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Fletcher, E.M.; Ballester, F.; Beaulieu, L.; Morrison, H.; Poher, A.; Rivard, M.J.; Sloboda, R.S.; Vijande, J.; Thomson, R.M. |
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Title |
Generation and comparison of 3D dosimetric reference datasets for COMS eye plaque brachytherapy using model-based dose calculations |
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Journal Article |
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Year |
2024 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume  |
51 |
Issue |
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Pages |
694-706 |
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Keywords |
Monte Carlo; ocular brachytherapy; treatment planning |
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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. |
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[Fletcher, Elizabeth M.; Thomson, Rowan M.] Carleton Univ, Phys Dept, Carleton Lab Radiotherapy Phys, Ottawa, ON, Canada, Email: rthomson@physics.carleton.ca |
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Wiley |
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0094-2405 |
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WOS:001058112300001 |
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no |
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yes |
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yes |
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IFIC @ pastor @ |
Serial |
5632 |
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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. |
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Title |
A MC-based anthropomorphic test case for commissioning model-based dose calculation in interstitial breast 192-Ir HDR brachytherapy |
Type |
Journal Article |
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Year |
2023 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
50 |
Issue |
7 |
Pages |
4675-4687 |
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Keywords |
anthropomorphic phantom; commissioning; HDR brachytherapy; model based dose calculation algorithms; Monte Carlo |
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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. |
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[Peppa, Vasiliki; Papagiannis, Panagiotis] Natl & Kapodistrian Univ Athens, Med Sch, Med Phys Lab, Athens, Greece, Email: ppapagi@med.uoa.gr |
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Wiley |
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0094-2405 |
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WOS:000989616100001 |
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no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5529 |
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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. |
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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 |
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Year |
2023 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
50 |
Issue |
8 |
Pages |
e946–e960 |
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Keywords |
brachytherapy; commissioning; dose calculation; model-based dose calculation; Monte Carlo; TG-186 |
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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. |
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[Beaulieu, Luc; Ma, Yunzhi] CHU Quebec Univ Laval, Serv Phys Med & Radioprotect, Quebec City, PQ, Canada, Email: beaulieu@phy.ulaval.ca |
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Wiley |
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0094-2405 |
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WOS:001026540300001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5579 |
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Author |
Valdes-Cortez, C.; Niatsetski, Y.; Perez-Calatayud, J.; Ballester, F.; Vijande, J. |
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Title |
A Monte Carlo study of the relative biological effectiveness in surface brachytherapy |
Type |
Journal Article |
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Year |
2022 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
49 |
Issue |
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Pages |
5576-5588 |
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Keywords |
Monte Carlo; relative biological effectiveness; surface HDR brachytherapy |
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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. |
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[Valdes-Cortez, Christian] Hosp Reg Antofagasta, Nucl Med Dept, Antofagasta, Chile, Email: cvalcort@gmail.com |
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Wiley |
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0094-2405 |
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Notes |
WOS:000811709400001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5262 |
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Author |
Assam, I.; Vijande, J.; Ballester, F.; Perez-Calatayud, J.; Poppe, B.; Siebert, F.A. |
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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 |
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Year |
2022 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
49 |
Issue |
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Pages |
6195-6208 |
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Keywords |
metallic artifact reduction; Monte Carlo dosimetry; post-implant CT; prostate brachytherapy; tissue assignment schemes; voxelized virtual patient model |
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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. |
