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Ros Garcia, A., Barrio, J., Etxebeste, A., Garcia-Lopez, J., Jimenez-Ramos, M. C., Lacasta, C., et al. (2020). MACACO II test-beam with high energy photons. Phys. Med. Biol., 65(24), 245027–12pp.
Abstract: The IRIS group at IFIC Valencia is developing a three-layer Compton camera for treatment monitoring in proton therapy. The system is composed of three detector planes, each made of a LaBr3<i monolithic crystal coupled to a SiPM array. Having obtained successful results with the first prototype (MACACO) that demonstrated the feasibility of the proposed technology, a second prototype (MACACO II) with improved performance has been developed, and is the subject of this work. The new system has an enhanced detector energy resolution which translates into a higher spatial resolution of the telescope. The image reconstruction method has also been improved with an accurate model of the sensitivity matrix. The device has been tested with high energy photons at the National Accelerator Centre (CNA, Seville). The tests involved a proton beam of 18 MeV impinging on a graphite target, to produce 4.4 MeV photons. Data were taken at different system positions of the telescope with the first detector at 65 and 160 mm from the target, and at different beam intensities. The measurements allowed successful reconstruction of the photon emission distribution at two target positions separated by 5 mm in different telescope configurations. This result was obtained both with data recorded in the first and second telescope planes (two interaction events) and, for the first time in beam experiments, with data recorded in the three planes (three interaction events).
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Valdes-Cortez, C., Ballester, F., Vijande, J., Gimenez, V., Gimenez-Alventosa, V., Perez-Calatayud, J., et al. (2020). Depth-dose measurement corrections for the surface electronic brachytherapy beams of an Esteya(R) unit: a Monte Carlo study. Phys. Med. Biol., 65(24), 245026–12pp.
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.
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Roser, J., Muñoz, E., Barrientos, L., Barrio, J., Bernabeu, J., Borja-Lloret, M., et al. (2020). Image reconstruction for a multi-layer Compton telescope: an analytical model for three interaction events. Phys. Med. Biol., 65(14), 145005–17pp.
Abstract: Compton Cameras are electronically collimated photon imagers suitable for sub-MeV to few MeV gamma-ray detection. Such features are desirable to enablein vivorange verification in hadron therapy, through the detection of secondary Prompt Gammas. A major concern with this technique is the poor image quality obtained when the incoming gamma-ray energy is unknown. Compton Cameras with more than two detector planes (multi-layer Compton Cameras) have been proposed as a solution, given that these devices incorporate more signal sequences of interactions to the conventional two interaction events. In particular, three interaction events convey more spectral information as they allow inferring directly the incident gamma-ray energy. A three-layer Compton Telescope based on continuous Lanthanum (III) Bromide crystals coupled to Silicon Photomultipliers is being developed at the IRIS group of IFIC-Valencia. In a previous work we proposed a spectral reconstruction algorithm for two interaction events based on an analytical model for the formation of the signal. To fully exploit the capabilities of our prototype, we present here an extension of the model for three interaction events. Analytical expressions of the sensitivity and the System Matrix are derived and validated against Monte Carlo simulations. Implemented in a List Mode Maximum Likelihood Expectation Maximization algorithm, the proposed model allows us to obtain four-dimensional (energy and position) images by using exclusively three interaction events. We are able to recover the correct spectrum and spatial distribution of gamma-ray sources when ideal data are employed. However, the uncertainties associated to experimental measurements result in a degradation when real data from complex structures are employed. Incorrect estimation of the incident gamma-ray interaction positions, and missing deposited energy associated with escaping secondaries, have been identified as the causes of such degradation by means of a detailed Monte Carlo study. As expected, our current experimental resolution and efficiency to three interaction events prevents us from correctly recovering complex structures of radioactive sources. However, given the better spectral information conveyed by three interaction events, we expect an improvement of the image quality of conventional Compton imaging when including such events. In this regard, future development includes the incorporation of the model assessed in this work to the two interaction events model in order to allow using simultaneously two and three interaction events in the image reconstruction.
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Muñoz, E., Barrientos, L., Bernabeu, J., Borja-Lloret, M., Llosa, G., Ros, A., et al. (2020). A spectral reconstruction algorithm for two-plane Compton cameras. Phys. Med. Biol., 65(2), 025011–17pp.
Abstract: One factor limiting the current applicability extent of hadron therapy is the lack of a reliable method for real time treatment monitoring. The use of Compton imaging systems as monitors requires the correct reconstruction of the distribution of prompt gamma productions during patient irradiation. In order to extract the maximum information from all the measurable events, we implemented a spectral reconstruction method that assigns to all events a probability of being either partial or total energy depositions. The method, implemented in a list-mode maximum likelihood expectation maximization algorithm, generates a four dimensional image in the joint spatial-spectral domain, in which the voxels containing the emission positions and energies are obtained. The analytical model used for the system response function is also employed to derive an analytical expression for the sensitivity, which is calculated via Monte Carlo integration. The performance of the method is evaluated through reconstruction of various experimental and simulated sources with different spatial and energy distributions. The results show that the proposed method can recover the spectral and spatial information simultaneously, but only under the assumption of ideal measurements. The analysis of the Monte Carlo simulations has led to the identification of two important degradation sources: the mispositioning of the gamma interaction point and the missing energy recorded in the interaction. Both factors are related to the high energy transferred to the recoil electrons, which can travel far from the interaction point and even escape the detector. These effects prevent the direct application of the current method in more realistic scenarios. Nevertheless, experimental point-like sources have been accurately reconstructed and the spatial distributions and spectral emission of complex simulated phantoms can be identified.
