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Author (up) Assam, I.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Poppe, B.; Siebert, F.A. doi  openurl
  Title Evaluation of dosimetric effects of metallic artifact reduction and tissue assignment on Monte Carlo dose calculations for I-125 prostate implants Type Journal Article
  Year 2022 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 49 Issue Pages 6195-6208  
  Keywords metallic artifact reduction; Monte Carlo dosimetry; post-implant CT; prostate brachytherapy; tissue assignment schemes; voxelized virtual patient model  
  Abstract Purpose Monte Carlo (MC) simulation studies, aimed at evaluating the magnitude of tissue heterogeneity in I-125 prostate permanent seed implant brachytherapy (BT), customarily use clinical post-implant CT images to generate a virtual representation of a realistic patient model (virtual patient model). Metallic artifact reduction (MAR) techniques and tissue assignment schemes (TAS) are implemented on the post-implant CT images to mollify metallic artifacts due to BT seeds and to assign tissue types to the voxels corresponding to the bright seed spots and streaking artifacts, respectively. The objective of this study is to assess the combined influence of MAR and TAS on MC absorbed dose calculations in post-implant CT-based phantoms. The virtual patient models used for I-125 prostate implant MC absorbed dose calculations in this study are derived from the CT images of an external radiotherapy prostate patient without BT seeds and prostatic calcifications, thus averting the need to implement MAR and TAS. Methods The geometry of the IsoSeed I25.S17plus source is validated by comparing the MC calculated results of the TG-43 parameters for the line source approximation with the TG-43U1S2 consensus data. Four MC absorbed dose calculations are performed in two virtual patient models using the egs_brachy MC code: (1) TG-43-based D-w,w-TG(43), (2) D-w,D-w-MBDC that accounts for interseed scattering and attenuation (ISA), (3) D-m,D-m that examines ISA and tissue heterogeneity by scoring absorbed dose in tissue, and (4) D-w,D-m that unlike D-m,D-m scores absorbed dose in water. The MC absorbed doses (1) and (2) are simulated in a TG-43 patient phantom derived by assigning the densities of every voxel to 1.00 g cm(-3) (water), whereas MC absorbed doses (3) and (4) are scored in the TG-186 patient phantom generated by mapping the mass density of each voxel to tissue according to a CT calibration curve. The MC absorbed doses calculated in this study are compared with VariSeed v8.0 calculated absorbed doses. To evaluate the dosimetric effect of MAR and TAS, the MC absorbed doses of this work (independent of MAR and TAS) are compared to the MC absorbed doses of different I-125 source models from previous studies that were calculated with different MC codes using post-implant CT-based phantoms generated by implementing MAR and TAS on post-implant CT images. Results The very good agreement of TG-43 parameters of this study and the published consensus data within 3% validates the geometry of the IsoSeed I25.S17plus source. For the clinical studies, the TG-43-based calculations show a D-90 overestimation of more than 4% compared to the more realistic MC methods due to ISA and tissue composition. The results of this work generally show few discrepancies with the post-implant CT-based dosimetry studies with respect to the D-90 absorbed dose metric parameter. These discrepancies are mainly Type B uncertainties due to the different I-125 source models and MC codes. Conclusions The implementation of MAR and TAS on post-implant CT images have no dosimetric effect on the I-125 prostate MC absorbed dose calculation in post-implant CT-based phantoms.  
