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PNNL Dose-per-Unit-Release Factors for Calculating Radionuclide Emissions Potential-to-Emit Doses

Revised PNNL-Richland campus dose-per-unit release factors based on the Environmental Protection Agency code CAP88-PC Version 4.1.1 code are provided. In addition to maximum receptor dose factors, maximum air concentration dose factors are provided. The PNNL-Sequim campus dose-per-unit release factors are included, as well, based on the Environmental Protection Agency code COMPLY Version 1.7.1.

40 CFR 61 Subpart H↗

Breast dosimetry in transverse and longitudinal field MRI-Linac radiotherapy systems

Purpose: In the framework of developing the integration of a MRI-Linac system, configurations of MRI-Linac units were simulated in order to improve the dose distribution in tangential breast radiotherapy using transverse and longitudinal magnetic field geometries of Lorentz force for both medial and lateral tangential fields. Methods: In this work, the GEANT4 Monte Carlo (MC) code was utilized to compare dose distributions in breast radiotherapy for Linac-MR systems in the transverse and longitudinal geometries within humanoid phantoms across a range of magnetic field strengths of 0.5 and 1.5 T. The dose increment due to scattering from the coils was investigated for both geometries as well. Computed tomography images of two patients were used for MC simulations. One patient had intact breast while the other was mastectomized. In the simulations, planning and methods of chest wall irradiation were similar to the actual clinical planning. Results: In a longitudinal geometry, the magnetic field is shown to restrict the lateral spread of secondary electrons to the lung, heart, and contralateral organs, which reduced the mean dose of the ipsilateral lung and heart by means of 17.2% and 6% at 1.5 T, respectively. The transverse configuration exhibits a significant increase in tissue interface effects, which increased dose buildup in the entrance regions of the lateral and medial tangent beams to the planning target volume (PTV) and improved dose homogeneity within the PTV. The improved relative average homogeneity index for two patients to the PTV at magnetic field strength of 1.5 T with respect to no magnetic field case evaluated was 11.79% and 34.45% in the LRBP and TRBP geometries, respectively. In both geometries, the simulations show significant mean dose reductions in the contralateral breast and chest wall skin, respectively, by a mean of 16.6% and 24.9% at 0.5 T and 17.2% and 28.1% at 1.5 T in the transverse geometry, and 10.56% and 14.6% at 0.5 T and 11.3% and 16.3% at 1.5 T in the longitudinal geometry. Considering the scattered photons which reflected from the coils, the average relative dose of each voxel is slightly increased by 0.53% and 0.32% in the LRBP and TRBP geometries, respectively. Conclusions: Orienting the B0 magnetic field parallel to the photon beam axis, LRBP geometry, tends to restrict the radial spread of secondary electrons which resulted in dose reduction to the lung. Dosimetry issues observed in both Linac-MR geometries, such as changes to the lateral dose distribution, significantly exhibited dose reduction in the contralateral organs on a representative breast plan. Further, the results show sharper edge dose volume histogram curves at 1.5 T for both geometries, especially in the LRBP configuration.

