Monte Carlo simulations of the relative biological effectiveness for DNA double strand breaks from 300 MeV u(-1) carbon-ion beams.

Monte Carlo simulations are used to calculate the relative biological effectiveness (RBE) of 300 MeV u(-1) carbon-ion beams at different depths in a cylindrical water phantom of 10 cm radius and 30 cm long. RBE values for the induction of DNA double strand breaks (DSB), a biological endpoint closely related to cell inactivation, are estimated for monoenergetic and energy-modulated carbon ion beams. Individual contributions to the RBE from primary ions and secondary nuclear fragments are simulated separately. These simulations are based on a multi-scale modelling approach by first applying the FLUKA (version 2011.2.17) transport code to estimate the absorbed doses and fluence energy spectra, then using the MCDS (version 3.10A) damage code for DSB yields. The approach is efficient since it separates the non-stochastic dosimetry problem from the stochastic DNA damage problem. The MCDS code predicts the major trends of the DSB yields from detailed track structure simulations. It is found that, as depth is increasing, RBE values increase slowly from the entrance depth to the plateau region and change substantially in the Bragg peak region. RBE values reach their maxima at the distal edge of the Bragg peak. Beyond this edge, contributions to RBE are entirely from nuclear fragments. Maximum RBE values at the distal edges of the Bragg peak and the spread-out Bragg peak are, respectively, 3.0 and 2.8. The present approach has the flexibility to weight RBE contributions from different DSB classes, i.e. DSB0, DSB+ and DSB++.

Microdosimetry spectra and relative biological effectiveness of 15 and 30MeV proton beams.

The relative biological effectiveness (RBE) of high-energy protons has been well investigated, but estimates of RBE for lower-energy (<40MeV) protons are scarce. In the present work, measurements were made of the lineal energy spectra using a home-made miniature tissue-equivalent proportional counter for 15 and 30MeV protons from the TR 30/15 cyclotron. Monte Carlo simulations were made for the same spectra using the FLUKA code. These spectra were coupled to several biological models to evaluate the RBE for various biological endpoints.

Ambient and personal dose assessment of a container inspection site using a mobile X-ray system.

Ambient monitor and phantom studies of absorbed and effective doses by TLDs were carried out in a non-intrusive inspection station for containers, Terminal I, of Taichung harbor, Taiwan. The doses from the X-ray scan in the control room and driver waiting room, located outside of the radiation control area, were quite small and could not be distinguished from the natural background radiation. The doses in the driver cab and the inspector cab of the X-ray scan car were also within background radiation levels. The protection wall, a 40-cm thick concrete barrier, can effectively attenuate the intensity of the primary X-ray scan. The possible effective dose of a person in the container or trailer is about 3.15 ± 0.23 µSv/scan and 2.31 ± 0.38 µSv/scan. This dose is below the annual background dose. If someone was to be scanned by the X-ray, the effective dose would be at an acceptable level.

Population dose from medical exposure in Taiwan for 2008.

PURPOSE: The largest contribution to the population dose from man-made ionizing radiation sources is the medical exposure. Exposure to patients from medical examinations is of interest because it is a global indicator for the quality of radiology practice. Due to the different healthcare systems and the considerable variations in the equipment and manpower in radiology, the population dose from medical exposure varies by a large extent in different countries. This dose from different diagnostic procedures provides information that can be used to establish national reference levels. It is also useful to determine the priority in terms of dose reduction so as to optimize the protection of patients in a cost-effective manner. In the present work, the collective effective doses due to different medical modalities were estimated for the Taiwan population in 2008. METHODS: The collective effective dose from medical exposure was calculated using information on the number of procedures and the average effective dose per procedure. The frequency of procedures was extracted from the National Health Insurance (NHI) research database. The enrollment of Taiwan population in the NHI program was 99.48% in 2008. The average effective dose per procedure was derived from hospital surveys, measured data, and published results. RESULTS: Estimates of the collective effective dose were made for different medical modalities, i.e., the conventional radiography and fluoroscopy, computed tomography, interventional fluoroscopy, nuclear medicine, and dental radiography. Each modality was further divided into relevant classes by the body part or organ system. Among 23 037 031 Taiwan population in 2008, the annual examination frequencies per 1000 population were 550, 55.1, 15.6, 13.6, and 112 for the conventional radiography and fluoroscopy, computed tomography, interventional fluoroscopy, nuclear medicine, and dental radiography, respectively. The corresponding collective effective doses were 3277, 8608, 2743, 2303, and 28 man-Sv, respectively. Thus, the average effective dose per caput was 0.74 mSv, which was in the range of 0.3-1.5 mSv for the 12 European countries estimated for 2008. CONCLUSIONS: In the period from 1997 to 2008, the procedure frequency per 1000 population increased by a factor of 2.3 for computed tomography, 2.2 for interventional fluoroscopy, 1.8 for conventional radiography and fluoroscopy, and 1.5 for nuclear medicine. It demonstrated that the medical utilization of imaging facilities raised rapidly.

