Engineering topics

Beaulieu, Luc

Publications and source records attributed to Beaulieu, Luc.

At least 19 records

DOE OSTI2021

Validation of the TOPAS Monte Carlo toolkit for HDR brachytherapy simulations

The goal of this work is to validate the user-friendly Geant4-based Monte Carlo toolkit TOol for PArticle Simulation (TOPAS) for brachytherapy applications. Brachytherapy simulations performed with TOPAS were systematically compared with published TG-186 reference data. The photon emission energy spectrum, the air-kerma strength, and the dose-rate constant of the model-based dose calculation algorithm (MBDCA)-WG generic Ir-192 source were extracted. For dose calculations, a track-length estimator was implemented. Additionally, the four Joint AAPM/ESTRO/ABG MBDCA-WG test cases were evaluated through histograms of the local and global dose difference volumes. A prostate, a palliative lung, and a breast case were simulated. For each case, the dose ratio map, the histogram of the global dose difference volume, and cumulative dose-volume histograms were calculated. The air-kerma strength was (9.772 ± 0.001) × 10 -8 U Bq -1 (within 0.3% of the reference value). The dose-rate constant was 1.1107 ± 0.0005 cGy h -1 U -1 (within 0.01% of the reference value). For all cases, at least 96.9% of voxels had a local dose difference within [-1%, 1%] and at least 99.9% of voxels had a global dose difference within [-0.1%, 0.1%]. The implemented track-length estimator scorer was more efficient than the default analog dose scorer by a factor of 237. For all clinical cases, at least 97.5% of voxels had a global dose difference within [-1%, 1%]. Dose-volume histograms were consistent with the reference data. TOPAS was validated for high-dose-rate brachytherapy simulations following the TG-186 recommended approach for MBDCAs. Built on top of Geant4, TOPAS provides broad access to a state-of-the-art Monte Carlo code for brachytherapy simulations.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2017

Multicenter Evaluation of Biochemical Relapse–Free Survival Outcomes for Intraoperatively Planned Prostate Brachytherapy Using an Automated Delivery System

Purpose: To report biochemical recurrence in prostate cancer treated with intraoperatively planned low-dose-rate prostate brachytherapy using an automated delivery system (IO-LDRB). Methods and Materials: Between 2003 and 2013, 2608 patients from 3 centers were treated with IO-LDRB as single-modality treatment for low or low-tier intermediate-risk prostate cancer. Databases from the 3 centers have been analyzed. These independent databases were collected prospectively. Patient, tumor, and treatment characteristics were then compared, Kaplan-Meier survival estimates of biochemical relapse–free survival (bRFS) were generated, and the Cox proportional hazards model was used to determine factors predicting for relapse. Results: A total of 2608 patients with a median follow-up of 4.7 (interquartile range, 3.1-6.9) years were analyzed. Median age was 64 (range, 42-84) years. In these patients, median initial prostate-specific antigen was 5.5 ng/mL, 74% were T1, and 26% were T2; 73% were Gleason 6, and 25% Gleason 7. Median percentage of biopsy cores positive was 33%, and median gland volume was 34.2 cm{sup 3}. Eleven percent of patients received hormones for a median of 3.0 months before implantation. Median seed activity was 0.437 mCi, D90 (dose covering 90% of the prostate volume) was 186.7 Gy, and V100 was 99.37%. Biochemical relapse was observed in 124 patients (4.8%), and median time to failure was 4.0 years. Predicted bRFS was 93% at 7 years. On Cox regression bRFS was dependent only on D90 at the time of implantation and prostate-specific antigen density. Conclusions: This study demonstrates that IO-LDRB is an effective treatment option for patients with low and low-tier intermediate-risk prostate cancer. Rates of biochemical relapse remain low several years after treatment. These results compared favorably to published manual preplan technique results.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2016

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 01: On the use of proton radiography to reduce beam range uncertainties and improve patient positioning accuracy in proton therapy