  Address [Assam, Isong; Siebert, Frank-Andre] UKSH, Clin Radiotherapy Radiooncol, Campus Kiel, Kiel, Germany, Email: Isong.Assam@uksh.de  
  Corporate Author Thesis  
  Publisher Wiley Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000835807200001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5321  
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Author (up) Ballester, F.; Granero, D.; Perez-Calatayud, J.; Venselaar, J.L.M.; Rivard, M.J. doi  openurl
  Title Study of encapsulated Tm-170 sources for their potential use in brachytherapy Type Journal Article
  Year 2010 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 37 Issue 4 Pages 1629-1637  
  Keywords brachytherapy; cancer; dosimetry; prosthetics; radioisotopes; thulium  
  Abstract Methods: The authors have assumed a theoretical Tm-170 cylindrical source encapsulated with stainless steel and typical dimensions taken from the currently available HDR Ir-192 brachytherapy sources. The dose-rate distribution was calculated for this source using the GEANT4 Monte Carlo (MC) code considering both photon and electron Tm-170 spectra. The AAPM TG-43 U1 brachytherapy dosimetry parameters were derived. To study general properties of Tm-170 encapsulated sources, spherical sources encapsulated with stainless steel and platinum were also studied. Moreover, the influence of small variations in the active core and capsule dimensions on the dosimetric characteristics was assessed. Treatment times required for a Tm-170 source were compared to those for Ir-192 and Yb-169 for the same contained activity. Results: Due to the energetic beta spectrum and the large electron yield, the bremsstrahlung contribution to the dose was of the same order of magnitude as from the emitted gammas and characteristic x rays. Moreover, the electron spectrum contribution to the dose was significant up to 4 mm from the source center compared to the photon contribution. The dose-rate constant Lambda of the cylindrical source was 1.23 cGy h(-1) U-1. The behavior of the radial dose function showed promise for applications in brachytherapy. Due to the electron spectrum, the anisotropy was large for r < 6 mm. Variations in manufacturing tolerances did not significantly influence the final dosimetry data when expressed in cGy h(-1) U-1. For typical capsule dimensions, maximum reference dose rates of about 0.2, 10, and 2 Gy min(-1) would then be obtained for Tm-170, Ir-192, and Yb-169, respectively, resulting in treatment times greater than those for HDR Ir-192 brachytherapy. Conclusions: The dosimetric characteristics of source designs exploiting the low photon energy of Tm-170 were studied for potential application in HDR-brachytherapy. Dose-rate distributions were obtained for cylindrical and simplified spherical Tm-170 source designs (stainless steel and platinum capsule materials) using MC calculations. Despite the high activity of Tm-170, calculated treatment times were much longer than for Ir-192.  
  Address [Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: fballest@uv.es  
  Corporate Author Thesis  
  Publisher Amer Assoc Physicists Medicine Amer Inst Physics Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes ISI:000276211200027 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ elepoucu @ Serial 478  
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Author (up) Calatayud-Jordan, J.; Candela-Juan, C.; Palma, J.D.; Pujades-Claumarchirant, M.C.; Soriano, A.; Gracia-Ochoa, M.; Vilar-Palop, J.; Vijande, J. doi  openurl
  Title Influence of the simultaneous calibration of multiple ring dosimeters on the individual absorbed dose Type Journal Article
  Year 2021 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 41 Issue 2 Pages 384-397  
  Keywords ring dosimeters; personal dosimetry; calibration; Monte Carlo; ISO 4037  
  Abstract Ring dosimeters for personal dosimetry are calibrated in accredited laboratories following ISO 4037-3 guidelines. The simultaneous irradiation of multiple dosimeters would save time, but has to be carefully studied, since the scattering conditions could change and influence the absorbed dose in nearby dosimeters. Monte Carlo simulations using PENELOPE-2014 were performed to explore the need to increase the uncertainty of H-p (0.07) in the simultaneous irradiation of three and five DXT-RAD 707H-2 (Thermo Scientific) ring dosimeters with beam qualities: N-30, N-80 and N-300. Results show that the absorbed dose in each dosimeter is compatible with each of the others and with the reference simulation (a single dosimeter), with a coverage probability of 95% (k = 2). Comparison with experimental data yielded consistent results with the same coverage probability. Therefore, five ring dosimeters can be simultaneously irradiated with beam qualities ranging, at least, between N-30 and N-300 with a negligible impact on the uncertainty of H-p (0.07).  
