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Author Vijande, J.; Granero, D.; Perez-Calatayud, J.; Ballester, F. doi  openurl
  Title Monte Carlo dosimetric study of the medium dose rate CSM40 source Type Journal Article
  Year 2013 Publication Applied Radiation and Isotopes Abbreviated Journal Appl. Radiat. Isot.  
  Volume 82 Issue Pages (up) 283-288  
  Keywords Brachytherapy; Cs-137 seed; TG-43 based dosimetry; Monte Carlo  
  Abstract The Cs-137 medium dose rate (MDR) CSM40 source model (Eckert & Ziegler BEBIG, Germany) is in clinical use but no dosimetric dataset has been published. This study aims to obtain dosimetric data for the CSM40 source for its use in clinical practice as required by the American Association of Physicists in Medicine (AAPM) and the European Society for Radiotherapy and Oncology (ESTRO). Penelope2008 and Geant4 Monte Carlo codes were used to characterize this source dosimetrically. It was located in an unbounded water phantom with composition and mass density as recommended by AAPM and ESTRO. Due to the low photon energies of Cs-137, absorbed dose was approximated by collisional kerma. Additional simulations were performed to obtain the air-kerma strength, sic. Mass-energy absorption coefficients in water and air were consistently derived and used to calculate collisional kerma. Results performed with both radiation transport codes showed agreement typically within 0.05%. Dose rate constant, radial dose function and anisotropy function are provided for the CSM40 and compared with published data for other commercially available Cs-137 sources. An uncertainty analysis has been performed. The data provided by this study can be used as input data and verification in the treatment planning systems. (C) 2013 Elsevier Ltd. All rights reserved.  
  Address [Vijande, J.; Ballester, F.] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: Javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Pergamon-Elsevier Science Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0969-8043 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000328804000043 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 1678  
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Author Granero, D.; Vijande, J.; Ballester, F.; Rivard, M.J. doi  openurl
  Title Dosimetry revisited for the HDR Ir-192 brachytherapy source model mHDR-v2 Type Journal Article
  Year 2011 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 38 Issue 1 Pages (up) 487-494  
  Keywords Ir-192; brachytherapy; dosimetry; TG-43; PSS model; MCNP5; PENELOPE2008; GEANT4  
  Abstract Purpose: Recently, the manufacturer of the HDR Ir-192 mHDR-v2 brachytherapy source reported small design changes (referred to herein as mHDR-v2r) that are within the manufacturing tolerances but may alter the existing dosimetric data for this source. This study aimed to (1) check whether these changes affect the existing dosimetric data published for this source; (2) obtain new dosimetric data in close proximity to the source, including the contributions from 192Ir electrons and considering the absence of electronic equilibrium; and (3) obtain scatter dose components for collapsed cone treatment planning system implementation. Methods: Three different Monte Carlo (MC) radiation transport codes were used: MCNP5, PENELOPE2008, and GEANT4. The source was centrally positioned in a 40 cm radius water phantom. Absorbed dose and collision kerma were obtained using 0.1 mm (0.5 mm) thick voxels to provide high-resolution dosimetry near (far from) the source. Dose-rate distributions obtained with the three MC codes were compared. Results: Simulations of mHDR-v2 and mHDR-v2r designs performed with three radiation transport codes showed agreement typically within 0.2% for r >= 0.25 cm. Dosimetric contributions from source electrons were significant for r<0.25 cm. The dose-rate constant and radial dose function were similar to those from previous MC studies of the mHDR-v2 design. The 2D anisotropy function also coincided with that of the mHDR-v2 design for r >= 0.25 cm. Detailed results of dose distributions and scatter components are presented for the modified source design. Conclusions: Comparison of these results to prior MC studies showed agreement typically within 0.5% for r >= 0.25 cm. If dosimetric data for r<0.25 cm are not needed, dosimetric results from the prior MC studies will be adequate. c 2011 American Association of Physicists in Medicine.  
