A dosimetric study of prostate brachytherapy using Monte Carlo simulations with a voxel phantom, measurements and a comparison with a treatment planning procedure.

In prostate brachytherapy treatments, there is an initial swelling of the prostate of the patient due to an oedema related to the insertion of the seeds. The variation of the prostate volume can lead to variations in the final prescribed dose in treatment planning procedures. As such, it is important to understand their influence for dose optimisation purposes. This work reports on a dosimetric study of the swelling of the prostate in prostate brachytherapy using Monte Carlo simulations. Dosimetric measurements performed on a physical anthropomorphic tissue-equivalent prostate phantom and thermoluminescent dosimeters (TLDs) were used to validate the MC model. Finally the MC model was also used to simulate prostate swelling in a real treatment planning procedure. The obtained results indicate that the parameters mentioned above represent a source of uncertainty in dose assessment in prostate brachytherapy, and can be detrimental to a correct dose evaluation in treatment plannings, and that these parameters can be accurately determined by means of MC simulations with a voxel phantom.

Application of digital image processing for the generation of voxels phantoms for Monte Carlo simulation.

This paper presents the application of a computational methodology for optimizing the conversion of medical tomographic images in voxel anthropomorphic models for simulation of radiation transport using the MCNP code. A computational system was developed for digital image processing that compresses the information from the DICOM medical image before it is converted to the Scan2MCNP software input file for optimization of the image data. In order to validate the computational methodology, a radiosurgery treatment simulation was performed using the Alderson Rando phantom and the acquisition of DICOM images was performed. The simulation results were compared with data obtained with the BrainLab planning system. The comparison showed good agreement for three orthogonal treatment beams of (60)Co gamma radiation. The percentage differences were 3.07%, 0.77% and 6.15% for axial, coronal and sagital projections, respectively.

Percentage depth dose evaluation in heterogeneous media using thermoluminescent dosimetry.

The purpose of this study is to investigate the influence of lung heterogeneity inside a soft tissue phantom on percentage depth dose (PDD). PDD curves were obtained experimentally using LiF:Mg,Ti (TLD-100) thermoluminescent detectors and applying Eclipse treatment planning system algorithms Batho, modified Batho (M-Batho or BMod), equivalent TAR (E-TAR or EQTAR), and anisotropic analytical algorithm (AAA) for a 15 MV photon beam and field sizes of 1 x 1, 2 x 2, 5 x 5, and 10 x 10 cm 2 . Monte Carlo simulations were performed using the DOSRZnrc user code of EGSnrc. The experimental results agree with Monte Carlo simulations for all irradiation field sizes. Comparisons with Monte Carlo calculations show that the AAA algorithm provides the best simulations of PDD curves for all field sizes investigated. However, even this algorithm cannot accurately predict PDD values in the lung for field sizes of 1 x 1 and 2 x 2 cm 2 . An overdosage in the lung of about 40% and 20% is calculated by the AAA algorithm close to the interface soft tissue/lung for 1 x 1 and 2 x 2 cm 2 field sizes, respectively. It was demonstrated that differences of 100% between Monte Carlo results and the algorithms Batho, modified Batho, and equivalent TAR responses may exist inside the lung region for the 1 x 1 cm 2 field.

Photon doses at the entrance of 60Co and low-energy medical accelerator rooms under unusual irradiation conditions.

In this paper, the general-purpose Monte Carlo code MCNP5 was used to study the dose variance due to the position of medical linear accelerators, under unusual conditions, for shielding design of radiotherapy facilities. It was found that the computational methods generally used to estimate the scattered photon doses at the entrance of radiotherapy unit vaults provide conservative results when compared with the MCNP results, considering the standard condition. On the other hand, for the situations where the axis of gantry rotation is redirected at, for example, 45 degrees with respect to the walls of the room, the photon doses at the entrance can reach values up to seven times higher than those obtained under the standard condition, depending on the energy of the primary beam.

Radiometric survey of teletherapy treatment rooms in Brazil.

The Brazilian national regulatory authority, National Commission of Nuclear Energy, requires that dose rates in the vicinity of teletherapy treatment rooms do not exceed the permissible limits for workers as well as members of the public, depending on the place considered. At the end of 2005, the Brazilian national regulatory authority reduced the permissible dose limit for controlled areas from 1000 to 400 microSv week(-1). Therefore, the aim of this work is to verify the adequacy of structural shielding to this new limit for telecobalt units that had their sources changed and clinic linear accelerators (ALs) installed before the end of 2005. Considering the ALs, measurements of dose rates in controlled areas did not exceed the new permissible limit, excepting for a single case. In the case of (60)Co units, a similar situation is observed for controlled areas, although several non-conformities to the limit of uncontrolled area could be observed.

The effects of the Brazilian regulatory inspection programme on nuclear medicine facilities.