To present two related developments of proton radiography (pRad) to minimize range uncertainty in proton therapy. The first combines a pRad with an X-ray CT to produce a patient-specific relative stopping power (RSP) map. The second aims to improve the pRad spatial resolution for accurate registration prior to the first. The enhanced-pRad can also be used in a novel proton-CT reconstruction algorithm. Monte Carlo pRad were computed from three phantoms; the Gammex, the Catphan and an anthropomorphic head. An optimized cubic-spline estimator derives the most likely path. The length crossed by the protons voxel-by-voxel was calculated by combining their estimated paths with the CT. The difference between the theoretical (length×RSP) and measured energy loss was minimized through a least squares optimization (LSO) algorithm yielding the RSP map. To increase pRad spatial resolution for registration with the CT, the phantom was discretized into voxels columns. The average column RSP was optimized to maximize the proton energy loss likelihood (MLE). Simulations showed precise RSP (<0.75%) for Gammex materials except low-density lung (<1.2%). For the head, accurate RSP were obtained (µ=−0.10%1.5σ=1.12%) and the range precision was improved (ΔR80 of −0.20±0.35%). Spatial resolution was increased in pRad (2.75 to 6.71 lp/cm) and pCT from MLE-enhanced pRad (2.83 to 5.86 lp/cm). The LSO decreases the range uncertainty (R80σ<1.0%) while the MLE-enhanced pRad spatial resolution (+244%) and is a great candidate for pCT reconstruction.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

Validation of a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial HDR brachytherapy

Purpose: In current clinical practice, there is no integrated 3D ultrasound (3DUS) guidance system clinically available for breast brachytherapy. In this study, the authors present a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial high dose rate (HDR) brachytherapy treatment. Methods: For this work, a new computer controlled robotic 3DUS system was built to perform a hybrid motion scan, which is a combination of a 6 cm linear translation with a 30° rotation at both ends. The new 3DUS scanner was designed to fit on a modified Kuske assembly, keeping the current template grid configuration but modifying the frame to allow the mounting of the 3DUS system at several positions. A finer grid was also tested. A user interface was developed to perform image reconstruction, semiautomatic segmentation of the surgical bed as well as catheter reconstruction and tracking. A 3D string phantom was used to validate the geometric accuracy of the reconstruction. The volumetric accuracy of the system was validated with phantoms using magnetic resonance imaging (MRI) and computed tomography (CT) images. In order to accurately determine whether 3DUS can effectively replace CT for treatment planning, the authors have compared the 3DUS catheter reconstruction to the one obtained from CT images. In addition, in agarose-based phantoms, an end-to-end procedure was performed by executing six independent complete procedures with both 14 and 16 catheters, and for both standard and finer Kuske grids. Finally, in phantoms, five end-to-end procedures were performed with the final CT planning for the validation of 3DUS preplanning. Results: The 3DUS acquisition time is approximately 10 s. A paired Student t-test showed that there was no statistical significant difference between known and measured values of string separations in each direction. Both MRI and CT volume measurements were not statistically different from 3DUS volume (Student t-test: p > 0.05) and they were significantly correlated to 3DUS measurement (Pearson test: MRI p < 0.05 and CT p < 0.001). The mean angular separation distance between catheter trajectories segmented from 3DUS and CT images was 0.42° ± 0.24°, while the maximum and mean trajectory separations were 0.51 ± 0.19 and 0.37 ± 0.17 mm, respectively. Overall, the new finer grid has performed significantly better in terms of dosimetric indices. The planning target volume dosimetric indices were not found statistically different between 3DUS and CT planning (Student t-test, p > 0.05). Both the skin and the pectoral muscle dosimetric indices were within ABS guidelines. Conclusions: A novel robot-assisted 3DUS system was designed and validated. To their knowledge, this is the first system capable of performing real-time guidance and planning of breast multicatheter HDR brachytherapy treatments. Future investigation will test the feasibility of using the system in the clinic and for permanent breast brachytherapy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

Systematic evaluation of photodetector performance for plastic scintillation dosimetry