  Address [Calatayud-Jordan, J.] Hosp Univ Politecn La Fe, Valencia, Spain, Email: calatayud_josjor@gva.es  
  Corporate Author Thesis  
  Publisher Iop Publishing Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0952-4746 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000657114600001 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 4850  
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Author (up) Candela-Juan, C.; Niatsetski, Y.; van der Laarse, R.; Granero, D.; Ballester, F.; Perez-Calatayud, J.; Vijande, J. doi  openurl
  Title Design and characterization of a new high-dose-rate brachytherapy Valencia applicator for larger skin lesions Type Journal Article
  Year 2016 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 43 Issue 4 Pages 1639-1648  
  Keywords skin applicator; Valencia applicator; HDR brachytherapy; dosimetry; Monte Carlo  
  Abstract Purpose: The aims of this study were (i) to design a new high-dose-rate (HDR) brachytherapy applicator for treating surface lesions with planning target volumes larger than 3 cm in diameter and up to 5 cm in size, using the microSelectron-HDR or Flexitron afterloader (Elekta Brachytherapy) with a Ir-192 source; (ii) to calculate by means of the Monte Carlo (MC) method the dose distribution for the new applicator when it is placed against a water phantom; and (iii) to validate experimentally the dose distributions in water. Methods: The PENELOPE2008 MC code was used to optimize dwell positions and dwell times. Next, the dose distribution in a water phantom and the leakage dose distribution around the applicator were calculated. Finally, MC data were validated experimentally for a 192Ir mHDR-v2 source by measuring (i) dose distributions with radiochromic EBT3 films (ISP); (ii) percentage depth-dose (PDD) curve with the parallel-plate ionization chamber Advanced Markus (PTW); and (iii) absolute dose rate with EBT3 films and the PinPoint T31016 (PTW) ionization chamber. Results: The new applicator is made of tungsten alloy (Densimet) and consists of a set of interchangeable collimators. Three catheters are used to allocate the source at prefixed dwell positions with preset weights to produce a homogenous dose distribution at the typical prescription depth of 3 mm in water. The same plan is used for all available collimators. PDD, absolute dose rate per unit of air kerma strength, and off-axis profiles in a cylindrical water phantom are reported. These data can be used for treatment planning. Leakage around the applicator was also scored. The dose distributions, PDD, and absolute dose rate calculated agree within experimental uncertainties with the doses measured: differences of MC data with chamber measurements are up to 0.8% and with radiochromic films are up to 3.5%. Conclusions: The new applicator and the dosimetric data provided here will be a valuable tool in clinical practice, making treatment of large skin lesions simpler, faster, and safer. Also the dose to surrounding healthy tissues is minimal.  
  Address [Candela-Juan, C.; Perez-Calatayud, J.] La Fe Univ & Polytech Hosp, Dept Radiat Oncol, Valencia 46026, Spain, Email: ccanjuan@gmail.com  
  Corporate Author Thesis  
  Publisher Amer Assoc Physicists Medicine Amer Inst Physics Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000373711000007 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 2620  
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Author (up) Candela-Juan, C.; Vijande, J.; Garcia-Martinez, T.; Niatsetski, Y.; Nauta, G.; Schuurman, J.; Ouhib, Z.; Ballester, F.; Perez-Calatayud, J. doi  openurl
  Title Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry Type Journal Article
  Year 2015 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 42 Issue 8 Pages 4954-4964  
  Keywords x-ray beams; electronic brachytherapy; surface applicators; dosimetry; uncertainty  
