Monte Carlo dosimetric characterization of the Flexisource Co-60 high-dose-rate brachytherapy source using PENELOPE.

PURPOSE: 60Co sources have been commercialized as an alternative to 192Ir sources for high-dose-rate (HDR) brachytherapy. One of them is the Flexisource Co-60 HDR source manufactured by Elekta. The only available dosimetric characterization of this source is that of Vijande et al. [J Contemp Brachytherapy 2012; 4:34-44], whose results were not included in the AAPM/ESTRO consensus document. In that work, the dosimetric quantities were calculated as averages of the results obtained with the Geant4 and PENELOPE Monte Carlo (MC) codes, though for other sources, significant differences have been quoted between the values obtained with these two codes. The aim of this work is to perform the dosimetric characterization of the Flexisource Co-60 HDR source using PENELOPE. METHODS AND MATERIALS: The MC simulation code PENELOPE (v. 2014) has been used. Following the recommendations of the AAPM/ESTRO report, the radial dose function, the anisotropy function, the air-kerma strength, the dose rate constant, and the absorbed dose rate in water have been calculated. RESULTS: The results we have obtained exceed those of Vijande et al. In particular, the absorbed dose rate constant is ∼0.85% larger. A similar difference is also found in the other dosimetric quantities. The effect of the electrons emitted in the decay of 60Co, usually neglected in this kind of simulations, is significant up to the distances of 0.25 cm from the source. CONCLUSIONS: The systematic and significant differences we have found between PENELOPE results and the average values found by Vijande et al. point out that the dosimetric characterizations carried out with the various MC codes should be provided independently.

Reply to Comment on 'A new method to measure electron density and effective atomic number using dual-energy CT images'.

In this note, we would like to respond to the comments made by Professor Bouchard on our recent published work and clarify some aspects of it.

Polarized dosimetry method for Gafchromic EBT3.

PURPOSE: To analyze the changes in the polarization state of the flatbed scanner light caused by the EBT3 films and to propose a new method for correcting the lateral effects. METHODS AND MATERIALS: The polarization changes induced by radiochromic films are analyzed using linear polarizing film. Based on the results, the linear polarizing films are used in the scanning process of the EBT3 films. This method is tested against the conventional EBT3 dosimetry using a series of simple regular beams and 21 cases of IMRT. RESULTS: The mean results are statically different from the conventional dosimetry with EBT3. Depending on the transmission axis of the polarizing sheet, the results are better or worse compared to conventional dosimetry EBT3 film. When the transmission axis of the polarizing sheet is parallel to the coating direction, the dosimetry results are better and its variability is smaller. However, when the polarizer transmission axis is perpendicular to the coating direction, results are worse as well as its variability. CONCLUSION: Using a polarized film with the polarization axis parallel to the coating direction of the radiochromic film, and preferably above it, significantly improves the dosimetry results and is an easy and inexpensive way to correct the lateral artifacts of the conventional EBT3 dosimetry.

A new method to measure electron density and effective atomic number using dual-energy CT images.

The purpose of this work is to present a new method to extract the electron density ([Formula: see text]) and the effective atomic number (Z eff) from dual-energy CT images, based on a Karhunen-Loeve expansion (KLE) of the atomic cross section per electron. This method was used to calibrate a Siemens Definition CT using the CIRS phantom. The predicted electron density and effective atomic number using 80 kVp and 140 kVp were compared with a calibration phantom and an independent set of samples. The mean absolute deviations between the theoretical and calculated values for all the samples were 1.7 % ± 0.1 % for [Formula: see text] and 4.1 % ± 0.3 % for Z eff. Finally, these results were compared with other stoichiometric method. The application of the KLE to represent the atomic cross section per electron is a promising method for calculating [Formula: see text] and Z eff using dual-energy CT images.

Dosimetric characterization of the (60)Co BEBIG Co0.A86 high dose rate brachytherapy source using PENELOPE.

(60)Co sources are being used as an alternative to (192)Ir sources in high dose rate brachytherapy treatments. In a recent document from AAPM and ESTRO, a consensus dataset for the (60)Co BEBIG (model Co0.A86) high dose rate source was prepared by using results taken from different publications due to discrepancies observed among them. The aim of the present work is to provide a new calculation of the dosimetric characteristics of that (60)Co source according to the recommendations of the AAPM and ESTRO report. Radial dose function, anisotropy function, air-kerma strength, dose rate constant and absorbed dose rate in water have been calculated and compared to the results of previous works. Simulations using the two different geometries considered by other authors have been carried out and the effect of the cable density and length has been studied.

