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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 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  
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Author Hueso-Gonzalez, F.; Ballester, F.; Perez-Calatayud, J.; Siebert, F.A.; Vijande, J. doi  openurl
  Title Towards clinical application of RayStretch for heterogeneity corrections in LDR permanent I-125 prostate brachytherapy Type Journal Article
  Year 2017 Publication Brachytherapy Abbreviated Journal Brachytherapy  
  Volume 16 Issue 3 Pages 616-623  
  Keywords Brachytherapy; Low-dose rate; Heterogeneities; Prostate; Calcifications; Dosimetry  
  Abstract PURPOSE: RayStretch is a simple algorithm proposed for heterogeneity corrections in low-dose-rate brachytherapy. It is built on top of TG-43 consensus data, and it has been validated with Monte Carlo (MC) simulations. In this study, we take a real clinical prostate implant with 71 1251 seeds as reference and we apply RayStretch to analyze its performance in worst-case scenarios. METHODS AND MATERIALS: To do so, we design two cases where large calcifications are located in the prostate lobules. RayStretch resilience under various calcification density values is also explored. Comparisons against MC calculations are performed. RESULTS: Dose volume histogram related parameters like prostate D-90, rectum D-2cc, or urethra D-10 obtained with RayStretch agree within a few percent with the detailed MC results for all cases considered. CONCLUSIONS: The robustness and compatibility of RayStretch with commercial treatment planning systems indicate its applicability in clinical practice for dosimetric corrections in prostate calcifications. Its use during intraoperative ultrasound planning is foreseen.  
  Address [Hueso-Gonzalez, Fernando] Target Systemelekt GmbH, Wuppertal, Germany, 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:000402231600019 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 3151  
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Author Vijande, J.; Ballester, F.; Ouhib, Z.; Granero, D.; Pujades-Claumarchirant, M.C.; Perez-Calatayud, J. doi  openurl
  Title 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 Vijande, J.; Granero, D.; Perez-Calatayud, J.; Ballester, F. doi  openurl
  Title 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 Piriz, G.H.; Gonzalez-Sprinberg, G.A.; Ballester, F.; Vijande, J. doi  openurl
  Title Dosimetry of Large Field Valencia applicators for Cobalt-60-based brachytherapy Type Journal Article
  Year 2024 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume Issue Pages 5pp  
  Keywords dosimetry; Monte Carlo; skin brachytherapy; Valencia applicators  
  Abstract BackgroundNon-melanoma skin cancer is one of the most common types of cancer and one of the main approaches is brachytherapy. For small lesions, the treatment of this cancer with brachytherapy can be done with two commercial applicators, one of these is the Large Field Valencia Applicators (LFVA).PurposeThe aim of this study is to test the capabilities of the LFVA to use clinically 60Co sources instead of the 192Ir ones. This study was designed for the same dwell positions and weights for both sources.MethodsThe Penelope Monte Carlo code was used to evaluate dose distribution in a water phantom when a 60Co source is considered. The LFVA design and the optimized dwell weights reported for the case of 192Ir are maintained with the only exception of the dwell weight of the central position, that was increased. 2D dose distributions, field flatness, symmetry and the leakage dose distribution around the applicator were calculated.ResultsWhen comparing the dose distributions of both sources, field flatness and symmetry remain unchanged. The only evident difference is an increase of the penumbra regions for all depths when using the 60Co source. Regarding leakage, the maximum dose within the air volume surrounding the applicator is in the order of 20% of the prescription dose for the 60Co source, but it decreases to less than 5% at about 1 cm distance.ConclusionsFlatness and symmetry remains unaltered as compared with 192Ir sources, while an increase in leakage has been observed. This proves the feasibility of using the LFVA in a larger range of clinical applications.  