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[Assam, Isong; Siebert, Frank-Andre] UKSH, Clin Radiotherapy Radiooncol, Campus Kiel, Kiel, Germany, Email: Isong.Assam@uksh.de |
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Wiley |
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0094-2405 |
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Notes |
WOS:000835807200001 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
5321 |
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Author |
Albiol, A.; Corbi, A.; Albiol, F. |
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Title |
Automatic intensity windowing of mammographic images based on a perceptual metric |
Type |
Journal Article |
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Year |
2017 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
44 |
Issue |
4 |
Pages |
1369-1378 |
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Keywords |
contrast stretching; Gabor filtering; human visual system; mammogram; mutual information; window level/width |
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Abstract |
Purpose: Initial auto-adjustment of the window level WL and width WW applied to mammographic images. The proposed intensity windowing (IW) method is based on the maximization of the mutual information (MI) between a perceptual decomposition of the original 12-bit sources and their screen displayed 8-bit version. Besides zoom, color inversion and panning operations, IW is the most commonly performed task in daily screening and has a direct impact on diagnosis and the time involved in the process. Methods: The authors present a human visual system and perception-based algorithm named GRAIL (Gabor-relying adjustment of image levels). GRAIL initially measures a mammogram's quality based on the MI between the original instance and its Gabor-filtered derivations. From this point on, the algorithm performs an automatic intensity windowing process that outputs the WL/WW that best displays each mammogram for screening. GRAIL starts with the default, high contrast, wide dynamic range 12-bit data, and then maximizes the graphical information presented in ordinary 8-bit displays. Tests have been carried out with several mammogram databases. They comprise correlations and an ANOVA analysis with the manual IW levels established by a group of radiologists. A complete MATLAB implementation of GRAIL is available at . Results: Auto-leveled images show superior quality both perceptually and objectively compared to their full intensity range and compared to the application of other common methods like global contrast stretching (GCS). The correlations between the human determined intensity values and the ones estimated by our method surpass that of GCS. The ANOVA analysis with the upper intensity thresholds also reveals a similar outcome. GRAIL has also proven to specially perform better with images that contain micro-calcifications and/or foreign X-ray-opaque elements and with healthy BI-RADS A-type mammograms. It can also speed up the initial screening time by a mean of 4.5 s per image. Conclusions: A novel methodology is introduced that enables a quality-driven balancing of the WL/WW of mammographic images. This correction seeks the representation that maximizes the amount of graphical information contained in each image. The presented technique can contribute to the diagnosis and the overall efficiency of the breast screening session by suggesting, at the beginning, an optimal and customized windowing setting for each mammogram. |
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[Albiol, Alberto] Univ Politecn Valencia, iTeam Res Inst, Valencia, Spain, Email: alberto.corbi@ific.uv.es |
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Wiley |
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0094-2405 |
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WOS:000400572700016 |
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no |
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Is ISI |
yes |
International Collaboration |
no |
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Call Number |
IFIC @ pastor @ |
Serial |
3122 |
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Author |
Ma, Y.Z.; Vijande, J.; Ballester, F.; Tedgren, A.C.; Granero, D.; Haworth, A.; Mourtada, F.; Fonseca, G.P.; Zourari, K.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; Sloboda, R.S.; Smith, R.; Chamberland, M.J.P.; Thomson, R.M.; Verhaegen, F.; Beaulieu, L. |
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Title |
A generic TG-186 shielded applicator for commissioning model-based dose calculation algorithms for high-dose-rate Ir-192 brachytherapy |
Type |
Journal Article |
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Year |
2017 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
44 |
Issue |
11 |
Pages |
5961-5976 |
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Keywords |
Ir-192; HDR brachytherapy; model based dose calculation; Monte Carlo methods; shielded applicator; TG-186 |
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Abstract |
PurposeA joint working group was created by the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy and Oncology (ESTRO), and the Australasian Brachytherapy Group (ABG) with the charge, among others, to develop a set of well-defined test case plans and perform calculations and comparisons with model-based dose calculation algorithms (MBDCAs). Its main goal is to facilitate a smooth transition from the AAPM Task Group No. 43 (TG-43) dose calculation formalism, widely being used in clinical practice for brachytherapy, to the one proposed by Task Group No. 186 (TG-186) for MBDCAs. To do so, in this work a hypothetical, generic high-dose rate (HDR) Ir-192 shielded applicator has been designed and benchmarked. MethodsA generic HDR Ir-192 shielded applicator was designed based on three commercially available gynecological applicators as well as a virtual cubic water phantom that can be imported into any DICOM-RT compatible treatment planning system (TPS). The absorbed