Purpose: The authors’ objective was to systematically assess the performance of seven photodetectors used in plastic scintillation dosimetry. The authors also propose some guidelines for selecting an appropriate detector for a specific application. Methods: The plastic scintillation detector (PSD) consisted of a 1-mm diameter, 10-mm long plastic scintillation fiber (BCF-60), which was optically coupled to a clear 10-m long optical fiber of the same diameter. A light-tight plastic sheath covered both fibers and the scintillator end was sealed. The clear fiber end was connected to one of the following photodetectors: two polychromatic cameras (one with an optical lens and one with a fiber optic taper replacing the lens), a monochromatic camera with an optical lens, a PIN photodiode, an avalanche photodiode (APD), or a photomultiplier tube (PMT). A commercially available W1 PSD was also included in the study, but it relied on its own fiber and scintillator. Each PSD was exposed to both low-energy beams (120, 180, and 220 kVp) from an orthovoltage unit and high-energy beams (6 and 23 MV) from a linear accelerator. Various dose rates were tested to identify the operating range and accuracy of each photodetector. Results: For all photodetectors, the relative uncertainty was less than 5% for dose rates higher than 3 mGy/s. The cameras allowed multiple probes to be used simultaneously, but they are less sensitive to low-light signals. The PIN, APD, and PMT had higher sensitivity, making them more suitable for low dose rate and out-of-field dose monitoring. The relative uncertainty of the PMT was less than 1% at the lowest dose rate achieved (0.10 mGy/s), suggesting that it was optimal for use in live dosimetry. Conclusions: For dose rates higher than 3 mGy/s, the PIN diode is the most effective photodetector in terms of performance/cost ratio. For lower dose rates, such as those seen in interventional radiology or high-gradient radiotherapy, PMTs are the optimal choice.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (<50 kV) brachytherapy system used in accelerated partial breast irradiation (APBI). Breast tissue is a heterogeneous tissue in terms of density and composition. Dosimetric calculations of seven APBI patients treated with Axxent were made using a model-based Monte Carlo platform for a number of tissue models and dose reporting methods and compared to TG-43 based plans. Methods: A model of the Axxent source, the S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (D{sub w,m}) and dose to medium (D{sub m,m}), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D{sub 90} to PTV was reduced by between ∼4% and ∼40%, depending on the scoring method, compared to the TG-43 result. Peak skin dose is also reduced by 10%–15% due to the absence of backscatter not accounted for in TG-43. The balloon applicator also contributed to the reduced dose. Other ROIs showed a difference depending on the method of dose reporting. Conclusions: TG-186-based calculations produce results that are different from TG-43 for the Axxent source. The differences depend strongly on the method of dose reporting. This study highlights the importance of backscatter to peak skin dose. Tissue heterogeneities, applicator, and patient geometries demonstrate the need for a more robust dose calculation method for low energy brachytherapy sources.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2014

On the Sensitivity of α/β Prediction to Dose Calculation Methodology in Prostate Brachytherapy

Purpose: To study the relationship between the accuracy of the dose calculation in brachytherapy and the estimations of the radiosensitivity parameter, α/β, for prostate cancer. Methods and Materials: In this study, Monte Carlo methods and more specifically the code ALGEBRA was used to produce accurate dose calculations in the case of prostate brachytherapy. Equivalent uniform biologically effective dose was calculated for these dose distributions and was used in an iso-effectiveness relationship with external beam radiation therapy. Results: By considering different levels of detail in the calculations, the estimation for the α/β parameter varied from 1.9 to 6.3 Gy, compared with a value of 3.0 Gy suggested by the American Association of Physicists in Medicine Task Group 137. Conclusions: Large variations of the α/β show the sensitivity of this parameter to dose calculation modality. The use of accurate dose calculation engines is critical for better evaluating the biological outcomes of treatments.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2013

Adaptation of the CVT algorithm for catheter optimization in high dose rate brachytherapy

