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Author Vijande, J.; Ballester, F.; Ouhib, Z.; Granero, D.; Pujades-Claumarchirant, M.C.; Perez-Calatayud, J. doi  openurl
  Title (up) 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 yes  
  Call Number IFIC @ pastor @ Serial 1227  
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Author Assam, I.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Poppe, B.; Siebert, F.A. doi  openurl
  Title (up) Evaluation of dosimetric effects of metallic artifact reduction and tissue assignment on Monte Carlo dose calculations for I-125 prostate implants Type Journal Article
  Year 2022 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 49 Issue Pages 6195-6208  
  Keywords metallic artifact reduction; Monte Carlo dosimetry; post-implant CT; prostate brachytherapy; tissue assignment schemes; voxelized virtual patient model  
  Abstract Purpose Monte Carlo (MC) simulation studies, aimed at evaluating the magnitude of tissue heterogeneity in I-125 prostate permanent seed implant brachytherapy (BT), customarily use clinical post-implant CT images to generate a virtual representation of a realistic patient model (virtual patient model). Metallic artifact reduction (MAR) techniques and tissue assignment schemes (TAS) are implemented on the post-implant CT images to mollify metallic artifacts due to BT seeds and to assign tissue types to the voxels corresponding to the bright seed spots and streaking artifacts, respectively. The objective of this study is to assess the combined influence of MAR and TAS on MC absorbed dose calculations in post-implant CT-based phantoms. The virtual patient models used for I-125 prostate implant MC absorbed dose calculations in this study are derived from the CT images of an external radiotherapy prostate patient without BT seeds and prostatic calcifications, thus averting the need to implement MAR and TAS. Methods The geometry of the IsoSeed I25.S17plus source is validated by comparing the MC calculated results of the TG-43 parameters for the line source approximation with the TG-43U1S2 consensus data. Four MC absorbed dose calculations are performed in two virtual patient models using the egs_brachy MC code: (1) TG-43-based D-w,w-TG(43), (2) D-w,D-w-MBDC that accounts for interseed scattering and attenuation (ISA), (3) D-m,D-m that examines ISA and tissue heterogeneity by scoring absorbed dose in tissue, and (4) D-w,D-m that unlike D-m,D-m scores absorbed dose in water. The MC absorbed doses (1) and (2) are simulated in a TG-43 patient phantom derived by assigning the densities of every voxel to 1.00 g cm(-3) (water), whereas MC absorbed doses (3) and (4) are scored in the TG-186 patient phantom generated by mapping the mass density of each voxel to tissue according to a CT calibration curve. The MC absorbed doses calculated in this study are compared with VariSeed v8.0 calculated absorbed doses. To evaluate the dosimetric effect of MAR and TAS, the MC absorbed doses of this work (independent of MAR and TAS) are compared to the MC absorbed doses of different I-125 source models from previous studies that were calculated with different MC codes using post-implant CT-based phantoms generated by implementing MAR and TAS on post-implant CT images. Results The very good agreement of TG-43 parameters of this study and the published consensus data within 3% validates the geometry of the IsoSeed I25.S17plus source. For the clinical studies, the TG-43-based calculations show a D-90 overestimation of more than 4% compared to the more realistic MC methods due to ISA and tissue composition. The results of this work generally show few discrepancies with the post-implant CT-based dosimetry studies with respect to the D-90 absorbed dose metric parameter. These discrepancies are mainly Type B uncertainties due to the different I-125 source models and MC codes. Conclusions The implementation of MAR and TAS on post-implant CT images have no dosimetric effect on the I-125 prostate MC absorbed dose calculation in post-implant CT-based phantoms.  