60 APPLIED LIFE SCIENCES↗

Comparison of dose calculation methods for brachytherapy of intraocular tumors

Purpose: To investigate dosimetric differences among several clinical treatment planning systems (TPS) and Monte Carlo (MC) codes for brachytherapy of intraocular tumors using {sup 125}I or {sup 103}Pd plaques, and to evaluate the impact on the prescription dose of the adoption of MC codes and certain versions of a TPS (Plaque Simulator with optional modules). Methods: Three clinical brachytherapy TPS capable of intraocular brachytherapy treatment planning and two MC codes were compared. The TPS investigated were Pinnacle v8.0dp1, BrachyVision v8.1, and Plaque Simulator v5.3.9, all of which use the AAPM TG-43 formalism in water. The Plaque Simulator software can also handle some correction factors from MC simulations. The MC codes used are MCNP5 v1.40 and BrachyDose/EGSnrc. Using these TPS and MC codes, three types of calculations were performed: homogeneous medium with point sources (for the TPS only, using the 1D TG-43 dose calculation formalism); homogeneous medium with line sources (TPS with 2D TG-43 dose calculation formalism and MC codes); and plaque heterogeneity-corrected line sources (Plaque Simulator with modified 2D TG-43 dose calculation formalism and MC codes). Comparisons were made of doses calculated at points-of-interest on the plaque central-axis and at off-axis points of clinical interest within a standardized model of the right eye. Results: For the homogeneous water medium case, agreement was within {approx}2% for the point- and line-source models when comparing between TPS and between TPS and MC codes, respectively. For the heterogeneous medium case, dose differences (as calculated using the MC codes and Plaque Simulator) differ by up to 37% on the central-axis in comparison to the homogeneous water calculations. A prescription dose of 85 Gy at 5 mm depth based on calculations in a homogeneous medium delivers 76 Gy and 67 Gy for specific {sup 125}I and {sup 103}Pd sources, respectively, when accounting for COMS-plaque heterogeneities. For off-axis points-of-interest, dose differences approached factors of 7 and 12 at some positions for {sup 125}I and {sup 103}Pd, respectively. There was good agreement ({approx}3%) among MC codes and Plaque Simulator results when appropriate parameters calculated using MC codes were input into Plaque Simulator. Plaque Simulator and MC users are perhaps at risk of overdosing patients up to 20% if heterogeneity corrections are used and the prescribed dose is not modified appropriately. Conclusions: Agreement within 2% was observed among conventional brachytherapy TPS and MC codes for intraocular brachytherapy dose calculations in a homogeneous water environment. In general, the magnitude of dose errors incurred by ignoring the effect of the plaque backing and Silastic insert (i.e., by using the TG-43 approach) increased with distance from the plaque's central-axis. Considering the presence of material heterogeneities in a typical eye plaque, the best method in this study for dose calculations is a verified MC simulation.

60 APPLIED LIFE SCIENCES↗

Comparison of CAP88 and MCNP for Overhead Gamma-emitting Plumes

The purpose of this paper is to use the Monte Carlo N-Particle Code (MCNP) to investigate the dose from gamma-emitting radionuclides such as Carbon-11 when a plume passes overhead. MCNP results are compared with results from the EPA program, CAP88. In some cases, typically near the source during stable conditions, the CAP88 results are less than the MCNP results. However, in the case of a receptor 800 m from a source at the Los Alamos Neutron Science Center (LANSCE), the CAP88 result is greater than the MCNP result.

61 RADIATION PROTECTION AND DOSIMETRY↗

Fuel Age Impacts on Gaseous Fission Product Capture During Separations

As a result of fuel reprocessing, volatile radionuclides will be released from the facility stack if no processes are put in place to remove them. The radionuclides that are of concern in this document are 3 H, 14 C, 85 Kr, and 129 I. The question we attempt to answer is how efficient must this removal process be for each of these radionuclides? To answer this question, we examine the three regulations that may impact the degree to which these radionuclides must be reduced before process gases can be released from the facility. These regulations are 40 CFR 61 (EPA 2010a), 40 CFR 190(EPA 2010b), and 10 CFR 20 (NRC 2012), and they apply to the total radonuclide release and to the dose to a particular organ – the thyroid. Because these doses can be divided amongst all the radionuclides in different ways and even within the four radionuclides in question, several cases are studied. These cases consider for the four analyzed radionuclides inventories produced for three fuel types—pressurized water reactor uranium oxide (PWR UOX), pressurized water reactor mixed oxide (PWR MOX), and advanced high-temperature gas-cooled reactor (AHTGR)—several burnup values and time out of reactor extending to 200 y. Doses to the maximum exposed individual (MEI) are calculated with the EPA code CAP-88 (Rosnick 2007, 1992). Two dose cases are considered. The first case, perhaps unrealistic, assumes that all of the allowable dose is assigned to the volatile radionuclides. In lieu of this, for the second case a value of 10% of the allowable dose is arbitrarily selected to be assigned to the volatile radionuclides. The required decontamination factors (DFs) are calculated for both of these cases, including the case for the thyroid dose for which 14 C and 129 I are the main contributors. However, for completeness, for one fuel type and burnup, additional cases are provided, allowing 25% and 50% of the allowable dose to be assigned to the volatile radionuclides. Because 3 H and 85 Kr have relatively short half-lives, 12.3 y and 10.7 y, respectively, the dose decreases with the time from when the fuel is removed from the reactor to the time it is processed (herein “fuel age”). One possible strategy for limiting the discharges of these short halflife radionuclides is to allow the fuel to age to take advantage of radioactive decay. Therefore, the doses and required DFs are calculated as a function of fuel age. Here we calculate, given the above constraints and assumptions, the minimum ages for each fuel type that would not require additional effluent controls for the shorter half-life volatile radionuclides based on dose considerations. With respect to 129 I doses, we find that the highest dose is calculated with iodine as a fine particulate. The dose scales as the fraction of the total 129 I that is particulate. Therefore, we assume for all of our calculations that 100% of the 129 I is particulate and allow the user of the results given here to scale our calculated doses to their needs. To summarize the data given in the body and appendices of this report, we find that the principal isotopes of concern are 3 H and 129 I, the latter requiring the highest DFs. The maximum DF value for 129 I is 8000 for the illustrated cases. The required DF for 3 H could be as high as 720, depending on the age of the fuel processed. The DF for 85 Kr could be up to ~60, depending on fuel age. The DF for 14 C is in many cases 1 (no treatment required) but could be as high as 30. The DFs required are within the range of DFs that are reported for the capture technologies that are available for the volatile radionuclides. Achieving the required 129 I and 3 H DFs is more challenging. Variations in stack design and other design factors may also significantly impact the DF requirements.