Purpose: An innovative, simple, and fast method to optimize the number and position of catheters is presented for prostate and breast high dose rate (HDR) brachytherapy, both for arbitrary templates or template-free implants (such as robotic templates).Methods: Eight clinical cases were chosen randomly from a bank of patients, previously treated in our clinic to test our method. The 2D Centroidal Voronoi Tessellations (CVT) algorithm was adapted to distribute catheters uniformly in space, within the maximum external contour of the planning target volume. The catheters optimization procedure includes the inverse planning simulated annealing algorithm (IPSA). Complete treatment plans can then be generated from the algorithm for different number of catheters. The best plan is chosen from different dosimetry criteria and will automatically provide the number of catheters and their positions. After the CVT algorithm parameters were optimized for speed and dosimetric results, it was validated against prostate clinical cases, using clinically relevant dose parameters. The robustness to implantation error was also evaluated. Finally, the efficiency of the method was tested in breast interstitial HDR brachytherapy cases.Results: The effect of the number and locations of the catheters on prostate cancer patients was studied. Treatment plans with a better or equivalent dose distributions could be obtained with fewer catheters. A better or equal prostate V100 was obtained down to 12 catheters. Plans with nine or less catheters would not be clinically acceptable in terms of prostate V100 and D90. Implantation errors up to 3 mm were acceptable since no statistical difference was found when compared to 0 mm error (p > 0.05). No significant difference in dosimetric indices was observed for the different combination of parameters within the CVT algorithm. A linear relation was found between the number of random points and the optimization time of the CVT algorithm. Because the computation time decrease with the number of points and that no effects were observed on the dosimetric indices when varying the number of sampling points and the number of iterations, they were respectively fixed to 2500 and to 100. The computation time to obtain ten complete treatments plans ranging from 9 to 18 catheters, with the corresponding dosimetric indices, was 90 s. However, 93% of the computation time is used by a research version of IPSA. For the breast, on average, the Radiation Therapy Oncology Group recommendations would be satisfied down to 12 catheters. Plans with nine or less catheters would not be clinically acceptable in terms of V100, dose homogeneity index, and D90.Conclusions: The authors have devised a simple, fast and efficient method to optimize the number and position of catheters in interstitial HDR brachytherapy. The method was shown to be robust for both prostate and breast HDR brachytherapy. More importantly, the computation time of the algorithm is acceptable for clinical use. Ultimately, this catheter optimization algorithm could be coupled with a 3D ultrasound system to allow real-time guidance and planning in HDR brachytherapy.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2013

3D tomodosimetry using long scintillating fibers: A feasibility study

Purpose: 3D dosimetry is recognized as an ideal for patient-specific quality assurance (QA) of highly conformal radiotherapy treatments. However, existing 3D dosimeters are not straightforward to implement in the clinic, as their read-out procedure is often tedious and their accuracy, precision, and/or sample size exhibit limitations. The purpose of this work is to develop a 3D dosimeter based on the concept of tomodosimetry inside concentric cylindrical planes using long scintillating fibers for the QA of modern radiotherapy techniques such as intensity-modulated radiation therapy (IMRT) or intensity-modulated arc therapy (IMAT).Methods: Using a model-based simulation, scintillating fibers were modeled on three concentric cylindrical planes of radii 2.5, 5.0, and 7.5 cm, inside a 10 cm radius water-equivalent cylinder phantom. The phantom was set to rotate around its central axis, made parallel to the linac gantry axis of rotation. Light acquisitions were simulated using the calculated dose from the treatment planning software and reconstructed in each cylindrical plane at a resolution of 1 mm{sup 2} using a total-variation minimization iterative reconstruction algorithm. The 3D dose was then interpolated from the reconstructed cylindrical plane doses at a resolution of 1 mm{sup 3}. Different scintillating fiber patterns were compared by varying the angle of each fiber in its cylindrical plane and introducing a light-tight cut in each fiber. The precision of the reconstructed cylindrical dose distribution was evaluated using a Poisson modeling of the acquired light signals and the accuracy of the interpolated 3D dose was evaluated using an IMRT clinical plan for a prostate case.Results: Straight scintillating fiber patterns with light-tight cuts were the most accurate in cylindrical dose reconstruction, showing less than 0.5 mm distance-to-agreement in dose gradients and a mean local dose difference of less than 0.2% in the high dose region for a 10 × 10 cm{sup 2} field. The precision attained with this fiber configuration was less than 0.9% in the high dose, low gradient region of an IMRT segment for light acquisitions of 0.1 MU over a 360 degree rotation of the cylinder phantom. 3D dose interpolation for the IMRT clinical plan yielded an overall dose difference with the reference input of less than 1%, except in high dose gradients.Conclusions: Using long scintillating fibers inside rotating, concentric cylindrical planes, the authors demonstrate that their tomodosimetry method has the potential for high resolution, precise, and accurate 3D dosimetry. Moreover, because of its water-equivalence and rotational symmetry, this design should find interesting application for both treatment QA and machine commissioning.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2013