  Address [Granero, Domingo] Hosp Gen Univ, Dept Radiat Phys, ERESA, E-46014 Valencia, 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 ISI:000285769800050 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 557  
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Author Vijande, J.; Ballester, F.; Ouhib, Z.; Granero, D.; Pujades-Claumarchirant, M.C.; Perez-Calatayud, J. doi  openurl
  Title Dosimetry comparison between TG-43 and Monte Carlo calculations using the Freiburg flap for skin high-dose-rate brachytherapy Type Journal Article
  Year 2012 Publication Brachytherapy Abbreviated Journal Brachytherapy  
  Volume 11 Issue 6 Pages (up) 528-535  
  Keywords Ir-192; Brachytherapy; Dosimetry; Penelope2008; Freiburg flap  
  Abstract PURPOSE: The purpose of this work was to evaluate whether the delivered dose to the skin surface and at the prescription depth when using a Freiburg flap applicator is in agreement with the one predicted by the treatment planning system (TPS) using the TG-43 dose-calculation formalism. METHODS AND MATERIALS: Monte Carlo (MC) simulations and radiochromic film measurements have been performed to obtain dose distributions with the source located at the center of one of the spheres and between two spheres. Primary and scatter dose contributions were evaluated to understand the role played by the scatter component. A standard treatment plan was generated using MC- and TG-43-based TPS applying the superposition principle. RESULTS: The MC model has been validated by performing additional simulations in the same conditions but transforming air and Freiburg flap materials into water to match TG-43 parameters. Both dose distributions differ less than 1%. Scatter defect compared with TG-43 data is up to 15% when the source is located at the center of the sphere and up to 25% when the source is between two spheres. Maximum deviations between TPS- and MC-based distributions are of 5%. CONCLUSIONS: The deviations in the TG-43-based dose distributions for a standard treatment plan with respect to the MC dose distribution calculated taking into account the composition and shape of the applicator and the surrounding air are lower than 5%. Therefore, this study supports the validity of the TPS used in clinical practice. (C) 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.  
  Address [Vijande, Javier; Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Elsevier Science Inc Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1538-4721 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000310863700018 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 1227  
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Author Pujades, M.C.; Granero, D.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Papagiannis, P.; Siebert, F.A. doi  openurl
  Title Air-kerma evaluation at the maze entrance of HDR brachytherapy facilities Type Journal Article
  Year 2014 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 34 Issue 4 Pages (up) 741-753  
  Keywords bunker; shielding; NCRP 151; brachytherapy; Monte Carlo  
  Abstract In the absence of procedures for evaluating the design of brachytherapy (BT) facilities for radiation protection purposes, the methodology used for external beam radiotherapy facilities is often adapted. The purpose of this study is to adapt the NCRP 151 methodology for estimating the air-kerma rate at the door in BT facilities. Such methodology was checked against Monte Carlo (MC) techniques using the code Geant4. Five different facility designs were studied for Ir-192 and Co-60 HDR applications to account for several different bunker layouts. For the estimation of the lead thickness needed at the door, the use of transmission data for the real spectra at the door instead of the ones emitted by Ir-192 and Co-60 will reduce the lead thickness by a factor of five for Ir-192 and ten for Co-60. This will significantly lighten the door and hence simplify construction and operating requirements for all bunkers. The adaptation proposed in this study to estimate the air-kerma rate at the door depends on the complexity of the maze: it provides good results for bunkers with a maze (i.e. similar to those used for linacs for which the NCRP 151 methodology was developed) but fails for less conventional designs. For those facilities, a specific Monte Carlo study is in order for reasons of safety and cost-effectiveness.  
  Address [Pujades, M. C.] Natl Ctr Dosimetry CND, Valencia, Spain, Email: mpuclau@gmail.com  
  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:000345895800005 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 2031  
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Author Rivard, M.J.; Granero, D.; Perez-Calatayud, J.; Ballester, F. doi  openurl
  Title Influence of photon energy spectra from brachytherapy sources on Monte Carlo simulations of kerma and dose rates in water and air Type Journal Article
  Year 2010 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 37 Issue 2 Pages (up) 869-876  
  Keywords biomedical materials; brachytherapy; dosimetry; iodine; iridium; Monte Carlo methods; palladium; radioisotopes  
  Abstract Methods: For Ir-192, I-125, and Pd-103, the authors considered from two to five published spectra. Spherical sources approximating common brachytherapy sources were assessed. Kerma and dose results from GEANT4, MCNP5, and PENELOPE-2008 were compared for water and air. The dosimetric influence of Ir-192, I-125, and Pd-103 spectral choice was determined. Results: For the spectra considered, there were no statistically significant differences between kerma or dose results based on Monte Carlo code choice when using the same spectrum. Water-kerma differences of about 2%, 2%, and 0.7% were observed due to spectrum choice for Ir-192, I-125, and Pd-103, respectively (independent of radial distance), when accounting for photon yield per Bq. Similar differences were observed for air-kerma rate. However, their ratio (as used in the dose-rate constant) did not significantly change when the various photon spectra were selected because the differences compensated each other when dividing dose rate by air-kerma strength. Conclusions: Given the standardization of radionuclide data available from the National Nuclear Data Center (NNDC) and the rigorous infrastructure for performing and maintaining the data set evaluations, NNDC spectra are suggested for brachytherapy simulations in medical physics applications.  
