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Author Vijande, J.; Carmona, V.; Lliso, F.; Ballester, F.; Perez-Calatayud, J. doi  openurl
  Title An efficient component of the redundancy calibration program to ensure equipment stability by assaying HDR Ir-192 sources at the time of replacement Type Journal Article
  Year 2024 Publication Journal of Applied Clinical Medical Physics Abbreviated Journal J. Appl. Clin. Med. Phys  
  Volume Issue Pages 5pp  
  Keywords brachytherapy  
  Abstract BackgroundBrachytherapy (BT) treatments involving temporary high-dose rate (HDR) sources are extensively employed in clinical practice. Ensuring the consistency of all measurement equipment at the hospital level is crucial, requiring a robust redundancy and consistency program. This enables the institution to verify the stability of the dosimetry system over time.PurposeTo describe, justify, and analyze a component of the redundancy program of the calibration protocols followed by the Radiotherapy Department of the Hospital Universitari i Polit & egrave;cnic La Fe (Val & egrave;ncia, Spain) during the last 10 years for the case of HDR BT as an additional component to ensure long term stability of the measurement equipment.MethodsAt the time the HDR BT source is replaced, its Air Kerma Strength (SK) is measured. By comparing this value with the one obtained at the time of installation (corrected by decay), a clear determination of the stability of the measurement equipment can be performed.ResultsDifference between SK,vendor and SK,hosp as a function of the measurement date is reported for a 10 years' period. All measurements are well within the +/- 3% tolerance level recommended in current international guidelines. Percentage differences of SK,hosp values at the time of replacement compared to SK,hosp ones at the time when the source was installed are within the +/- 0.5% range, reflecting oscillations around a null deviation.ConclusionsThe method proposed allows any hospital to ensure a redundancy component of the long-term stability of all equipment involved in BT measurements in a very simple and time efficient manner. Additionally, it enables the hospital to maintain a detailed log of historical differences, facilitating the identification and correction of potential systematic deviations over time.  
  Address [Vijande, Javier; Ballester, Facundo] Univ Valencia UV, Dept Fis Atom Mol & Nucl, Burjassot, Spain, Email: Javier.Vijande@uv.es  
  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 1526-9914 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:001306138000001 Approved no  
  Is ISI yes International Collaboration (up) no  
  Call Number IFIC @ pastor @ Serial 6250  
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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 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 (up) yes  
  Call Number IFIC @ elepoucu @ Serial 478  
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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 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 (up) yes  
  Call Number IFIC @ elepoucu @ Serial 504  
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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 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 (up) yes  
  Call Number IFIC @ pastor @ Serial 1227  
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Author Granero, D.; Perez-Calatayud, J.; Vijande, J.; Ballester, F.; Rivard, M.J. doi  openurl
  Title Limitations of the TG-43 formalism for skin high-dose-rate brachytherapy dose calculations Type Journal Article
  Year 2014 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 41 Issue 2 Pages 021703 - 8pp  
  Keywords HDR; brachytherapy; skin; Monte Carlo; Geant4; Co-60; Ir-192; Yb-169  
  Abstract Purpose: In skin high-dose-rate (HDR) brachytherapy, sources are located outside, in contact with, or implanted at some depth below the skin surface. Most treatment planning systems use the TG-43 formalism, which is based on single-source dose superposition within an infinite water medium without accounting for the true geometry in which conditions for scattered radiation are altered by the presence of air. The purpose of this study is to evaluate the dosimetric limitations of the TG-43 formalism in HDR skin brachytherapy and the potential clinical impact. Methods: Dose rate distributions of typical configurations used in skin brachytherapy were obtained: a 5 cm x 5 cm superficial mould; a source inside a catheter located at the skin surface with and without backscatter bolus; and a typical interstitial implant consisting of an HDR source in a catheter located at a depth of 0.5 cm. Commercially available HDR Co-60 and Ir-192 sources and a hypothetical Yb-169 source were considered. The Geant4Monte Carlo radiation transport code was used to estimate dose rate distributions for the configurations considered. These results were then compared to those obtained with the TG-43 dose calculation formalism. In particular, the influence of adding bolus material over the implant was studied. Results: For a 5 cm x 5 cm Ir-192 superficial mould and 0.5 cm prescription depth, dose differences in comparison to the TG-43 method were about -3%. When the source was positioned at the skin surface, dose differences were smaller than -1% for Co-60 and Ir-192, yet -3% for Yb-169. For the interstitial implant, dose differences at the skin surface were -7% for Co-60, -0.6% for Ir-192, and -2.5% for Yb-169. Conclusions: This study indicates the following: (i) for the superficial mould, no bolus is needed; (ii) when the source is in contact with the skin surface, no bolus is needed for either Co-60 and Ir-192. For lower energy radionuclides like Yb-169, bolus may be needed; and (iii) for the interstitial case, at least a 0.1 cm bolus is advised for Co-60 to avoid underdosing superficial target layers. For Ir-192 and Yb-169, no bolus is needed. For those cases where no bolus is needed, its use might be detrimental as the lack of radiation scatter may be beneficial to the patient, although the 2% tolerance for dose calculation accuracy recommended in the AAPM TG-56 report is not fulfilled.  
  Address [Granero, Domingo] Hosp Gen Univ, ERESA, Dept Radiat Phys, 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:000331213300006 Approved no  
  Is ISI yes International Collaboration (up) yes  
  Call Number IFIC @ pastor @ Serial 1704  
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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 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 (up) yes  
  Call Number IFIC @ pastor @ Serial 2031  
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Author Hueso-Gonzalez, F.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Siebert, F.A. doi  openurl
  Title A simple analytical method for heterogeneity corrections in low dose rate prostate brachytherapy Type Journal Article
  Year 2015 Publication Physics in Medicine and Biology Abbreviated Journal Phys. Med. Biol.  
  Volume 60 Issue 14 Pages 5455-5469  
  Keywords brachytherapy; low dose rate; heterogeneities; prostate; calcifications  
  Abstract In low energy brachytherapy, the presence of tissue heterogeneities contributes significantly to the discrepancies observed between treatment plan and delivered dose. In this work, we present a simplified analytical dose calculation algorithm for heterogeneous tissue. We compare it with Monte Carlo computations and assess its suitability for integration in clinical treatment planning systems. The algorithm, named as RayStretch, is based on the classic equivalent path length method and TG-43 reference data. Analytical and Monte Carlo dose calculations using Penelope2008 are compared for a benchmark case: a prostate patient with calcifications. The results show a remarkable agreement between simulation and algorithm, the latter having, in addition, a high calculation speed. The proposed analytical model is compatible with clinical real-time treatment planning systems based on TG-43 consensus datasets for improving dose calculation and treatment quality in heterogeneous tissue. Moreover, the algorithm is applicable for any type of heterogeneities.  
  Address [Hueso-Gonzalez, Fernando; 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 0031-9155 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000357620400009 Approved no  
  Is ISI yes International Collaboration (up) yes  
  Call Number IFIC @ pastor @ Serial 2296  
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Author 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 (up) yes  
  Call Number IFIC @ pastor @ Serial 2323  
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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 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 (up) 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 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 (up) yes  
  Call Number IFIC @ pastor @ Serial 2753  
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