Investigation of applicability of alanine and radiochromic detectors to dosimetry of proton clinical beams.

Cancer therapy studies using proton accelerators are underway in several major medical centers in the U.S., Russia, Japan and elsewhere. To facilitate dosimetry intercomparisons between these laboratories, alanine-based detectors produced at the National Institute of Standards and Technology and commercially available radiochromic films were studied for their possible use as passive transfer dosimeters for clinical proton beams. Evaluation of characteristics of these instruments, including the LET dependence of their response of proton energy, was carried out at the Institute of Theoretical and Experimental Physics. Results of absolute dose measurements were regarded as a preliminary step of dose intercomparison between ITEP and NIST. Measurements made in a number of experiments showed average agreement between the ITEP and NIST dosimetry standards to 2.5%.

The use of a radiochromic detector for the determination of stereotactic radiosurgery dose characteristics.

The measurement of absorbed dose as well as dose distributions (profiles and isodose curves) for small radiation fields (as encountered in stereotactic surgery) has been difficult due to the usual large detector size or densitometer aperture (> 1 mm) relative to the radiation field (as small as 4 mm). The radiochromic direct-imaging film, when read with a scanning laser microdensitometer (laser beam diameter 0.1 mm), overcomes this difficulty and has advantages over conventional film in providing improved precision, better tissue equivalence, greater dynamic range, higher spatial resolution, and room light handling. As a demonstration of suitability, the calibrated radiochromic film has been used to measure the dose characteristics for the 18-, 14-, 8-, and 4-mm fields from the gamma-ray stereotactic surgery units at Mayo Clinic and the University of Pittsburgh. Intercomparisons of radiochromic film with conventional methods of dosimetry and vendor-supplied computational dose planning system values indicate agreement to within +/- 2%. The dose, dose profiles, and isodose curves obtained with radiochromic film can provide high-spatial-resolution information of value for acceptance testing and quality control of dose measurement and/or calculation.

A radiation accident at an industrial accelerator facility.

On 11 December 1991, a radiation overexposure occurred at an industrial radiation facility in Maryland. The radiation source was a 3-MV potential drop accelerator designed to produce high electron beam currents for materials-processing applications. This accelerator is capable of producing a 25 milliampere swept electron beam that is scanned over a width of 112.5 cm and which emerges from the accelerator vacuum system through a titanium double window assembly. During maintenance on the lower window pressure plate, an operator placed his hands, head, and feet in the beam. This was done with the filament voltage of the electron source turned "off," but with the full accelerating potential on the high voltage terminal. The operator's body, especially his extremities and head, were exposed to electron dark current. In an attempt to reconstruct the accident, radiochromic film and alanine measurements were made with the accelerator operated at two beam currents. Measured dose rates ranged from approximately 40 cGy s-1 inside the victim's shoe to 1,300 cGy s-1 at the hand position. Approximately 3 mo after the accident, it was necessary to amputate the four digits of the victim's right hand and most of the four digits of his left hand. Electron paramagnetic resonance spectrometry, which measures the concentration of radiation-induced paramagnetic centers in calcified tissues, was used to estimate the dose to the victim's extremities. A mean dose estimate of 55.0 +/- 3.5 Gy (95% confidence level) averaged over the mass of the bone was obtained for the victim's left middle finger (middle phalanx).

New method for shielding electron beams used for head and neck cancer treatment.

Shields and stents of metals with high atomic number, which are custom cast in molds from the melt, are the materials most widely used to protect surrounding tissues during treatment of skin or oral lesions with therapeutic electron beams. An improved fabrication method is to mix a polysiloxane-metal composite, which is readily cast at room temperature by combining a metal-powder/polysiloxane resin mixture with a hardening catalyst. The purpose of the present study is to compare the shielding effectiveness of two different metal-polysiloxane composites with that of conventional cast Lipowitz metal (50.1% Bi, 26.6% Pb, 13.3% Sn, 10% Cd). Also, a 2(3) factorial experiment was run to investigate the effects and interactions of metal particle size (20-microns vs 100-microns diameter), the atomic weight of the metal (304 stainless steel vs 70% Ag, 30% Cu alloy), and the presence or absence of a layer of unfilled polymer added to the forward-scatter side of the shield. The composites of different thicknesses were made by blending 90% (w/w) metal powder separately with 10% polysiloxane base and catalyst. A thin GafChromic dosimeter film was placed between the shielding material and a polystyrene base to measure the radiation shielding effect of composite disc samples irradiated with a 6-MeV electron beam normal to the flat surface of the disc. The results show that composite shields with the metal of higher atomic weight and density (Ag-Cu) combined with an additional unfilled layer are more effective than the stainless-steel composite with a similar additional unfilled layer, in terms of diminishing the dose at the surface of the polystyrene backing material.(ABSTRACT TRUNCATED AT 250 WORDS)

Photon energy dependence of the sensitivity of radiochromic film and comparison with silver halide film and LiF TLDs used for brachytherapy dosimetry.