  Abstract Purpose: A surface electronic brachytherapy (EBT) device is in fact an x-ray source collimated with specific applicators. Low-energy (<100 kVp) x-ray beam dosimetry faces several challenges that need to be addressed. A number of calibration protocols have been published for x-ray beam dosimetry. The media in which measurements are performed are the fundamental difference between them. The aim of this study was to evaluate the surface dose rate of a low-energy x-ray source with small field applicators using different calibration standards and different small-volume ionization chambers, comparing the values and uncertainties of each methodology. Methods: The surface dose rate of the EBT unit Esteya (Elekta Brachytherapy, The Netherlands), a 69.5 kVp x-ray source with applicators of 10, 15, 20, 25, and 30 mm diameter, was evaluated using the AAPM TG-61 (based on air kerma) and International Atomic Energy Agency (IAEA) TRS-398 (based on absorbed dose to water) dosimetry protocols for low-energy photon beams. A plane parallel T34013 ionization chamber (PTW Freiburg, Germany) calibrated in terms of both absorbed dose to water and air kerma was used to compare the two dosimetry protocols. Another PTW chamber of the same model was used to evaluate the reproducibility between these chambers. Measurements were also performed with two different Exradin A20 (Standard Imaging, Inc., Middleton, WI) chambers calibrated in terms of air kerma. Results: Differences between surface dose rates measured in air and in water using the T34013 chamber range from 1.6% to 3.3%. No field size dependence has been observed. Differences are below 3.7% when measurements with the A20 and the T34013 chambers calibrated in air are compared. Estimated uncertainty (with coverage factor k = 1) for the T34013 chamber calibrated in water is 2.2%-2.4%, whereas it increases to 2.5% and 2.7% for the A20 and T34013 chambers calibrated in air, respectively. The output factors, measured with the PTW chambers, differ by less than 1.1% for any applicator size when compared to the output factors that were measured with the A20 chamber. Conclusions: Measurements using both dosimetric protocols are consistent, once the overall uncertainties are considered. There is also consistency between measurements performed with both chambers calibrated in air. Both the T34013 and A20 chambers have negligible stem effect. Any x-ray surface brachytherapy system, including Esteya, can be characterized using either one of these calibration protocols and ionization chambers. Having less correction factors, lower uncertainty, and based on measurements, performed in closer to clinical conditions, the TRS-398 protocol seems to be the preferred option.  
  Address [Candela-Juan, C.; Perez-Calatayud, J.] La Fe Univ, Dept Radiat Oncol, Valencia 46026, Spain, Email: ccanjuan@gmail.com  
  Corporate Author Thesis  
  Publisher Amer Assoc Physicists Medicine Amer Inst Physics Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000358933000051 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 2323  
Permanent link to this record
 

 
Author (up) Gimenez-Alventosa, V.; Antunes, P.C.G.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Andreo, P. doi  openurl
  Title Collision-kerma conversion between dose-to-tissue and dose-to-water by photon energy-fluence corrections in low-energy brachytherapy Type Journal Article
  Year 2017 Publication Physics in Medicine and Biology Abbreviated Journal Phys. Med. Biol.  
  Volume 62 Issue 1 Pages 146-164  
  Keywords Monte Carlo; dosimetry; low-energy seed; collision-kerma; mass energy-absorption coefficients; energy-fluence correction factor  
  Abstract The AAPM TG-43 brachytherapy dosimetry formalism, introduced in 1995, has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations, except in the vicinity of the source capsule. Subsequent dosimetry developments, based on Monte Carlo calculations or analytical solutions of transport equations, do not rely on the CPE assumption and determine directly the dose to different tissues. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so that the absorbed dose in the two media can be related by their ratio of mass energy-absorption coefficients. In this work, an efficient way to correlate absorbed dose to water and absorbed dose to tissue in brachytherapy calculations at clinically relevant distances for low-energy photon emitting seeds is proposed. A correction is introduced that is based on the ratio of the water-to-tissue photon energy-fluences. State-of-the art Monte Carlo calculations are used to score photon fluence differential in energy in water and in various human tissues (muscle, adipose and bone), which in all cases include a realistic modelling of low-energy brachytherapy sources in order to benchmark the formalism proposed. The energy-fluence based corrections given in this work are able to correlate absorbed dose to tissue and absorbed dose to water with an accuracy better than 0.5% in the most critical cases (e.g. bone tissue).  