  Address [Piriz, Gustavo H.; Gonzalez-Sprinberg, Gabriel A.] Univ Republica, Fac Sci, Med Phys Unit, Montevideo, Uruguay, Email: ghpiriz@gmail.com  
  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:001187737100001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 6011  
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Author Fletcher, E.M.; Ballester, F.; Beaulieu, L.; Morrison, H.; Poher, A.; Rivard, M.J.; Sloboda, R.S.; Vijande, J.; Thomson, R.M. doi  openurl
  Title Generation and comparison of 3D dosimetric reference datasets for COMS eye plaque brachytherapy using model-based dose calculations Type Journal Article
  Year 2024 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 51 Issue Pages 694-706  
  Keywords Monte Carlo; ocular brachytherapy; treatment planning  
  Abstract PurposeA joint Working Group of the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy and Oncology (ESTRO), and the Australasian Brachytherapy Group (ABG) was created to aid in the transition from the AAPM TG-43 dose calculation formalism, the current standard, to model-based dose calculations. This work establishes the first test cases for low-energy photon-emitting brachytherapy using model-based dose calculation algorithms (MBDCAs).Acquisition and Validation MethodsFive test cases are developed: (1) a single model 6711 125I brachytherapy seed in water, 13 seeds (2) individually and (3) in combination in water, (4) the full Collaborative Ocular Melanoma Study (COMS) 16-mm eye plaque in water, and (5) the full plaque in a realistic eye phantom. Calculations are done with four Monte Carlo (MC) codes and a research version of a commercial treatment planning system (TPS). For all test cases, local agreement of MC codes was within & SIM;2.5% and global agreement was & SIM;2% (4% for test case 5). MC agreement was within expected uncertainties. Local agreement of TPS with MC was within 5% for test case 1 and & SIM;20% for test cases 4 and 5, and global agreement was within 0.4% for test case 1 and 10% for test cases 4 and 5.Data Format and Usage NotesDose distributions for each set of MC and TPS calculations are available online () along with input files and all other information necessary to repeat the calculations.Potential ApplicationsThese data can be used to support commissioning of MBDCAs for low-energy brachytherapy as recommended by TGs 186 and 221 and AAPM Report 372. This work additionally lays out a sample framework for the development of test cases that can be extended to other applications beyond eye plaque brachytherapy.  
  Address [Fletcher, Elizabeth M.; Thomson, Rowan M.] Carleton Univ, Phys Dept, Carleton Lab Radiotherapy Phys, Ottawa, ON, Canada, Email: rthomson@physics.carleton.ca  
  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:001058112300001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5632  
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Author Beaulieu, L.; Ballester, F.; Granero, D.; Tedgren, A.C.; Haworth, A.; Lowenstein, J.R.; Ma, Y.Z.; Mourtada, F.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; Sloboda, R.S.; Smith, R.L.; Thomson, R.M.; Verhaegen, F.; Fonseca, G.; Vijande, J. doi  openurl
  Title AAPM WGDCAB Report 372: A joint AAPM, ESTRO, ABG, and ABS report on commissioning of model-based dose calculation algorithms in brachytherapy Type Journal Article
  Year 2023 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 50 Issue 8 Pages e946–e960  
  Keywords brachytherapy; commissioning; dose calculation; model-based dose calculation; Monte Carlo; TG-186  
  Abstract The introduction of model-based dose calculation algorithms (MBDCAs) in brachytherapy provides an opportunity for a more accurate dose calculation and opens the possibility for novel, innovative treatment modalities. The joint AAPM, ESTRO, and ABG Task Group 186 (TG-186) report provided guidance to early adopters. However, the commissioning aspect of these algorithms was described only in general terms with no quantitative goals. This report, from the Working Group on Model-Based Dose Calculation Algorithms in Brachytherapy, introduced a field-tested approach to MBDCA commissioning. It is based on a set of well-characterized test cases for which reference Monte Carlo (MC) and vendor-specific MBDCA dose distributions are available in a Digital Imaging and Communications in Medicine-Radiotherapy (DICOM-RT) format to the clinical users. The key elements of the TG-186 commissioning workflow are now described in detail, and quantitative goals are provided. This approach leverages the well-known Brachytherapy Source Registry jointly managed by the AAPM and the Imaging and Radiation Oncology Core (IROC) Houston Quality Assurance Center (with associated links at ESTRO) to provide open access to test cases as well as step-by-step user guides. While the current report is limited to the two most widely commercially available MBDCAs and only for Ir-192-based afterloading brachytherapy at this time, this report establishes a general framework that can easily be extended to other brachytherapy MBDCAs and brachytherapy sources. The AAPM, ESTRO, ABG, and ABS recommend that clinical medical physicists implement the workflow presented in this report to validate both the basic and the advanced dose calculation features of their commercial MBDCAs. Recommendations are also given to vendors to integrate advanced analysis tools into their brachytherapy treatment planning system to facilitate extensive dose comparisons. The use of the test cases for research and educational purposes is further encouraged.  