Population dose from medical diagnostic exposure in Taiwan.

Medical exposure showed a continuous increasing trend. This trend was due to the growth of diagnostic procedures such as computed tomography (CT) and interventional fluoroscopy (IVF). In the present work, results of a recent study on medical exposure in Taiwan are reported. This study analysed data from the National Health Insurance Research Database. Surveyed data on the dose indices, including the entrance surface dose in radiography, dose area product in fluoroscopy, CT dose index in CT and mean glandular dose in mammography, were applied. Using programmes and databases, dose indices were converted to the effective dose. For the year 2008, individual effective doses in Taiwan were estimated as 0.16, 0.37, 0.12 and 0.12 mSv for conventional radiography and fluoroscopy, CT, IVF and nuclear medicine, respectively. The total collective effective dose and the effective dose per individual for medical exposure were 17 788 person-Sv and 0.77 mSv, respectively.

Determination of voxel phantom for reference Taiwanese adult from CT image analyses.

The International Commission on Radiological Protection Publication 103 recommended that ionising radiation doses should be assessed based on voxel phantoms. An anthropomorphic voxel phantom for the Reference Taiwanese Adult was built from analyses of computed tomography (CT) images. Thirty representative adult individuals were selected from normal patients in the hospital, with body mass index between 19.6 and 25.6 for males and 18.8 and 27.0 for females and body height between 163 and 175 cm for males and 152 and 162 cm for females. The Reference Taiwanese Adult was determined from these individuals by analysing their CT images for parameters characterising the size, position and orientation of several organs. Analysed parameters included the volume, surface area, major and minor axes, mean chord length, position relative to the body centre, and orientation with respect to the body axis, for liver, spleen, kidney, stomach, gallbladder and bladder. The person with the highest score was designated the Reference Taiwanese Adult.

Cellular dosimetry and microdosimetry for internal electron emitters.

Radiobiological descriptions of cellular dosimetry and microdosimetry require both radiation dose and radiation quality. The lineal energy, defined as a ratio of the energy deposition by a particle in the biological target and the mean chord length of this target, is generally adopted to characterise the radiation quality. Most microdosimetry applications assume that the cell nucleus is the target region. Therefore, the lineal energy is obtained for the source (S) to target (T) geometry, T ← S, where S = cell surface, cytoplasm, cell nucleus and T = cell nucleus. The definition of lineal energy is based on the approximation that the particle mean pathlength is equal to target mean chord length. This approximation is valid for crossers of external irradiations. In the case of starters, insiders and stoppers of internal sources, particle pathlengths are always shorter than target chord lengths. Thus, the lineal energy does not reflect the specific energy deposition along particle path. In the present work, the specific energy deposition in a target is calculated using three distance parameters, i.e. target mean chord length, particle mean pathlength in the target and particle individual pathlength in the target. Monte Carlo calculations are performed for electrons of various energies and cells of different sizes. Results are analysed and discussed.

The evaluation of 6 and 18 MeV electron beams for small animal irradiation.

A small animal irradiator is critical for providing optimal radiation dose distributions for pre-clinical animal studies. This paper focuses on the evaluation of using 6 or 18 MeV electron beams as small animal irradiators. Compared with all other prototypes which use photons to irradiate small animals, an electron irradiator has many advantages in its shallow dose distribution. Two major approaches including simulation and measurement were used to evaluate the feasibility of applying electron beams in animal irradiation. These simulations and measurements were taken in three different fields (a 6 cm x 6 cm square field, and 4 mm and 30 mm diameter circular fields) and with two different energies (6 MeV and 18 MeV). A PTW Semiflex chamber in a PTW-MP3 water tank, a PTW Markus chamber type 23343, a PTW diamond detector type 60003 and KODAK XV films were used to measure PDDs, lateral beam profiles and output factors for either optimizing parameters of Monte Carlo simulation or to verify Monte Carlo simulation in small fields. Results show good agreement for comparisons of percentage depth doses (

Microdosimetry study of THOR BNCT beam using tissue equivalent proportional counter.