  Address [Gimenez-Alventosa, Vicent; Antunes, Paula C. G.; Vijande, Javier; Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: vijande@uv.es  
  Corporate Author Thesis  
  Publisher Iop Publishing Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0031-9155 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000391567700001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 2923  
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Author (up) Gimenez-Alventosa, V.; Gimenez, V.; Ballester, F.; Vijande, J.; Andreo, P. doi  openurl
  Title Monte Carlo calculation of beam quality correction factors for PTW cylindrical ionization chambers in photon beams Type Journal Article
  Year 2020 Publication Physics in Medicine and Biology Abbreviated Journal Phys. Med. Biol.  
  Volume 65 Issue 20 Pages 205005 - 11pp  
  Keywords TRS 398; Monte Carlo; dosimetry; ionization chambers; MV photon beams  
  Abstract The beam quality correction factork(Q)for megavoltage photon beams has been calculated for eight PTW (Freiburg, Germany) ionization chambers (Farmer chambers PTW30010, PTW30011, PTW30012, and PTW30013, Semiflex 3D chambers PTW31021, PTW31010, and PTW31013, and the PinPoint 3D chamber PTW31016). Simulations performed on the widely used NE-2571 ionization chamber have been used to benchmark the results. The Monte Carlo code PENELOPE/penEasy was used to calculate the absorbed dose to a point in water and the absorbed dose to the active air volume of the chambers for photon beams in the range 4 to 24 MV. Of the nine ionization chambers analysed, only five are included in the current version of the International Code of Practice for dosimetry based on standards of absorbed dose to water (IAEA TRS 398). The values reported in this work agree with those in the literature within the uncertainty estimates and are to be included in the average values of the data obtained by different working groups for the forthcoming update of TRS 398.  
  Address [Gimenez-Alventosa, Vicent] Univ Politecn Valencia, CSIC, Ctr Mixto, Inst Instrumentac Imagen Mol I3M, Valencia, Spain, Email: javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Iop Publishing Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0031-9155 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000576070000001 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 4556  
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Author (up) Gimenez-Alventosa, V.; Gimenez, V.; Ballester, F.; Vijande, J.; Andreo, P. doi  openurl
  Title Correction factors for ionization chamber measurements with the 'Valencia' and 'large field Valencia' brachytherapy applicators Type Journal Article
  Year 2018 Publication Physics in Medicine and Biology Abbreviated Journal Phys. Med. Biol.  
  Volume 63 Issue 12 Pages 125004 - 10pp  
  Keywords skin applicator; Valencia applicator; large field Valencia applicator; HDR brachytherap; brachytherapy dosimetry; Monte Carlo  
  Abstract Treatment of small skin lesions using HDR brachytherapy applicators is a widely used technique. The shielded applicators currently available in clinical practice are based on a tungsten-alloy cup that collimates the source-emitted radiation into a small region, hence protecting nearby tissues. The goal of this manuscript is to evaluate the correction factors required for dose measurements with a plane-parallel ionization chamber typically used in clinical brachytherapy for the 'Valencia' and 'large field Valencia' shielded applicators. Monte Carlo simulations have been performed using the PENELOPE-2014 system to determine the absorbed dose deposited in a water phantom and in the chamber active volume with a Type A uncertainty of the order of 0.1%. The average energies of the photon spectra arriving at the surface of the water phantom differ by approximately 10%, being 384 keV for the 'Valencia' and 343 keV for the 'large field Valencia'. The ionization chamber correction factors have been obtained for both applicators using three methods, their values depending on the applicator being considered. Using a depth-independent global chamber perturbation correction factor and no shift of the effective point of measurement yields depth-dose differences of up to 1% for the 'Valencia' applicator. Calculations using a depth-dependent global perturbation factor, or a shift of the effective point of measurement combined with a constant partial perturbation factor, result in differences of about 0.1% for both applicators. The results emphasize the relevance of carrying out detailed Monte Carlo studies for each shielded brachytherapy applicator and ionization chamber.  