On the use of a single-fiber multipoint plastic scintillation detector for {sup 192}Ir high-dose-rate brachytherapy

Purpose: The goal of this study was to prove the feasibility of using a single-fiber multipoint plastic scintillation detector (mPSD) as an in vivo verification tool during {sup 192}Ir high-dose-rate brachytherapy treatments.Methods: A three-point detector was built and inserted inside a catheter-positioning template placed in a water phantom. A hyperspectral approach was implemented to discriminate the different optical signals composing the light output at the exit of the single collection optical fiber. The mPSD was tested with different source-to-detector positions, ranging from 1 to 5 cm radially and over 10.5 cm along the longitudinal axis of the detector, and with various integration times. Several strategies for improving the accuracy of the detector were investigated. The device's accuracy in detecting source position was also tested.Results: Good agreement with the expected doses was obtained for all of the scintillating elements, with average relative differences from the expected values of 3.4 {+-} 2.1%, 3.0 {+-} 0.7%, and 4.5 {+-} 1.0% for scintillating elements from the distal to the proximal. A dose threshold of 3 cGy improved the general accuracy of the detector. An integration time of 3 s offered a good trade-off between precision and temporal resolution. Finally, the mPSD measured the radioactive source positioning uncertainty to be no more than 0.32 {+-} 0.06 mm. The accuracy and precision of the detector were improved by a dose-weighted function combining the three measurement points and known details about the geometry of the detector construction.Conclusions: The use of a mPSD for high-dose-rate brachytherapy dosimetry is feasible. This detector shows great promise for development of in vivo applications for real-time verification of treatment delivery.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2012

Report of the Task Group 186 on model-based dose calculation methods in brachytherapy beyond the TG-43 formalism: Current status and recommendations for clinical implementation

