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Author |
Valdes-Cortez, C.; Niatsetski, Y.; Perez-Calatayud, J.; Ballester, F.; Vijande, J. |
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Title |
A Monte Carlo study of the relative biological effectiveness in surface brachytherapy |
Type |
Journal Article |
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Year |
2022 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
49 |
Issue |
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Pages |
5576-5588 |
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Keywords |
Monte Carlo; relative biological effectiveness; surface HDR brachytherapy |
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Abstract |
Purpose This work aims to simulate clustered DNA damage from ionizing radiation and estimate the relative biological effectiveness (RBE) for radionuclide (rBT)- and electronic (eBT)-based surface brachytherapy through a hybrid Monte Carlo (MC) approach, using realistic models of the sources and applicators. Methods Damage from ionizing radiation has been studied using the Monte Carlo Damage Simulation algorithm using as input the primary electron fluence simulated using a state-of-the-art MC code, PENELOPE-2018. Two Ir-192 rBT applicators, Valencia and Leipzig, one Co-60 source with a Freiburg Flap applicator (reference source), and two eBT systems, Esteya and INTRABEAM, have been included in this study implementing full realizations of their geometries as disclosed by the manufacturer. The role played by filtration and tube kilovoltage has also been addressed. Results For rBT, an RBE value of about 1.01 has been found for the applicators and phantoms considered. In the case of eBT, RBE values for the Esteya system show an almost constant RBE value of about 1.06 for all depths and materials. For INTRABEAM, variations in the range of 1.12-1.06 are reported depending on phantom composition and depth. Modifications in the Esteya system, filtration, and tube kilovoltage give rise to variations in the same range. Conclusions Current clinical practice does not incorporate biological effects in surface brachytherapy. Therefore, the same absorbed dose is administered to the patients independently on the particularities of the rBT or eBT system considered. The almost constant RBE values reported for rBT support that assumption regardless of the details of the patient geometry, the presence of a flattening filter in the applicator design, or even significant modifications in the photon energy spectra above 300 keV. That is not the case for eBT, where a clear dependence on the eBT system and the characteristics of the patient geometry are reported. A complete study specific for each eBT system, including detailed applicator characteristics (size, shape, filtering, among others) and common anatomical locations, should be performed before adopting an existing RBE value. |
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[Valdes-Cortez, Christian] Hosp Reg Antofagasta, Nucl Med Dept, Antofagasta, Chile, Email: cvalcort@gmail.com |
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Wiley |
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English |
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0094-2405 |
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WOS:000811709400001 |
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no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5262 |
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Author |
Otal, A.; Celada, F.; Chimeno, J.; Vijande, J.; Pellejero, S.; Perez-Calatayud, M.J.; Villafranca, E.; Fuentemilla, N.; Blazquez, F.; Rodriguez, S.; Perez-Calatayud, J. |
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Title |
Review on Treatment Planning Systems for Cervix Brachytherapy (Interventional Radiotherapy): Some Desirable and Convenient Practical Aspects to Be Implemented from Radiation Oncologist and Medical Physics Perspectives |
Type |
Journal Article |
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Year |
2022 |
Publication |
Cancers |
Abbreviated Journal |
Cancers |
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Volume |
14 |
Issue |
14 |
Pages |
3467 - 15pp |
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Keywords |
cervix; treatment planning systems; interstitial applicators; magnetic resonance |
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Abstract |
Simple Summary There are no brachytherapy treatment planning systems (TPS) exclusively for the treatment of cervical tumours, so general-purpose TPSs are used. However, these treatments have some particular features concerning the treatment of other pathologies, especially in the case of exclusive use of MRI as an imaging modality and the presence of gynaecological applicators in combination with an interstitial part. That is why it is essential to review the latest versions of commercial TPSs to find the potential features to improve with the help of a group of experimented medical physicists and radiation oncologists. Furthermore, after reviewing the recent literature for advances applicable to cervical brachytherapy and through his own clinical experience, possible improvements are proposed to software providers for the development of new tools. Intracavitary brachytherapy (BT, Interventional Radiotherapy, IRT), plays an essential role in the curative intent of locally advanced cervical cancer, for which the conventional approach involves external beam radiotherapy with concurrent chemotherapy followed by BT. This work aims to review the different methodologies used by commercially available treatment planning systems (TPSs) in exclusive magnetic resonance imaging-based (MRI) cervix BT with interstitial component treatments. Practical aspects and improvements to be implemented into the TPSs are discussed. This review is based on the clinical expertise of a group of radiation oncologists and medical physicists and on interactive demos provided by the software manufacturers. The TPS versions considered include all the new tools currently in development for future commercial releases. The specialists from the supplier companies were asked to propose solutions to some of the challenges often encountered in a clinical environment through a questionnaire. The results include not only such answers but also comments by the authors that, in their opinion, could help solve the challenges covered in these questions. This study summarizes the possibilities offered nowadays by commercial TPSs, highlighting the absence of some useful tools that would notably improve the planning of MR-based interstitial component cervix brachytherapy. |