carbon-14↗

Correction Factors Applied to Finger Dosimetry: A Theoretical Assessment of Appropriate Values for Use in Handling Radiopharmaceuticals

United States Nuclear Regulatory Commission (USNRC) regulations limit the dose to the skin to 500 mSv per year. This is also the dose limit recommended by the International Commission on Radiological Protection (ICRP). The operational quantity recommended by ICRP for quantifying dose to the skin is the personal dose equivalent, Hp(0.07) and is identical to NRC s shallow dose equivalent, Hs, also measured at a skin depth of 7 mg cm 2. However, whereas ICRP recommends averaging the dose to the skin over an area of 1 cm2 regardless of the size of the exposed area of skin, USNRC requires the shallow dose equivalent to be averaged over 10 cm2. To monitor dose to the skin of the hands of workers handling radioactive materials and particularly in radiopharmaceutical manufacturing facilities, which is the focus of this work, workers are frequently required to wear finger ring dosimeters. The dosimeters monitor the dose at the location of the sensitive element, but this is not the dose required to show compliance (i.e., the dose averaged over the highest exposed contiguous 10 cm2 of skin). Therefore, it may be necessary to apply a correction factor that enables estimation of the required skin dose from the dosimeter reading. This work explored the effects of finger ring placement and of the geometry of the radioactive materials being handled by the worker on the relationship between the dosimeter reading and the desired average dose. A mathematical model of the hand was developed for this purpose that is capable of positioning the fingers in any desired grasping configuration, thereby realistically modeling manipulation of any object. The model was then used with the radiation transport code MCNP to calculate the dose distribution on the skin of the hand when handling a variety of radioactive vials and syringes, as well as the dose to the dosimeter element. Correction factors were calculated using the results of these calculations and examined for any patterns that may be useful in establishing an appropriate correction factor for this type of work. It was determined that a correction factor of one applied to the dosimeter reading, with the dosimeter placed at the base of the middle finger, provides an adequate estimate of the required average dose during a monitoring period for most commonly encountered geometries. Different correction factors may be required for exceptional or unusual source geometries and must be considered on a case-by-case basis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Dosimetric evaluation of new approaches in GRID therapy using nonconventional radiation sources

