RESUMO
PURPOSE: The IAEA newly developed "end-to-end" audit methodology for on-site verification of IMRT dose delivery has been carried out in Portugal in 2018. The main goal was to evaluate the physical aspects of the head and neck (H&N) cancer IMRT treatments. This paper presents the national results. METHODS: All institutions performing IMRT treatments in Portugal, 20 out of 24, have voluntarily participated in this audit. Following the adopted methodology, a Shoulder, Head and Neck End-to-End phantom (SHANE) - that mimics an H&N region, underwent all steps of an IMRT treatment, according to the local practices. The measurements using an ionization chamber placed inside the SHANE phantom at four reference locations (three in PTVs and one in the spinal cord) and an EBT3 film positioned in a coronal plane were compared with calculated doses. FilmQA Pro software was used for film analysis. RESULTS: For ionization chamber measurements, the percent difference was within the specified tolerances of ±5% for PTVs and ±7% for the spinal cord in all participating institutions. Considering film analysis, gamma passing rates were on average 96.9%±2.9% for a criterion of 3%/3 mm, 20% threshold, all above the acceptance limit of 90%. CONCLUSIONS: The national results of the H&N IMRT audit showed a compliance between the planned and the delivered doses within the specified tolerances, confirming no major reasons for concern. At the same time the audit identified factors that contributed to increased uncertainties in the IMRT dose delivery in some institutions resulting in recommendations for quality improvement.
Assuntos
Auditoria Clínica , Radioterapia de Intensidade Modulada/normas , Imagens de Fantasmas , Portugal , Planejamento da Radioterapia Assistida por Computador , Tomografia Computadorizada por Raios XRESUMO
This work describes an investigation of mercury contamination in an abandoned gold mining site in the rural area of Descoberto, Minas Gerais, Brazil, whose inhabitants have reported "silver balls" present in the soil. Different granulometric fractions of soil samples and sedimented material from rainwater retention tanks in this area were analyzed for total mercury, organic matter, and mercury speciation by thermodesorption/atomic absorption spectrometry. The results showed mercury concentrations in the soils in the range of (0.0371-161) mg kg(-1), and the occurrence of Hg(0) oxidation. Some samples had concentrations as high as 90 mg kg(-1) with the majority as Hg(2+), which is important information in order to understand the biogeochemical behavior of mercury in contaminated sites and to apply the appropriate remediation technology. The retention boxes and tank samples showed that fine particles with high mercury content (3.3-90) mg kg(-1) are leached from the contaminated area, which reveals the need for efficient control of this material to prevent the contamination of stream waters. This study is an example that may be useful for other contaminated sites.