The charge of Task Group 186 (TG-186) is to provide guidance for early adopters of model-based dose calculation algorithms (MBDCAs) for brachytherapy (BT) dose calculations to ensure practice uniformity. Contrary to external beam radiotherapy, heterogeneity correction algorithms have only recently been made available to the BT community. Yet, BT dose calculation accuracy is highly dependent on scatter conditions and photoelectric effect cross-sections relative to water. In specific situations, differences between the current water-based BT dose calculation formalism (TG-43) and MBDCAs can lead to differences in calculated doses exceeding a factor of 10. MBDCAs raise three major issues that are not addressed by current guidance documents: (1) MBDCA calculated doses are sensitive to the dose specification medium, resulting in energy-dependent differences between dose calculated to water in a homogeneous water geometry (TG-43), dose calculated to the local medium in the heterogeneous medium, and the intermediate scenario of dose calculated to a small volume of water in the heterogeneous medium. (2) MBDCA doses are sensitive to voxel-by-voxel interaction cross sections. Neither conventional single-energy CT nor ICRU/ICRP tissue composition compilations provide useful guidance for the task of assigning interaction cross sections to each voxel. (3) Since each patient-source-applicator combination is unique, having reference data for each possible combination to benchmark MBDCAs is an impractical strategy. Hence, a new commissioning process is required. TG-186 addresses in detail the above issues through the literature review and provides explicit recommendations based on the current state of knowledge. TG-43-based dose prescription and dose calculation remain in effect, with MBDCA dose reporting performed in parallel when available. In using MBDCAs, it is recommended that the radiation transport should be performed in the heterogeneous medium and, at minimum, the dose to the local medium be reported along with the TG-43 calculated doses. Assignments of voxel-by-voxel cross sections represent a particular challenge. Electron density information is readily extracted from CT imaging, but cannot be used to distinguish between different materials having the same density. Therefore, a recommendation is made to use a number of standardized materials to maintain uniformity across institutions. Sensitivity analysis shows that this recommendation offers increased accuracy over TG-43. MBDCA commissioning will share commonalities with current TG-43-based systems, but in addition there will be algorithm-specific tasks. Two levels of commissioning are recommended: reproducing TG-43 dose parameters and testing the advanced capabilities of MBDCAs. For validation of heterogeneity and scatter conditions, MBDCAs should mimic the 3D dose distributions from reference virtual geometries. Potential changes in BT dose prescriptions and MBDCA limitations are discussed. When data required for full MBDCA implementation are insufficient, interim recommendations are made and potential areas of research are identified. Application of TG-186 guidance should retain practice uniformity in transitioning from the TG-43 to the MBDCA approach.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2012

Exploring {sup 57}Co as a new isotope for brachytherapy applications

Purpose: The characteristics of the radionuclide {sup 57}Co make it interesting for use as a brachytherapy source. {sup 57}Co combines a possible high specific activity with the emission of relatively low-energy photons and a half-life (272 days) suitable for regular source exchanges in an afterloader. {sup 57}Co decays by electron capture to the stable {sup 57}Fe with emission of 136 and 122 keV photons. Methods: A hypothetical {sup 57}Co source based on the Flexisource brachytherapy encapsulation with the active core set as a pure cobalt cylinder (length 3.5 mm and diameter 0.6 mm) covered with a cylindrical stainless-steel capsule (length 5 mm and thickness 0.125 mm) was simulated using Geant4 Monte Carlo (MC) code version 9.4. The radial dose function, g(r), and anisotropy function F(r,{theta}), for the line source approximation were calculated following the TG-43U1 formalism. The results were compared to well-known {sup 192}Ir and {sup 125}I radionuclides, representing the higher and the lower energy end of brachytherapy, respectively. Results: The mean energy of photons in water, after passing through the core and the encapsulation material was 123 keV. This hypothetical {sup 57}Co source has an increasing g(r) due to multiple scatter of low-energy photons, which results in a more uniform dose distribution than {sup 192}Ir. Conclusions: {sup 57}Co has many advantages compared to {sup 192}Ir due to its low-energy gamma emissions without any electron contamination. {sup 57}Co has an increasing g(r) that results in a more uniform dose distribution than {sup 192}Ir due to its multiple scattered photons. The anisotropy of the {sup 57}Co source is comparable to that of {sup 192}Ir. Furthermore, {sup 57}Co has lower shielding requirements than {sup 192}Ir.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2012

Dosimetric performance and array assessment of plastic scintillation detectors for stereotactic radiosurgery quality assurance