Purpose: Spatial fractionation of the dose has proven to be a promising approach to increase the tolerance of healthy tissue, which is the main limitation of radiotherapy. A good example of that is GRID therapy, which has been successfully used in the management of large tumors with low toxicity. The aim of this work is to explore new avenues using nonconventional sources: GRID therapy by using kilovoltage (synchrotron) x-rays, the use of very high-energy electrons, and proton GRID therapy. They share in common the use of the smallest possible grid sizes in order to exploit the dose–volume effects. Methods: Monte Carlo simulations (PENELOPE/PENEASY and GEANT4/GATE codes) were used as a method to study dose distributions resulting from irradiations in different configurations of the three proposed techniques. As figure of merit, percentage (peak and valley) depth dose curves, penumbras, and central peak-to-valley dose ratios (PVDR) were evaluated. As shown in previous biological experiments, high PVDR values are requested for healthy tissue sparing. A superior tumor control may benefit from a lower PVDR. Results: High PVDR values were obtained in the healthy tissue for the three cases studied. When low energy photons are used, the treatment of deep-seated tumors can still be performed with submillimetric grid sizes. Superior PVDR values were reached with the other two approaches in the first centimeters along the beam path. The use of protons has the advantage of delivering a uniform dose distribution in the tumor, while healthy tissue benefits from the spatial fractionation of the dose. In the three evaluated techniques, there is a net reduction in penumbra with respect to radiosurgery. Conclusions: The high PVDR values in the healthy tissue and the use of small grid sizes in the three presented approaches might constitute a promising alternative to treat tumors with such spatially fractionated radiotherapy techniques. The dosimetric results presented here support the interest of performing radiobiology experiments in order to evaluate these new avenues.

07 ISOTOPE AND RADIATION SOURCES↗

Dosimetric characterization of two radium sources for retrospective dosimetry studies

Purpose: During the first part of the 20th century, {sup 226}Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two {sup 226}Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg {sup 226}Ra tube and a 10 mg {sup 226}Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a {sup 226}Ra point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including g{sub L}(r), F(r, θ), Λ, and s{sub K}] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%–15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%–25%. Conclusions: The results provided here facilitate retrospective dosimetry studies of {sup 226}Ra using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-761: TOMOMC, A Monte Carlo-Based Planning VerificationTool for Helical Tomotherapy

Purpose: Present a new Monte Carlo code (TOMOMC) to calculate 3D dose distributions for patients undergoing helical tomotherapy treatments. TOMOMC performs CT-based dose calculations using the actual dynamic variables of the machine (couch motion, gantry rotation, and MLC sequences). Methods: TOMOMC is based on the GEPTS (Gama Electron and Positron Transport System) general-purpose Monte Carlo system (Chibani and Li, Med. Phys. 29, 2002, 835). First, beam models for the Hi-Art Tomotherpy machine were developed for the different beam widths (1, 2.5 and 5 cm). The beam model accounts for the exact geometry and composition of the different components of the linac head (target, primary collimator, jaws and MLCs). The beams models were benchmarked by comparing calculated Pdds and lateral/transversal dose profiles with ionization chamber measurements in water. See figures 1–3. The MLC model was tuned in such a way that tongue and groove effect, inter-leaf and intra-leaf transmission are modeled correctly. See figure 4. Results: By simulating the exact patient anatomy and the actual treatment delivery conditions (couch motion, gantry rotation and MLC sinogram), TOMOMC is able to calculate the 3D patient dose distribution which is in principal more accurate than the one from the treatment planning system (TPS) since it relies on the Monte Carlo method (gold standard). Dose volume parameters based on the Monte Carlo dose distribution can also be compared to those produced by the TPS. Attached figures show isodose lines for a H&N patient calculated by TOMOMC (transverse and sagittal views). Analysis of differences between TOMOMC and TPS is an ongoing work for different anatomic sites. Conclusion: A new Monte Carlo code (TOMOMC) was developed for Tomotherapy patient-specific QA. The next step in this project is implementing GPU computing to speed up Monte Carlo simulation and make Monte Carlo-based treatment verification a practical solution.

60 APPLIED LIFE SCIENCES↗

Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurements were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG and A{sup ~} was determined by the integration of measured {sup 131}I activity in the thyroid gland and based on T{sub eff}, respectively. No statistically significant relationship was found between therapeutic response and patients’ age, administered {sup 131}I activity (MBq), 24-h thyroid {sup 131}I uptake (%) or T{sub eff} (p ≥ 0.064); nonetheless, a good relationship was found between the therapeutic response and m{sub th} (p ≤ 0.035). Conclusions: According to the results of this study, the most effective thyroid absorbed dose to be targeted in GD therapy should not be based on a fixed dose but rather should be individualized based on the patient'sm{sub th} and A{sup ~}. To achieve a therapeutic success (i.e., durable euthyroidism or hypothyroidism) rate of at least 95%, a thyroid absorbed dose of 200 or 330 Gy is required depending on the methodology used for estimating m{sub th} and A{sup ~}.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