  Address [Rivard, Mark J.] Tufts Univ, Sch Med, Dept Radiat Oncol, Boston, MA 02111 USA, Email: mrivard@tuftsmedicalcenter.org  
  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:000274075600048 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ elepoucu @ Serial 504  
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Author Beaulieu, L.; Ballester, F.; Granero, D.; Tedgren, A.C.; Haworth, A.; Lowenstein, J.R.; Ma, Y.Z.; Mourtada, F.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; Sloboda, R.S.; Smith, R.L.; Thomson, R.M.; Verhaegen, F.; Fonseca, G.; Vijande, J. doi  openurl
  Title AAPM WGDCAB Report 372: A joint AAPM, ESTRO, ABG, and ABS report on commissioning of model-based dose calculation algorithms in brachytherapy Type Journal Article
  Year 2023 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 50 Issue 8 Pages (up) e946–e960  
  Keywords brachytherapy; commissioning; dose calculation; model-based dose calculation; Monte Carlo; TG-186  
  Abstract The introduction of model-based dose calculation algorithms (MBDCAs) in brachytherapy provides an opportunity for a more accurate dose calculation and opens the possibility for novel, innovative treatment modalities. The joint AAPM, ESTRO, and ABG Task Group 186 (TG-186) report provided guidance to early adopters. However, the commissioning aspect of these algorithms was described only in general terms with no quantitative goals. This report, from the Working Group on Model-Based Dose Calculation Algorithms in Brachytherapy, introduced a field-tested approach to MBDCA commissioning. It is based on a set of well-characterized test cases for which reference Monte Carlo (MC) and vendor-specific MBDCA dose distributions are available in a Digital Imaging and Communications in Medicine-Radiotherapy (DICOM-RT) format to the clinical users. The key elements of the TG-186 commissioning workflow are now described in detail, and quantitative goals are provided. This approach leverages the well-known Brachytherapy Source Registry jointly managed by the AAPM and the Imaging and Radiation Oncology Core (IROC) Houston Quality Assurance Center (with associated links at ESTRO) to provide open access to test cases as well as step-by-step user guides. While the current report is limited to the two most widely commercially available MBDCAs and only for Ir-192-based afterloading brachytherapy at this time, this report establishes a general framework that can easily be extended to other brachytherapy MBDCAs and brachytherapy sources. The AAPM, ESTRO, ABG, and ABS recommend that clinical medical physicists implement the workflow presented in this report to validate both the basic and the advanced dose calculation features of their commercial MBDCAs. Recommendations are also given to vendors to integrate advanced analysis tools into their brachytherapy treatment planning system to facilitate extensive dose comparisons. The use of the test cases for research and educational purposes is further encouraged.  
  Address [Beaulieu, Luc; Ma, Yunzhi] CHU Quebec Univ Laval, Serv Phys Med & Radioprotect, Quebec City, PQ, Canada, Email: beaulieu@phy.ulaval.ca  
  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:001026540300001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5579  
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Author Garcia-Cases, F.; Perez-Calatayud, J.; Ballester, F.; Vijande, J.; Granero, D. doi  openurl
  Title Peripheral dose around a mobile linac for intraoperative radiotherapy: radiation protection aspects Type Journal Article
  Year 2018 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 38 Issue 4 Pages (up) 1393-1411  
  Keywords Mobetron; mobile electron linear accelerator; radiotherapy intraoperative  
  Abstract The aim of this work is to analyse the scattered radiation produced by the mobile accelerator Mobetron 1000. To do so, detailed Monte Carlo simulations using two different codes, Penelope2008 and Geant4, were performed. Measurements were also done. To quantify the attenuation due to the internal structures, present in the accelerator head, on the scattered radiation produced, some of the main structural shielding in the Mobetron 1000 has been incorporated into the geometry simulation. Results are compared with measurements. Some discrepancies between the calculated and measured dose values were found. These differences can be traced back to the importance of the radiation component due to low energy scattered electrons. This encouraged us to perform additional calculations to separate the role played by this component. Ambient dose equivalent, H*(10), outside of the operating room (OR) has been evaluated using Geant4. H*(10) has been measured inside and outside the OR, being its values compatible with those reported in the literature once the low energy electron component is removed. With respect to the role played by neutrons, estimations of neutron H*(10) using Geant4 together with H*(10) measurements has been performed for the case of the 12 MeV electron beam. The values obtained agree with the experimental values existing in the literature, being much smaller than those registered in conventional accelerators. This study is a useful tool for the clinical user to investigate the radiation protection issues arising with the use of these accelerators in ORs without structural shielding. These results will also enable to better fix the maximum number of treatments that could be performed while insuring adequate radiological protection of workers and public in the hospital.  
  Address [Garcia-Cases, F.] Hosp Univ San Juan de Alicante, Serv Radiofis & Protecc Radiol, Alacant, Spain, Email: garcia_frad@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:000448769200001 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 3784  
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Author 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 (up) 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 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 (up) 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 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 (up) 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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