dose distribution around the applicator with the TG-186 Ir-192 source located at one dwell position at its center was computed using two commercial TPSs incorporating MBDCAs (Oncentra((R)) Brachy with Advanced Collapsed-cone Engine, ACE, and BrachyVision ACUROS) and state-of-the-art Monte Carlo (MC) codes, including ALGEBRA, BrachyDose, egs_brachy, Geant4, MCNP6, and Penelope2008. TPS-based volumetric dose distributions for the previously reported source centered in water and source displaced test cases, and the new source centered in applicator test case, were analyzed here using the MCNP6 dose distribution as a reference. Volumetric dose comparisons of TPS results against results for the other MC codes were also performed. Distributions of local and global dose difference ratios are reported. ResultsThe local dose differences among MC codes are comparable to the statistical uncertainties of the reference datasets for the source centered in water and source displaced test cases and for the clinically relevant part of the unshielded volume in the source centered in applicator case. Larger local differences appear in the shielded volume or at large distances. Considering clinically relevant regions, global dose differences are smaller than the local ones. The most disadvantageous case for the MBDCAs is the one including the shielded applicator. In this case, ACUROS agrees with MC within [-4.2%, +4.2%] for the majority of voxels (95%) while presenting dose differences within [-0.12%, +0.12%] of the dose at a clinically relevant reference point. For ACE, 95% of the total volume presents differences with respect to MC in the range [-1.7%, +0.4%] of the dose at the reference point. ConclusionsThe combination of the generic source and generic shielded applicator, together with the previously developed test cases and reference datasets (available in the Brachytherapy Source Registry), lay a solid foundation in supporting uniform commissioning procedures and direct comparisons among treatment planning systems for HDR Ir-192 brachytherapy. |
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Address |
[Ma, Yunzhi; Beaulieu, Luc] CHU Quebec, Dept Radio Oncol & Axe Oncol, Ctr Rech, Quebec City, PQ G1R 2J6, Canada, Email: yunzhi.Ma@crchuq.ulaval.ca |
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Wiley |
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0094-2405 |
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WOS:000414970800039 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
3370 |
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Author |
Candela-Juan, C.; Niatsetski, Y.; van der Laarse, R.; Granero, D.; Ballester, F.; Perez-Calatayud, J.; Vijande, J. |
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Title |
Design and characterization of a new high-dose-rate brachytherapy Valencia applicator for larger skin lesions |
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Journal Article |
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2016 |
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Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
43 |
Issue |
4 |
Pages |
1639-1648 |
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Keywords |
skin applicator; Valencia applicator; HDR brachytherapy; dosimetry; Monte Carlo |
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Abstract |
Purpose: The aims of this study were (i) to design a new high-dose-rate (HDR) brachytherapy applicator for treating surface lesions with planning target volumes larger than 3 cm in diameter and up to 5 cm in size, using the microSelectron-HDR or Flexitron afterloader (Elekta Brachytherapy) with a Ir-192 source; (ii) to calculate by means of the Monte Carlo (MC) method the dose distribution for the new applicator when it is placed against a water phantom; and (iii) to validate experimentally the dose distributions in water. Methods: The PENELOPE2008 MC code was used to optimize dwell positions and dwell times. Next, the dose distribution in a water phantom and the leakage dose distribution around the applicator were calculated. Finally, MC data were validated experimentally for a 192Ir mHDR-v2 source by measuring (i) dose distributions with radiochromic EBT3 films (ISP); (ii) percentage depth-dose (PDD) curve with the parallel-plate ionization chamber Advanced Markus (PTW); and (iii) absolute dose rate with EBT3 films and the PinPoint T31016 (PTW) ionization chamber. Results: The new applicator is made of tungsten alloy (Densimet) and consists of a set of interchangeable collimators. Three catheters are used to allocate the source at prefixed dwell positions with preset weights to produce a homogenous dose distribution at the typical prescription depth of 3 mm in water. The same plan is used for all available collimators. PDD, absolute dose rate per unit of air kerma strength, and off-axis profiles in a cylindrical water phantom are reported. These data can be used for treatment planning. Leakage around the applicator was also scored. The dose distributions, PDD, and absolute dose rate calculated agree within experimental uncertainties with the doses measured: differences of MC data with chamber measurements are up to 0.8% and with radiochromic films are up to 3.5%. Conclusions: The new applicator and the dosimetric data provided here will be a valuable tool in clinical practice, making treatment of large skin lesions simpler, faster, and safer. Also the dose to surrounding healthy tissues is minimal. |
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Address |
[Candela-Juan, C.; Perez-Calatayud, J.] La Fe Univ & Polytech Hosp, Dept Radiat Oncol, Valencia 46026, Spain, Email: ccanjuan@gmail.com |
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Amer Assoc Physicists Medicine Amer Inst Physics |
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English |
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ISSN |
0094-2405 |
ISBN |
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Conference |