WE-AB-BRB-01: Development of a Probe-Format Graphite Calorimeter for Practical Clinical Dosimetry: Numerical Design Optimization, Prototyping, and Experimental Proof-Of-Concept

Purpose: In this work, the feasibility of performing absolute dose to water measurements using a constant temperature graphite probe calorimeter (GPC) in a clinical environment is established. Methods: A numerical design optimization study was conducted by simulating the heat transfer in the GPC resulting from irradiation using a finite element method software package. The choice of device shape, dimensions, and materials was made to minimize the heat loss in the sensitive volume of the GPC. The resulting design, which incorporates a novel aerogel-based thermal insulator, and 15 temperature sensitive resistors capable of both Joule heating and measuring temperature, was constructed in house. A software based process controller was developed to stabilize the temperatures of the GPC’s constituent graphite components to within a few 10’s of µK. This control system enables the GPC to operate in either the quasi-adiabatic or isothermal mode, two well-known, and independent calorimetry techniques. Absorbed dose to water measurements were made using these two methods under standard conditions in a 6 MV 1000 MU/min photon beam and subsequently compared against TG-51 derived values. Results: Compared to an expected dose to water of 76.9 cGy/100 MU, the average GPC-measured doses were 76.5 ± 0.5 and 76.9 ± 0.5 cGy/100 MU for the adiabatic and isothermal modes, respectively. The Monte Carlo calculated graphite to water dose conversion was 1.013, and the adiabatic heat loss correction was 1.003. With an overall uncertainty of about 1%, the most significant contributions were the specific heat capacity (type B, 0.8%) and the repeatability (type A, 0.6%). Conclusion: While the quasi-adiabatic mode of operation had been validated in previous work, this is the first time that the GPC has been successfully used isothermally. This proof-of-concept will serve as the basis for further study into the GPC’s application to small fields and MRI-linac dosimetry. This work has been supported in part by the CREATE Medical Physics Research Training Network of the Natural Sciences and Engineering Research Council (NSERC) grant 432290, NSERC grants RGPIN 298191 & 435608-13, Canadian Institutes of Health Research doctoral scholarship GSD-121793. This work has also been supported by Sun Nuclear Corporation.

60 APPLIED LIFE SCIENCES↗

SU-E-T-254: Optimization of GATE and PHITS Monte Carlo Code Parameters for Uniform Scanning Proton Beam Based On Simulation with FLUKA General-Purpose Code

Purpose: Monte Carlo codes are becoming important tools for proton beam dosimetry. However, the relationships between the customizing parameters and percentage depth dose (PDD) of GATE and PHITS codes have not been reported which are studied for PDD and proton range compared to the FLUKA code and the experimental data. Methods: The beam delivery system of the Indiana University Health Proton Therapy Center was modeled for the uniform scanning beam in FLUKA and transferred identically into GATE and PHITS. This computational model was built from the blue print and validated with the commissioning data. Three parameters evaluated are the maximum step size, cut off energy and physical and transport model. The dependence of the PDDs on the customizing parameters was compared with the published results of previous studies. Results: The optimal parameters for the simulation of the whole beam delivery system were defined by referring to the calculation results obtained with each parameter. Although the PDDs from FLUKA and the experimental data show a good agreement, those of GATE and PHITS obtained with our optimal parameters show a minor discrepancy. The measured proton range R90 was 269.37 mm, compared to the calculated range of 269.63 mm, 268.96 mm, and 270.85 mm with FLUKA, GATE and PHITS, respectively. Conclusion: We evaluated the dependence of the results for PDDs obtained with GATE and PHITS Monte Carlo generalpurpose codes on the customizing parameters by using the whole computational model of the treatment nozzle. The optimal parameters for the simulation were then defined by referring to the calculation results. The physical model, particle transport mechanics and the different geometrybased descriptions need accurate customization in three simulation codes to agree with experimental data for artifact-free Monte Carlo simulation. This study was supported by Grants-in Aid for Cancer Research (H22-3rd Term Cancer Control-General-043) from the Ministry of Health, Labor and Welfare of Japan, Grants-in-Aid for Scientific Research (No. 23791419), and JSPS Core-to-Core program (No. 23003). The authors have no conflict of interest.

