatment of craniopharyngioma has been retrospectively evaluated in 16 patients. The median tumor diameter was 2.8 cm (range 1.5–6.1) and the median tumor volume was 7.7 cc (range 0.7–62.8). SRT was delivered to a single isocenter using a dedicated 6 MV linear accelerator to patients immobilized with a relocatable stereotactic head frame. The three-year actuarial overall survival was 93% and the rate of survival free of any imaging evidence of progressive disease was 75%. The three-year actuarial survival rates free of solid tumor growth or cyst enlargement were 94% and 81% respectively. Our results suggest that SRT is a safe and effective treatment approach for patients with craniopharyngioma. Long-term follow-up is required to determine whether the normal tissue-sparing inherent with SRT results in reduction of the neurocognitive effects of conventional radiotherapy for craniopharyngioma. SRT can be delivered to craniopharyngioma that may be difficult to treat with stereotactic radiosurgery due to proximity of the optic chiasm. Further clinical experience is necessary to determine the clinical utility of beam shaping in the setting of SRT.

Evaluation of a new brachytherapy iodine-125 source by AAPM TG43 formalism

Dosimetric measurements were performed to characterize a new 125I source that is similar in design to existing sources and that has application in interstitial brachytherapy. Thermoluminescent dosimeters were placed in phantom to measure transverse-axis and angular dose profiles over a range of distances from 0.5 to 7 cm. The data were analyzed in terms of parameters recommended by AAPM Task Group #43. Tabular data evaluated in liquid water are provided for the dose-rate constant, lambda, radial dose function, g(r), the anisotropy function, F(r, theta), the anisotropy factor, phi an(r), the point-source approximation anisotropy constant, phi an, and the point-source average dose rate times the square of distance for unit air kerma strength, r2D(r). The new source is compared to the model 6702 125I source design, demonstrating similar dose-rate constant, lambda, and radial dose function, g(r). Differences in the anisotropy of the dose distributions are discussed. Finally, a comparison of the radial dose distribution is made between liquid water and tissue equivalent materials.

Dosimetric parameters of three new solid core I-125 brachytherapy sources

Monte Carlo calculations and TLD measurements have been performed for the purpose of characterizing dosimetric properties of new commercially available brachytherapy sources. All sources tested consisted of a solid core, upon which a thin layer of I125 has been adsorbed, encased within a titanium housing. The PharmaSeed BT‐125 source manufactured by Syncor is available in silver or palladium core configurations while the ADVANTAGE source from IsoAid has silver only. Dosimetric properties, including the dose rate constant, radial dose function, and anisotropy characteristics were determined according to the TG‐43 protocol. Additionally, the geometry function was calculated exactly using Monte Carlo and compared with both the point and line source approximations. The 1999 NIST standard was followed in determining air kerma strength. Dose rate constants were calculated to be 0.955±0.005,0.967±0.005, and 0.962±0.005 cGyh−1U−1 for the PharmaSeed BT‐125‐1, BT‐125‐2, and ADVANTAGE sources, respectively. TLD measurements were in excellent agreement with Monte Carlo calculations. Radial dose function, g(r), calculated to a distance of 10 cm, and anisotropy function F(r, θ), calculated for radii from 0.5 to 7.0 cm, were similar among all source configurations. Anisotropy constants, ϕ¯an, were calculated to be 0.941, 0.944, and 0.960 for the three sources, respectively. All dosimetric parameters were found to be in close agreement with previously published data for similar source configurations. The MCNP Monte Carlo code appears to be ideally suited to low energy dosimetry applications. PACS number(s): 87.53.–j

Model 3500 125I brachytherapy source dosimetric characterization

Low-energy gamma-emitting isotopes encapsulated for permanent implant are routinely applied in brachytherapy, most notably for prostate cancer. Before clinical use of a new source design, a full dosimetric analysis and standardized calibration are essential. Results of experimental measurement and analysis are reported here for the I-Plant (Implant Sciences Corporation) 125I source, model 3500. Dose measurements were made using standard methods employing thermoluminscent dosimeters in a water equivalent plastic phantom. Precision machined bores in the phantom located dosimeters and source(s) in a reproducible fixed geometry providing for transverse-axis and angular dose profiles over a range of distances from 0.17 to 10 cm. The data were analyzed in terms of parameters recommended by AAPM TG-43. The dose-rate constant, delta = 1.01 cGy/h U (+/-6%) (1 U = 1 cGy cm2 h(-1)), was evaluated with reference to a TG-51 calibrated 60Co standard, accounting for dosimeter response differences between 60Co and 125I photons. The radial dose function, g(r), the anisotropy function, F(r, theta), the anisotropy factor, phi(an)(r), and the point-source approximation anisotropy constant, phi(an), were derived from one- and two-dimensional dose distribution data measured in the phantom, accounting for finite dosimeter volume and with attention to inter-chip effects. The results confirm prior dosimetric characterization of the model 3500, and indicate that the new source is comparable to the MED3631-A/M and 6702 source designs and may substitute for model 6711 in permanent implants for the treatment of prostate cancer.

Empirical dosimetric characterization of model I125-SL 125iodine brachytherapy source in phantom.

Low-energy photon emitting radionuclides encapsulated for a permanent implant are routinely applied in prostate cancer brachytherapy. Before clinical use, a new source design requires full dosimetric analysis and calibration standardization. The results of one such experimental measurement and analysis are reported here for a new design of 125I source, model I125-SL. Dose measurements were made using standard methods employing thermoluminscent dosimeters in a water equivalent plastic phantom, in accord with the AAPM Task Group #43 recommendation of liquid water reference material. Precision machined bores in the phantom located dosimeters and source(s) in a reproducible fixed geometry providing for transverse-axis and angular dose profiles over a range of distances from 0.17 to 10 cm. The data were analyzed in terms of parameters recommended by AAPM TG43. The dose-rate constant, lambda, was evaluated by two methods, the first with reference to a 60Cobalt standard, accounting for response variation with photon energy spectrum. Second, the dose-rate constant was determined with reference to phantom measurements using NIST traceable calibrated model 6702 and 6711 sources. The radial dose function, g(r), the anisotropy function, F(r,theta), the anisotropy factor, phi(an)(r), and the point-source approximation anisotropy constant, phi(an), were derived from one- and two-dimensional dose distribution data measured in the phantom, accounting for finite dosimeter volume and with attention to interchip effects. The results are compared to TG43 and other existing data for 125I sources. The new source is comparable to the model 6711 source design.