  Address [Assam, Isong; Siebert, Frank-Andre] UKSH, Clin Radiotherapy Radiooncol, Campus Kiel, Kiel, Germany, Email: Isong.Assam@uksh.de  
  Corporate Author Thesis  
  Publisher Wiley Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0094-2405 ISBN Medium  
  Area Expedition Conference  
  Notes WOS:000835807200001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5321  
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Author Palomo, R.; Pujades, M.C.; Gimeno-Olmos, J.; Carmona, V.; Lliso, F.; Candela-Juan, C.; Vijande, J.; Ballester, F.; Perez-Calatayud, J. doi  openurl
  Title (up) Evaluation of lens absorbed dose with Cone Beam IGRT procedures Type Journal Article
  Year 2015 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 35 Issue 4 Pages N33-N41  
  Keywords IGRT; CBCT; lens absorbed dose; TLD  
  Abstract The purpose of this work is to evaluate the absorbed dose to the eye lenses due to the cone beam computed tomography (CBCT) system used to accurately position the patient during head-and-neck image guided procedures. The on-board imaging (OBI) systems (v. 1.5) of Clinac iX and TrueBeam (Varian) accelerators were used to evaluate the imparted dose to the eye lenses and some additional points of the head. All CBCT scans were acquired with the Standard-Dose Head protocol from Varian. Doses were measured using thermoluminescence dosimeters (TLDs) placed in an anthropomorphic phantom. TLDs were calibrated at the beam quality used to reduce their energy dependence. Average dose to the lens due to the OBI systems of the Clinac iX and the TrueBeam were 0.71 +/- 0.07 mGy/CBCT and 0.70 +/- 0.08 mGy/CBCT, respectively. The extra absorbed dose received by the eye lenses due to one CBCT acquisition with the studied protocol is far below the 500 mGy threshold established by ICRP for cataract formation (ICRP 2011 Statement on Tissue Reactions). However, the incremental effect of several CBCT acquisitions during the whole treatment should be taken into account.  
  Address [Palomo, R.; Gimeno-Olmos, J.; Carmona, V.; Lliso, F.; Candela-Juan, C.; Perez-Calatayud, J.] La Fe Univ, Dept Radiotherapy, Phys Sect, E-46026 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:000366388500002 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 2494  
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Author Ibanez-Rosello, B.; Bautista-Ballesteros, J.A.; Candela-Juan, C.; Villaescusa, J.I.; Ballester, F.; Vijande, J.; Perez-Calatayud, J. doi  openurl
  Title (up) Evaluation of the shielding in a treatment room with an electronic brachytherapy unit Type Journal Article
  Year 2017 Publication Journal of Radiological Protection Abbreviated Journal J. Radiol. Prot.  
  Volume 37 Issue 2 Pages N5-N12  
  Keywords Esteya; electronic brachytherapy; shielding; radiation protection  
  Abstract Esteya (R) (Elekta Brachytherapy, Veenendaal, The Netherlands) is an electronic brachytherapy (eBT) system based on a 69.5 kVp x-ray source and a set of collimators of 1 to 3 cm in diameter, used for treating non-melanoma skin cancer lesions. This study aims to estimate room shielding requirements for this unit. The non-primary (scattered and leakage) ambient dose equivalent rates were measured with a Berthold LB-133 monitor (Berthold Technologies, Bad Wildbad, Germany). The latter ranges from 17 mSv h(-1) at 0.25 m distance from the x-ray source to 0.1 mSv h(-1) at 2.5 m. The necessary room shielding was then estimated following US and some European guidelines. The room shielding for all barriers considered was below 2 mmPb. The dose to a companion who, exceptionally, would stay with the patient during all treatment was estimated to be below 1 mSv if a leaded apron is used. In conclusion, Esteya shielding requirements are minimal.  
  Address [Ibanez-Rosello, Blanca; Ignacio Villaescusa, Juan] La Fe Univ, Radioprotect Dept, E-46026 Valencia, Spain, Email: blanca.ibanez.rosello@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:000413778600001 Approved no  
  Is ISI yes International Collaboration no  
  Call Number IFIC @ pastor @ Serial 3344  
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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 (up) 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 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 Rivard, M.J.; Granero, D.; Perez-Calatayud, J.; Ballester, F. doi  openurl
  Title (up) 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 yes  
  Call Number IFIC @ elepoucu @ Serial 504  
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Author Granero, D.; Perez-Calatayud, J.; Vijande, J.; Ballester, F.; Rivard, M.J. doi  openurl
  Title (up) 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 yes  
  Call Number IFIC @ pastor @ Serial 1704  
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Author Vijande, J.; Granero, D.; Perez-Calatayud, J.; Ballester, F. doi  openurl
  Title (up) 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 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 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 (up) Monte Carlo flattening filter design to high energy intraoperative electron beam homogenization Type Journal Article
  Year 2023 Publication 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 Garcia-Cases, F.; Perez-Calatayud, J.; Ballester, F.; Vijande, J.; Granero, D. doi  openurl
  Title (up) 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 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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