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-14: Dose Weighted Linear Energy Transfer Analysis of Critical Structures in Proton Therapy of Pediatric Brain Tumor Patients

Purpose: Dose weighted Linear Energy Transfer (LETd) analysis of critical structures may be useful in understanding the side effects of the proton therapy. The objective is to analyze the differences between LETd and dose distributions in brain tumor patients receiving double scattering proton therapy, to quantify LETd variation in critical organs, and to identify beam arrangements contributing to high LETd in critical organs. Methods: Monte Carlo simulations of 9 pediatric brain tumor patients were performed. The treatment plans were reconstructed with the TOPAS Monte Carlo code to calculate LETd and dose. The beam data were reconstructed proximal to the aperture of the double scattering nozzle. The dose and LETd to target and critical organs including brain stem, optic chiasm, lens, optic nerve, pituitary gland, and hypothalamus were computed for each beam. Results: Greater variability in LETd compared to dose was observed in the brainstem for patients with a variety of tumor types including 5 patients with tumors located in the posterior fossa. Approximately 20%–44% brainstem volume received LETd of 5kev/µm or greater from beams within gantry angles 180°±30° for 5 patients treated with a 3 beam arrangement. Critical organs received higher LETd when located in the vicinity of the beam distal edge. Conclusion: This study presents a novel strategy in the evaluation of the proton treatment impact on critical organs. While the dose to critical organs is confined below the required limits, the LETd may have significant variation. Critical organs in the vicinity of beam distal edge receive higher LETd and depended on beam arrangement, e.g. in posterior fossa tumor treatment, brainstem receive higher LETd from posterior-anterior beams. This study shows importance of the LETd analysis of the radiation impact on the critical organs in proton therapy and may be used to explain clinical imaging observations after therapy.

60 APPLIED LIFE SCIENCES↗

SU-E-T-439: An Improved Formula of Scatter-To-Primary Ratio for Photon Dose Calculation

Purpose: Scatter-to-primary ratio (SPR) is an important dosimetric quantity that describes the contribution from the scatter photons in an external photon beam. The purpose of this study is to develop an improved analytical formula to describe SPR as a function of circular field size (r) and depth (d) using Monte Carlo (MC) simulation. Methods: MC simulation was performed for Mohan photon spectra (Co-60, 4, 6, 10, 15, 23 MV) using EGSNRC code. Point-spread scatter dose kernels in water are generated. The scatter-to-primary ratio (SPR) is also calculated using MC simulation as a function of field size for circular field size with radius r and depth d. The doses from forward scatter and backscatter photons are calculated using a convolution of the point-spread scatter dose kernel and by accounting for scatter photons contributing to dose before (z' d) reaching the depth of interest, d, where z' is the location of scatter photons, respectively. The depth dependence of the ratio of the forward scatter and backscatter doses is determined as a function of depth and field size. Results: We are able to improve the existing 3-parameter (a, w, d0) empirical formula for SPR by introducing depth dependence for one of the parameter d0, which becomes 0 for deeper depths. The depth dependence of d0 can be directly calculated as a ratio of backscatter-to-forward scatter doses for otherwise the same field and depth. With the improved empirical formula, we can fit SPR for all megavoltage photon beams to within 2%. Existing 3-parameter formula cannot fit SPR data for Co-60 to better than 3.1%. Conclusion: An improved empirical formula is developed to fit SPR for all megavoltage photon energies to within 2%.

60 APPLIED LIFE SCIENCES↗

SU-E-T-561: Monte Carlo-Based Organ Dose Reconstruction Using Pre-Contoured Human Model for Hodgkins Lymphoma Patients Treated by Cobalt-60 External Beam Therapy