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[Otal, Antonio] Hosp Arnau Vilanova, Med Phys Dept, Lleida 25198, Spain, Email: aotalpalacin@gmail.com; |
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Mdpi |
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Notes |
WOS:000832057600001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
no |
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Call Number |
IFIC @ pastor @ |
Serial |
5304 |
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Author |
Assam, I.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Poppe, B.; Siebert, F.A. |
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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 |
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Year |
2022 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
49 |
Issue |
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Pages |
6195-6208 |
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Keywords |
metallic artifact reduction; Monte Carlo dosimetry; post-implant CT; prostate brachytherapy; tissue assignment schemes; voxelized virtual patient model |
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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. |
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Address |
[Assam, Isong; Siebert, Frank-Andre] UKSH, Clin Radiotherapy Radiooncol, Campus Kiel, Kiel, Germany, Email: Isong.Assam@uksh.de |
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Wiley |
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English |
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0094-2405 |
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Notes |
WOS:000835807200001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5321 |
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Author |
Perez-Calatayud, J.; Ballester, F.; Tedgren, C.; DeWerd, L.A.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; Vijande, J. |
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Title |
GEC-ESTRO ACROP recommendations on calibration and traceability of HE HDR-PDR photon-emitting brachytherapy sources at the hospital level |
Type |
Journal Article |
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Year |
2022 |
Publication |
Radiotherapy and Oncology |
Abbreviated Journal |
Radiother. Oncol. |
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Volume |
176 |
Issue |
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Pages |
108-117 |
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Keywords |
Brachytherapy; High energy; Calibration; Dosimetry; HDR-PDR |
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Abstract |
The vast majority of radiotherapy departments in Europe using brachytherapy (BT) perform temporary implants of high-or pulsed-dose rate (HDR-PDR) sources with photon energies higher than 50 keV. Such techniques are successfully applied to diverse pathologies and clinical scenarios. These recommen-dations are the result of Working Package 21 (WP-21) initiated within the BRAchytherapy PHYsics Quality Assurance System (BRAPHYQS) GEC-ESTRO working group with a focus on HDR-PDR source cal-ibration. They provide guidance on the calibration of such sources, including practical aspects and issues not specifically accounted for in well-accepted societal recommendations, complementing the BRAPHYQS WP-18 Report dedicated to low energy BT photon emitting sources (seeds). The aim of this report is to provide a European-wide standard in HDR-PDR BT source calibration at the hospital level to maintain high quality patient treatments. |
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[Perez-Calatayud, Jose] La Fe Hosp, Radiotherapy Dept, Valencia, Spain, Email: javier.vijande@uv.es |
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Elsevier Ireland Ltd |
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English |
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ISSN |
0167-8140 |
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Notes |
WOS:000880438000006 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5466 |
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Author |
Oliver-Canamas, L.; Vijande, J.; Candela-Juan, C.; Gimeno-Olmos, J.; Pujades-Claumarchirant, M.C.; Rovira-Escutia, J.J.; Ballester, F.; Perez-Calatayud, J. |
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Title |
A User-Friendly System for Mailed Dosimetric Audits of Ir-192 or Co-60 HDR Brachytherapy Sources |
Type |
Journal Article |
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Year |
2023 |
Publication |
Cancers |
Abbreviated Journal |
Cancers |
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Volume |
15 |
Issue |
9 |
Pages |
2484 - 14pp |
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Keywords |
high dose rate brachytherapy; dosimetric audit; error detection; phantom |
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Abstract |