This paper aims to demonstrate the importance of the regulatory inspections carried out by the Brazilian regulatory body in the area of nuclear medicine. The main aspects observed during the inspections are presented as well as the time evolution of the non-compliances, according to their occurrence by type. We also evaluate factors concerning the working of the nuclear medicine facility responsible for solving the non-compliances. The results suggest a decrease of occurrence of non-compliances with time that can be related to the strictness of the inspections and the awareness of the personnel in the nuclear medicine facilities. An analysis of radiation dose exposure levels for the professionals involved in nuclear medicine was carried out; although dose values are below regulatory dose limits, their occurrence is not decreasing satisfactorily. Results indicate the need for staff training and commitment of the responsible nuclear medicine facility staff to the radiological protection procedures. Our results also emphasise the importance of continuous coercive actions to improve the level of radiological protection in nuclear medicine facilities in compliance with the standards established by the national regulatory authority and international recommendations.

On the production of neutrons in laminated barriers for 10 MV medical accelerator rooms.

When space limitations are primary constraints, laminated barriers with metals can be an option to provide sufficient shielding for a radiotherapy treatment room. However, if a photon clinical beam with end point energy of 10 MeV or higher interacts with the metal inside the barriers neutrons are ejected and can result in an exposure problem inside and outside the vault. The empirical formulae existing in the literature to estimate neutron dose equivalents beyond laminated barriers do not take into account neutron production for spectra below 15 MV. In this work, the Monte Carlo code MCNP was used to simulate the production and transport of photoneutrons across primary barriers of 10 MV accelerator treatment rooms containing lead or steel, in order to obtain the ambient dose equivalents produced by these particles outside the room and in the patient plane. It was found that the neutron doses produced are insignificant when steel is present in the primary barriers of 10 MV medical accelerators. On the other hand, the results show that, in all cases where lead sheets are positioned in the primary barriers, the neutron ambient dose equivalents outside the room generally exceed the shielding design goal of 20 microSv/week for uncontrolled areas, even when the lead sheets are positioned inside the treatment room. Moreover, for laminated barriers, the photoneutrons produced in the metals are summed with the particles generated in the accelerator head shielding and can represent a significant component of additional dose to the patients. In this work, it was found that once lead sheets are positioned inside the room, the neutron ambient dose equivalents can reach the value of 75 microSv per Gray of photon absorbed dose at the isocenter. However, for all simulated cases, a tendency in the reduction of neutron doses with increasing lead thickness can be observed. This trend can imply in higher neutron ambient dose equivalents outside the room for thinner lead sheets. Therefore, when a medical accelerator treatment room is designed with laminated barriers to receive equipment with an end point energy equal to or higher than 10 MeV, not only the required shielding thickness for photon radiation attenuation should be considered, but also the dose due to photoneutrons produced in the metal, which may involve an increase of the lead thickness or even the use of neutron shielding.

Dosimetric audits of photon beams in radiation therapy centres in Rio de Janeiro, Brazil.

Data related to 11 y of high-energy photon radiotherapy beam dosimetry are presented and analysed. Dosimetric evaluations were carried out using water phantoms and thimble ionisation chambers and are part of the radiation protection regulatory licensing process for medicine facilities of Brazilian government. Measurements were done at reference conditions for a standard absorbed dose of 100 cGy [cGy (=1 rad)]. The absolute per cent deviation between the measured and presumed delivered doses should not exceed the tolerance level of +/-3%. The first dosimetry survey from 1996 to 1998 showed a situation that was an object of concern. Deviations of 22 and 18.7% could be measured, although small deviations were also obtained. After 1998, the improvement in dosimetry quality control by the radiotherapy centres became clear, with most of the deviations situated within the +/-3% range. The decrease in the measured deviations presents the effective success of the Institute of Radiation Protection and Dosimetry audit programme for the improvement in the control of radiotherapy photon beams in Rio de Janeiro. Also, it is possible to recommend to Brazilian regulatory organisation a decrease in the tolerance level for dosimetric deviations in order to achieve a more precise dose delivered to patients in radiotherapy centres.

Radiotherapy dosimetry using a commercial OSL system.

A commercial optically stimulated luminescence (OSL) system developed for radiation protection dosimetry by Landauer, Inc., the InLight microStar reader, was tested for dosimetry procedures in radiotherapy. The system uses carbon-doped aluminum oxide, Al2O3:C, as a radiation detector material. Using this OSL system, a percent depth dose curve for 60Co gamma radiation was measured in solid water. Field size and SSD dependences of the detector response were also evaluated. The dose response relationship was investigated between 25 and 400 cGy. The decay of the response with time following irradiation and the energy dependence of the Al2O3:C OSL detectors were also measured. The results obtained using OSL dosimeters show good agreement with ionization chamber and diode measurements carried out under the same conditions. Reproducibility studies show that the response of the OSL system to repeated exposures is 2.5% (1sd), indicating a real possibility of applying the Landauer OSL commercial system for radiotherapy dosimetric procedures.

TLD environmental monitoring at the Institute of Nuclear Engineering in Brazil.