Purpose: Organ doses for the Hodgkin’s lymphoma patients treated with cobalt-60 radiation were estimated using an anthropomorphic model and Monte Carlo modeling. Methods: A cobalt-60 treatment unit modeled in the BEAMnrc Monte Carlo code was used to produce phase space data. The Monte Carlo simulation was verified with percent depth dose measurement in water at various field sizes. Radiation transport through the lung blocks were modeled by adjusting the weights of phase space data. We imported a precontoured adult female hybrid model and generated a treatment plan. The adjusted phase space data and the human model were imported to the XVMC Monte Carlo code for dose calculation. The organ mean doses were estimated and dose volume histograms were plotted. Results: The percent depth dose agreement between measurement and calculation in water phantom was within 2% for all field sizes. The mean organ doses of heart, left breast, right breast, and spleen for the selected case were 44.3, 24.1, 14.6 and 3.4 Gy, respectively with the midline prescription dose of 40.0 Gy. Conclusion: Organ doses were estimated for the patient group whose threedimensional images are not available. This development may open the door to more accurate dose reconstruction and estimates of uncertainties in secondary cancer risk for Hodgkin’s lymphoma patients. This work was partially supported by the intramural research program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics.

61 RADIATION PROTECTION AND DOSIMETRY↗

The effect of voxel size on dose distribution in Varian Clinac iX 6 MV photon beam using Monte Carlo simulation

Recently, Monte Carlo (MC) calculation method has reported as the most accurate method of predicting dose distributions in radiotherapy. The MC code system (especially DOSXYZnrc) has been used to investigate the different voxel (volume elements) sizes effect on the accuracy of dose distributions. To investigate this effect on dosimetry parameters, calculations were made with three different voxel sizes. The effects were investigated with dose distribution calculations for seven voxel sizes: 1 × 1 × 0.1 cm{sup 3}, 1 × 1 × 0.5 cm{sup 3}, and 1 × 1 × 0.8 cm{sup 3}. The 1 × 10{sup 9} histories were simulated in order to get statistical uncertainties of 2%. This simulation takes about 9-10 hours to complete. Measurements are made with field sizes 10 × 10 cm2 for the 6 MV photon beams with Gaussian intensity distribution FWHM 0.1 cm and SSD 100.1 cm. MC simulated and measured dose distributions in a water phantom. The output of this simulation i.e. the percent depth dose and dose profile in d{sub max} from the three sets of calculations are presented and comparisons are made with the experiment data from TTSH (Tan Tock Seng Hospital, Singapore) in 0-5 cm depth. Dose that scored in voxels is a volume averaged estimate of the dose at the center of a voxel. The results in this study show that the difference between Monte Carlo simulation and experiment data depend on the voxel size both for percent depth dose (PDD) and profile dose. PDD scan on Z axis (depth) of water phantom, the big difference obtain in the voxel size 1 × 1 × 0.8 cm{sup 3} about 17%. In this study, the profile dose focused on high gradient dose area. Profile dose scan on Y axis and the big difference get in the voxel size 1 × 1 × 0.1 cm{sup 3} about 12%. This study demonstrated that the arrange voxel in Monte Carlo simulation becomes important.

61 RADIATION PROTECTION AND DOSIMETRY↗

Improving the energy response of external beam therapy (EBT) GafChromic{sup TM} dosimetry films at low energies (≤100 keV)