Boron neutron capture therapy (BNCT) is a cancer treatment modality using a nuclear reactor and a boron compound drug. In Taiwan, Tsing Hua open-pool reactor (THOR) has been modulated for the basic research of BNCT for years. A new BNCT beam port was built in 2004 and used to prepare the first clinical trial in the near future. This work reports the microdosimetry study of the THOR BNCT beam by means of the tissue equivalent proportional counter (TEPC). Two self-fabricated TEPCs (the boron-doped versus the boron-free counter wall) were introduced. These dual TEPCs were applied to measure the lineal energy distributions in air and water phantom irradiated by the THOR BNCT mixed radiation field. Dose contributions from component radiations of different linear energy transfers (LETs) were analyzed. Applying a lineal energy dependent biological weighting function, r(y), to the total and individual lineal energy distributions, the effective relative biological effectiveness (RBE), neutron RBE, photon RBE, and boron capture RBE (BNC RBE) were all determined at various depths of the water phantom. Minimum and maximum values of the effective RBE were 1.68 and 2.93, respectively. The maximum effective RBE occurred at 2cm depth in the phantom. The average neutron RBE, photon RBE, and BNC RBE values were 3.160+/-0.020, 1.018+/-0.001, and 1.570+/-0.270, respectively, for the THOR BNCT beam.

Assessment of dose rate scaling factors used in NCTPlan treatment planning code for the BNCT beam of THOR.

Tsing Hua open-pool reactor (THOR) at Tsing Hua University in Taiwan has been used to investigate the feasibility and to enhance the technology of boron neutron capture therapy (BNCT) for years. A rebuilt epithermal beam port for BNCT at THOR was finished in the summer of 2004, and then researches and experiments were performed to hasten the first clinical treatment case of BNCT in Taiwan in the near future. NCTPlan, a Monte Carlo-based clinical treatment planning code, was used to calculate the dose-rate distributions of BNCT in this work. A self-made Snyder head phantom with a servo-motor control system was irradiated in front of the THOR BNCT beam exit. The phantom was made from a 3mm shell of quartz wool impregnated with acrylic casting resin mounted on an acrylic base, and was filled with water. Gold foils (bare and cadmium-covered) and paired ion chambers (one with graphite wall and filled with CO(2) gas, another with A-150 plastic tissue equivalent wall and filled with tissue equivalent gas) were placed inside the Snyder phantom to measure and estimate the depth-dose distributions in the central axis of the beam. Dose components include the contribution of thermal neutrons, fast neutrons, photons and emitted alpha particles from (10)B(n,alpha)(7)Li reaction. Comparison and analysis between computed and measured results of depth-dose distributions were made in this work. Dose rate scaling factors (DRSFs) were defined as normalization factors derived individually for each dose component in the BNCT in-phantom radiation field that provide the best agreement between measured and computed data. This paper reports the in-phantom calculated and experimental dosimetry and the determined DRSFs used in NCTPlan code for the BNCT beam of THOR.

Survey of computed tomography scanners in Taiwan: dose descriptors, dose guidance levels, and effective doses.

The IAEA and the ICRP recommended dose guidance levels for the most frequent computed tomography (CT) examinations to promote strategies for the optimization of radiation dose to CT patients. A national survey, including on-site measurements and questionnaires, was conducted in Taiwan in order to establish dose guidance levels and evaluate effective doses for CT. The beam quality and output and the phantom doses were measured for nine representative CT scanners. Questionnaire forms were completed by respondents from facilities of 146 CT scanners out of 285 total scanners. Information on patient, procedure, scanner, and technique for the head and body examinations was provided. The weighted computed tomography dose index (CTDI(w)), the dose length product (DLP), organ doses and effective dose were calculated using measured data, questionnaire information and Monte Carlo simulation results. A cost-effective analysis was applied to derive the dose guidance levels on CTDI(w) and DLP for several CT examinations. The mean effective dose +/- standard deviation distributes from 1.6 +/- 0.9 mSv for the routine head examination to 13 +/- 11 mSv for the examination of liver, spleen, and pancreas. The surveyed results and the dose guidance levels were provided to the national authorities to develop quality control standards and protocols for CT examinations.

In vivo dosimetry for external photon treatments of head and neck cancers by diodes and TLDS.