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Notes |
WOS:000373711000007 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
2620 |
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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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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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0094-2405 |
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Area |
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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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Author |
Ballester, F.; Tedgren, A.C.; Granero, D.; Haworth, A.; Mourtada, F.; Fonseca, G.P.; Zourari, K.; Papagiannis, P.; Rivard, M.J.; Siebert, F.A.; Sloboda, R.S.; Smith, R.L.; Thomson, R.M.; Verhaegen, F.; Vijande, J.; Ma, Y.Z.; Beaulieu, L. |
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Title |
A generic high-dose rate Ir-192 brachytherapy source for evaluation of model-based dose calculations beyond the TG-43 formalism |
Type |
Journal Article |
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Year |
2015 |
Publication |
Medical Physics |
Abbreviated Journal |
Med. Phys. |
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Volume |
42 |
Issue |
6 |
Pages |
3048-3062 |
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Keywords |
Ir-192; HDR brachytherapy; Monte Carlo methods; model-based dose calculation; TG-186 |
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Abstract |
Purpose: In order to facilitate a smooth transition for brachytherapy dose calculations from the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) formalism to model-based dose calculation algorithms (MBDCAs), treatment planning systems (TPSs) using a MBDCA require a set of well-defined test case plans characterized by Monte Carlo (MC) methods. This also permits direct dose comparison to TG-43 reference data. Such test case plans should be made available for use in the software commissioning process performed by clinical end users. To this end, a hypothetical, generic high-dose rate (HDR) Ir-192 source and a virtual water phantom were designed, which can be imported into a TPS. Methods: A hypothetical, generic HDR Ir-192 source was designed based on commercially available sources as well as a virtual, cubic water phantom that can be imported into any TPS in DICOM format. The dose distribution of the generic Ir-192 source when placed at the center of the cubic phantom, and away from the center under altered scatter conditions, was evaluated using two commercial MBDCAs [Oncentra (R) Brachy with advanced collapsed-cone engine (ACE) and BrachyVision AcuRos (TM)]. Dose comparisons were performed using state-of-the-art MC codes for radiation transport, including ALGEBRA, BrachyDose, GEANT4, MCNP5, MCNP6, and pENELopE2008. The methodologies adhered to recommendations in the AAPM TG-229 report on high-energy brachytherapy source dosimetry. TG-43 dosimetry parameters, an along-away dose-rate table, and primary and scatter separated (PSS) data were obtained. The virtual water phantom of (201)(3) voxels (1 mm sides) was used to evaluate the calculated dose distributions. Two test case plans involving a single position of the generic HDR Ir-192 source in this phantom were prepared: (i) source centered in the phantom and (ii) source displaced 7 cm laterally from the center. Datasets were independently produced by different investigators. MC results were then compared against dose calculated using TG-43 and MBDCA methods. Results: TG-43 and PSS datasets were generated for the generic source, the PSS data for use with the ACE algorithm. The dose-rate constant values obtained from seven MC simulations, performed independently using different codes, were in excellent agreement, yielding an average of 1.1109 +/- 0.0004 cGy/(h U) (k = 1, Type A uncertainty). MC calculated dose-rate distributions for the two plans were also found to be in excellent agreement, with differences within type A uncertainties. Differences between commercial MBDCA and MC results were test, position, and calculation parameter dependent. On average, however, these differences were within 1% for ACUROS and 2% for ACE at clinically relevant distances. Conclusions: A hypothetical, generic HDR Ir-192 source was designed and implemented in two commercially available TPSs employing different MBDCAs. Reference dose distributions for this source were benchmarked and used for the evaluation of MBDCA calculations employing a virtual, cubic water phantom in the form of a CT DICOM image series. The implementation of a generic source of identical design in all TPSs using MBDCAs is an important step toward supporting univocal commissioning procedures and direct comparisons between TPSs. |
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Address |
[Ballester, Facundo] Univ Valencia, Dept Atom Mol & Nucl Phys, E-46100 Burjassot, Spain, Email: Facundo.Ballester@uv.es |
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Thesis |
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Publisher |
Amer Assoc Physicists Medicine Amer Inst Physics |
Place of Publication |
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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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Series Title |
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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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Area |
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Conference |
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Notes |
WOS:000356998300031 |
Approved |
no |
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Is ISI |
yes |
International Collaboration |
yes |
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Call Number |
IFIC @ pastor @ |
Serial |
2315 |
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| Permanent link to this record |