Technical note: An algorithm to calculate the tissue phantom ratio from depth dose in radiosurgery.

PURPOSE: To propose a method to calculate the tissue phantom ratio (TPR) using the depth dose and to compare the proposed method with two other methods. METHODS: An analytical dose model from Bjärngard was used to describe the depth dose and the TPR. The parameters of the model were derived from depth dose measurements, which were then used to calculate the TPR. The calculated TPR values were compared with actual measurements as well as with TPR values predicted from two methods that also use depth dose, namely, the method proposed by BrainLAB and the conventional method that sets the quotients of the scatter phantom ratios (Sp) to 1. RESULTS: TPR values calculated from the proposed algorithm deviated by -0.2 +/- 0.1% (mean deviation) from the experimental measurements, over a range of field sizes and depths. CONCLUSIONS: The results of the proposed method were in better agreement with the experimental measurements than were results using the other two methods. Furthermore, the differences between the proposed method and the other methods are statistically significant.

Changes in pulmonary function after incidental lung irradiation for breast cancer: A prospective study.

PURPOSE: The aim of this study was to analyze changes in pulmonary function after radiation therapy (RT) for breast cancer. METHODS AND MATERIALS: A total of 39 consecutive eligible women, who underwent postoperative irradiation for breast cancer, were entered in the study. Spirometry consisting of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), carbon monoxide diffusing capacity (DLCO), and gammagraphic (ventilation and perfusion) pulmonary function tests (PFT) were performed before RT and 6, 12, and 36 months afterwards. Dose-volume and perfusion-weighted parameters were obtained from 3D dose planning: Percentage of lung volume receiving more than a threshold dose (Vi) and between 2 dose levels (V(i-j)). The impact of clinical and dosimetric parameters on PFT changes (Delta PFT) after RT was evaluated by Pearson correlation coefficients and stepwise lineal regression analysis. RESULTS: No significant differences on mean PFT basal values (before RT) with respect to age, smoking, or previous chemotherapy (CT) were found. All the PFT decreased at 6 to 12 months. Furthermore FVC, FEV(1), and ventilation recovered almost to their previous values, whereas DLCO and perfusion continued to decrease until 36 months (-3.3% and -6.6%, respectively). Perfusion-weighted and interval-scaled dose-volume parameters (pV(i-j)) showed better correlation with Delta PFT (only Delta perfusion reached statistically significance at 36 months). Multivariate analysis showed a significant relation between pV(10-20) and Delta perfusion at 3 years, with a multiple correlation coefficient of 0.48. There were no significant differences related to age, previous chemotherapy, concurrent tamoxifen and smoking, although a tendency toward more perfusion reduction in older and nonsmoker patients was seen. CONCLUSIONS: Changes in FVC, FEV1 and ventilation were reversible, but not the perfusion and DLCO. We have not found a conclusive mathematical predictive model, provided that the best model only explained 48% of the variability. We suggest the use of dose-perfused volume and interval-scaled parameters (i.e., pV(10-20)) for further studies.

Dosimetry characterization of 32P intravascular brachytherapy source wires using Monte Carlo codes PENELOPE and GEANT4.

Monte Carlo calculations using the codes PENELOPE and GEANT4 have been performed to characterize the dosimetric parameters of the new 20 mm long catheter-based 32P beta source manufactured by the Guidant Corporation. The dose distribution along the transverse axis and the two-dimensional dose rate table have been calculated. Also, the dose rate at the reference point, the radial dose function, and the anisotropy function were evaluated according to the adapted TG-60 formalism for cylindrical sources. PENELOPE and GEANT4 codes were first verified against previous results corresponding to the old 27 mm Guidant 32P beta source. The dose rate at the reference point for the unsheathed 27 mm source in water was calculated to be 0.215 +/- 0.001 cGy s(-1) mCi(-1), for PENELOPE, and 0.2312 +/- 0.0008 cGy s(-1) mCi(-1), for GEANT4. For the unsheathed 20 mm source, these values were 0.2908 +/- 0.0009 cGy s(-1) mCi(-1) and 0.311 0.001 cGy s(-1) mCi(-1), respectively. Also, a comparison with the limited data available on this new source is shown. We found non-negligible differences between the results obtained with PENELOPE and GEANT4.