There is a new radiochromic film, a highly uniform, thin (100-microns) detector whose sensitive layer (6 microns thick) changes from colorless to blue by dye polymerization without processing, upon exposure to ionizing radiation. Because the dose gradients around brachytherapy sources are steep, the high spatial resolution offered by film dosimetry is an advantage over other detectors such as thermoluminescent dosimeters (TLDs). This compares the photon energy dependence of the sensitivities of GafChromic film, silver halide verification film (Kodak X-Omat V Film), and lithium fluoride TLDs (Harshaw), over the photon energy range 28 keV to 1.7 MeV, which is of interest in brachytherapy. Sensitivity of the radiochromic film is observed to decrease by about 30% as effective photon energy decreases from 1710 keV (4-MV x rays) to 28 keV (60-kV x rays, 2-mm A1 filter). In contrast, the sensitivity of verification film increases by 980% and that of LiF TLDs increases by 41%. The variation of the sensitivity of radiochromic film with photon energy is considerably less than that for silver halide film and similar to that for LiF TLDs, but in the opposite direction. Radiochromic film, like LIF TLDs, does not exhibit the drastic sensitivity changes below 127 keV that silver halide film exhibits. Dose distribution in the immediate vicinity of a high activity (370 GBq) brachytherapy 192Ir source has been mapped using radiochromic film and is presented to illustrate the applicability of this new technology to brachytherapy dosimetry.

Metal-polysiloxane shields for radiation therapy of maxillo-facial tumors.

In the treatment of some head and neck lesions with high-intensity radiation (teletherapy), an essential procedure is the application of an individually customized shielding appliance, which is designed, modeled, and formed into a working extra- or intraoral stent for the purpose of sparing healthy tissues. The present state of the art is slow and technique intensive, which can add to patient discomfort and inconvenience during molding and fabrication. A new formulation is described, which offers speed and ease of forming a moldable composite stent especially for intraoral use. Interleaved stacks of calibrated thin radiochromic film strips and soft-tissue-simulating plastic (polystyrene) layers gave a means of mapping one- or two-dimensional profiles of dose distributions adjacent to the high-density shielding materials using a spectrophotometer equipped with a gel scanner or a scanning laser-beam microdensitometer. Tests using collimated gamma-ray beams from a 60Co teletherapy unit were made in order to measure the dose distribution near interfaces of tissue-simulating polymer and the composite stent material with and without mixtures of metals (Ag-Cu and Sn-Sb). These results show that quickly formed composites made of a flexible resin with high concentrations of powdered spherical metal alloys provide effective custom-designed shielding, and, with a thin overlayer of the resin without metal, a diminished back-scattered radiation dose to normal tissues. An example of a successful formulation is a mixture of 90% by weight Ag-Cu alloy powder in a vinyl polysiloxane resin. This material is a moldable putty which, upon polymerization, forms a rigid elastomeric material, providing a half-value layer of approximately 2.5 to 2.8 cm for a gamma-ray beam from a 60Co source.

Measurement of absorbed doses near metal and dental material interfaces irradiated by x- and gamma-ray therapy beams.

Soft-tissue damage adjacent to dental restorations is a deleterious side effect of radiation therapy which is associated with low-energy electron scatter from dental materials of high electron density. This study was designed to investigate the enhancement of dose to soft tissue (or water) close to high electron-density materials and to measure the detailed lateral and depth-dose profiles in soft-tissue-simulating polymer adjacent to planar interfaces of several higher atomic-number materials: 18-carat gold dental casting alloy; Ag-Hg dental amalgam alloy; Ni-Cr dental casting alloy; and natural human tooth structure. Interleaved stacks of calibrated thin radiochromic dosimeter films and tissue-simulating polymer were used for these measurements. Assemblies of these polymer-dosimeter stacks on both sides of the dental materials were irradiated in one fixed direction by collimated 60Co gamma-ray or 10 MV x-ray beams directed perpendicularly to the material interfaces. In another test, designed to simulate more closely therapeutic treatment conditions, a phantom constructed on both sides of a row of restored and unrestored whole teeth (restoration materials: gold alloy crown; Ni-Cr alloy crown; Ag-Hg mesial-occlusal-distal (MOD) amalgam filling; unrestored tooth) was irradiated in one fixed direction by the collimated photon beams. Results indicate that the dose-enhancement in 'tissue' is as great as a factor of 2 on the backscatter side adjacent to gold and a factor of 1.2 adjacent to tooth tissue, but is insignificant on the forward-scatter side because of the predominant effect of attenuation by the high-density, high atomic-number absorbing material.

Paraurethral vaginal leiomyoma.

A case of paraurethral vaginal leiomyoma becoming clinically apparent in the postpartum period is presented. As is frequently the case, the diagnosis was not apparent. Urinary tract origin is commonly suspected, since the majority of these tumors occur in the midline of the anterior vaginal wall. The tumors are often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. Pathologically, they are well circumscribed and have the typical microscopic features of leiomyomas found elsewhere. Simple excision is usually adequate treatment.

Drug activation by gamma irradiation: a new direction for molecular design. Part I: In vitro and in vivo studies of a substituted polyaminoaryl nitrile.

The disodium salt of 4-diethyl aminophenyl-4',4''-bis(3-sulfobenzyl ethyl aminophenyl)acetonitrile was made and studied. It was found to release cyanide lineraly with exposure to ionizing radiation. When administered ip to mice, it was absorbed in significant amounts and retained its ability to cleave upon irradiation. Based upon this, we gathered evidence and proposed that it is feasible to design a non-toxic compound which when exposed to ionizing radiation would yield predictable reactive end products that would remain localized and augment the effects of irradiation upon a neoplasm.