Purpose: To compare the performance of plastic scintillation detectors (PSD) for quality assurance (QA) in stereotactic radiosurgery conditions to a microion-chamber (IC), Gafchromic EBT2 films, 60 008 shielded photon diode (SD) and unshielded diodes (UD), and assess a new 2D crosshair array prototype adapted to small field dosimetry. Methods: The PSD consists of a 1 mm diameter by 1 mm long scintillating fiber (BCF-60, Saint-Gobain, Inc.) coupled to a polymethyl-methacrylate optical fiber (Eska premier, Mitsubishi Rayon Co., Ltd., Tokyo, Japan). Output factors (S{sub c,p}) for apertures used in radiosurgery ranging from 4 to 40 mm in diameter have been measured. The PSD crosshair array (PSDCA) is a water equivalent device made up of 49 PSDs contained in a 1.63 cm radius area. Dose profiles measurements were taken for radiosurgery fields using the PSDCA and were compared to other dosimeters. Moreover, a typical stereotactic radiosurgery treatment using four noncoplanar arcs was delivered on a spherical phantom in which UD, IC, or PSD was placed. Using the Xknife planning system (Integra Radionics Burlington, MA), 15 Gy was prescribed at the isocenter, where each detector was positioned. Results: Output Factors measured by the PSD have a mean difference of 1.3% with Gafchromic EBT2 when normalized to a 10 x 10 cm{sup 2} field, and 1.0% when compared with UD measurements normalized to the 35 mm diameter cone. Dose profiles taken with the PSD crosshair array agreed with other single detectors dose profiles in spite of the presence of the 49 PSDs. Gamma values comparing 1D dose profiles obtained with PSD crosshair array with Gafchromic EBT2 and UD measured profiles shows 98.3% and 100.0%, respectively, of detector passing the gamma acceptance criteria of 0.3 mm and 2%. The dose measured by the PSD for a complete stereotactic radiosurgery treatment is comparable to the planned dose corrected for its SD-based S{sub c,p} within 1.4% and 0.7% for 5 and 35 mm diameter cone, respectively. Furthermore, volume averaging of the IC can be observed for the 5 mm aperture where it differs by as much as 9.1% compared to the PSD measurement. The angular dependency of the UD is also observed, unveiled by an under-response around 2.5% of both 5 and 35 mm apertures. Conclusions: Output Factors and dose profiles measurements performed, respectively, with the PSD and the PSDCA were in agreement with those obtained with the UD and EBT2 films. For stereotactic radiosurgery treatment verification, the PSD gives accurate results compared to the planning system and the IC once the latter is corrected to compensate for the averaging effect of the IC. The PSD provides precise results when used as a single detector or in a dense array, resulting in a great potential for stereotactic radiosurgery QA measurements.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2011

A new water-equivalent 2D plastic scintillation detectors array for the dosimetry of megavoltage energy photon beams in radiation therapy

Purpose: The objective of this work is to present a new 2D plastic scintillation detectors array (2D-PSDA) designed for the dosimetry of megavoltage (MV) energy photon beams in radiation therapy and to characterize its basic performance. Methods: We developed a 2D detector array consisting of 781 plastic scintillation detectors (PSDs) inserted into a plane of a water-equivalent phantom. The PSDs were distributed on a 26 x 26 cm{sup 2} grid, with an interdetector spacing of 10 mm, except for two perpendicular lines centered on the detection plane, where the spacing was 5 mm. Each PSD was made of a 1 mm diameter by 3 mm long cylindrical polystyrene scintillating fiber coupled to a clear nonscintillating plastic optical fiber. All of the light signals emitted by the PSDs were read simultaneously with an optical system at a rate of one measurement per second. We characterized the performance of the optical system, the angular dependency of the device, and the perturbation of dose distributions caused by the hundreds of PSDs inserted into the phantom. We also evaluated the capacity of the system to monitor complex multileaf collimator (MLC) sequences such as those encountered in step-and-shoot intensity modulated radiation therapy (IMRT) plans. We compared our results with calculations performed by a treatment planning system and with measurements taken with a 2D ionization chamber array and with a radiochromic film. Results: The detector array that we developed allowed us to measure doses with an average precision of better than 1% for cumulated doses equal to or greater than 6.3 cGy. Our results showed that the dose distributions produced by the 6-MV photon beam are not perturbed (within {+-}1.1%) by the presence of the hundreds of PSDs located into the phantom. The results also showed that the variations in the beam incidences have little effect on the dose response of the device. For all incidences tested, the passing rates of the gamma tests between the 2D-PSDA and the treatment planning system were higher than 97.5% when the standard clinical tolerances of 3% or 3 mm were used. Excellent agreement was obtained between the doses measured and calculated when we used the 2D-PSDA for monitoring a MLC sequence from a step-and-shoot IMRT plan. Conclusions: We demonstrated the feasibility of using a large number of PSDs in a new 2D-PSDA for the dosimetry of MV energy photon beams in radiation therapy. The excellent precision, accuracy, and low angular dependence of the device indicate that such a prototype could potentially be used as a high-accuracy quality assurance tool for IMRT and arc therapy patient plan verification. The homogeneity and water-equivalence of the prototype we built suggest that this technology could be extended to multiple detection planes by arranging the fibers into more complex orientations, opening the possibility for 3D dosimetry with PSDs.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2011