  Address [Gimenez-Alventosa, V.] Univ Politecn Valencia, CSIC, Ctr Mixto, Inst Instrumentac Imagen Mol I3M, E-46022 Valencia, Spain, Email: Javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Iop Publishing Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0031-9155 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000434682500004 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 3609  
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Author (up) Gimenez-Alventosa, V.; Vijande, J.; Ballester, F.; Perez-Calatayud, J. doi  openurl
  Title Transit dose comparisons for Co-60 and Ir-192 HDR sources Type Journal Article
  Year 2016 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 36 Issue 4 Pages 858-864  
  Keywords Monte Carlo; dosimetry; HDR brachytherapy; transit dose  
  Abstract The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) Co-60 sources along a transfer tube as compared to Ir-192 ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom. The movement of the source was included by displacing their positions along the connecting tube from z = – 75 cm to z = + 75 cm and combining them. Since modern afterloaders like Flexitron (Elekta) or Saginova (BEBIG GmbH) are able to use equally 192Ir and 60Co sources, it was assumed that both sources are displaced with equal speed. Typical HDR source activity content values were provided by the manufacturer. 2D distributions were obtained with type-A uncertainties (k = 2) less than 0.01%. From those, the air-kerma ratio Co-60/Ir-192 was evaluated weighted by their corresponding typical activities. It was found that it varies slowly with distance (less than 10% variation at 75 cm) but strongly in time due to the shorter half-life of the 192Ir (73.83 d). The maximum ratio is located close to the tube. It reaches a value of 0.57 when the typical activity of the sources at the time when they were installed by the vendor was used. Such ratio increases up to 1.28 at the end of the recommended working life (90 d) of the Ir-192 source. Co-60/Ir-192 air-kerma ratios are almost constant (0.51-0.57) in the vicinity of the source-tube with recent installed sources. Nevertheless, air-kerma ratios increase rapidly (1.15-1.29) whenever the Ir-192 is approaching the end of its life. In case of a medical event requiring the medical staff to access the treatment room, these ratios indicate that the dosimetric impact on the medical team will be lower, with a few exceptions, in the case of Co-60-based HDR brachytherapy as compared to Ir-192-based one when typical air-kerma strength values are considered.  
  Address [Gimenez-Alventosa, Vicent; Vijande, Javier; Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Iop Publishing Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0952-4746 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000386436100002 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 2839  
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Author (up) Granero, D.; Candela-Juan, C.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Jacob, D.; Mourtada, F. doi  openurl
  Title Technical Note: Dosimetry of Leipzig and Valencia applicators without the plastic cap Type Journal Article
  Year 2016 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 43 Issue 5 Pages 2087 - 4pp  
  Keywords Leipzig applicators; Valencia applicators; skin brachytherapy; Monte Carlo; dosimetry  
  Abstract Purpose: High dose rate (HDR) brachytherapy for treatment of small skin lesions using the Leipzig and Valencia applicators is a widely used technique. These applicators are equipped with an attachable plastic cap to be placed during fraction delivery to ensure electronic equilibrium and to prevent secondary electrons from reaching the skin surface. The purpose of this study is to report on the dosimetric impact of the cap being absent during HDR fraction delivery, which has not been explored previously in the literature. Methods: GEANT4 Monte Carlo simulations (version 10.0) have been performed for the Leipzig and Valencia applicators with and without the plastic cap. In order to validate the Monte Carlo simulations, experimental measurements using radiochromic films have been done. Results: Dose absorbed within 1 mm of the skin surface increases by a factor of 1500% for the Leipzig applicators and of 180% for the Valencia applicators. Deeper than 1 mm, the overdosage flattens up to a 10% increase. Conclusions: Differences of treating with or without the plastic cap are significant. Users must check always that the plastic cap is in place before any treatment in order to avoid overdosage of the skin. Prior to skin HDR fraction delivery, the timeout checklist should include verification of the cap placement. (C) 2016 American Association of Physicists in Medicine.  
  Address [Granero, D.] Hosp Gen Univ, Dept Radiat Phys, ERESA, Valencia 46014, Spain, Email: dgranero@eresa.com  
  Corporate Author Thesis  
  Publisher Amer Assoc Physicists Medicine Amer Inst Physics Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000378924200010 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 2753  
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