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Author |
Granero, D.; Perez-Calatayud, J.; Vijande, J.; Ballester, F.; Rivard, M.J. |
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Title  |
Limitations of the TG-43 formalism for skin high-dose-rate brachytherapy dose calculations |
Type |
Journal Article |
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Year |
2014 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
41 |
Issue |
2 |
Pages |
021703 - 8pp |
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Keywords |
HDR; brachytherapy; skin; Monte Carlo; Geant4; Co-60; Ir-192; Yb-169 |
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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. |
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Address |
[Granero, Domingo] Hosp Gen Univ, ERESA, Dept Radiat Phys, Valencia 46014, Spain, Email: dgranero@eresa.com |
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Amer Assoc Physicists Medicine Amer Inst Physics |
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English |
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ISSN |
0094-2405 |
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Notes |
WOS:000331213300006 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
1704 |
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Author |
Ballester, F.; Granero, D.; Perez-Calatayud, J.; Venselaar, J.L.M.; Rivard, M.J. |
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Title |
Study of encapsulated Tm-170 sources for their potential use in brachytherapy |
Type |
Journal Article |
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Year |
2010 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
37 |
Issue |
4 |
Pages |
1629-1637 |
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Keywords |
brachytherapy; cancer; dosimetry; prosthetics; radioisotopes; thulium |
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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. |
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Address |
[Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: fballest@uv.es |
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Amer Assoc Physicists Medicine Amer Inst Physics |
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English |
Summary Language |
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Abbreviated Series Title |
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Series Volume |
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Series Issue |
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Edition |
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ISSN |
0094-2405 |
ISBN |
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Conference |
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Notes |
ISI:000276211200027 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ elepoucu @ |
Serial |
478 |
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Author |
Granero, D.; Candela-Juan, C.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Jacob, D.; Mourtada, F. |
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Title |
Technical Note: Dosimetry of Leipzig and Valencia applicators without the plastic cap |
Type |
Journal Article |
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Year |
2016 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
43 |
Issue |
5 |
Pages |
2087 - 4pp |
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Keywords |
Leipzig applicators; Valencia applicators; skin brachytherapy; Monte Carlo; dosimetry |
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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. |
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Address |
[Granero, D.] Hosp Gen Univ, Dept Radiat Phys, ERESA, Valencia 46014, Spain, Email: dgranero@eresa.com |
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Publisher |
Amer Assoc Physicists Medicine Amer Inst Physics |
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Editor |
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Language |
English |
Summary Language |
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Original Title |
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Series Editor |
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Abbreviated Series Title |
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Series Volume |
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ISSN |
0094-2405 |
ISBN |
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Conference |
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Notes |
WOS:000378924200010 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
2753 |
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