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Etxebeste, A., Barrio, J., Bernabeu, J., Lacasta, C., Llosa, G., Muñoz, E., et al. (2019). Study of sensitivity and resolution for full ring PET prototypes based on continuous crystals and analytical modeling of the light distribution. Phys. Med. Biol., 64(3), 035015–17pp.
Abstract: Sensitivity and spatial resolution are the main parameters to maximize in the performance of a PET scanner. For this purpose, detectors consisting of a combination of continuous crystals optically coupled to segmented photodetectors have been employed. With the use of continuous crystals the sensitivity is increased with respect to the pixelated crystals. In addition, spatial resolution is no longer limited to the crystal size. The main drawback is the difficulty in determining the interaction position. In this work, we present the characterization of the performance of a full ring based on cuboid continuous crystals coupled to SiPMs. To this end, we have employed the simulations developed in a previous work for our experimental detector head. Sensitivity could be further enhanced by using tapered crystals. This enhancement is obtained by increasing the solid angle coverage, reducing the wedge-shaped gaps between contiguous detectors. The performance of the scanners based on both crystal geometries was characterized following NEMA NU 4-2008 standardized protocol in order to compare them. An average sensitivity gain over the entire axial field of view of 13.63% has been obtained with tapered geometry while similar performance of the spatial resolution has been proven with both scanners. The activity at which NECR and true peak occur is smaller and the peak value is greater for tapered crystals than for cuboid crystals. Moreover, a higher degree of homogeneity was obtained in the sensitivity map due to the tighter packing of the crystals, which reduces the gaps and results in a better recovery of homogeneous regions than for the cuboid configuration. Some of the results obtained, such as spatial resolution, depend on the interaction position estimation and may vary if other method is employed.
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Gimenez-Alventosa, V., Antunes, P. C. G., Vijande, J., Ballester, F., Perez-Calatayud, J., & Andreo, P. (2017). Collision-kerma conversion between dose-to-tissue and dose-to-water by photon energy-fluence corrections in low-energy brachytherapy. Phys. Med. Biol., 62(1), 146–164.
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).
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Garcia-Cases, F., Perez-Calatayud, J., Ballester, F., Vijande, J., & Granero, D. (2018). Peripheral dose around a mobile linac for intraoperative radiotherapy: radiation protection aspects. J. Radiol. Prot., 38(4), 1393–1411.
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.
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Quintero-Quintero, A., Patiño-Camargo, G., Soriano, A., Palma, J. D., Vilar-Palop, J., Pujades, M. C., et al. (2018). Calibration of a thermoluminescent dosimeter worn over lead aprons in fluoroscopy guided procedures. J. Radiol. Prot., 38(2), 549–563.
Abstract: Fluoroscopy guided interventional procedures provide remarkable benefits to patients. However, medical staff working near the scattered radiation field may be exposed to high cumulative equivalent doses, thus requiring shielding devices such as lead aprons and thyroid collars. In this situation, it remains an acceptable practice to derive equivalent doses to the eye lenses or other unprotected soft tissues with a dosimeter placed above these protective devices. Nevertheless, the radiation backscattered by the lead shield differs from that generated during dosimeter calibration with a water phantom. In this study, a passive personal thermoluminescent dosimeter (TLD) was modelled by means of the Monte Carlo (MC) code Penelope. The results obtained were validated against measurements performed in reference conditions in a secondary standard dosimetry laboratory. Next, the MC model was used to evaluate the backscatter correction factor needed for the case where the dosimeter is worn over a lead shield to estimate the personal equivalent dose H-p(0.07) to unprotected soft tissues. For this purpose, the TLD was irradiated over a water slab phantom with a photon beam representative of the result of a fluoroscopy beam scattered by a patient. Incident beam angles of 0 degrees and 60 degrees, and lead thicknesses between the TLD and phantom of 0.25 and 0.5 mm Pb were considered. A backscatter correction factor of 1.23 (independent of lead thickness) was calculated comparing the results with those faced in reference conditions (i.e., without lead shield and with an angular incidence of 0 degrees). The corrected dose algorithm was validated in laboratory conditions with dosi-meters irradiated over a thyroid collar and angular incidences of 0 degrees, 40 degrees and 60 degrees, as well as with dosimeters worn by interventional radiologists and cardiologists. The corrected dose algorithm provides a better approach to estimate the equivalent dose to unprotected soft tissues such as eye lenses. Dosimeters that are not shielded from backscatter radiation might underestimate personal equivalent doses when worn over a lead apron and, therefore, should be specifically characterized for this purpose.
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Ibanez-Rosello, B., Bautista-Ballesteros, J. A., Candela-Juan, C., Villaescusa, J. I., Ballester, F., Vijande, J., et al. (2017). Evaluation of the shielding in a treatment room with an electronic brachytherapy unit. J. Radiol. Prot., 37(2), N5–N12.
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.
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AGATA Collaboration(Lalovic, N. et al), Gadea, A., & Domingo-Pardo, C. (2018). Study of isomeric states in Pb-198, Pb-200, Pb-202, Pb-206 and Hg-206 populated in fragmentation reactions. J. Phys. G, 45(3), 035105–27pp.
Abstract: Isomeric states in isotopes in the vicinity of doubly-magic Pb-208 were populated following reactions of a relativistic Pb-208 primary beam impinging on a Be-9 fragmentation target. Secondary beams of Pb-198,Pb-200,Pb-202,Pb-206 and Hg-206 were isotopically separated and implanted in a passive stopper positioned in the focal plane of the GSI Fragment Separator. Delayed gamma rays were detected with the Advanced Gamma Tracking Array (AGATA). Decay schemes were reevaluated and interpreted with shell-model calculations. The momentum-dependent population of isomeric states in the two-nucleon hole nuclei Pb-206/Hg-206 was found to differ from the population of multi neutron-hole isomeric states in Pb-198,Pb-200,Pb-202.
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