In vivo dosimetry was implemented for treatments of head and neck cancers in the large fields. Diode and thermoluminescence dosemeter (TLD) measurements were carried out for the linear accelerators of 6 MV photon beams. ESTRO in vivo dosimetry protocols were followed in the determination of midline doses from measurements of entrance and exit doses. Of the fields monitored by diodes, the maximum absolute deviation of measured midline doses from planned target doses was 8%, with the mean value and the standard deviation of -1.0 and 2.7%. If planned target doses were calculated using radiological water equivalent thicknesses rather than patient geometric thicknesses, the maximum absolute deviation dropped to 4%, with the mean and the standard deviation of 0.7 and 1.8%. For in vivo dosimetry monitored by TLDs, the shift in mean dose remained small but the statistical precision became poor.

Calculations of cellular microdosimetry parameters for alpha particles and electrons.

The cellular microdosimetry parameters including the cellular S-value and the single-event specific energy distribution for alpha particles and electrons are important in radiation dosimetry and biology. These parameters may be used to determine the relative biological effectiveness of radiations in the boron neutron capture therapy. In the present work, such parameters were calculated for different source to target region combinations, i.e. cell surface, cytoplasm, nucleus and cell. Calculations were made using a semi-analytical model that simulated the emission of alpha particles or electrons by the Monte Carlo method and calculated the energy imparted to the target volume by the analytical method. Delta particle equilibrium and partial delta particle equilibrium were applied to alpha particles and electrons, respectively. Range-energy relations were employed to determine the incident and emerging energies of the primary particles. For electrons, the fraction in the energy loss resulting from the generation of bremsstrahlung and high-energy secondary electrons was estimated. The energy loss straggling of electrons entering and leaving a target volume was also estimated. Calculated cellular S-values were compared to corresponding data of the MIRD Committee. Calculated single-event specific energy distributions were also compared to results calculated using the Penelope code.

Characteristics of the new THOR epithermal neutron beam for BNCT.

A characterization of the new Tsing Hua open-pool reactor (THOR) epithermal neutron beam designed for boron neutron capture therapy (BNCT) has been performed. The facility is currently under construction and expected in completion in March 2004. The designed epithermal neutron flux for 1 MW power is 1.7x10(9)n cm(-2)s(-1) in air at the beam exit, accompanied by photon and fast neutron absorbed dose rates of 0.21 and 0.47 mGys(-1), respectively. With (10)B concentrations in normal tissue and tumor of 11.4 and 40 ppm, the calculated advantage depth dose rate to the modified Snyder head phantom is 0.53RBE-Gymin(-1) at the advantage depth of 85 mm, giving an advantage ratio of 4.8. The dose patterns determined by the NCTPlan treatment planning system using the new THOR beam for a patient treated in the Harvard-MIT clinical trial were compared with results of the MITR-II M67 beam. The present study confirms the suitability of the new THOR beam for possible BNCT clinical trials.

Dose-rate scaling factor estimation of THOR BNCT test beam.

In 1998, an epithermal neutron test beam was designed and constructed at the Tsing Hua Open-Pool Reactor (THOR) for the purpose of preliminary dosimetric experiments in boron neutron capture therapy (BNCT). A new epithermal neutron beam was designed at this facility, and is currently under construction, with clinical trials targeted in late 2004. Depth dose-rate distributions for the THOR BNCT test beam have been measured by means of activation foil and dual ion chamber techniques. Neutron and structure-induced gamma spectra measured at the test beam exit were configured into a source function for the Monte Carlo-based treatment planning code NCTPlan. Dose-rate scaling factors (DRSFs) were determined to normalize computationally derived dose-rate distributions with experimental measurements in corresponding mathematical and physical phantoms, and to thus enable accurate treatment planning using the NCTPlan code. A similar approach will be implemented in characterizing the new THOR epithermal beam in preparation for clinical studies. This paper reports the in-phantom calculated and experimental dosimetry comparisons and derived DRSFs obtained with the THOR test beam.

Microdosimetric spectra of the THOR neutron beam for boron neutron capture therapy.

A primary objective of the BNCT project in Taiwan, involving THOR (Tsing Hua Open Pool Reactor), was to examine the potential treatment of hepatoma. To characterise the epithermal neutron beam in THOR, the microdosimetry distributions in lineal energy were determined using paired tissue-equivalent proportional counters with and without boron microfoils. Microdosimetry results were obtained in free-air and at various depths in a PMMA phantom near the exit of the beam port. A biological weighting function, dependent on lineal energy, was used to estimate the relative biological effectiveness of the beam. An effective RBE of 2.7 was found at several depths in the phantom.

Dose reconstruction for residents living in buildings with moderate and minor 60Co contamination in rebar.