Purpose: Purpose of this work is to investigate the effects of varying the active layer composition of external beam therapy (EBT) GafChromic{sup TM} films on the energy dependence of the film, as well as try to develop a new prototype with more uniform energy response at low photon energies (⩽100 keV). Methods: First, the overall energy response (S{sub AD,} {sub W}(Q)) of different commercial EBT type film models that represent the three different generations produced to date, i.e., EBT, EBT2, and EBT3, was investigated. Pieces of each film model were irradiated to a fixed dose of 2 Gy to water for a wide range of beam qualities and the corresponding S{sub AD,} {sub W}(Q) was measured using a flatbed document scanner. Furthermore, the DOSRZnrc Monte Carlo code was used to determine the absorbed dose to water energy dependence of the film, f(Q). Moreover, the intrinsic energy dependence, k{sub bq}(Q), for each film model was evaluated using the corresponding S{sub AD,} {sub W}(Q) and f(Q). In the second part of this study, the authors investigated the effects of changing the chemical composition of the active layer on S{sub AD,} {sub W}(Q). Finally, based on these results, the film manufacturer fabricated several film prototypes and the authors evaluated their S{sub AD,} {sub W}(Q). Results: The commercial EBT film model shows an under response at all energies below 100 keV reaching 39% ± 4% at about 20 keV. The commercial EBT2 and EBT3 film models show an under response of about 27% ± 4% at 20 keV and an over response of about 16% ± 4% at 40 keV.S{sub AD,} {sub W}(Q) of the three commercial film models at low energies show strong correlation with the corresponding f{sup −1}(Q) curves. The commercial EBT3 model with 4% Cl in the active layer shows under response of 22% ± 4% at 20 keV and 6% ± 4% at about 40 keV. However, increasing the mass percent of chlorine makes the film more hygroscopic which may affect the stability of the film's readout. The EBT3 film prototype with 7.5% Si shows a significant improvement in the energy response at very low energies compared to the commercial EBT3 films with 4% Cl. It shows under response of 15% ± 5% at about 20 keV to 2% ± 5% at about 40 keV. However, according to the manufacturer, the addition of 7.5% Si as SiO{sub 2} adversely affected the viscosity of the active fluid and therefore affected the potential use in commercial machine coating. The latest commercial EBT3 film model with 7% Al as Al{sub 2}O{sub 3} shows an overall improvement in S{sub AD,} {sub W}(Q) compared to previous commercial EBT3 films. It shows under response at all energies <100 keV, varying from 20% ± 4% at 20 keV to 6% ± 4% at 40 keV. Conclusions: The energy response of films in the energy range <100 keV can be improved by adjusting the active layer chemical composition. Removing bromine eliminated the over response at about 40 keV. The under response at energies ≤30 keV is improved by adding 7% Al to the active layer in the latest commercial EBT3 film models.

61 RADIATION PROTECTION AND DOSIMETRY↗

Monte Carlo-based treatment planning system calculation engine for microbeam radiation therapy

Purpose: Microbeam radiation therapy (MRT) is a synchrotron radiotherapy technique that explores the limits of the dose-volume effect. Preclinical studies have shown that MRT irradiations (arrays of 25-75-{mu}m-wide microbeams spaced by 200-400 {mu}m) are able to eradicate highly aggressive animal tumor models while healthy tissue is preserved. These promising results have provided the basis for the forthcoming clinical trials at the ID17 Biomedical Beamline of the European Synchrotron Radiation Facility (ESRF). The first step includes irradiation of pets (cats and dogs) as a milestone before treatment of human patients. Within this context, accurate dose calculations are required. The distinct features of both beam generation and irradiation geometry in MRT with respect to conventional techniques require the development of a specific MRT treatment planning system (TPS). In particular, a Monte Carlo (MC)-based calculation engine for the MRT TPS has been developed in this work. Experimental verification in heterogeneous phantoms and optimization of the computation time have also been performed. Methods: The penelope/penEasy MC code was used to compute dose distributions from a realistic beam source model. Experimental verification was carried out by means of radiochromic films placed within heterogeneous slab-phantoms. Once validation was completed, dose computations in a virtual model of a patient, reconstructed from computed tomography (CT) images, were performed. To this end, decoupling of the CT image voxel grid (a few cubic millimeter volume) to the dose bin grid, which has micrometer dimensions in the transversal direction of the microbeams, was performed. Optimization of the simulation parameters, the use of variance-reduction (VR) techniques, and other methods, such as the parallelization of the simulations, were applied in order to speed up the dose computation. Results: Good agreement between MC simulations and experimental results was achieved, even at the interfaces between two different media. Optimization of the simulation parameters and the use of VR techniques saved a significant amount of computation time. Finally, parallelization of the simulations improved even further the calculation time, which reached 1 day for a typical irradiation case envisaged in the forthcoming clinical trials in MRT. An example of MRT treatment in a dog's head is presented, showing the performance of the calculation engine. Conclusions: The development of the first MC-based calculation engine for the future TPS devoted to MRT has been accomplished. This will constitute an essential tool for the future clinical trials on pets at the ESRF. The MC engine is able to calculate dose distributions in micrometer-sized bins in complex voxelized CT structures in a reasonable amount of time. Minimization of the computation time by using several approaches has led to timings that are adequate for pet radiotherapy at synchrotron facilities. The next step will consist in its integration into a user-friendly graphical front-end.

62 RADIOLOGY AND NUCLEAR MEDICINE↗