Patient-Specific Monte Carlo-Based Dose-Kernel Approach for Inverse Planning in Afterloading Brachytherapy

Purpose: Brachytherapy planning software relies on the Task Group report 43 dosimetry formalism. This formalism, based on a water approximation, neglects various heterogeneous materials present during treatment. Various studies have suggested that these heterogeneities should be taken into account to improve the treatment quality. The present study sought to demonstrate the feasibility of incorporating Monte Carlo (MC) dosimetry within an inverse planning algorithm to improve the dose conformity and increase the treatment quality. Methods and Materials: The method was based on precalculated dose kernels in full patient geometries, representing the dose distribution of a brachytherapy source at a single dwell position using MC simulations and the Geant4 toolkit. These dose kernels are used by the inverse planning by simulated annealing tool to produce a fast MC-based plan. A test was performed for an interstitial brachytherapy breast treatment using two different high-dose-rate brachytherapy sources: the microSelectron iridium-192 source and the electronic brachytherapy source Axxent operating at 50 kVp. Results: A research version of the inverse planning by simulated annealing algorithm was combined with MC to provide a method to fully account for the heterogeneities in dose optimization, using the MC method. The effect of the water approximation was found to depend on photon energy, with greater dose attenuation for the lower energies of the Axxent source compared with iridium-192. For the latter, an underdosage of 5.1% for the dose received by 90% of the clinical target volume was found. Conclusion: A new method to optimize afterloading brachytherapy plans that uses MC dosimetric information was developed. Including computed tomography-based information in MC dosimetry in the inverse planning process was shown to take into account the full range of scatter and heterogeneity conditions. This led to significant dose differences compared with the Task Group report 43 approach for the Axxent source.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2011

Modeling a Hypothetical {sup 170}Tm Source for Brachytherapy Applications

Purpose: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical {sup 170}Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons. Methods: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of {sup 170}Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical {sup 170}Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation. Results: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (<1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively. Conclusions: A {sup 170}Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of {sup 170}Tm as a brachytherapy source presents notable challenges.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2011

Extraction of depth-dependent perturbation factors for silicon diodes using a plastic scintillation detector

Purpose: This work presents the experimental extraction of the perturbation factor in megavoltage electron beams for three models of silicon diodes (IBA Dosimetry, EFD and SFD, and the PTW 60012 unshielded) using a plastic scintillation detector (PSD). Methods: The authors used a single scanning PSD mounted on a high-precision scanning tank to measure depth-dose curves in 6-, 12-, and 18-MeV clinical electron beams. They also measured depth-dose curves using the IBA Dosimetry, EFD and SFD, and the PTW 60012 unshielded diodes. The authors used the depth-dose curves measured with the PSD as a perturbation-free reference to extract the perturbation factors of the diodes. Results: The authors found that the perturbation factors for the diodes increased substantially with depth, especially for low-energy electron beams. The experimental results show the same trend as published Monte Carlo simulation results for the EFD diode; however, the perturbations measured experimentally were greater. They found that using an effective point of measurement (EPOM) placed slightly away from the source reduced the variation of perturbation factors with depth and that the optimal EPOM appears to be energy dependent. Conclusions: The manufacturer recommended EPOM appears to be incorrect at low electron energy (6 MeV). In addition, the perturbation factors for diodes may be greater than predicted by Monte Carlo simulations.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