Since 2003 the Institute of Nuclear Engineering in Rio de Janeiro city, Brazil, operates a new cyclotron, RDS-111, to produce (18)F-Fluorodeoxyglucose to be used in nuclear medicine. Additionally, the IEN radioactive waste repository has been enlarged during the past last years, receiving a considerable amount of radioactive materials. Therefore, it became necessary to evaluate a possible increase of the environmental gamma exposure rates at the institute site due to the operation of the new accelerator and the enlargement of the institute waste repository as well. LiF:Mg,Cu,P, TLD-100H, and TL detectors were employed for environmental kerma rate evaluation and the results were compared with previous results obtained before the RDS-111 operation initialisation and the enlargement of IEN waste repository. No significant contribution for the enhancement of environmental gamma kerma rates was detected.

Dose evaluation for paediatric chest x-ray examinations in Brazil and Sudan: low doses and reliable examinations can be achieved in developing countries.

Radiation protection in paediatric radiology deserves special attention since it is assumed that children are more sensitive to radiation than adults. The aim of this work is to estimate the entrance skin dose (ESD), the body organ dose (BOD) and the effective dose (E) for chest x-ray exposure of paediatric patients in five large units, three in Sudan and two in Brazil, and to compare the results obtained in both countries with each other and with other values obtained by some European countries. Two examination projections have been investigated, namely, postero-anterior (PA) and antero-posterior (AP). The age intervals considered were: 0-1 year, 1-5 years, 5-10 years and 10-15 years. The results have been obtained with the use of a software called DoseCal. Results of mean ESD for the age interval 1-5 years and AP projection are: 66 microGy (Instituto de Pediatria e Puericultura Martagão Gesteira--IPPMG Hospital), 41, 86 and 68 microGy (Instituto Fernandes Figueira--IFF Hospital), 161 microGy (Omdurman Hospital), 395 microGy (Khartoum Hospital) and 23 microGy (Ahmed Gasim Hospital). In the case of the IFF Hospital, the results refer, respectively, to rooms 1, 2 and for the six mobile equipments. The reference dose values given by the European Guidelines were exceeded in the Khartoum Hospital whilst in all the other hospitals results obtained were below CEC reference values and comparable with the results found in Sweden, Germany, Spain and Italy. The mean E for the same age interval was 11 microSv in the IPPMG, 6, 15 and 11 microSv in the IFF, respectively for rooms 1, 2 and the 6 mobiles, 25 microSv in the Omdurman Hospital, 45 microSv in the Khartoum Hospital and 3 microSv in the Ahmed Gasim Hospital. These are some examples of the large discrepancies that have been detected in this survey.

Dose measurements using thermoluminescent dosimeters and DoseCal software at two paediatric hospitals in Rio de Janeiro.

A dosimetric survey in paediatric radiology is currently being carried out at the paediatric units of two large hospitals in Rio de Janiero city: IPPMG (Instituto de Pediatria e Puericultura Martagão Gesteira, University Hospital of Federal University of Rio de Janeiro) and IFF (Instituto Fernandes Figueira, FIOCRUZ). Chest X-ray examination doses for AP, PA and LAT projections of paediatric patients have been obtained with thermoluminescent dosimeters (TLDs) and with use of a software package DoseCal. In IPPMG and IFF 100 patients have been evaluated with the use of the TLDs and another group of 100 patients with the DoseCal software. The aim of this work was to estimate the entrance skin dose (ESD) for frontal, back and lateral chest X-rays exposure of paediatric patients. For ESD evaluation, three different TL dosimeters have been used, namely LIF:Mg,Ti (TLD100), CaSO4:Dy and LiF:Mg,Cu,P (TLD100H). The age intervals considered were 0-1, 1-5, 5-10 and 10-15 years. The results obtained with all dosimeters are similar, and it is in good agreement with the DoseCal software, especially for AP and PA projections. However, some larger discrepancies are presented for the LAT projection.

Reproducibility study of TLD-100 micro-cubes at radiotherapy dose level.

The precision of the thermoluminescent response of Harshaw micro-cube dosimeters (TLD-100), evaluated in both Harshaw thermoluminescent readers 5500 and 3500, for 1 Gy dose value, was investigated. The mean reproducibility for micro-cubes, pre-readout annealed at 100 degrees C for 15 min, evaluated with the manual planchet reader 3500, is 0.61% (1 standard deviation). When micro-cubes are evaluated with the automated hot-gas reader 5500, reproducibility values are undoubtedly worse, mean reproducibility for numerically stabilised dosimeters being equal to 3.27% (1 standard deviation). These results indicate that the reader model 5500, or, at least, the instrument used for the present measurements, is not adequate for micro-cube evaluation, if precise and accurate dosimetry is required. The difference in precision is apparently due to geometry inconsistencies in the orientation of the imperfect micro-cube faces during readout, requiring careful and manual reproducible arrangement of the selected micro-cube faces in contact with the manual reader planchet.