  Address [Beaulieu, Luc; Ma, Yunzhi] CHU Quebec Univ Laval, Serv Phys Med & Radioprotect, Quebec City, PQ, Canada, Email: beaulieu@phy.ulaval.ca  
  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:001026540300001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5579  
Permanent link to this record
 

 
Author Peppa, V.; Thomson, R.M.; Enger, S.A.; Fonseca, G.P.; Lee, C.N.; Lucero, J.N.E.; Mourtada, F.; Siebert, F.A.; Vijande, J.; Papagiannis, P. doi  openurl
  Title A MC-based anthropomorphic test case for commissioning model-based dose calculation in interstitial breast 192-Ir HDR brachytherapy Type Journal Article
  Year 2023 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 50 Issue 7 Pages 4675-4687  
  Keywords anthropomorphic phantom; commissioning; HDR brachytherapy; model based dose calculation algorithms; Monte Carlo  
  Abstract PurposeTo provide the first clinical test case for commissioning of Ir-192 brachytherapy model-based dose calculation algorithms (MBDCAs) according to the AAPM TG-186 report workflow. Acquisition and Validation MethodsA computational patient phantom model was generated from a clinical multi-catheter Ir-192 HDR breast brachytherapy case. Regions of interest (ROIs) were contoured and digitized on the patient CT images and the model was written to a series of DICOM CT images using MATLAB. The model was imported into two commercial treatment planning systems (TPSs) currently incorporating an MBDCA. Identical treatment plans were prepared using a generic Ir-192 HDR source and the TG-43-based algorithm of each TPS. This was followed by dose to medium in medium calculations using the MBDCA option of each TPS. Monte Carlo (MC) simulation was performed in the model using three different codes and information parsed from the treatment plan exported in DICOM radiation therapy (RT) format. Results were found to agree within statistical uncertainty and the dataset with the lowest uncertainty was assigned as the reference MC dose distribution. Data Format and Usage NotesThe dataset is available online at ,. Files include the treatment plan for each TPS in DICOM RT format, reference MC dose data in RT Dose format, as well as a guide for database users and all files necessary to repeat the MC simulations. Potential ApplicationsThe dataset facilitates the commissioning of brachytherapy MBDCAs using TPS embedded tools and establishes a methodology for the development of future clinical test cases. It is also useful to non-MBDCA adopters for intercomparing MBDCAs and exploring their benefits and limitations, as well as to brachytherapy researchers in need of a dosimetric and/or a DICOM RT information parsing benchmark. Limitations include specificity in terms of radionuclide, source model, clinical scenario, and MBDCA version used for its preparation.  
  Address [Peppa, Vasiliki; Papagiannis, Panagiotis] Natl & Kapodistrian Univ Athens, Med Sch, Med Phys Lab, Athens, Greece, Email: ppapagi@med.uoa.gr  
  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:000989616100001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5529  
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Author Assam, I.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Poppe, B.; Siebert, F.A. doi  openurl
  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
  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 Valdes-Cortez, C.; Niatsetski, Y.; Perez-Calatayud, J.; Ballester, F.; Vijande, J. doi  openurl
  Title A Monte Carlo study of the relative biological effectiveness in surface brachytherapy Type Journal Article
  Year 2022 Publication Medical Physics Abbreviated Journal Med. Phys.  
  Volume 49 Issue Pages 5576-5588  
  Keywords Monte Carlo; relative biological effectiveness; surface HDR brachytherapy  
  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.  
  Address [Valdes-Cortez, Christian] Hosp Reg Antofagasta, Nucl Med Dept, Antofagasta, Chile, Email: cvalcort@gmail.com  
  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:000811709400001 Approved no  
  Is ISI yes International Collaboration yes  
  Call Number IFIC @ pastor @ Serial 5262  
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