Previously, we have reconstructed cohort dependent individual doses for residents living in rebar buildings of high 60Co contamination. These reconstructions were carried out using intensively collected TLD data on exposure rates at locations of 1 m height and 1 m x 1 m intersections. The present work deals with dose reconstructions for residents living in rebar buildings of moderate and minor 60Co contamination. Since only limited data on exposure rates from survey meters were available, dose reconstructions were based on these data using interpolations. To utilize such data, we examined them with respect to all factors that influenced the dose uncertainties. The interpolated results were given in terms of contour plots (isodose curves) and compared with corresponding results derived from TLD data and Monte Carlo simulations. The comparison revealed that survey meter data could be used to provide reasonable and conservative estimates of residential doses. By applying the cohort-dependent room occupancy factor and the site-dependent area occupancy factor, we reconstructed cohort dependent individual doses and associated uncertainties. Results of dose reconstructions for all residents living in contaminated rebar buildings were provided to the Atomic Energy Council and health authorities for epidemiologic and medical uses.

Analyses and applications of single scan dose profiles in computed tomography.

Comprehensive analyses and measurements of computed tomography (CT) single-scan dose profiles were performed for several scanners and operating conditions. Measurements were made using two types of thermoluminescent dosimeters, LiF:Mg,Cu,P and CaSO4:Dy, and two CT dosimetry phantoms, head and body. Analyses of CT single-scan dose profiles were made in terms of a Gaussian function for primary radiation and a Lorentzian function for scattered radiation. This function was used to investigate several common descriptions of the CT dose, including the computed tomography dose index (CTDI) and the multiple scan average dose. The relative percentage of scatter versus primary radiation to the contribution of CTDI at the central and peripheral locations was determined and analyzed. The correlation between CTDI of thermoluminescent dosimeter measurements and pencil-shaped ionization chamber measurements was determined. A method for estimating organ dose from CT was developed and compared to organ-dose estimates from Monte Carlo simulations.

Determination of guidance levels of dose for diagnostic radiography in Taiwan.

The International Atomic Energy Agency has recommended guidance levels of dose for diagnostic radiography for a typical adult patient. These levels were intended to act as thresholds to trigger investigations or corrective actions in ensuring optimized protection of patients and maintaining appropriate levels of good practice. Since guidance levels should be derived from wide scale surveys of exposure factors performed in individual hospitals, a national survey was conducted recently in Taiwan to collect these factors for the most frequent radiographic procedures. A total of 276 completed questionnaires were received and analyzed. In the questionnaire, respondents were asked to check those projections that were routinely performed in their department and to report machine data, patient data, output measurements, and technical factors including kVp, mAs, focus-to-film distance, table-to-film distance, aluminum filtration, and focal spot size. Based on the survey data, entrance skin exposures in air, i.e., free air exposures at the point of intersection of the x-ray central beam with the entrance surface of the patient, were estimated using the RADCOMP program. Entrance surface doses to air and tissue with backscatter were then evaluated by the application of the exposure-dose conversion factor and the backscatter factor obtained from TLD measurements and Monte Carlo simulations. Guidance levels were determined from survey results on the entrance surface dose based on optimization considerations involving the cost-effectiveness analysis. Except for chest PA and LAT and skull LAT procedures, all guidance levels derived in this work are less than those recommended by the International Atomic Energy Agency. Survey data and guidance levels were provided to the national authorities to help them develop quality control and radiation protection programs for medical exposures.

Evaluations of gonad and fetal doses for diagnostic radiology.

A national survey of patient doses for diagnostic radiology was planned in the Republic of China. We performed a pilot study for this survey to develop a protocol of the dose assessments. Entrance skin doses and organ (including ovary, testicle and uterus) doses were measured by thermoluminescent dosimeters and calculated by means of Monte Carlo simulations for several diagnostic procedures. We derived a formula and used the RadComp software for the computation of entrance skin doses. This formula involves several factors, such as kVp, mAs, the focus-to-skin-distance and aluminum filtration. RadComp software was applied to obtain free-air entrance exposures which were converted to entrance skin doses by considering the backscattering radiation from the body. Organ doses were measured using a RANDO phantom and calculated using a mathematical phantom for several diagnostic examinations. Genetically significant doses were calculated from ovary and testicle doses for the evaluation of hereditary effects. Embryo/fetal doses were determined from the uterine doses by considering the increase in uterus size with gestational age. We found that the patient doses studied in this work were all below the reference doses recommended by the National Radiological Protection Board of the U.K.