Nowadays, the options available to perform external dosimetric audits of the high dose rate (HDR) brachytherapy treatment process are limited. In this work, we present a methodology that allows for performing dosimetric audits in this field. A phantom was designed and manufactured for this purpose. The criteria for its design, together with the in-house measurements for its characterization, are presented. The result is a user-friendly system that can be mailed to perform dosimetric audits in HDR brachytherapy on-site for systems using either Iridium-192 (Ir-192) or Cobalt-60 (Co-60) sources. Objectives: The main goal of this work is to design and characterize a user-friendly methodology to perform mailed dosimetric audits in high dose rate (HDR) brachytherapy for systems using either Iridium-192 (Ir-192) or Cobalt-60 (Co-60) sources. Methods: A solid phantom was designed and manufactured with four catheters and a central slot to place one dosimeter. Irradiations with an Elekta MicroSelectron V2 for Ir-192, and with a BEBIG Multisource for Co-60 were performed for its characterization. For the dose measurements, nanoDots, a type of optically stimulated luminescent dosimeters (OSLDs), were characterized. Monte Carlo (MC) simulations were performed to evaluate the scatter conditions of the irradiation set-up and to study differences in the photon spectra of different Ir-192 sources (Microselectron V2, Flexisource, BEBIG Ir2.A85-2 and Varisource VS2000) reaching the dosimeter in the irradiation set-up. Results: MC simulations indicate that the surface material on which the phantom is supported during the irradiations does not affect the absorbed dose in the nanoDot. Generally, differences below 5% were found in the photon spectra reaching the detector when comparing the Microselectron V2, the Flexisource and the BEBIG models. However, differences up to 20% are observed between the V2 and the Varisource VS2000 models. The calibration coefficients and the uncertainty in the dose measurement were evaluated. Conclusions: The system described here is able to perform dosimetric audits in HDR brachytherapy for systems using either Ir-192 or Co-60 sources. No significant differences are observed between the photon spectra reaching the detector for the MicroSelectron V2, the Flexisource and the BEBIG Ir-192 sources. For the Varisource VS2000, a higher uncertainty is considered in the dose measurement to allow for the nanoDot response. |
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Address |
[Oliver-Canamas, Laura] Serv Radiofis & Proteccio Radiol, Consorci Hospitalari Prov Castello CHPC, Castellon de La Plana 12002, Spain, Email: laura.oliver.canas@gmail.com |
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Mdpi |
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English |
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Notes |
WOS:000987247100001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
no |
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Call Number |
IFIC @ pastor @ |
Serial |
5542 |
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Author |
Oliver, S.; Vijande, J.; Tejedor-Aguilar, N.; Miro, R.; Rovira-Escutia, J.J.; Ballester, F.; Juste, B.; Carmona, V.; Felici, G.; Verdu, G.; Sanchis, E.; Conde, A.; Perez-Calatayud, J. |
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Title |
Monte Carlo flattening filter design to high energy intraoperative electron beam homogenization |
Type |
Journal Article |
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Year |
2023 |
Publication |
Radiation Physics and Chemistry |
Abbreviated Journal |
Radiat. Phys. Chem. |
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Volume |
212 |
Issue |
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Pages |
111102 - 6pp |
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Keywords |
Intraoperative radiotherapy; Electron portable LinAc; Flattening filter; Dosimetry; Monte Carlo |
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Abstract |
Intraoperative radiotherapy using mobile linear accelerators is used for a wide variety of malignancies. However, when large fields are used in combination with high energies, a deterioration of the flatness dose profile is measured with respect to smaller fields and lower energies. Indeed, for the LIAC HWL of Sordina, this deterioration is observed for the 12 MeV beam combined with 10 cm (or larger) diameter applicator. Aimed to solve this problem, a flattening filter has been designed and validated evaluating the feasibility of its usage at the upper part of the applicator. The design of the filter was based on Monte Carlo simulations because of its accuracy in modeling components of clinical devices, among other purposes. The LIAC 10 cm diameter applicator was modeled and simulated independently by two different research groups using two different MC codes, reproducing the heterogeneity of the 12 MeV energy beam. Then, an iterative process of filter design was carried out. Finally, the MC designed conical filter with the optimal size and height to obtain the desired flattened beam was built in-house using a 3D printer. During the experimental validation of the applicator-filter, percentage depth dose, beam profiles, absolute and peripheral dose measurements were performed to demonstrate the effectiveness of the filter addition in the applicator. These measurements conclude that the beam has been flattened, from 5.9% with the standard configuration to 1.6% for the configuration with the filter, without significant increase of the peripheral dose. Consequently, the new filter-applicator LIAC configuration can be used also in a conventional surgery room. A reduction of 16% of the output dose and a reduction of 1.1 mm in the D50 of the percentage depth dose was measured with respect to the original configuration. This work is a proof-of-concept that demonstrates that it is possible to add a filter able to flatten the beam delivered by the Sordina LIAC HWL. Future studies will focus on more refined technical solutions fully compatible with the integrity of the applicator, including its sterilization, to be safely introduced in the clinical practice. |
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Address |
[Oliver, S.; Miro, R.; Juste, B.; Verdu, G.] Univ Polite cn Vale ncia, Inst Segur Ind Radiofis & Medioambiental ISIRYM, Cami Vera S-N, Valencia 46022, Spain, Email: gverdu@iqn.upv.es |
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Pergamon-Elsevier Science Ltd |
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0969-806x |
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Notes |
WOS:001026194900001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5578 |
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