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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. doi  openurl
  Title GEC-ESTRO ACROP recommendations on calibration and traceability of HE HDR-PDR photon-emitting brachytherapy sources at the hospital level Type Journal Article
  Year 2022 Publication (down) Radiotherapy and Oncology Abbreviated Journal Radiother. Oncol.  
  Volume 176 Issue Pages 108-117  
  Keywords Brachytherapy; High energy; Calibration; Dosimetry; HDR-PDR  
  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.  
  Address [Perez-Calatayud, Jose] La Fe Hosp, Radiotherapy Dept, Valencia, Spain, Email: javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Elsevier Ireland Ltd Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0167-8140 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000880438000006 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5466  
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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. doi  openurl
  Title Monte Carlo flattening filter design to high energy intraoperative electron beam homogenization Type Journal Article
  Year 2023 Publication (down) Radiation Physics and Chemistry Abbreviated Journal Radiat. Phys. Chem.  
  Volume 212 Issue Pages 111102 - 6pp  
  Keywords Intraoperative radiotherapy; Electron portable LinAc; Flattening filter; Dosimetry; Monte Carlo  
  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.  
  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  
  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 0969-806x ISBN Medium  
  Area Expedition Conference  
  Notes WOS:001026194900001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5578  
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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 (down) 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 yes  
  Call Number IFIC @ pastor @ Serial 2296  
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Author 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 (down) 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 Valdes-Cortez, C.; Ballester, F.; Vijande, J.; Gimenez, V.; Gimenez-Alventosa, V.; Perez-Calatayud, J.; Niatsetski, Y.; Andreo, P. doi  openurl
  Title Depth-dose measurement corrections for the surface electronic brachytherapy beams of an Esteya(R) unit: a Monte Carlo study Type Journal Article
  Year 2020 Publication (down) Physics in Medicine and Biology Abbreviated Journal Phys. Med. Biol.  
  Volume 65 Issue 24 Pages 245026 - 12pp  
  Keywords electronic brachytherapy; eBT; dosimetry; ionization chamber; Monte Carlo  
  Abstract Three different correction factors for measurements with the parallel-plate ionization chamber PTW T34013 on the Esteya electronic brachytherapy unit have been investigated. This chamber type is recommended by AAPM TG-253 for depth-dose measurements in the 69.5 kV x-ray beam generated by the Esteya unit. Monte Carlo simulations using the PENELOPE-2018 system were performed to determine the absorbed dose deposited in water and in the chamber sensitive volume at different depths with a Type A uncertainty smaller than 0.1%. Chamber-to-chamber differences have been explored performing measurements using three different chambers. The range of conical applicators available, from 10 to 30 mm in diameter, has been explored. Using a depth-independent global chamber perturbation correction factor without a shift of the effective point of measurement yielded differences between the absorbed dose to water and the corrected absorbed dose in the sensitive volume of the chamber of up to 1% and 0.6% for the 10 mm and 30 mm applicators, respectively. Calculations using a depth-dependent perturbation factor, including or excluding a shift of the effective point of measurement, resulted in depth-dose differences of about +/- 0.5% or less for both applicators. The smallest depth-dose differences were obtained when a shift of the effective point of measurement was implemented, being displaced 0.4 mm towards the center of the sensitive volume of the chamber. The correction factors were obtained with combined uncertainties of 0.4% (k = 2). Uncertainties due to chamber-to-chamber differences are found to be lower than 2%. The results emphasize the relevance of carrying out detailed Monte Carlo studies for each electronic brachytherapy device and ionization chamber used for its dosimetry.  
  Address [Valdes-Cortez, Christian; Ballester, Facundo; Vijande, Javier] Univ Valencia UV, Dept Fis Atom Mol & Nucl, Burjassot, Spain, Email: cvalcort@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 0031-9155 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000618031500001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 4708  
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Author Vijande, J.; Tedgren, A.C.; Ballester, F.; Baltas, D.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; De Werd, L.; Perez-Calatayud, J. doi  openurl
  Title Source strength determination in iridium-192 and cobalt-60 brachytherapy: A European survey on the level of agreement between clinical measurements and manufacturer certificates Type Journal Article
  Year 2021 Publication (down) Physics and Imaging in Radiation Oncology Abbreviated Journal Phys. Imag. Radiat. Oncol.  
  Volume 19 Issue Pages 108-111  
  Keywords RAKR; Calibration; HDR; PDR; Brachytherapy  
  Abstract Background and purpose: Brachytherapy treatment outcomes depend on the accuracy of the delivered dose distribution, which is proportional to the reference air-kerma rate (RAKR). Current societal recommendations require the medical physicist to compare the measured RAKR values to the manufacturer source calibration certificate. The purpose of this work was to report agreement observed in current clinical practice in the European Union. Materials and methods: A European survey was performed for high- and pulsed-dose-rate (HDR and PDR) highenergy sources (Ir-192 and Co-60), to quantify observed RAKR differences. Medical physicists at eighteen hospitals from eight European countries were contacted, providing 1,032 data points from 2001 to 2020. Results: Over the survey period, 77% of the Ir-192 measurements used a well chamber instead of the older Krieger phantom method. Mean differences with the manufacturer calibration certificate were 0.01% +/- 1.15% for Ir-192 and -0.1% +/- 1.3% for Co-60. Over 95% of RAKR measurements in the clinic were within 3% of the manufacturer calibration certificate. Conclusions: This study showed that the agreement level was generally better than that reflected in prior societal recommendations positing 5%. Future recommendations on high-energy HDR and PDR source calibrations in the clinic may consider tightened agreements levels.  
  Address [Vijande, Javier; Ballester, Facundo] Univ Valencia UV, Dept Fis Atom Mol & Nucl, Burjassot, Spain, Email: Javier.vijande@uv.es  
  Corporate Author Thesis  
  Publisher Elsevier Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000694711800017 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 4969  
Permanent link to this record
 

 
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 (down) 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 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 (down) 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 yes  
  Call Number IFIC @ elepoucu @ Serial 504  
Permanent link to this record
 

 
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 (down) 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 yes  
  Call Number IFIC @ pastor @ Serial 1704  
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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 (down) 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  
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